Medicine and Health Sciences Commons^™

A Systematic Review And Meta-Analysis Finds That Psychological Well-Being Predicts All-Cause Mortality Independently Of Psychological Ill-Being., Max Genecov, David Yeager

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Does psychological well-being (e.g. life satisfaction, happiness, meaning in life) predict the length of a person’s life, or are measures of well-being simply assessing the absence of ill-being (depression, loneliness, sadness) and are therefore redundant with ill-being measures? Individual studies have examined this question by measuring and controlling for both well-being and ill-being, but inconsistent findings have been reported. METHODS: A systematic review and random-effects meta-analysis was conducted on the literature of prospective longitudinal studies linking all-cause mortality to well-being. Studies that controlled for ill-being were compared to studies that did not control for ill-being to identify the unique …

Admixture-Informed Polygenic Risk Reporting Using The Eprs Framework, Yu-Jyun Huang, Nuzulul Kurniansyah, Matthew O Goodman, Brian W Spitzer, Jiongming Wang, Adrienne Stilp, Cecelia Laurie, Paul S De Vries, Han Chen, Yuan-I Min, Mario Sims, Gina M Peloso, Xiuqing Guo, Joshua C Bis, Jennifer A Brody, Laura M Raffield, Jennifer A Smith, Wei Zhao, Jerome I Rotter, Stephen S Rich, Susan Redline, Myriam Fornage, Robert Kaplan, Nora Franceschini, Daniel Levy, Alanna C Morrison, Eric Boerwinkle, Nicholas L Smith, Charles Kooperberg, Bruce M Psaty, Sebastian Zöllner, Tamar Sofer

Faculty, Staff and Student Publications

Polygenic risk score values vary with genetic ancestry due to differences in population-specific allele frequencies and linkage disequilibrium patterns. We present a framework to calibrate polygenic risk scores based on ancestral makeup. We propose the "expected polygenic risk score" or ePRS, defined as the expected value of a polygenic risk score based on one's global or local admixture patterns. We further define the "residual polygenic risk score" or rPRS as measuring the deviation of the polygenic risk score from the ePRS. The ePRS reflects the baseline ancestry-driven component of genetic risk, whereas the rPRS isolates an ancestry-agnostic measure of genetic …

Improving Reflective Practice And Care Consistency In The Mental Health Connect Line: Addressing Compassion Fatigue Through A Quality Improvement Initiative, Chloe Parkin

South West Clinical School Journal

#400WORDS: QUALITY IMPROVEMENT REPORT

The Lived Experience Of Vicarious Trauma In Specialist Nurses Facilitating Organ Donation: A Narrative Review, Sharon Johnson, Kevin Hambridge

South West Clinical School Journal

#400 words: knowledge and action

The Use Of Thickener In Dysphagia Management: An Evaluation Of Current Practice, Morgane Griffiths

South West Clinical School Journal

#400WORDS: EVIDENCE INFORMED CHANGE PROJECT

Improving Reflective Practice And Care Consistency In The Mental Health Connect Line: Addressing Compassion Fatigue Through A Quality Improvement Initiative, Lauren Collier, Chloe Parkin

South West Clinical School Journal

#400WORDS: QUALITY IMPROVEMENT REPORT

Clustering Digestive Tract Tumors Using Transcriptomic And Mutation Data, Dwayne G Tally, Polina Bombina, Jake Reed, Jeffrey Kinne, Lynne V Abruzzo, Kevin R Coombes, Zachary B Abrams

2020-Current year OA Pubs

BACKGROUND: Digestive tract cancers, like most other cancers, are usually categorized based on cell or tissue of origin. Molecular clustering based on the transcriptome often produces the same classification.

