Medicine and Health Sciences Commons^™

What Is Scannable? An Mri Safety Guide, Michael Burcescu, Ravi Patel, Robert Hessemer, Peter Lore, Sriharsha Kota, Guarav Kumar

West Florida Division GME Research Day 2020

Supernumerary MRI protocols and recommendations exist to guide physicians at the forefront of patient care. While urgent imaging may be necessary for critical patients, inadvertent imaging of implantable devices can incur serious morbidity and mortality[11]. The American College of Radiology published a 30-page manual in 2013[1] on MRI safe practices and releases yearly updates with critical information separately[2]. There is increased utilization of advanced imaging modalities, especially among academic institutions[3]. Physicians are hard pressed to maximize efficiency; uncertainty delays imaging. Moreover, inappropriate orders delay appropriate management. We present pertinent and often questioned considerations in a comprehensible format along with devices …

Sexual Identity And Alcohol, Cigarette, And E-Cigarette Use, Zoe H. Webster, Elizabeth K. Do Phd, Mph

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

The Effects Of Emotional Distress On Substance Use In First Generation And Continuing Generation College Students, E. Noelle Rogers, Karen G. Chartier Phd, Msw

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

The Association Between Frequency Of Alcohol Consumption And Sensation Seeking In College Freshmen, Anna Lee, Elizabeth Prom-Wormley Mph, Phd

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

Spiraling: Do Parents Help Lighten The Blow Of Trauma, Ruth Laryea, Marcia Winter Phd

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

Worried About Being Un-Masked By Booze? Associations Between Psychopathy And The Fear Of Behavioral Disinhibition During Alcohol Misuse, Jenely J. Villegas, David S. Chester Phd

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

Portrait Of A Novice Medical Family Therapist, Working In A Medical Setting With Head And Neck Cancer Patients Observed Through A Bowen Family Systems Theory’S Lens, Venetia Bennett

Department of Family Therapy Dissertations and Applied Clinical Projects

Each year, approximately 43,000 people in the United States, receive a diagnosis of cancer of the head and neck (American Cancer Society 2019). A diagnosis of cancer, regardless of its location can be overwhelming for patients, their caregivers, and their family system. Receiving such a diagnosis causes a reaction of heightened emotions and anxiety. With that, there is a growing need for medical familytherapists. Medical family therapy has been documented as an effective approach for aiding medical providers to increase the quality of care for patients. Traditionally, medical family therapy is associated withgeneral practitioners, pediatricians, and such medical environments. This …

Awareness Of The Use Of Self In Therapy: An Autoethnographic Inquiry Into The Training Experiences Of A Black, Single, Female Mft Doctoral Student, Phyllis Days

Department of Family Therapy Dissertations and Applied Clinical Projects

The "self" of the therapist is an essential factor in the therapeutic process (Baldwin, 2000) and is impacted by intersections of identities and prejudicial treatment, which creates unjust conditions for Black women in society and academia. Nonmembers of the predominant culture can find difficulties in navigating the "self" of the therapist, which reflects personal and social experiences. In academia, the Black woman's identity continues to face problems of exclusion and oppressive related situations, which can complicate the learning process (Ong, Wright, Espinosa, & Orfield, 2011). Several studies have explored the challenges ofAfrican-American students and faculty, in MFT graduate programs, who …

Implicit Racial Bias In Physicians: Racial Disparity In Opioid Prescriptions In United States Emergency Departments, Anjali Ta

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Over the past 30 years, a documented racial disparity in opioid prescriptions in U.S. emergency care departments has persisted despite overall prescription trends fluctuating throughout the rise and fall of the early 2000’s opioid epidemic. Consistently, Blacks and other minorities receive lower levels of opioid analgesics when presenting with conditions or characterizing pain levels similar to white patients. This study focuses on identifying the mechanisms of implicit racial bias, quantified by scores on the Implicit Bias Association Test (IAT), that influences physicians’ abilities to equitably assess and treat pain of racially diverse patient populations. Research has shown that physicians with …

Frequency And Perceived Authenticity Of Social Determinants Of Health Discussion By Medical Trainees, Priyadarshini Chandrashekhar, Emily J. Noonan, Laura A. Weingartner

Undergraduate Arts and Research Showcase

Introduction

Social determinants of health (SDOH)—the conditions in which people live, learn, and work—play a vital, but often neglected role in shaping a community’s health. SDOH influence risk factors for disease and access to healthcare, consequently promoting health inequities among different populations. Examining how providers discuss SDOH with patients can identify opportunities to better integrate social context into care.

