Medicine and Health Sciences Commons^™

Ossifying Fibromyxoid Tumor: A Rare Subcutaneous Tumor, Karla C. Guerra, Luke Godwin, Chad Johnston, Maggie Noland, David Rowe

HCA Healthcare Journal of Medicine

The following case study demonstrates a 26-year-old male that presented to the dermatology clinic with an enlarging, raised skin nodule located on the left inferior lateral lower back. The patient reported it had persisted for two years, and he had not received prior treatment. He noted a family history of nonmelanoma skin cancer but had no other dermatological issues in the past. Physical examination revealed a pink, firm and well-circumscribed subcutaneous mass with a prominent follicular pore. It was assumed the lesion was an epidermal inclusion cyst, and surgical excision was performed. Histopathology revealed lobules of epithelioid cells with indistinct …

Classical Findings Of Infantile Hepatic Hemangiomas, Senayit Demie, Michael Bossak

HCA Healthcare Journal of Medicine

Introduction

Hemangiomas are benign vascular tumors that are common during infancy. They are most commonly noted as superficial bright red lesions on the skin but can also be found deeper as subcutaneous lesions. Patients with multifocal cutaneous hemangiomas are at risk of visceral involvement with the liver being most commonly affected. Most hemangiomas can be monitored clinically as they are self-limiting. Despite this, hepatic hemangiomas can have serious complications including large arteriovenous shunts leading to cardiac compromise as well as severe hepatomegaly which can cause abdominal compartment syndrome, impaired ventilation and renal vein compression.

Clinical Findings

A six-month-old female, born …

Lymphoproliferative Disease In A Non-Transplant Patient And Spironolactone’S Activity Against Epstein Barr Virus, Anthony Derenzi, Jessie Penico

HCA Healthcare Journal of Medicine

Epstein Barr Virus (EBV) may cause lymphoproliferative disorder that can cause malignancies in patients who are immunosuppressed. These malignancies may be suppressed or reversed by antiviral therapy including spironolactone.

We present a case of a 66-year-old female who had been immunosuppressed through use of interferon and tumor necrosis factor (TNF)-active agents for multiple sclerosis (MS). She met the criteria for idiopathic CD4 T-lymphocytopenia or non-human immunodeficiency syndrome (HIV) acquired immunodeficiency syndrome (AIDS). She developed a reactivation of EBV due to the immunosuppression which caused a subset of Non-Hodgkin’s lymphoma. The patient was initially treated with valacyclovir but she developed brain …

Use Of Ultrasound-Guided Platelet-Rich Plasma In The Treatment Of Carpometacarpal Osteoarthritis, Manuel Britto, Siraaj Dawood, Siyang Lu, Martin Canillas

HCA Healthcare Journal of Medicine

Introduction

Osteoarthritis (OA) is the most common form of arthritis and can severely affect function and quality of life. Platelet-rich plasma (PRP) is derived from a patient’s own blood and has potential as an adjunct to treat OA. However, research has been limited for small joints such as the carpometacarpal (CMC) joint.

Clinical Findings

A 65-year-old Caucasian male complained of bilateral wrist and neck pain after a motor vehicle accident. His initial exam noted swelling, tenderness and pain with movement at the bilateral thumb CMC joints and anatomic snuffboxes. However, there was no strength, range of motion or tactile deficits …

The Role Of The Pharmacist In The Treatment Of Infantile Botulism, Rachel E. Huntsman, Abigail Schauble

HCA Healthcare Journal of Medicine

Infantile botulism is a potentially devastating disease caused by ingestion of Clostridium botulinum spores through food products or dust particles. The toxin produced by the spores can lead to descending paralysis requiring hospitalization for supportive care which sometimes includes mechanical ventilation. Human Botulism Immune Globulin-Intravenous (BIG-IV or BabyBIG) from the Infant Botulism Treatment and Prevention Program (IBTPP) has been shown to greatly improve outcomes. A previously healthy 5-month-old infant was admitted to her regional hospital for poor feeding and lethargy. When the weakness progressed and she had trouble with protecting her airway, she was intubated and transferred to our institution. …