METHODS: We developed a new method, Newmanization, to reduce underlying tissue signals from transcriptomic analysis. To test our method, we downloaded data on 1635 samples of digestive tract cancers from The Cancer Genome Atlas. The available data includes transcriptomic data by RNA-Seq, as well as binary mutation allele frequency data by whole exome sequencing. We compared, using silhouette widths and visualization by dimension reduction plots, the effectiveness of Newmanized transcriptome and …

Hyperdynamic Microtubule-Based Structural Changes In Monocyte-Derived-Neuronal-Like Cells From Patients With Schizophrenia, Alfredo Bellon, Alonso Cortez-Resendiz, Lauren N Forrest, Omar Elmarasi, Janani Iyer, Anjali Iyer, Chachrit Khunsriraksakul, Dajiang Liu, L Elliot Hong, Therese M Jay, Marie-Odile Krebs, Anne Hosmalin

Faculty, Staff and Student Publications

A consistent postmortem finding in schizophrenia (SCZ) is reduction in dendrites' size. However, neurons with larger dendritic trees have also been encountered. In vitro experiments with neurons and neuronal-like cells coming directly from patients with SCZ showed similar results, evidencing at times more extensions and at others less arborizations. The process of extending and retracting neuronal outgrowths depends on microtubules polymerization and depolymerization. The possibility that microtubule polymerization/depolymerization is related to defects in the neuronal structure comes from several microtubular anomalies reported in SCZ such as its abnormal distribution in the cytoplasm, irregular shape of microtubules and even absence of …

Extrapulmonary Small Cell Carcinoma Presenting As Bilateral Papilledema, Hyponatremia, Encephalitis, Seizures, Crmp5-Igg Reactivity, And Prominent Anterior Tubular Perivascular Spaces, Ramsis Benjamin, Drew Thomas, Nina Mourao, J. Judd Fite, Brianna Woodliff, Shubhank Goyal

School of Medicine Publications

Background: Paraneoplastic syndromes that affect both the optic disc and the brain parenchyma typically harbor antibodies directed toward CV2/collapsin response-mediator protein 5 (anti-CRMP5), amphiphysin, Ma antigen 2 (Ma2/Ta), and Yo. The most common cancers linked to anti-CRMP5 antibodies include small-cell lung carcinoma (SCLC), followed by thymoma, renal cell carcinoma, and thyroid papillary carcinoma. A long-held belief explains papilledema as related to increased pressure within the subarachnoid space or the microvascular capillaries, but intracranial pressures within the normal standard range may exist in a person with a paraneoplastic syndrome and papilledema. The glymphatic system, a central waste-clearance conduit, may play a …

Case Report Of Mixed Liver Injury Following Five Days Exposure To Cefepime In Young Adults, Widyati Widyati, Pandu Harijono, Gunady Wibowo Rencong

Pharmaceutical Sciences and Research

Drug-induced liver injury (DILI) remains a challenge in clinical practice and is still a diagnosis of exclusion. Although it has a low incidence amongst the general population, DILI accounts for most cases of acute liver failure with a fatality rate of up to 50%.

Case : A 56-year-old male was transferred to the Intensive Care Unit (ICU) with fever and severe thrombocytopenia,17,000. The patient was diagnosed with suspected sepsis and potential disseminated intravascular coagulation (DIC). Consequently, the patient was put on cefepime, administered 2g three times daily for over 30 minutes, and combined with amikacin at 1500 mg to be …

Mislabeling And Inappropriate Analysis Render Interpretations From “The Effect Of The Participatory Heat Education And Awareness Tools (Heat) Intervention On Agricultural Worker Physiological Heat Strain: Results From A Parallel, Comparison, Group Randomized Study” Unreliable, Chelsi M Webster, Yasaman Jamshidi-Naeini, Lilian Golzarri-Arroyo, Colby J Vorland, Zachary J Schlader, Blair D Johnson, David B Allison

Faculty, Staff and Students Publications

No abstract provided.

Inherited Tbx4 Frameshifting Variants Predicted To Escape Nonsense Mediated Decay In Two Families With Variable Phenotypes, Including Lethal Lung Developmental Disorders, Shruti A Pande, Hiuling Chan Joiner, Przemyslaw Szafranski, Tomasz Gambin, Michelle Wright, Qian Wang, Maiah Walters, Jan M Friedman, Jessica Saunders, Nicholas Avdimiretz, Cornelius F Boerkoel, Nahir Cortes-Santiago, Gail Deutsch, Pawel Stankiewicz

Faculty, Staff and Students Publications

Background: Pathogenic variants involving the transcription factor TBX4 gene have been associated with various skeletal and pulmonary abnormalities, including lethal lung developmental disorders (LLDD).

Methods: Whole-genome sequencing (WGS) with AI-powered platform for variant detection and interpretation followed by Sanger sequencing targeted variant segregation analysis were used. Reverse transcription quantitative PCR (RT-qPCR) and immunohistochemistry (IHC) studies were performed to assess gene and protein expression levels, respectively.

