Medicine and Health Sciences Commons^™

Quantifying Health Facility Service Readiness For Small And Sick Newborn Care: Comparing Standards-Based And Who Level-2 + Scoring For 64 Hospitals Implementing With Nest360 In Kenya, Malawi, Nigeria, And Tanzania, Rebecca E. Penzias, Christine Bohne, Edith Gicheha, Elizabeth Molyneux, David Gathara, Samuel K. Ngwala, Evelyn Zimba, Ekran Rashid, Opeyemi Odedere, Olabisi Dosunmu

Paediatrics and Child Health, East Africa

Background: Service readiness tools are important for assessing hospital capacity to provide quality small and sick newborn care (SSNC). Lack of summary scoring approaches for SSNC service readiness means we are unable to track national targets such as the Every Newborn Action Plan targets.

Methods: A health facility assessment (HFA) tool was co-designed by Newborn Essential Solutions and Technologies (NEST360) and UNICEF with four African governments. Data were collected in 68 NEST360-implementing neonatal units in Kenya, Malawi, Nigeria, and Tanzania (September 2019-March 2021). Two summary scoring approaches were developed: a) standards-based, including items for SSNC service readiness by health system …

Reducing Harm: The Legal Viability Of Supervised Consumption Sites In Georgia, Kathleen Kassa

Georgia State University Law Review

Every five minutes in the United States, someone dies from a drug overdose. This public health crisis, referred to as the opioid epidemic, caused the federal government and many states and localities to issue public health emergency declarations. Despite billions of dollars in funding and response at every level of government, overdoses continue to increase.

The complexity of addiction prevention and treatment, socioeconomic inequalities, and the stigmatization of drug use make the opioid crisis difficult to solve. The severity of the epidemic led many jurisdictions to adopt once-controversial harm reduction approaches aimed at reducing the stigma and negative impacts of …

Safety Of Ambulatory Surgery For Obstructive Sleep Apnea: A Retrospective Review, Dylan Gregory Bertoni, Emily Garvey, Neha Garg, Dev Amin, Sruti Tekumalla, Derek Mann, Bita Naimi, Tingting Zhan, Patrick Hunt, Maurits Boon, Colin Huntley

Jefferson Hospital Staff Papers and Presentations

OBJECTIVE: Assess the safety of ambulatory surgery performed for obstructive sleep apnea.

STUDY DESIGN: Retrospective chart review.

SETTING: Tertiary care hospital.

METHODS: Demographic data including age, gender, race, body mass index, insurance status, socioeconomic status, and distance traveled for surgery was collected, as well as comorbidities, and apnea-hypopnea index (AHI). Outcome variables included continuous positive airway pressure reinitiation, planned/unplanned postoperative admission, emergency department (ED) presentation, or readmission within 7 and 14 days of surgery.

RESULTS: A total of 601 patients were included, who underwent sleep surgery between 2017 and 2022. The median age was 55 years [interquartile range: 19]. A …

Comparison Of Short-Arm Immobilization And Long-Arm Immobilization In Conservatively Managed Distal Radius Fractures: A Meta-Analysis And Systematic Review., Yash P Chaudhry, Genoveffa R Morway, Efstratios A Papadelis, Nikki A Doerr, Kenneth W Graf, Rakesh P Mashru, Henry J Dolch

Orthopedic Surgery Resident Research

Distal radius fractures are often treated conservatively with immobilization. Immobilizing above the elbow limits forearm rotation, though recent literature has suggested the effects on radiographic or functional outcomes may be negligible. This systematic review and meta-analysis aimed to analyze the radiographic and functional outcome scores of distal radius fractures managed with short-arm (SA) immobilization and long-arm (LA) immobilization. An electronic systematic search was performed of the PubMed and EMBASE databases from inception to October 5, 2022. All randomized controlled trials (RCTs) involving patients with acute distal radius fractures undergoing nonoperative treatment (involving application/maintenance of immobilization) comparing above-elbow versus below-elbow constructs …

Entrance Surface Air Kerma To Patients During Digital Radiographic Examinations In Tanzania, Atumaini Makoba, Ahmed Jusabani, Wilbroad Muhogora, Abdallah Kileo, Musa Ndukeki, Huruma Mammba, Hilda Makungu, Haika Maro, Erick Onoka, Miguta Ngulimi