The Science Of Learning: Why Learning Theories Matter In Graduate Medical Education, Jacklyn C. Fuller, Melissa E. Woods

HCA Healthcare Journal of Medicine

Learning theories are necessary to help inform teaching strategies and promote successful educational outcomes. Having an in-depth knowledge about learning theories and their applicability to teaching and educating healthcare professionals will help support and promote excellence in medical education. Demonstrating an understanding of effective learning theories in the classroom will benefit both educators and trainees, while supporting a collaborative mentor-mentee relationship.

An Acknowledgement To The Hca Healthcare Journal Of Medicine’S Reviewers And Editors For The 1st Half Of 2021, Bruce Deighton, Hossein Akhondi, David Scott Lind, Graig Donini

HCA Healthcare Journal of Medicine

As we reach the midway point of 2021, the HCA Healthcare Journal of Medicine would like to thank those behind the scenes that make this publication possible. Our journal would not have been possible without the assistance of our reviewers, authors and board members.

Value Of Systematic Approach To Assess Health-System Pharmacy Services, Sonnia Zambrano, Radha Patel, L. Hayley Burgess, Kimberly Heath

HCA Healthcare Journal of Medicine

Health-system pharmacy leaders are tasked with determining key staffing decisions based on evolving patient care needs and present-day staffing capacity. A systematic approach to evaluate patient care needs, current model and potential gaps enables leaders to allocate resources in patient care need expansions or sudden fluctuations of patient volumes. Resource management, preparedness and ongoing maintenance form principles used by pharmacy leaders to create an optimal operational environment and elevate clinical pharmacy services. Use of this approach for multiple sites of care across a large network of health systems resulted in identification and improvement in pharmacist coverage and retention of clinical …

The Hidden Child: Analyzing The Cyclical Nature Of Statelessness And Violations Of Reproductive Autonomy, Simone Lieban Levine, Kelsey J. Peden

The Journal of International Relations, Peace Studies, and Development

Statelessness is a reproductive justice issue. When states explicitly or implicitly regulate or restrict reproduction, it results in children being born into statelessness. When there is a risk that a child will be born into statelessness, it both impacts the parents’ ability to parent with dignity and can have a chilling effect on the parents’ decision to have a child in the first place. In this way, statelessness results both in and from violations of reproductive autonomy. To combat statelessness, the international human rights community must use a reproductive justice lens to examine the ways that policies related to regulating …

Multi-Stage Stochastic Optimization And Reinforcement Learning For Forestry Epidemic And Covid-19 Control Planning, Sabah Bushaj

Dissertations

This dissertation focuses on developing new modeling and solution approaches based on multi-stage stochastic programming and reinforcement learning for tackling biological invasions in forests and human populations. Emerald Ash Borer (EAB) is the nemesis of ash trees. This research introduces a multi-stage stochastic mixed-integer programming model to assist forest agencies in managing emerald ash borer insects throughout the U.S. and maximize the public benets of preserving healthy ash trees. This work is then extended to present the first risk-averse multi-stage stochastic mixed-integer program in the invasive species management literature to account for extreme events. Significant computational achievements are obtained using …

Stochastic Programming And Agent-Based Simulation Approaches For Epidemics Control And Logistics Planning, Xuecheng Yin

Dissertations

This dissertation addresses the resource allocation challenges of fighting against infectious disease outbreaks. The goal of this dissertation is to formulate multi-stage stochastic programming and agent-based models to address the limitations of former literature in optimizing resource allocation for preventing and controlling epidemics and pandemics. In the first study, a multi-stage stochastic programming compartmental model is presented to integrate the uncertain disease progression and the logistics of resource allocation to control a highly contagious infectious disease. The proposed multi-stage stochastic program, which involves various disease growth scenarios, optimizes the distribution of treatment centers and resources while minimizing the total expected …

