Medicine and Health Sciences Commons^™

Medicare For All: A Health Insurance Literacy Perspective, Suad Ghaddar

Health & Biomedical Sciences Faculty Publications

No abstract provided.

The Impact Of Clinical Decision Support Tool (Supravista) In Identifying Sepsis Cases, Brandy N. Manigo

Doctoral Dissertations and Projects

This paper describes an evidence-based quality improvement project within an acute healthcare organization to prevent early sepsis and mortality due to sepsis in the emergency department of a Veterans Affairs (VA) facility. Early recognition and intervention of sepsis is essential to provide the best treatment. The intent of the project is to support the utilization of health information technology (HIT) in preventing early sepsis and death related to sepsis. The project was implemented to determine the effect of identifying sepsis cases with the use of the patient electronic health record (EHR) through the use of the Sequential Organ Failure Assessment …

The Use Of Video Monitoring To Decrease Falls, Marie Elizabeth Mo

Doctoral Dissertations and Projects

Fall prevention is a constant challenge for inpatient nursing staff. The purpose of this project is to demonstrate that falls in hospitalized patients will decrease with the initiation of video monitoring. A fall while in the hospital can lead to increased length of stay, increased cost to the organization, lack of reimbursement from Medicare, and the worst outcome is the patient never returning to baseline. Nursing staff struggle with fall prevention daily and are often unsuccessful. One to one sitters are often utilized as a fall prevention measure; this can be draining to hospital resources. Identified best practices of one-to-one …

Palliative Care And Improving Quality Of Life With End Stage Renal Disease: An Integrative Review, Natoya Bender

Doctoral Dissertations and Projects

End-stage renal disease is a rising health care problem effecting greater than 10% of the US population. there are 700,000 patients in dialysis in the U.S who are characterized by multiple comorbidities and increasing, distressing symptom burden. The need for palliative care for patient with end-stage renal disease is becoming standard of care due to their complex medical needs and high symptom burden. The aim of this integrative review investigated the incorporation of palliative care will improve the quality-of-life of patients with end-stage renal disease once introduced in their care. While palliative care provides an ideal opportunity to assess the …

Of Blood Transfusions And Feeding Tubes: Anorexia-Nervosa And Consent, Samuel Director

Jepson School of Leadership Studies articles, book chapters and other publications

Individuals suffering from anorexia nervosa experience dysmorphic perceptions of their body and desire to act on these perceptions by refusing food. In some cases, anorexics want to refuse food to the point of death. This paper explores the following question: If an anorexic, A, wants to refuse food when the food would either be lifesaving or prevent serious bodily harm, can A's refusal be valid? It is shown that there is compelling reason to think that anorexics can validly refuse food, even in these extreme circumstances.

Using Increased Trust In Medical Researchers To Increase Minority Recruitment: The Recruit Cluster Randomized Clinical Trial, Barbara C Tilley, Arch G Mainous, Rossybelle P Amorrortu, M Diane Mckee, Daniel W Smith, Ruosha Li, Stacia M Desantis, Sally W Vernon, Gary Koch, Marvella E Ford, Vanessa Diaz, Jennifer Alvidrez

Faculty, Staff and Student Publications

While extensive literature exists on barriers and strategies to increase minority participation in clinical trials, progress is limited. Few strategies were evaluated in randomized trials. We studied the impact of RECRUIT, a trust-based, cluster randomized minority recruitment trial layered on top of four traditional NIH-funded parent trials (BMT CTN, CABANA, PACES, STEADY-PD III; fifty specialty sites). RECRUIT was conducted from July 2013 through April 2017. Intervention sites implemented trust-based approaches customized to individual sites, promoting relationships between physician-investigators and minority-serving physicians and their minority patients. Control sites implemented only parent trials' recruitment procedures. Adjusting for within-site clustering, we detected no …

A Novel Imputation Approach For Sharing Protected Public Health Data, Elizabeth A Erdman, Leonard D Young, Dana L Bernson, Cici Bauer, Kenneth Chui, Thomas J Stopka

Faculty, Staff and Student Publications

Objectives. To develop an imputation method to produce estimates for suppressed values within a shared government administrative data set to facilitate accurate data sharing and statistical and spatial analyses.

Methods. We developed an imputation approach that incorporated known features of suppressed Massachusetts surveillance data from 2011 to 2017 to predict missing values more precisely. Our methods for 35 de-identified opioid prescription data sets combined modified previous or next substitution followed by mean imputation and a count adjustment to estimate suppressed values before sharing. We modeled 4 methods and compared the results to baseline mean imputation.