Imaging & Diagnostic Radiology, East Africa

The aim of this study was to determine the entrance surface air kerma (ESAK) in adult patients during digital radiography and to evaluate the optimisation potential in five common X-ray examinations in Tanzania. Based on a sample of 240–610 patients, ESAK was estimated using X-ray tube output measurements, patient information and backscatter factors. The results show that the mean ESAK values were higher or comparable to data from the literature. The diagnostic reference values of ESAK for digital radiography were 0.31 mGy (chest PA), 4 mGy (lumbar spine AP), 5.4 mGy (lumbar spine LAT), 3.8 mGy (abdomen AP) and 2.4 …

Timing Of Decompressive Surgery In Patients With Acute Spinal Cord Injury: Systematic Review Update, Michael G Fehlings, Laureen D Hachem, Lindsay A Tetreault, Andrea C Skelly, Joseph R Dettori, Erika D Brodt, Shay Stabler-Morris, Britt J Redick, Nathan Evaniew, Allan R Martin, Benjamin Davies, Farzin Farahbakhsh, James D Guest, Daniel Graves, Radha Korupolu, Stephen L Mckenna, Brian K Kwon

Faculty, Staff and Student Publications

STUDY DESIGN: Systematic review and meta-analysis.

OBJECTIVE: Surgical decompression is a cornerstone in the management of patients with traumatic spinal cord injury (SCI); however, the influence of the timing of surgery on neurological recovery after acute SCI remains controversial. This systematic review aims to summarize current evidence on the effectiveness, safety, and cost-effectiveness of early (≤24 hours) or late (>24 hours) surgery in patients with acute traumatic SCI for all levels of the spine. Furthermore, this systematic review aims to evaluate the evidence with respect to the impact of ultra-early surgery (earlier than 24 hours from injury) on these …

Midterm Outcomes Of Suture Anchor Fixation For Displaced Olecranon Fractures, Michael Gutman, Jacob Kirsch, Jonathan Koa, Mohamad Fares, Joseph Abboud

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Displaced olecranon fractures constitute a challenging problem for elbow surgeons. The purpose of this study is to evaluate the role of suture anchor fixation for treating patients with displaced olecranon fractures.

METHODS: A retrospective review was performed for all consecutive patients with displaced olecranon fractures treated with suture anchor fixation with at least 2 years of clinical follow-up. Surgical repair was performed acutely in all cases with nonmetallic suture anchors in a double-row configuration utilizing suture augmentation via the triceps tendon. Osseous union and perioperative complications were uniformly assessed.

RESULTS: Suture anchor fixation was performed on 17 patients with …

Venovenous Extracorporeal Membrane Oxygenation Usage Following Bullet Embolism To The Pulmonary Artery, Jonathan E. Schoen, Brian Carr, Murtuza Ali, Brett Chapman, Alan Marr, Lance Stuke, Patrick Greiffenstein, John P. Hunt, Paige Deville, Alison Smith

School of Medicine Faculty Publications

Background: Pulmonary artery embolus is a rare complication following gunshot wounds that creates a unique and serious challenge for trauma surgeons. While the majority of bullets that embolize through the vascular system end in the peripheral circulation, approximately one-third enter the central venous circulation. Case Report: We present the case of a bullet embolus to the left pulmonary artery following gunshot wounds to the right chest and the abdomen, with the abdominal ballistic traversing the liver before entering the vena cava and embolizing. The patient’s course was complicated by the development of severe acute respiratory distress syndrome that was successfully …

Effect Of Implementation Of Mobility Partner In Post-Operative Trauma Surgery Patients In Local Community Hospital, Samantha Finkelstein Md, Joseph J. Stirparo Md

USF-LVHN SELECT

No abstract provided.

Washington’S Ride Program: A Model Providing Rural Practitioners, Mary K. Smith Dds, Mba

The Journal of the Michigan Dental Association

The University of Washington School of Dentistry Regional Initiatives in Dental Education (RIDE) program is an award-winning dental education model that trains dentists to practice in rural and underserved areas. Its first cohort of students graduated in 2012. To date, there have been 96 graduates. More than 80% of RIDE graduates in practice are in rural and underserved areas, including those seeking specialty training. RIDE is successful because it collaborates with multiple universities, community health centers, local dental associations, and community leaders in the area where the students are located.