Development Of Coordination Skills In Children Aged 6-7 Years With Disabilities Through Action Games, Farkhat Mukhmudjanovich Muradov

Eurasian Journal of Sport Science

Purpose: The goal was to create an integral system of the pedagogical process, which, taking into account the age and individual characteristics of preschool children with disabilities, ensures the creation of optimal conditions for the comprehensive development and strengthening of motor and psychophysical abilities by increasing their physiological level. Activity of organs and systems of the child's body; correction of motor disorders; as part of the training, it consists in the development and use of methods and tools that have a high ability to protect the body from adverse environmental factors, contribute to the functional improvement of its body, increase …

Essays On Health Care Quality: Timeliness, Equity, And Efficiency, Abubakar-Sadiq Bouda Abdulai

Dissertations

According to the National Academy of Medicine (NAM) (formerly called the Institute of Medicine), a quality health care system embodies six attributes: timeliness, equity, safety, efficiency, effectiveness, and patient-centeredness. Timeliness is to avoid unnecessary delays in care delivery for patients and caregivers; equity is to ensure that the quality of care that patients receive does not vary based on their personal characteristics; safety is to ensure that the care that is intended to help patients does not harm them; efficiency is to avoid waste and optimize resource allocation to improve care delivery; effective care is one that relies on sound …

Towards Quality By Design (Qbd) Of Pharmaceutical Oral Films Loaded With Poorly Watersoluble Drugs, Eylul Cetindag

Dissertations

Oral films are an emerging drug delivery dosage form with numerous advantages such as ease of handling, the possibility to circumvent the first-pass metabolism, better patient compliance, capability for continuous manufacturing, and as a platform for personalized medicine. As films are different from other final dosages by their dimensions and their matrix form, further research is required to better understand the impact of excipient and drug on product performance to assure a consistent and good quality product. Therefore, this dissertation aims to contribute towards the processability and manufacturability of films by examining the impact of the materials and processes. First, …

Exploring Fused Deposition Modeling (Fdm) Three-Dimensional Printing Tablet Design Options For Pharmaceutical Dosage Forms, Guluzar Gorkem Buyukgoz

Dissertations

This dissertation examines the use of Fused Deposition Modeling (FDM) based three-dimensional (3D) printing approach for developing patient-specific dosage forms and addressing related technical challenges in such drug delivery systems. The first main objective is to explore pharmaceutical tablet design options using novel FDM 3D printing technology as the drug delivery platform such that drug form and tablet properties are tailored by considering patient age-specific formulations and dissolution control. Of the five different design options, two proposed options meet the main objective of providing similar drug release, whereas the popular option of fixed drug concentration but differing tablet size could …

2021-08-31_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated three times a week on Mondays, Wednesdays, and Fridays.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, …

2021-08-31_Michiganoverview_Covidlongtermcare, Michigan Department Of Health & Human Services

Michigan COVID-19 Long Term Care Data

The COVID Long Term Care Facilities page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-526911--,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by long-term care facilities into EMResource. Data for all reporting facilities is posted weekly each Monday.

The information below represents COVID-19 data reported directly to MDHHS by licensed and operating Skilled Nursing, Home for the Aged and Adult Foster Care facilities (licensed to serve 13 or more individuals) in Michigan from January 1, 2020. All long-term care facilities additionally have an obligation to report COVID-positive residents and/or staff …

Coronavirus Update 8-31-21, The Coronavirus Planning Team

University Briefings & Virtual Events

Wear a Mask Indoors! As you know, we are requiring that everyone wear a mask when indoors, except in their dorm rooms with only roommates present or alone in offices for faculty and staff. Unfortunately, we have observed a significant number of students who are not adhering to this mandate. To be compliant, you need to be wearing a mask that completely covers your nose and mouth.