Methods

We analyzed standardized patient (SP) encounters of rising UofL M3 trainees to 1) determine whether SDOH are integrated into healthcare conversations, and 2) investigate what constitutes an authentic conversation to identify how trainees can better express interest in a patient. …

Screening For E-Cigarette And Tobacco Use In Standardized Patient Encounters, Michael A. Schmidt, Emily J. Noonan, Laura A. Weingartner

Undergraduate Arts and Research Showcase

E-cigarette usage has grown significantly in recent years, with over 5 million US middle and high school students reporting recent usage. The long-term health consequences of these devices are still being investigated, but it is known that e-cigarette aerosol could contain harmful substances including nicotine, heavy metals, and carcinogens. Therefore, it is important for physicians to ask patients about e-cigarette usage specifically, as this may contribute to future health problems. The goal of this study was to investigate if and how medical students screen for e-cigarette usage. Screening language was reviewed in standardized patient encounters, which are a type of …

A Qualitative Descriptive Analysis Of Erowid Gabapentinoid Forum Posts, Haylee E Figg Rn Bsn Student, Rachel Vickers-Smith Phd, Mph

Undergraduate Arts and Research Showcase

Purpose/Background: With increased controls on opioid prescribing, the CDC has suggested prescribing gabapentinoids as a first-line alternative to opioids for pain. However, there have been an increasing number of reports of gabapentinoid misuse. Drug use forums are online spaces where individuals can anonymously post about their drug use experiences and may provide insight on gabapentinoid misuse. The purpose of this study was to extract and analyze posts from the drug use forum, Erowid, to examine reports of gabapentinoid misuse.

Methods: Data for the study was drawn from 53 pregabalin forum posts and 89 gabapentin forum posts by unique usernames. In …

The Role Of Female Headed Households Caring For Children And No Spouse In Gentrification In Los Angeles, Jovita Murillo

CGU Theses & Dissertations

Gentrification is the “in-migration of a relatively well-off, middle- and upper-middle-class population” into historically marginalized communities (Centers for Disease Control and Prevention (CDC); Matsuoka et al. 2017). Literature has repeatedly shown that gentrification is placing cost and rent-burdened residents at risk of displacement due to the hike in housing prices and rents. Most cost and rent burdened households are female-headed households caring for children without a spouse (FHHCCNS) (Colburn and Allen, 2018). Given there is a lack of literature describing the role of gender in gentrification, this descriptive study aims to describe the gentrification profile in Los Angeles using multiple …

A Multinational Study Of The Etiology And Clinical Teleology Of Moral Evaluations Of Patient Behaviors, Anna Yu Lee

CGU Theses & Dissertations

This dissertation is a collection of four studies which collectively explore a hypothesized construct of ‘moral evaluation of patient behaviors’ (MEPB) as a driver of health professionals’ readiness to interact humanistically with their patients. In these studies, ‘humanistic interactions’ refer to the non-technical, intangible skills and factors of clinical competence; the factors specifically explored in these studies were compassion toward patients, self-efficacy for treating patients, and optimism toward patient treatment. For the purpose of specificity, all factors were examined as they pertained to patients with substance use disorders. Survey data from a convenience sample of 524 health professionals (i.e. physicians, …

Recidivism Among Previously Incarcerated People Enrolled In Riverside County Whole Person Care, Ndifreke Emmanuel Etim

CGU Theses & Dissertations

The United States continues to policy shift towards reducing the number of incarcerated people; however, many people released from incarceration will be rearrested due to re-entry challenges. Several re-entry programs, such as the Whole Person Care pilot, have been developed to address these challenges and ensure that formerly incarcerated people successfully transition into the community. The primary aim of this project is to explore the determinants of recidivism among previously incarcerated people enrolled in the Whole Person Care pilot in Riverside County. This study suggests early linkage to services, such as mental health and substance use treatment services, will reduce …

Access To Medication-Assisted Treatment For Opioid Dependence In The United States – Identifying Implications For Policy And Practice, Mofoluwake Adeniyi

CGU Theses & Dissertations

Americans make and use the most opioids in the world. Although comprising somewhat less than 5% of the world’s population, the United States (US) produces approximately 90% of the global supply of Hydrocodone and consumes an estimated 80% of the total international supply. It is not surprising, therefore, that the American opioid epidemic, particularly as it involves adults (those 18 years and older), is worsening—Indeed, President Trump declared it a national public health emergency. Many therefore anticipate that the US Congress will enact evidence-informed policies to address the opioid crisis. Opioid Use Disorder (OUD) is a pattern of opioid use …

Systemic Risk Management Plan For Electronic Medical Records (Emr): Why And How?, Ziniya Zahedi, Faisal Mahmud, Cesar Pinto

Engineering Management & Systems Engineering Faculty Publications

Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person’s social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk …

Just Because (Most) Hospitals Are Publishing Charges Does Not Mean Prices Are More Transparent, Cody L. Mullens, J Andres Hernandez, Evan D. Anderson, Lindsay Allen

Faculty & Staff Scholarship

Background: The Centers for Medicare and Medicaid Services (CMS) recently mandated that all hospitals publish their charge description masters (CDMs) online, in a machine-readable format, by January 1, 2019. In addition, CMS recommended that CDM data be made available in a manner that was consumer friendly and accessible to patients.