Results: We describe two unrelated families with intrafamilial variability in the TBX4 phenotypic expressivity, including LLDDs. WGS analyses revealed two frameshift variants, c.1019del; p.(Arg340GlnfsTer40) in the penultimate exon and c.1167dup; p.(Arg390GlnfsTer30) in the last exon …

Igg4-Related Disease As An Uncommon Cause Of Myocarditis: A Case Report., Emily Ellis, Sarah Grebennikov, Rodolfo Jose Denadai Benatti

Heart and Vascular Articles

BACKGROUND: IgG-4-related disease (IgG4-RD) is a systemic fibroinflammatory disease that can affect any organ system. Myocarditis is a rare manifestation.

CASE SUMMARY: A 65-year-old woman with clinically diagnosed IgG4-RD, who had recently completed corticosteroid taper, presented with multiple admissions for recurrent chest pain and myocardial injury. Coronary angiography repeatedly showed preserved coronary anatomy, and initial transthoracic echocardiography showed preserved left ventricular systolic function. Subsequent transthoracic echocardiography showed rapid decline in ejection fraction, and cardiac magnetic resonance imaging (MRI) showed myocardial oedema, infarct scar, and patchy non-ischaemic fibrosis. A probable diagnosis of IgG4-RD myocarditis was made clinically based on medical history, …

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

A Hybrid Coaching Model In A Multi-Center Networked Care Experience Learning Collaborative, Elizabeth Rizzo, Victoria Adams, James Perry, Nicole Szalay, Samuel Verkhovsky, Megan Morse Holthoff, Alice Mae Kennedy, Brant Oliver

Patient Experience Journal

Coaching teams and leaders conducting quality improvement (QI) has shown to be an effective method for project success. Our coaches were well versed in Lean Six Sigma and IHI Model for Improvement methods. Certified Lean Six Sigma Blackbelts coaches were assigned to project teams. Routine participation in project team meetings and one-on-one coaching sessions reenforced tools necessary to complete improvement work. Additionally, coaches met with one another to discuss their methods, work through challenges, and celebrate successes. Fourteen improvement teams led work in Care Experience related projects. Eleven project leaders certified in Lean Six Sigma methodology through the Value Institute …

Documentation And Dashboard Driven Quality And Safety Improvement In Interpreter Services For Limited English Proficient Patients, Richard T. Dillehay, Samuel Verkhovsky, Andrew Bohm, Harley Friedman, Dawn Welshman, Ann Morong, Vidya Karthikeyan, Jessica Dampier, Amanda Racine, Brant Oliver

Patient Experience Journal

Limited English Proficiency is known as an independent driver of disparities in patient's access to healthcare and their healthcare outcomes. The Joint Commission standards require that health systems document language services delivery to patients with limited English proficiency in a systematic way. Our health system had not historically utilized a methodical system for documenting language services utilization prior to the launch of this initiative. By utilizing a Lean Six Sigma approach, a project team comprised of leaders from interpreter services, operations, data analytics, and data informatics codesigned an Epic SmartForm data collection instrument and series of Tableau dashboards to monitor …

``We'll Be Right With You'', Improving Patient Experience With Complaint Management Within A Learning Health System Collaborative, James J. Perry, Mackenzie Hahn, Angela Kmiec, Brant J. Oliver

Patient Experience Journal

An improvement team at Cheshire Medical-Dartmouth Health participated in the Care Experience Collaborative aimed at enhancing the patient and workforce experience. Utilizing a hybrid Lean Six Sigma DMAIC approach alongside modified Institute for Healthcare Improvement learning techniques, local teams were coached by quality improvement specialists. The project's focus was on improving the complaint management process to boost hospital ratings and recommendations. Initial assessments revealed significant inefficiencies, such as delays in response times and poor tracking of complaint resolutions. Implementing a new digital monitoring system in conjunction with standardized training resulted in substantial improvements: complaint resolution times decreased by 53%, while …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Patient Engagement In Developing Radiology Patient Education Materials, T Arleo, Harrisd Harrisd, J Hislop, J Moon, H Li, N Kadom