The Effect Of First-Time 4-Wheeled Walker Use On The Gait Of Younger And Older Adults, Humberto A. Omana, Edward Madou, Alison Divine, Walter Wittich, Keith D. Hill, Andrew M. Johnson, Jeffrey D. Holmes, Susan W. Hunter

Physical Therapy Publications

INTRODUCTION: The 4-wheeled walker is intended to enhance balance and gait for older adults. Yet, some research suggests that walking aids increase falls risk. An understanding of the influence of age with walker use on gait performance is required.

OBJECTIVE: To examine the effect of initial 4-wheeled walker use on spatiotemporal gait parameters between younger and older adults.

DESIGN: Cross-sectional, repeated-measures.

SETTING: Community-dwelling.

PARTICIPANTS: Twenty-five younger (age: 26.5 ± 4.1 years) and 24 older (age: 68.5 ± 10.5 years) adults participated. Younger adults were aged 18 to 35 years, whereas older adults were 50 years or older. Included were people …

Covid-19 Newsletter (Vol. 87), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Association Between Self-Reported Fatigue And Sarcopenia Measures Among Elderly In Selangor, Malaysia, Maria Justine, Aliff Latir, Nadhirah Noor, Angelbeth Joanny, Izzaty Iskandar, Maisarah Sakinah Amirul Faizi, Dzulhelmi Edinan

Kesmas

The association between fatigue and sarcopenia is not well understood, therefore, this study aimed to compare the sarcopenia measures among elderly with mild and severe fatigue and to determine whether fatigue severity is associated with sarcopenia measures. This was a cross-sectional study conducted on201 elderly (age = 68.45±6.30 years). The elderly was classified into either mild or severe fatigue based on the Fatigue Severity Scale (FSS), meanwhile, sarcopenia measures include SARC-F score, muscle mass (ASM/height2), calf circumference (CC), upper (handgrip) and lower limb muscle strength, as well as physical performance (gait speed). Data were analyzed using independent t-tests and logistic …

Correlation Between Care Burden And Mental Health With The Perceived Social Support Of Patients Relatives In Turkey, Mehtap Şahi̇ngöz Tahta, Elçin Balci

Kesmas

The people providing care for relatives always need support and accompaniment from their families and friends. This study aimed to evaluate the correlation among the care burden, mental health and social support perceptions of the patients’ relatives that provide long-term care for patients receiving service from the home care service (HCS) unit in one city. This descriptive study was carried out with the relatives of patients receiving service from home health units. Among the relatives providing care for a total of 859 patients, those that did not comply with the inclusion criteria were excluded, which made a total population of …

Factors Shaping Uptake Of Antenatal Care In Surabaya Municipality, Indonesia: A Qualitative Study, Lisa Jones, Nyoman Anita Damayanti, Nicola Wiseman, Neil Harris

Kesmas

Five focus group discussions (FGDs) with 61 pregnant women were conducted in June and July 2019 at primary health care (PHC) services within five urban areas of Surabaya, Indonesia. In addition, five semi-structured interviews with five midwives were carried out to explore the experiences of pregnant women accessing Antenatal Care (ANC) and the factors shaping uptake of ANC services. Data were audio-recorded, transcribed, and translated into English, and analyzed using thematic analysis. Findings from focus group discussions suggested that fears of negative diagnosis before initial ANC appointment and personal beliefs and myths surrounding pregnancy may delay uptake of ANC. Further, …

Free N95 Kit For Employees, August 31, 2021, University Of Northern Iowa

UNI Response to COVID-19

Announces the availability of N95 kit for university employees.

Bridging The Knowledge-To-Action Gap: A Qualitative Description Of The Use Of Knowledge Translation In Entry-Level Doctor Of Occupational Therapy Capstones, Maria Martino

Doctor of Philosophy in Translational Health Sciences Dissertations

Although developments in the use of knowledge translation (KT) in occupational therapy practice and research are emerging, a gap in education remains. A recent revision of accrediting standards for doctor of occupational therapy (OTD) programs now specifies scholarly study that advances KT. However, little is understood of how this change in accreditation standards is being implemented, nor of its effect on OTD capstones. The purpose of this study was to describe how KT is reflected and can be promoted in entry-level OTD capstones. A descriptive qualitative design was used with semi-structured individual interviews of OTD faculty as well as content …