Uda To Rda: A Pathway To Greater Success, Margaret Gingrich Dds

The Journal of the Michigan Dental Association

UDA to RDA: A Pathway to Greater Success" by Margaret Gingrich, DDS, explores the advantages of transitioning unlicensed dental auxiliaries (UDAs) to registered dental assistants (RDAs). The article emphasizes the benefits for both practitioners and staff, citing increased efficiency, improved patient care, and expanded practice capabilities. Dr. Gingrich shares personal experiences from her rural practice, highlighting the challenges of workforce shortages and the strategic adoption of RDAs to address these issues. She outlines a pathway for UDAs to attain RDA status through targeted training programs and contractual agreements, enhancing career satisfaction and practice productivity. The article underscores the importance of …

J Mich Dent Assoc March 2024

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It stands as the primary publication reaching Michigan dentists.

In the March 2024 issue, the Journal focuses on the landscape of practicing in rural settings. Original content includes:

• A cover story discussing "Market Realities for Rural and Small-Town Practices"

• A feature commentary from a new dentist in the Upper Peninsula on "Why I Chose to Practice in Rural Michigan"

• A feature article highlighting a dental education initiative, "Washington’s RIDE Program: A Model …

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Staff Matters: How To Address Derogatory Comments Among Staff Members, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

Addressing derogatory comments among staff members requires a systematic approach. Document the incident, meet individually with each employee, and assess their reactions. Responses may vary from denial to remorse. Tailor disciplinary action based on their accountability and alignment with office values. Consider potential legal ramifications and seek HR or legal guidance if needed. Regardless, swift action is essential to maintain a respectful workplace environment.

Understanding The Impact Of Adverse Childhood Experiences On Non-Suicidal Self-Injury In Youth: A Systematic Review, Sadia Suhail Usmani, Meghana Mehendale, Mahnoor Yousif Shaikh, Sourav Sudan, Prathima Guntipalli, Lara Ouellette, Anem Sajid Malik, Naila Siddiqi, Namrata Walia, Kaushal Shah, Fahimeh Saeed, Domenico De Berardis, Sheikh Shoib

Library Staff Publications

OBJECTIVE: Non-suicidal self-injury (NSSI), defined as a deliberate destruction of one's own body without a suicidal intent, is a global public health issue. Adverse childhood events (ACEs) have been shown to be associated with various mental illnesses; however, to date the impact of such events on NSSI in youth has not been reviewed.

METHODS: We conducted a systematic review, searched 5 databases for published articles evaluating ACE and NSSI in youth less than or equal to 21 years of age. After screening 247 articles, we included 21 unique articles in this systematic review.

RESULTS: Increasing ACE score, physical, sexual or …

A Word From The Writing Team (March 2024), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Join Us for Our Virtual Writing Retreat on March 1^st
• Attend Inclusive Writing and Language Workshop at EF
• Come and Judge the Jefferson Science Slam
• Publication Spotlight
• Jefferson's AI Library Guide is Available
• The OPWPC Canvas Page Offers Helpful Tools
• Scott Memorial Library Renovations Continue
• Wiley Open Access Fees Waived for Jefferson Authors

Adverse Childhood Experiences And Early Initiation Of Substance Use: A Survival Analysis., Amy L. Meadows, Justin C Strickland, S Maela Hyder, Rita C Basconi, Margaret E Stull, Frances P Wagner, Mai N Nguyen, Abner O. Rayapati, Craig R Rush

Psychiatry Faculty Publications

OBJECTIVE: Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using survival analysis. It is hypothesized that individuals with higher ACEs will have an earlier age of initiation.

METHOD: Participants were recruited from the University of Kentucky's Laboratory for Human Behavioral Pharmacology. Participants were 18 years or older, English speaking, and actively engaged in substance use. Participants were not in substance abuse treatment nor were they …

Of Hearth And Home: Professional Wellness After Hours, Timothy J. Ainger, Meriem Bensalem-Owen, Joanna Fong-Isariyawongse, Matthew William Luedke

Neurology Faculty Publications

Burnout is a prevalent problem in the contemporary practice of medicine. Defined by the Agency for Healthcare Research and Quality as, “a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment,” this multifactorial condition has significant implications for the clinicians who suffer it, their patients, and families. Neurologists suffer some of the highest rates of burnout. Burnout research on interventions often focus on the work environment. In this article, we will focus on burnout’s effects on home life and features of home life that can impact resiliency, specifically sleep hygiene.