Patient Experience Journal

Purpose: This initiative aimed to engage patients in the process of developing patient education materials (PEM) on the major imaging modalities at our institution. Materials and Methods: PEM were created for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), fluoroscopy, and radiography. Content was sourced from various sources, consolidated into a draft, and iteratively updated: They were simplified using a ChatGPT-4.0 prompt designed to achieve a 7th grade reading level; they were reviewed for accuracy by subject matter experts (SME); they were assessed for readability and understandability using the Flesch-Kincaid Grade Level (FKGL) and the Patient Education Materials Assessment …

Utilization Of Visual Metaphors For Improving Health Literacy, Kadir Alp Özler, Morgan Dressel, Madeline Weiner, Robert D Lucito, Alice Fornari

Patient Experience Journal

Health education is practiced in patient encounters via verbal communication and educational pamphlets. However, these techniques are faulty and do not provide true patient comprehension of their conditions and treatments reform is necessary to prevent the mortality and hospitalization rates that are linked to poor health literacy. Visual aids and metaphors are individually known to be powerful educational tools. A student organization at Stony Brook University, Artists in Medicine, has sought to synergize these tools to create visual metaphors artwork that links everyday concepts to patient illnesses to facilitate comprehension of this information. For example, one project “Aortic Dissections” depicts …

Patient Experience (Px) In Low- And Middle-Income Countries (Lmics): A Scoping Review, Yara Abou Harb, Geoffrey A. Silvera

Patient Experience Journal

Patient Experience (PX) is a growing subject in the healthcare industry due to its association with improved clinical outcomes, patient safety, and business motives. While PX is well studied in high income countries, little is known about the state of PX in Low and Middle-income countries (LMICs). Objective: The study aims to examine literature on PX and related concepts in LMICs. Methods: This study executes a PRISMA literature review of academic databases (Ovid Medline, CINAHL, EMBASE and Google Scholar) as well as hand searching of PX related websites from 2005 to 2024. Results: 67 references met search criteria. Four themes …

Multilevel Factors Shaping The Patient Experience With Health Services In Torbat Heydarieh, Iran, Fatemeh Pourhaji, Mohammad Hossein Delshad

Patient Experience Journal

Background: One of the main aims of public health is to ensure that health services are used and available. However, access alone does not guarantee a positive patient experience, which is critical to achieving optimal health outcomes and ensuring health equity. Aims: The objective of this study is to analyse in a comprehensive way the multiple factors influencing the patient experience and subsequent use of healthcare services by households in Torbat Heydarieh, Iran, by examining the independent and interactive contributions of individual, household and environmental (community) determinants using THUMS data. Methods: This analytical study, which covered a 1-year period, looked …

Factors Influencing Patient Satisfaction In Health Services: A Cross-Sectional Study In The Holy City Of Najaf, Ahmed Abdul Hasan Mohsin, Lamees A. Abdul-Lateef, Noor Ismeal Nasser

Patient Experience Journal

The healthcare system in the city of Najaf works to improve the quality of services provided to patients. Since patient satisfaction serves as a key measure of service quality, this study was designed to identify the potential factors that influence satisfaction within these facilities. cross-sectional study was conducted for 300 patients using public healthcare services in Najaf. the selection of patients based on the stratified random sampling across hospitals and primary health centers. Data were collected using a 24-item structured questionnaire that measured four domains: accessibility, staff attitude, service quality, and physical environment, rated on a four-point Likert scale. The …

Nursing Staff Attitude Towards Nurse-Physician Collaboration In The Neonatal Intensive Care Unit In Al Ahsa City, Saudi Arabia, Makarim Taqi Al Helal, Yaqoub Yousef Al Mousa

Patient Experience Journal

Objective: Effective nurse-physician collaboration is fundamental to ensuring quality healthcare delivery, particularly in Neonatal Intensive Care Units (NICUs), where patient outcomes rely heavily on coordinated teamwork. This study aimed to assess nursing staff attitudes toward nurse-physician collaboration in NICUs, examine the influence of demographic and professional characteristics, and provide evidence-based recommendations to strengthen interprofessional collaboration. Methods: A quantitative, non-experimental, cross-sectional survey was conducted from April to June 2024 in the NICU of Maternity and Children's Hospital, Al Ahsa, Saudi Arabia. A total of 180 nurses with at least one year of NICU experience participated. Data were collected using the …