Results. We assessed performance by …

Barriers To Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: A Systematic Review, Trisha L Amboree, Charles Darkoh

Faculty, Staff and Student Publications

BACKGROUND: Human papillomavirus (HPV) is associated with poor health outcomes, including cervical cancer. Racial/ethnic minority populations experience poor health outcomes associated with HPV at higher rates. A vaccine is available to protect against HPV infections and prevent HPV-related sequelae; however, vaccination rates have remained low in the United States (U.S.) population. Thus, there is an urgent need to increase the HPV vaccination rate. Moreover, little is known about barriers to HPV vaccination in racial/ethnic minority groups. This paper highlights the most recent findings on barriers experienced by these groups.

METHODS: The PubMed database was searched on July 30, 2020, for …

The Holistic Self-Care Learning Experience Of Rn-To-Bsn Students: A Phenomenological Study Of Meaning And Value, Elaina C. Mahlan

Doctor of Education (Ed.D)

The health of the nursing workforce is a critical aspect of high-quality health care and community health promotion, but extensive research indicates that too many nurses neglect selfcare and suffer negative health outcomes. While nursing education must provide self-care learning experiences to improve the health of nurses, the value and influence of a learning experience must be interpreted from the learner’s point of view. The purpose of this phenomenological study was to elicit the personal value that RN-to-BSN students ascribed to a self-care learning experience within a holistic nursing course at a public university. The holistic nursing paradigm offers a …

Real-World Assessment Of Asthma Specialist Visits Among U.S. Patients With Severe Asthma., Jessica F Most, Christopher S Ambrose, Yen Chung, James L Kreindler, Aimee Near, Stephen Brunton, Yao Cao, Huan Huang, Xiaohui Zhao

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

BACKGROUND: U.S. guidelines recommend that patients with severe asthma be referred to specialists (allergists/immunologists or pulmonologists) for systematic assessment or comanagement; however, contemporary, real-world data on the frequency and impact of specialist care among U.S. severe asthma patients are lacking.

OBJECTIVES: To quantify the frequency of asthma specialist visits among U.S. patients with severe asthma, identify patient demographic and clinical characteristics associated with specialist visits and describe health outcomes following specialist care.

METHODS: Severe asthma patients aged 6 years or older were identified between January 1, 2015, and December 31, 2017, in the IQVIA PharMetrics® Plus database of commercially insured …

How Analogizing Socio-Legal Responses To Organ Transplantation Can Further The Legalization Of Reproductive Genetic Innovation, Myrisha S. Lewis

Faculty Publications

The Nobel Foundation emphasized the significance of genetic innovation to society, science, and medicine by awarding the 2020 Nobel Prize in Chemistry to “the CRISPR/Cas9 genetic scissors.” This Article focuses on “reproductive genetic innovation,” a term that includes cytoplasmic transfer, mitochondrial transfer, and germline or heritable gene editing techniques that are all categorized as “experimental” in the United States. These techniques all use in vitro fertilization, a legal and widely available practice. Yet reproductive genetic innovation has resulted in controversy and numerous barriers including a recurring federal budget rider, threats of federal enforcement action, and the unavailability of federal funding. …

How The Practice/Academic Partnership Model Helped One State During Covid-19, Mary E. Dietmann, Audrey M. Beauvais, Beth P. Beckman, Marianne Snyder, Cheryl-Ann Resha, Lisa Rebeschi, Pamela Forte

Nursing Faculty Publications

During the spring and summer of 2020, boards of nursing (BONs) throughout the U.S. were faced with requests from educational programs for ways to replace clinical hours due to the inability to access clinical sites caused by the COVID-19 pandemic. While many clinical sites have since reopened to nursing students, some barriers still remain, resulting in a backlog of clinical hours for many nursing students throughout the state of Connecticut. Reflecting on lessons learned over the past year, collaboration between the BON and nursing leaders throughout the state has proved essential to providing the practice hours and clinical learning experiences …

Reporting Of Harm In Randomized Controlled Trials Of Therapeutic Exercise For Knee Osteoarthritis: A Systematic Review, Johan Von Heideken, Sana Chowdhry, Joanna Borg, Khara James, Maura D. Iversen

Physical Therapy Faculty Publications

Objective: The Consolidated Standards of Reporting Trials (CONSORT) recommends reporting adverse events (AEs) and dropouts (DOs) with their definitions. The purpose of this study was to identify how AEs and DOs were reported in randomized controlled trials (RCTs) of therapeutic exercise for knee osteoarthritis (OA).

