Medicine and Health Sciences Commons^™

Competency-Based Medical Education And The Education Continuum: Establishing A Framework For Lifelong Learning, Ann E. Burke, Daniel J. Sklansky, Hilary M. Haftel, Andrew Mitchell, Keith J. Mann

Pediatrics Faculty Publications

Competency Based Medical Education (CBME) is built on the concept that the competencies of learners, both graduates and practicing physicians, should ensure they are ready to meet the ever-changing healthcare needs of patients.1, 2, 3 Education outcomes in a CBME system are defined based on the needs of patients, and in healthy CBME systems, there is a paradigm shift from a focus on process and teachers to outcomes and learners.2,4 CBME should occur across the continuum of one's career, from undergraduate medical education through retirement. Furthermore, learners must be accustomed to driving their own educational processes.4,5 This learner-centered perspective requires …

The Psychometric Properties Of The Swahili Version Of The Primary Care Post Traumatic Stress Disorder Screen For Dsm-5 Among Adults In Kenya, Patrick Nzivo Mwangala, Joseph Newton Guni, Paul Mwangi, Millicent Makandi, Anita Kerubo, Rachel Odhiambo, Amina Abubakar

Institute for Educational Development, East Africa

Background: The psychometric properties of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are undocumented in Kenya and sub-Saharan Africa (SSA) at large. This study aimed to evaluate the psychometric properties of the Swahili version of the tool, S-PC-PTSD-5, in a community sample of adults 18 years and older drawn from Nairobi, Mombasa and Kwale counties in Kenya.

Methods: Analysis of cross-sectional data from 1431 adults from the community was conducted, examining the reliability, factorial structure, measurement invariance, and convergent and divergent validity of the interviewer-administered S-PC-PTSD-5.

Results: Out of 1431 adults who completed the S-PC-PTSD-5, 666 (46.5%) reported experiencing …

Decreasing Utilization Of Indwelling Urinary Catheters, Stacie Lomibao Fujimoto

Articles, Abstracts, and Reports

Increased utilization and prolonged dwell times of indwelling urinary catheters (IUCs) are directly related to the risk of catheter-associated urinary tract infections (CAUTIs)- the fifth most common type of healthcare associated infection (HAI). The National Health and Safety Network (NHSN) uses the Standardized Utilization Ratio (SUR) metric to measure and compare device utilization in acute care hospitals across the nation. The national target SUR benchmark is 1.0, and a SUR under 1.0 indicates less device usage than NHSN predicts on an inpatient unit. In 2022 a Neuro Med-Surg unit experienced an overall SUR of 1.047 with 2 CAUTIs observed. A …

Coal Ash Triggers An Elevated Temperature Landfill Development: Lessons From The Bristol Virginia Solid Waste Landfill Neighboring Community, Reagan Patton Witt, Marcelo I. Guzman

UK CARES Faculty Publications

Landfills for disposing of solid waste are designed, located, managed, and monitored facili- ties expected to comply with government regulations to prevent contamination of the surrounding environment. After the average life expectancy of a typical landfill (30 to 50 years), a large investment in the construction, operation, final closure, and 30-year monitoring of a new site is needed. In this case study, we provide a holistic explanation of the unexpected development of elevated temperature landfills (ETLFs), such as that in the city of Bristol (United States) on the border of the states of Virginia and Tennessee, including the initial role …

Evaluating Efficacy Of Vedolizumab, Ustekinumab, And Golimumab In The Management Of Inflammatory Bowel Disease And The Combined Role Of Nutritional Therapy With Biologics: A Review, Shahed Kamal, Karan Varshney, Danielle Josefa F. Uayan, Fides Myles C. Caliwag

Ateneo School of Medicine and Public Health Publications

Inflammatory bowel disease (IBD), which encompasses both ulcerative colitis (UC) and Crohn’s disease (CD), is a major health burden worldwide. There are increasing concerns surrounding the impacts of this disease due to significant rises in the prevalence rates of IBD across the world. In consideration of the complexities of managing IBD along with this marked rise in prevalence and incidence, developing new forms of treatment for this condition has become a major priority. In recent years, a potential new form of treatment for IBD has emerged in the form of biologic therapies. While there is a high level of optimism …

Neurological Symptoms And Cause Of Death Among Young Children In Low- And Middle-Income Countries, Sara Ajanovic, Zachary Madewell, Shams El Arifeen, Emily Gurley, Mohammad Zahid Hossain, Kazi Munisul Islam, Afruna Rahman, Nega Assefa, Lola Madrid, R Gunturu

Pathology, East Africa

Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies.