Do Allied Health Professionals' Workplace Experiences Affect Their Decisions To Stay? A Quantitative Investigation Into The Relationship Between Wellness And Employee Retention In United States Hospitals, Dina Jarjees, Lihua Dishman

Patient Experience Journal

Allied Health Professionals (AHPs) are university-trained practitioners with specialized skills essential for preventing, diagnosing, and treating health conditions. AHPs play a vital role in comprehensive healthcare, including hospitals, where they comprise a significant portion of the workforce and recurrent health expenditures. However, AHPs experience considerable burnout and emotional distress, negatively impacting retention. This issue worsens workforce shortages and limits access to care, which jeopardizes patient safety. This national, cross-sectional, quantitative study examined the relationship between AHPs' wellness dimensions (physical, emotional, mental, social, and spiritual) and AHPs' retention in United States hospitals. A self-developed survey instrument included 10 demographic and 25 …

Investigating The Effectiveness Of Different Modalities In Interprofessional Training, Rose Ann Mathai, Sean Lopez, Maureen Emlund, Jim Scherrer, Elisa Buzinski, Julia Sonnichsen, Myra Carew

Patient Experience Journal

Background: Interprofessional education (IPE) highlights the importance of values and ethics, teamwork, communication, and roles and responsibilities for healthcare professionals. Different modalities have been used to teach these skills. The most effective teaching modality must be determined to enhance the collaborative learning experience. Purpose: This study evaluated the changes in student perceptions on each interprofessional competency with respect to the teaching modality. Two groups were evaluated for this study. One was taught using a hybrid curriculum and the other in-person. Methods: This study utilized the Students' Perceptions of Interprofessional Clinical Education (SPICE-R2) survey to determine the changes in student …

Exploring Patient Satisfaction: Descriptive And Predictive Insights From Hcahps Surveys In U.S. Hospitals, Naveen Gudigantala, Tanush Sistla, Ramu Gudigantala, Naga Vemprala

Patient Experience Journal

This study analyzes patient experience data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys across three time periods: 2020–21, 2021–22, and 2022–23. Utilizing both descriptive and predictive analytics, we examined ten key variables related to patient communication, hospital environment, discharge information, and overall hospital ratings. Descriptive analytics using longitudinal data analysis revealed that while patient experience metrics were strong in 2020–21, a significant downturn was observed in 2021–22, followed by a marked recovery in 2022–23. These results suggest that while COVID-19 pandemic negatively impacted patient satisfaction metrics in 2021–22, the emerging evidence suggests U.S. healthcare system …

Patient Satisfaction And Perceived Quality Of Care: A Population-Based Cross-Sectional Study Of United States Adults, Samuel Ofei-Dodoo, Carter Altenbernt, Yessin Wael, Hayrettin Okut, Alex Watkins, Nola Tran, Alishka Rojas-Addari

Patient Experience Journal

Patient satisfaction and perceived quality of care are key indicators of health care performance, yet the relative influence of demographic versus communication-related factors remains underexplored. Using data from 7,278 non-institutionalized United States adults in the nationally representative Health Information National Trends Survey, descriptive statistics summarized respondent characteristics and experiences with health care professionals, and survey-weighted multinomial logistic regression identified predictors of perceived health care quality. Respondents generally reported positive experiences, with communication-related factors emerging as the strongest predictors of excellent ratings. Patients who were always included in decisions (OR = 3.44; 95% CI, 1.11-10.69), received clear explanations (OR = 11.24; …

System-Level Barriers To Patient Engagement With Electronic Medical Records, Corey Adams, Reema Harrison, Guncag Ozavci, Kathleen Gray, Nilmini Wickramasinghe, Vicky Yuan, Tracey Bucknall, Elizabeth Manias

Patient Experience Journal

Objective: Electronic medical records (EMRs) can support patient-centered care, but system-level barriers often limit how patients engage with EMR systems. This study explored the system-level barriers and enablers to patient engagement with EMRs from the perspectives of healthcare leaders. Methods: Semi-structured interviews were conducted with 20 participants in senior EMR-related roles across healthcare organizations in two Australian states. Data were analyzed using reflexive thematic analysis to identify key system-level influences on patient engagement. Results: Seven themes were identified: 1) EMRs for digital storage, not connection, 2) Privacy rules create challenges to accessing information, 3) Communication barriers when using EMRs, 4) …