Methods: Data sources were the Cochrane Library, EMBASE, PUBMED, and CINAHL. Databases were searched to identify RCTs of therapeutic exercise for Knee OA published from January 1, 1980, through July 23, 2020. Researchers independently extracted participant and intervention characteristics and determined whether a clear statement of and reasons for AEs and DOs existed. The primary …

Pre-Licensure Nursing Students' Experiences Of Psychological Safety: A Qualitative Descriptive Study, Bret Lyman, Camille R. Mendon

Faculty Publications

Background: Organizational learning is essential for consistently providing safe, efficient, high-quality patient care. Psychological safety is foundational for organizational learning. For pre-licensure nursing students psychological safety is crucial for both their learning and patient safety. Understanding pre-licensure nursing students' experiences of psychological safety can guide efforts to cultivate clinical environments conducive to learning and excellent patient care.

Objectives: The objective of this study was to gain insight into pre-licensure nursing students' first-hand experiences with psychological safety in clinical settings.

Design: A qualitative, descriptive design was used for this study.

Settings: Participants were recruited from 12 different nursing programs across eight …

Pulmonary Artery Sling-An Extremely Rare Etiology Of Dysphagia, Khola Qamar, Abhinav Tiwari

Conference Presentation Abstracts

No abstract provided.

Hereditary Hemochromatosis As An Independent Risk Factor For Liver Cancer: A Matched Case-Control Study Of The National Inpatient Sample Database, Maryam Haider, Ali F. Alsbihi, Zaid Imam, Adnan Malik, Sana Iqbal, Mahum Nadeem, Ahmed J. Chaudhary

Conference Presentation Abstracts

No abstract provided.

Multicenter, Double-Blind, Placebo-Controlled Trial Of Seviprotimut-L Polyvalent Melanoma Vaccine In Patients With Post-Resection Melanoma At High Risk Of Recurrence, Craig L Slingluff, Karl D Lewis, Robert Andtbacka, John Hyngstrom, Mohammed Milhem, Svetomir N Markovic, Tawnya Bowles, Omid Hamid, Leonel Hernandez-Aya, Joel Claveau, Sekwon Jang, Prejesh Philips, Shernan G Holtan, Montaser F Shaheen, Brendan Curti, William Schmidt, Marcus O Butler, Juan Paramo, Jose Lutzky, Arvinda Padmanabhan, Sajeve Thomas, Daniel Milton, Andrew Pecora, Takami Sato, Eddy Hsueh, Suprith Badarinath, John Keech, Sujith Kalmadi, Pallavi Kumar, Robert Weber, Edward Levine, Adam Berger, Anna Bar, J Thaddeus Beck, Jeffrey B Travers, Catalin Mihalcioiu, Brian Gastman, Peter Beitsch, Suthee Rapisuwon, John Glaspy, Edward C Mccarron, Vinay Gupta, Deepti Behl, Brent Blumenstein, Joanna J Peterkin

Department of Medical Oncology Faculty Papers

Background: Most patients with advanced melanomas relapse after checkpoint blockade therapy. Thus, immunotherapies are needed that can be applied safely early, in the adjuvant setting. Seviprotimut-L is a vaccine containing human melanoma antigens, plus alum. To assess the efficacy of seviprotimut-L, the Melanoma Antigen Vaccine Immunotherapy Study (MAVIS) was initiated as a three-part multicenter, double-blind, placebo-controlled phase III trial. Results from part B1 are reported here.

Methods: Patients with AJCC V.7 stage IIB-III cutaneous melanoma after resection were randomized 2:1, with stage stratification (IIB/C, IIIA, IIIB/C), to seviprotimut-L 40 mcg or placebo. Recurrence-free survival (RFS) was the primary endpoint. For …

Flowcharts Improve Periodontal Diagnosis By Dental And Dental Hygiene Students, Karo Parsegian, Srinivas Ayilavarapu, Tulsi Patel, Harold A Henson, Nikola Angelov

Faculty, Staff and Student Publications

BACKGROUND: In 2017, the American Academy of Periodontology and the European Federation of Periodontology updated the classification of periodontal and peri-implant diseases and conditions. The goal of the present crossover study was to develop straightforward, illustrative flowcharts and determine their impact on the accuracy and speed of diagnosing periodontal conditions by predoctoral dental students (DS) and dental hygiene students (DHS).