Utilizing Digital Technology To Address Loneliness And Isolation In Older Adults Through A Community-Based Connection Model: Responding To A Pandemic, Melissa A. Nagel

Doctor of Nursing Practice (DNP) Projects

Problem: Loneliness and social isolation, both of which can have serious detrimental effects on health and well-being, have become more prevalent during the recent COVID-19 pandemic, particularly in the older adult population. During part of the past year, older adults were strongly encouraged to follow strict quarantine measures because of their vulnerability to the virus. This forced isolation exacerbated the already existing issue of loneliness and social isolation in this population.

Interventions: Older adults who are members of a local non-profit community organization, focused on increasing independence and social vitality, were invited to participate in a virtual, interactive social engagement …

Improved Psychological Services For American Indian Communities, Grace Anna Hofer

Honors Thesis

The importance of mental health care is growing. Inadequate psychological aid in underserved areas creates an environment for health disparities. There is a needed emphasis for outreach in rural and ethnically diverse communities with a lack of healthcare professionals to service those afflicted by mental illness. One such group is the American Indian communities of indigent populations that experience multifactorial inequalities. The treatment and reception of mental health care continue to face many challenges such as access to care, lack of education, and stereotypes. To provide effective mental health services to the American Indian population, a collaboration in designing interventions …

Effects Of Hydroxyurea Treatment On Haemolysis In Patients With Sickle Cell Disease At Muhimbili National Hospital, Tanzania, Azra Gangji, Upendo Masamu, Josephine Mgaya, Joyce Ndunguru, Agnes Jonathan, Irene Kida Minja, Julie Makani, Emmanuel Balandya, Paschal Ruggjao, Siana Nkya

Tanzania Journal of Science

Tanzania is one of the countries with a high burden of sickle cell disease (SCD). Haemolytic anaemia is a clinical feature of SCD, and has been linked to major complications leading to morbidity and mortality. Treatment with hydroxyurea (HU) has shown to induce foetal haemoglobin (HbF) which in turn decreases haemolysis in patients. This study aimed to investigate the effects of HU on haemolysis in SCD patients attending Muhimbili National Hospital, Tanzania by comparing their haemolytic parameters before and after therapy. Patients meeting the criteria were initiated on HU therapy for 3 months. Two haemolytic biomarkers: unconjugated plasma bilirubin levels …

Online Learning And Teaching Approaches Used In Midwifery Programs: A Scoping Review, Terri Downer, Michelle Gray, Tanya Capper

Research outputs 2014 to 2021

Objective: The objective of this scoping review was to map and identify existing literature that described online learning and teaching approaches used in midwifery education.

Design: An extensive search of multiple databases and gray literature was undertaken following the JBI standards, using predefined selection criteria and following the PRISMA guidelines.

Methods: This scoping review included studies published in English between 2010 and 2020 that explored the online approaches to learning and teaching for undergraduate midwifery students. The articles were reviewed by three reviewers and content analysis was undertaken.

Results: Twenty-seven articles were included in the review. Results suggest that student …

Language Abilities In Children Born To Mothers Diagnosed With Diabetes: A Systematic Review And Meta-Analysis, Diana Arabiat, Mohammad Al Jabery, Mark Jenkins, Vivien Kemp, Lisa Whitehead, Gary Adams

Research outputs 2014 to 2021

Background: This meta-analysis reviewed and synthesized the available evidence on the association between intrauterine exposure to maternal diabetes and language abilities in children. MEDLINE/PubMed, EMBASE, PsycINFO, Proquest Dissertations and Theses Global, and Google Scholar databases were searched through December 2020. Studies were systematically searched, and effect sizes were calculated using random effects models.

Results: Twelve studies were identified for inclusion in this review, however, only 10 were included in the meta-analysis. Sample size ranged from 9 to 115 participants in the diabetes group and 28 to 8192 in the control and aged around 3 years. The pooled results of the …