Mnemonic Utilization In Stroke Education: Fast And Befast Adoption By Certified Comprehensive Stroke Centers, Christopher Hogge, Larry B. Goldstein, Sushanth R. Aroor

Neurology Faculty Publications

Introduction: Symptom recognition and timely access to treatment are critical components of acute stroke care systems. Two mnemonics widely used in public educational campaigns for recognizing stroke symptoms include FAST (Face-Arm-Speech-Time) and BEFAST (Balance-Eyes-Face-Arm Speech-Time). The FAST mnemonic can miss up to 14% of strokes. BEFAST includes common posterior circulation stroke symptoms and has been implemented by several Comprehensive Stroke Centers (CSCs).

Methods: We sought to analyze the pattern of public educational materials available on the websites of US CSCs. The Joint Commission (JC) quality check website compiles a list containing the names and locations of the country’s 217 JC-certified …

Accuracy And Surface Roughness Of Co-Cr Partial Denture Frameworks With Different Digital Fabrication Methods, Islam Heiba

Dentistry

Statement of problem. Traditional removable partial denture (RPD) manufacture is being phased out in favor of computer-aided design and computer-aided manufacturing (CAD-CAM) techniques and rapid prototyping (RP), which provide more efficient methods of producing RPD frameworks. However, studies comparing the accuracy and surface roughness of these approaches on RPD frameworks are still scarce. Purpose. The purpose of this in vitro study was to evaluate the accuracy and surface roughness of class I cobalt chromium (Co-Cr) removable partial denture frameworks digitally constructed using 2 different CAD-CAM technologies: direct milling (DM) and selective laser melting (SLM). Material and methods. An educational maxillary …

The Adverse Childhood Experiences Identification Gap In Speech Language Pathology, Mallory Prior

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Children exposed to adverse childhood experiences, a variety of potentially traumatic events occurring within the first 18 years of life, are at increased risk for speech and language disorders. Due to the high prevalence of trauma and its lasting effects, it is almost guaranteed that children who are experiencing the ongoing effects from adversity will be found on practicing Speech Language Pathologists’ caseloads. This scoping review was designed to identify current screening practices of Speech Language Pathologists (SLP) in comparison to other professionals (e.g., allied health and education), as well as additional information related to screening procedures for SLPs. The …

The Great Resignation: Narratives Of Mid-Career Teacher Burnout And Attrition, Nicole Burton

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The COVID-19 pandemic has increased the issues of teacher attrition. According to the U.S. Bureau of Labor and Statistics, from January to November 2021, there was a 40% increase in the quit levels of teachers within the state and local education agencies (John, 2022). While prior research has examined early-career teachers leaving the profession, mid-career teachers have largely been left out of the conversation. This narrative inquiry investigates the reasons that mid-career teachers are leaving the profession. Semi-structured interviews were conducted with four mid-career teachers hailing from the Midwest region. Interviews focused on understanding how teachers have experienced stress and …

Narratives Of Reproductive Control In The American Eugenics Movement, Cassandra M. Provost

Honors Program: Senior Projects (Public)

In this paper, I will explore the eugenics movement as a pseudo-scientific political, social, and legal phenomenon which had a devastating historical impact on America’s most vulnerable women, as well as briefly discuss its residual effects on contemporary reproductive rights conversations, through the lens of literature. Using an interdisciplinary discourse and narrative analysis approach, I identify two distinct themes within the explored narratives: (1) the importance of a government’s attempt to override a person’s autonomy by destroying the person’s ability to reproduce, and (2) the impropriety of actions based on a negative attitude toward disabled or undesirable persons. In my …

Early Life Experiences As Later Life Predictors For Criminality: Examination Of Public Criminal Records., Juliana S. Bastien

College of Arts & Sciences Senior Theses

Crime's detrimental impact on society, victims, families, and the justice system is undeniable. Thus, identifying factors that contribute to the perpetration of crime is essential to reduce the public health impact of crime. Adverse Childhood Experiences (ACEs) are frequently found in community samples and are consistently associated with physical, psychological, and behavioral consequences. Research suggests that negative childhood experiences contribute to maladaptive behaviors, including delinquency and perpetration of crime later in life (Perez et al., 2018). The present study's purpose is to identify specific childhood experiences associated with criminality. The data presented on criminality and ACEs was collected from recruited …

Wilson’S Disease Presenting As Status Epilepticus: A Case Report, Iqra Athar, Neelma Naz Khattak, Hania Batool, Tehreem Farah, Tashfain Shifa, Zukhruf Zayian