METHODS: Two flowcharts (a decision-tree flowchart and one based on the periodontal disease/condition entity) were developed using updated diagnostic determinants proposed by the 2017 classification. A total of 26 second-, third-, and fourth-year DS (DS2, DS3, and DS4, respectively) and …

Characteristics And Quality Of Mobile Apps Containing Prenatal Genetic Testing Information: Systematic App Store Search And Assessment, Ko Lin Wu, Rebeca Alegria, Jazzlyn Gonzalez, Harrison Hu, Haocen Wang, Robin Page, Patricia Robbins-Furman, Ping Ma, Tung-Sung Tseng, Lei Shih Chen

School of Public Health Faculty Publications

Background: Prenatal genetic testing is an essential part of routine prenatal care. Yet, obstetricians often lack the time to provide comprehensive prenatal genetic testing education to their patients. Pregnant women lack prenatal genetic testing knowledge, which may hinder informed decision-making during their pregnancies. Due to the rapid growth of technology, mobile apps are a potentially valuable educational tool through which pregnant women can learn about prenatal genetic testing and improve the quality of their communication with obstetricians. The characteristics, quality, and number of available apps containing prenatal genetic testing information are, however, unknown. Objective: This study aims to conduct a …

Association Of The Psychological Response To The Acl-Sports Training Program And Self-Reported Function At 2 Years After Anterior Cruciate Ligament Reconstruction, Ryan Zarzycki, Jacob J. Capin, Elanna Arhos, Matthew Failla, Angel H. Smith, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Background:

Psychological readiness to return to sport has emerged as an important factor associated with outcomes after anterior cruciate ligament reconstruction (ACLR). Psychological factors are potentially modifiable during the course of rehabilitation, and improving them may lead to better outcomes.

Purpose:

To determine whether athletes with a positive psychological response after participation in a neuromuscular training and second injury prevention program had better self-reported function and activity outcomes compared with athletes who did not have a meaningful change.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

After ACLR and the completion of formal rehabilitation, 66 level I/II athletes completed …

An Integrative Literature Review And Critical Reflection Of Intersectionality Theory, Ashley Ruiz, Jeneile Luebke, Katie Klein, Kaylen M. Moore, Michael Gonzalez, Anne Dressel, Lucy Mkandawire-Valhmu

College of Nursing Faculty Research and Publications

Intersectionality theory has been used by nursing scholars to offer insight into how multiple systems of oppression mutually interact to impact health and to examine how multiple social modes of existence shape individual and group experiences of health inequality. The application of intersectionality theory, however, requires a reflexive critical lens to more effectively inform nursing science and practice. We draw on a comprehensive integrative literature review to offer a critical reflection by considering the semantic and structural consistency, generalizability, simplicity and complexity, and the utility and value of intersectionality theory to nursing science and practice. If nurses are to effectively …

Improved Resection Rates In Locally Advanced Pancreatic Cancer (Lapc) Following Eus-Fni Of Large Surface Area Microparticle Paclitaxel (Lsam Pac), Neil Sharma Md, C Max Schmidt Md, Sushil Jain Md, Joseph Mccollom Do, Holly Maulhardt Bs, Shelagh Verco Bsc, Phd, Mariajose Rojas Md, Saurabh Gupta Md, Chetan Mittal Md, Christina Zelt, Ashley Rumple Rn, Bsn, James Verco Bs, Ccra, Abhilash Perisetti Md, Gere S. Dizerega Md

PCI Publications and Projects

Introduction:

LAPC is generally defined as unresectable disease without evidence of metastatic spread, and reports suggest between 8-25% of these patients may become resectable following current standard of care (SOC) therapy. EUS-FNI allows for the delivery of drug therapies directly into the tumor, which led to the development of LSAM pac currently being evaluated in LAPC and other solid tumors by means of direct injection, where the particles of pure drug act as a depot releasing paclitaxel over several weeks.

Methods:

Clinical study [NCT # 03077685] enrolled patients with LAPC, confirmed non-surgical despite SOC therapy, to additionally receive LSAM pac …

Reduced Incidence Of New Gastrointestinal Cancers Diagnosis During Covid-19 Pandemic, Abhilash Perisetti Md, Syed Mahanazuddin Phd, Rachana Yendala Md, Hermant Goyal Md, Benjamin Tharian Md, Mariajose Rojas Md, Neil Sharma Md

PCI Publications and Projects

Introduction- Gastrointestinal cancers such as esophageal, gastric, colon, liver, and pancreas cancers present a significant global challenge. The burden of these cancers depends mainly on early recognition and treatment initiation. COVID-19 pandemic led to a strain on multiple healthcare systems resulting in stay-at-home restraints, which might have impacted early recognition of these cancers. The data about the the incidence of GI cancers during the pandemic is scarce.