Objective: To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival.

Design, Setting, and Participants: This cross-sectional …

Can Written Prompts Help Medical Residents To Accurately Monitor Their Own Communication Skills And Those Of Others?, F. O. De Meijer, N. Nyamu, A. H. De Bruin

Family Medicine, East Africa

In healthcare, effective communication in complex situations such as end of life conversations is critical for delivering high quality care. Whether residents learn from communication training with actors depends on whether they are able to select appropriate information or ‘predictive cues’ from that learning situation that accurately reflect their or their peers’ performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predictive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties were randomly assigned to …

Can Written Prompts Help Medical Residents To Accurately Monitor Their Own Communication Skills And Those Of Others?, Fleur Demeijer, Nelson Nyamu, A. B. H. De Bruin

Family Medicine, East Africa

In healthcare, effective communication in complex situations such as end of life conversa- tions is critical for delivering high quality care. Whether residents learn from communica- tion training with actors depends on whether they are able to select appropriate informa- tion or ‘predictive cues’ from that learning situation that accurately reflect their or their peers’ performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predic- tive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties …

Burnout: Half A Century Of Controversy, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout has become a focal point of concern in the contemporary workplace. The syndrome has elicited undiminished interest among occupational health specialists. The World Health Organization defines burnout as a syndrome "resulting from chronic workplace stress." Burnout is said to comprise three components: (i) feelings of energy depletion or exhaustion; (ii) increased mental distance from one’s job, or feelings of negativism or cynicism toward one’s job; and (iii) a sense of ineffectiveness and lack of accomplishment. This definition mirrors the conceptualization of burnout embodied in the Maslach Burnout Inventory (MBI), the ‘gold standard’ for the assessment of burnout. However, controversies …

Nutrition Education For Refugees: Successful Strategies And Barriers, Jessica Smith, Habiba Nur, Martha Archuleta, Mateja R. Savoie-Roskos, Celina Wille, Casey Coombs, Heidi J. Wengreen

Journal of Human Sciences and Extension

Nutrition education can improve nutrition and health for refugees. Extension program directors providing nutrition education to refugees were surveyed regarding successful program techniques, program challenges, and both the barriers refugees face and the strengths they possess concerning healthy eating. Researchers used grounded theory to explore the qualitative data. Hands-on, skill-based learning emerged as a main theme of successful programs. Language and cultural issues emerged as main program challenges. It is recommended that future refugee nutrition education programs provide culturally sensitive opportunities for skill-based learning.

Annual Adherence Of Asian American Individuals In A Lung Cancer Screening Program Compared With Other Racial Groups, Benjamin Tasevac, Christine S. Shusted, Brooke Ruane, Emily Muse, Olugbenga Okusanya, Tyler Grenda, Nathaniel R. Evans, Gregory C. Kane, Kuang-Yi Wen, Hee-Soon Juon, Julie Barta

Department of Medicine Faculty Papers

Racial differences in lung cancer screening (LCS) eligibility and outcomes persist despite recent expansion of the US Preventive Services Task Force criteria and greater recognition of screening disparities. Research Question: What is the annual screening adherence rate for US Preventive Services Task Force-eligible Asian American individuals receiving LCS through a centralized screening program? Study Design and Methods: Individuals screened through a centralized LCS program were identified retrospectively using the Jefferson LCS Program Registry. Sociodemographic and clinical data were extracted from the prospectively maintained registry. Frequency statistics were compared by race including among Asian American subgroups, and multivariate logistic regression was …

Fact Sheet: Dental Student Rotations At Community Health Centers In North Dakota: Increasing The Dental Workforce And Serving Community, Shawnda Schroeder

Indigenous Health Faculty Publications

North Dakota has no dental school. Recognizing the need to address dental workforce shortages, and barriers to recruiting new dental professionals to the state, the North Dakota Department of Health & Human Services Oral Health Program (OHP) and the North Dakota Area Health Education Center financially support dental rotations at three community health centers in North Dakota.