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Wilson’s disease (WD) is a rare disorder of copper metabolism, caused by a mutation in the ATPB7 gene, resulting in a defect in copper elimination leading to its accumulation in various organs, with the liver being the most common. Here, we describe a case of a 19-year-old boy who presented with a history of hallucinations and status epilepticus. Initial investigations were normal, but due to a rising trend in alanine transaminase (ALT), a slit lamp examination was performed, revealing Kayser-Fleischer (KF) rings in the eyes. The patient was diagnosed with WD due to the presence of these KF rings …

Atypical Facio-Scapulo-Humeral Dystrophy With Facial Sparing: A Case Report, Umer Younas, Asma Aamir, Farooq Azam Rathore

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Facio-Scapulo-Humeral Dystrophy (FSHD) is an autosomal dominant and third most common inherited muscular dystrophy. Typical phenotype of FSHD initially affects the muscles of the face and upper arm. Atypical FSHD refers to genetically confirmed FSHD with phenotypic variations. Scapulo-Humeral Dystrophy (SHD) is the most common atypical form of FSDH characterized by no facial muscle weakness on clinical examination, while other signs remain consistent with FSHD. We report a 31-year-old male who presented with foot drop and had an unexpected presentation as SHD. Provisional diagnosis of SHD was based on careful medical history, physical examination findings, modest rise in muscle …

Role Of Minimal F-Wave Latency In The Electrodiagnosis Of Polyneuropathy, Areeba Qaiser, Safia Bano, Muhammad Imran Khan, Ahsan Numan

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and Objective:

Polyneuropathy is a debilitating condition that causes damage to more than two peripheral nerves in the body. The objective of this research was to detect the role of minimal F-wave latency as compared with other nerve conduction parameters for the electro-diagnosis of polyneuropathies.

Methods:

In this descriptive, prospective cross-sectional study, 80 consecutive patients with clinical diagnosis of polyneuropathy (both acute and chronic) between July and December 2023, presenting to the Neurology Department at King Edward Medical University were enrolled. Patients with clinical diagnosis of cervical/lumbar radiculopathies, plexopathies, compressive myelopathy , neuromuscular junction diseases, motor neuron disorders, …

Analyzing The Impact Of Pulse Steroid Therapy On Relapse Rates And Disease Progression In Relapsing-Remitting Multiple Sclerosis: A Comprehensive Retrospective Study, Sana Ghous, Anjlee Shankar, Abdul Rahman Soomro, Abdul Qadir Baloch, Asif Ali, Alam Ibrahim Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

Background and Objective:

Relapsing remitting MS (RRMS) is characterized by recurrent relapses with remissions. Over an extended time-frame, high-dose steroid administration has primarily centered on the treatment of acute relapses, rather than relapse prevention. The objective of this retrospective study is to assess the long-term impact of administering three monthly pulse steroid therapy for three days on relapse rates and the Expanded Disability Status Scale (EDSS) scores in patients with RRMS.

Methods:

This study was conducted at Neurology ward of Chandka Medical College Hospital in Larkana from January 2021 to January 2023. A retrospective analysis of historical patient data, …

Factors Associated With Late Diagnosis Of Cervical Cancer At Two National Referral Hospitals, Kenya 2017: A Case Control Study., Valerian Mwenda, Martin Mwangi, Gladwell Gathecha, Joseph Kibachio, Robert Too, Zeinab Gura, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Cervical cancer is the leading cause of cancer mortality among women in Kenya. Two thirds of cervical cancer cases in Kenya are diagnosed in advanced stages. We aimed to identify factors associated with late diagnosis of cervical cancer, to guide policy interventions.

Methods: An unmatched case control study (ratio 1:2) was conducted among women aged ≥ 18 years with cervical cancer at Kenyatta National and Moi Teaching and Referral Hospitals. We defined a case as patients with International Federation of Gynecology and Obstetrics (FIGO) stage ≥ 2A and controls as those with stage ≤ 1B. A structured questionnaire was …

Validation Of The Self-Efficacy For Sleep Hygiene Inventory In Young Adult College Students, Romo A. Gouvea, Christine S. Gipson, Belinda Deal, K. Gosselin

Honors Nursing Posters

Presented at Great Plains Honors Council (GPHC) Conference, March 22, 2024; Oklahoma State University, Stillwater, Oklahoma.

Working-Age Caregivers Of Stroke Survivors: Needs, Concerns, And Quality Of Life, Daira Kim Carbonell, Ava Martinolli, Fernando Arredondo, Dixie Rose

Honors Nursing Posters

Presented at Great Plains Honors Council (GPHC) Conference, March 22, 2024; Oklahoma State University, Stillwater, Oklahoma.