Methods- All adult patients with a new diagnosis of GI cancers in 2020 were compared with the patients in 2019. ICD-10 codes were utilized to identify these patient from TriNetX, a federated cloud-based …

Financial Toxicity During Breast Cancer Treatment: A Qualitative Analysis To Inform Strategies For Mitigation, Laila A. Gharzai, Kerry A. Ryan, Lauren Szczygiel, Susan Goold, Grace Li Smith, Sarah T. Hawley, John A.E. Pottow, Reshma Jagsi

Articles

Financial toxicity from cancer treatment is a growing concern. Its impact on patients requires refining our understanding of this phenomenon. We sought to characterize patients' experiences of financial toxicity in the context of an established framework to identify knowledge gaps and strategies for mitigation. Semistructured interviews with patients with breast cancer who received financial aid from a philanthropic organization during treatment were conducted from February to May 2020. Interviews were transcribed and coded until thematic saturation was reached, and findings were contextualized within an existing financial toxicity framework. Thirty-two patients were interviewed, of whom 58% were non-Hispanic White. The mean …

Viability And Application Of Mounting Personal Pid Voc Sensors To Small Unmanned Aircraft Systems, Cheri Marcham

Publications

Small Unmanned Aerial Systems in Emergency Response

Current sUAS Uses

• Search and rescue
• Thermal imaging
• Evaluating structural stability
• Spread of wildfires
• Storm damage

Hepatic Schistosomiasis, Upper Gastrointestinal Bleeding, And Health Related Quality Of Life Measurements From The Albert Nile Basin, Christopher Opio, Francis Kazibwe, Lalitha Rejani, Narcis B. Kabatereine, Ponsiano Ocama

Internal Medicine, East Africa

Background: Health related quality of life measurements are vital elements of public health surveillance that uncover unmet health needs and predict the success of health interventions. We described health related quality of life measurements using the EuroQoL 5-dimension (EQ-VAS/EQ-5D) instrument and associated factors among patients with upper gastrointestinal bleeding (UGIB) and hepatic schistosomiasis at a rural health facility in the Albert Nile Basin, Uganda.

Methods and materials: This was a cross-sectional study at Pakwach Health Centre IV. Participants included adult inpatients and outpatients with a history of UGIB and ultrasound evidence of hepatic schistosomiasis. We evaluated and recorded …

Labrad : Vol 46, Issue 4 - October 2021, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Role of Barcoding in a Clinical Laboratory to Reduce Pre-Analytical Errors
• Congenital Dyserythropoietic Anemia: The Morphological Diagnosis
• Digital Imaging in Hematology: A New Beginning
• Metabolomics: Identification of Fatty Acid Oxidation (FAO) Disorders
• Next-Generation Sequencing for HLA Genotyping
• Urine Metabolomics to identify Organic Academia
• Next-Generation Sequencing (NGS) of Solid Tumor
• Importance of using Genomic Tool in Microbial Identification
• Radiology Practice in 21st Century: Role of Artificial Intelligence
• Case Quiz
• Best of the Recent Past
• Polaroid

Inspire : Vol 4, Issue 10, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message from the Chair
• Medicine at National and International Forums
• In-depth- featuring Professor Dr. Muhammad Irfan
• Featured Faculty- Dr Nanik Ram “…Dedication, hard work, patience and honesty are keys to success …”
• Faculty’s –Favorite poem
• What are Academics Around the World Reading This Month?
• Publications

The Multi-Step Approach To Covid Prevention In The Casamance Region, Saraí Hernandez Salguero

Independent Study Project (ISP) Collection

Located in the Oussouye Department approximately 43 kilometers away from the city of Ziguinchor in the Basse Casamance region of southern Senegal is the Oussouye commune where I had the pleasure of staying for three weeks. I had learned that the inhabitants of this village were not significantly impacted by the Covid-19 virus since it became global knowledge at the start of 2020. As of March 2020, the village had only reported 69 active cases and the department saw only 8 deaths in total. I sought to figure out what could be the cause of this and through a series …

Analysis Of The Moroccan Government & Ngos Responses To Migrant Health Crisis, Jepchirchir Mutwol

Independent Study Project (ISP) Collection

Healthcare access in Morocco for migrants has been a topic of growing interest. With the implementation of migration reforms in response to Morocco becoming a destination for migrants, it is important to assess the effectiveness of government policies in aiding migrant health. Additionally, assessing other political actors' influence in government policies is equally important. Through research of existing scholarship, I theorize that the biggest issue impacting migrant access to health is the illegalization of migrants. Without being a legal resident, let alone in asylum or a refugee, migrants cannot access public health services without the fear of deportation. Local and …