Fact Sheet: North Dakota Schools Welcome School-Based Dental Sealant Programs: 2023-2024 School Year, Shawnda Schroeder

Indigenous Health Faculty Publications

The North Dakota Department of Health & Human Services Oral Health Program (OHP) established a school-based dental sealant program (SEAL!ND) in 2012 which continues to provide dental sealants, fluoride varnish applications, oral health education, dental screenings, and referrals for students.

Imaging Markers Of Future Neurodegeneration Following Moderate-Severe Traumatic Brain Injury, Daniel Brennan

Dissertations, Theses, and Capstone Projects

The overall goal of this dissertation was to identify patterns of cerebral atrophy following traumatic brain injury and relate relevant imaging measures to that atrophy. In Chapter 2, we outline a spatiotemporal profile of atrophy in the first year following moderate-severe TBI: prior to 3-months post injury, the frontal and temporal cortices were observed to be thinner than controls, and thalamic volumes were reduced. From 3-12 months post-injury, significant atrophy was observed in white matter, subcortical gray matter structures (including thalamus), and cortical thinning was observed in the parietal and occipital cortices.

In Chapter 3, we identified widespread white matter …

Repurposing Bt-11 To Treat Alzheimer’S Disease: Exploring The Glutathione-S-Transferase Lancl2 As A Target, Emily Birnbaum

Dissertations, Theses, and Capstone Projects

Approximately 99.6% of potential Alzheimer’s drugs fail, thus developing successful drugs is a high priority. The failure at developing successful drugs relates to the complex nature of the disease itself. Many components act together to trigger a cascade that ultimately results in neurodegeneration and cognitive dysfunction associated with the disease. In building a multiplex model of Alzheimer’s it is important to understand its specific biological mechanisms. One of these key pathological mechanisms is neuroinflammation. Understanding the pathways involved in neuroinflammation in Alzheimer’s is an urgent need, as it poses a promising avenue for future effective therapeutics. Specifically, as many investigational …

The Epigenetic Impact Of Dietary Choline On Growth Outcomes Of Children Exposed To Gestational Diabetes Mellitus, Ismail Kadam

Dissertations, Theses, and Capstone Projects

Maternal insulin resistance and hyperglycemia lead to gestational diabetes mellitus (GDM) which can cause fetal hyperinsulinemia, ultimately leading to excessive fetal growth associated with macrosomia and increased adiposity at birth. Increased placental macronutrient transport and epigenetic changes in growth and metabolic genes affected by GDM contribute to fetal overgrowth and can result in complications such as overweight/obesity, insulin resistance/type 2 diabetes, cardiovascular disease risk factors, as well as cognitive impairment later in life. Choline, an essential nutrient, participates in lipid and energy metabolism by providing methyl groups for DNA methylation and thus may overcome the hypomethylation of growth and metabolic …

Reviving Hysteria: The Nineteenth Century At The End Of The Twentieth, Christina Quintana

Dissertations, Theses, and Capstone Projects

This dissertation explores popular and medical representations of female madness in two time periods: the late nineteenth and late twentieth centuries. I argue that 1990s American culture produced an abundance of texts, images, and narratives that revitalized the iconography and medical discourses of late nineteenth-century hysteria. Analyzing popular texts, films, and cultural touchstones of the 1990s, I explore how Victorian ideas about women’s minds—such as the inherent feebleness of the female brain and nervous system; the fatalistic, life-altering effects of female puberty; the association between hysteria and deviant female sexuality; and the implicit racialization of hysteria and female madness more …

Examining Mental Health Differences Between Traditional And Nontraditional College Students From 2017-2022, Terrence A. Calistro Jr.

Dissertations, Theses, and Capstone Projects

The COVID-19 pandemic and societal changes in response to the pandemic have contributed to increasing the prevalence of mental health issues among college students globally. Because of their additional responsibilities, the prevalence of mental issues among the subpopulation of Nontraditional College Students (NTCS) is even more concerning. NTCS possess at least one of the following characteristics (e.g., working full-time, part-time employment, having financial dependents, etc.) that differentiates them from typical college students who enter higher education right after high school. Prior research has shown that NTCS generally experience more life stressors and challenges associated with mental health issues (e.g., depression, …

Exploiting The Heavy Chain Glycans For The Improvement Of Radioimmunoconjugates, Cindy Rodriguez

Dissertations, Theses, and Capstone Projects

Radiolabeled antibodies have become indispensable tools in nuclear medicine. However, the natural roles of antibodies within the immune system mean that they have several intrinsic limitations as a platform for radiopharmaceuticals. A handful of recent preclinical studies suggest that binding by FcR and particularly FcyRI can affect the pharmacokinetic profiles of 89Zr-labeled radioimmunoconjugates. Fc receptors (FcR) are responsible for many of the interactions between immunoglobulins (IgG) and immune cells. In biomedicine, this interplay is critical to the activity of several types of immunotherapeutics; however, relatively little is known about how FcRs affect the in vivo performance of radiolabeled antibodies. Antibodies …

Complications And Healthcare Cost Of Total Hip Arthroplasty In Patients With Depressive Disorder, Antoinette R Portnoy, Shirley Chen, Ameer Tabbaa, Matthew L Magruder, Kevin Kang, Afshin E Razi

SKMC Student Presentations and Publications

PURPOSE: The purpose of this study was to determine whether the rates of (1) in-hospital lengths of stay (LOS), (2) readmissions, (3) medical complications, and (4) costs of care are higher for patients with depressive disorder (DD) undergoing primary total hip arthroplasty (THA) for treatment of femoral neck fractures (FNFs).

MATERIALS AND METHODS: A retrospective query of a national administrative claims database for patients undergoing primary THA from 2006 to 2014 was conducted. Patients with DD undergoing THA for treatment of FNF were 1:5 ratio propensity score matched to a cohort (DD=6,758, controls=33,708). Primary endpoints included LOS, 90-day medical complications, …

Antimicrobial Efficacy Of Different Intracanal Medicaments Used In Regenerative Endodontics Against A Mature Multi-Species Biofilm Model (An Ex-Vivo Study), Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Introduction: The aim of this study was to compare the efficacy of different antimicrobial agents, including Ciprofloxacin, Doxycycline, Clindamycin, Metronidazole, Amoxicillin and Clavulanate, Triple antibiotic paste (TAP) and Calcium hydroxide (CH), as intra-canal medications for regenerative endodontics against an aged, multispecies ex-vivo biofilm model.

Methods: A total of one hundred fifty single-rooted human teeth were used in this study. Fifteen teeth were used to monitor the formation and maturation of a multispecies biofilm model consisting of Enterococcus faecalis, Staphylococcus epidermidis and Candida albicans. After 21 days of incubation, the other one-hundred and thirty-five teeth were divided into 9 equal …

Evaluation Of The Quality Of Root Canal Obturation Using Resin And Silicon-Based Sealers: A Randomized Clinical Trial, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Aim: to assess and compare the quality of root canal obturation using AH Plus and GuttaFlow 2 in patients with symptomatic

irreversible pulpitis.

Materials and methods: This randomized clinical trial included 50 participants with mandibular molars diagnosed with

symptomatic irreversible pulpitis. Participants were randomly assigned to two groups: the AH Plus group (RBS) and the

GuttaFlow 2 group (SBS). Clinical procedures included local anesthesia, access cavity preparation under a surgical microscope,

rubber dam isolation, and root canal preparation using the ProTaper Gold system. For the RBS group, AH Plus sealer was used

with cold lateral condensation, while for the SBS …

Evidence-Based Approach For Prevention Of Surgical Site Infection, Mehmet Kursat Yilmaz, Nursanem Celik, Saad Tarabichi, Ahmad Abbaszadeh, Javad Parvizi

Rothman Institute Papers

Periprosthetic joint infection (PJI) is regarded as a critical factor contributing to the failure of primary and revision total joint arthroplasty (TJA). With the increasing prevalence of TJA, a significant increase in the incidence of PJI is expected. The escalating number of cases, along with the significant economic strain imposed on healthcare systems, place emphasis on the pressing need for development of effective strategies for prevention. PJI not only affects patient outcomes but also increases mortality rates, thus its prevention is a matter of vital importance. The longer-term survival rates for PJI after total hip and knee arthroplasty correspond with …

Return To Play Time After Achilles Tendon Rupture In Professional Soccer Players, Oyinkansola Mudasiru, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Achilles tendon ruptures are severe injuries that drastically affect the careers of athletes. These ruptures typically occur during matches, often due to dorsiflexion of the ankle during passes or when tackling. Professional athletes tend to have surgical repair quickly with the goal of returning to their sport as fast as possible.

Objective: To present a scoping review to identify the return to play (RTP) rates following Achilles tendon rupture and whether these athletes achieve functional outcomes comparable to their pre- operative conditions.

Methods: 2 databases were queried; Google Scholar and PubMed using the search terms "Achilles tendon rupture" AND …

Predicting The Association Of Metabolites With Both Pathway Categories And Individual Pathways, Erik D. Huckvale, Hunter Moseley

Markey Cancer Center Faculty Publications

Metabolism is a network of chemical reactions that sustain cellular life. Parts of this metabolic network are defined as metabolic pathways containing specific biochemical reactions. Products and reactants of these reactions are called metabolites, which are associated with certain human-defined metabolic pathways. Metabolic knowledgebases, such as the Kyoto Encyclopedia of Gene and Genomes (KEGG) contain metabolites, reactions, and pathway annotations; however, such resources are incomplete due to current limits of metabolic knowledge. To fill in missing metabolite pathway annotations, past machine learning models showed some success at predicting the KEGG Level 2 pathway category involvement of metabolites based on their …

Detection And Prevalence Of A Novel Bandavirus Related To Guertu Virus In Amblyomma Gemma Ticks And Human Populations In Isiolo County, Kenya, Hellen Koka, Solomon Langat, Samuel Oyola, Faith Cherop, Gilbert Rotich, James Mutisya, Victor Ofula, Konongoi Limbaso, Juliette R. Ongus, Joel Lutomiah, Rosemary Sang

All Peer-Reviewed Publications

Introduction Emerging tick-borne viruses of medical and veterinary importance are increasingly being reported globally. This resurgence emphasizes the need for sustained surveillance to provide insights into tick-borne viral diversity and associated potential public health risks. We report on a virus tentatively designated Kinna virus (KIV) in the family Phenuiviridae and genus Bandavirus. The virus was isolated from a pool of Amblyomma gemma ticks from Kinna in Isiolo County, Kenya. High throughput sequencing of the virus isolate revealed close relatedness to the Guertu virus. The virus genome is consistent with the described genomes of other members of the genus Bandavirus, with …

The Implementation Of A Fall Education Program To Enhance Functional Outcomes In An Acute Orthopedic Hospital Setting, Stacy Wentz Ms, Otr/L, Jared Schnell Pt, Dpt, Haily Roth Pt, Dpt

Department of Medicine

No abstract provided.

Characterization Of High-Risk-Other Human Papillomavirus Genotypes In Papanicolaou Tests, High-Grade Squamous Intraepithelial Lesions, And Cervical Cancer, Caitlin E. Witt, Elizabeth F. Sutton, Ashley M. Stansbury, Ashley N. Winters, Luke C. Konur, Meng Luo, Jennifer E. Cameron, Beverly Ogden

School of Medicine Faculty Publications

Background: The objective of this study was to determine the human papillomavirus (HPV) genotypes of high-risk-other HPV Papanicolaou (Pap) tests and of biopsy tissues from patients with high-grade squamous intraepithelial lesion (HGSIL) or cervical cancer. High-risk-other HPV status was determined with the cobas HPV Test (Roche Diagnostics, North America) that identifies 12 high-risk, non-16/18 HPV genotypes. We hypothesized that we would find genotypes of HPV in our population that are not covered by the 9-valent HPV vaccine. Methods: For this retrospective cohort study, we randomly selected 50 high-risk-other HPV Pap test samples from 2018 from our pathology department registries for …

A Problem-Solving Tool You Can Use, Michelle C. Dziurgot Dds

The Journal of the Michigan Dental Association

This month, the MDA Editor discusses a presentation from the summer board meeting that resulted in nostalgic recollection of the '90s hit "Whoomp! (There It Is)" and the evolution of her career from a dental student to managing a large practice. The article introduces the WOOP (Wish, Outcome, Obstacle, Plan) method, a problem-solving tool used to address challenges in patient scheduling due to a shortage of hygienists. By applying WOOP, the practice aims to prioritize reliable patients and manage appointments more effectively, ultimately reducing stress and improving workflow.

J Mich Dent Assoc September 2024

The Journal of the Michigan Dental Association

Each 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. The September issue highlights Michigan's dental schools and provides practical information for dentists. Key Content:

• Cover Stories: Features written by the deans of the University of Detroit Mercy and the University of Michigan dental schools.
• CDT Code Revision: A guide on how to contribute to the revision of the Current Dental Terminology code.
• UP Dental Meeting: An overview of the upcoming Upper Peninsula …