Objective: This study aimed to (1) examine all hospitals across the state of Pennsylvania to understand policy compliance and (2) use established metrics to measure accessibility and consumer friendliness of posted CDM data.

Methods: A cross-sectional analysis was conducted to quantify hospital website compliance with the recent CMS policies requiring …

Differentiating Peripherally-Located Small Cell Lung Cancer From Non-Small Cell Lung Cancer Using A Ct Radiomic Approach, Bihong T. Chen, Zikuan Chen, Ningrong Ye, Isa Mambetsariev, Jeremy Fricke, Ebenezer Daniel, George Wang, Chi Wah Wong, Russell C. Rockne, Rivka R. Colen, Mohd W. Nasser, Surinder K. Batra, Andrei I. Holodny, Sagus Sampath, Ravi Salgia

Journal Articles: Biochemistry & Molecular Biology

Lung cancer can be classified into two main categories: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), which are different in treatment strategy and survival probability. The lung CT images of SCLC and NSCLC are similar such that their subtle differences are hardly visually discernible by the human eye through conventional imaging evaluation. We hypothesize that SCLC/NSCLC differentiation could be achieved via computerized image feature analysis and classification in feature space, as termed a radiomic model. The purpose of this study was to use CT radiomics to differentiate SCLC from NSCLC adenocarcinoma. Patients with primary lung cancer, …

Profile Of Cardiac Arrhythmia In Acute Stroke Patients, Julius Stephen Nkhondeya Msukuya

Master of Medicine in Internal Medicine

Introduction: Cardiac arrhythmias are common and can be fatal in acute strokes, but they are often under-recognized. The presence of cardiac arrhythmia in acute stroke doubles the mortality. Objectives: This study aimed to determine the types of cardiac arrhythmia in acute stroke patients admitted in two urban hospitals in Dar es Salaam, The Aga Khan Hospital, Dar es Salaam and Muhimbili National Hospital. The secondary objectives were to determine the associations between the characteristic of stroke and cardiac arrhythmias as well as to determine the impact of cardiac arrhythmia on 30- days stroke outcomes. Methods: This was a prospective longitudinal …

The Clinicodemographic Profile Of Multiple Sclerosis At Aga Khan University Hospital (Nairobi), Imran Jamal

Master of Medicine in Internal Medicine

Background: Multiple sclerosis (MS) is the leading cause of nontraumatic disability in young adults and is the most common immune-mediated inflammatory demyelinating disease of the CNS. MS was initially considered to be rare in sub-Saharan Africa (SSA). However, there have been reports of rising trends of MS in regions with previously low prevalence. Objective: The primary objective of this study was to describe the demographic and clinical characteristics of MS patients at AKUHN. Methods: Medical records of patients with MS at the AKUHN were obtained using the ICD 10 code search at the medical records section of the hospital between …

Validation Of Kiswahili Version Of World Health Organization Quality Of Life-Hiv Bref Questionnaire Among People Living With Hiv/Aids In Tanzania., Nuru Abdallah Kondo

Master of Medicine in Family Medicine

Background: WHO has developed an HIV specific quality of life tool (WHOQOLHIV-BREF) for assessing Quality of life of HIV positive individuals. This tool takes to account the different cultural variations that exist worldwide and hence enable assessment of the quality of life across different cultures/context. This tool has been validated in different cultures and is cross-culturally a promising tool. It is simple to use in routine clinics as it is self-administered. Despite its sound validity and reliability from several studies, the developers recommend it to be validated in different cultures to fully assess its psychometric properties before its adaptation. Objectives: …

Implementation Of A Novel Return-To-Ride Concussion Management Policy For Collegiate Hunter/Jumper Equestrian Athletes, Devon Serrano, Velyn Wu

Clinical Practice in Athletic Training

A concussion return-to-participation protocol specific to equestrian is critical in the safe return of athletes to their respective discipline. When the care of the hunter/jumper equestrian teams became the responsibility of the Sports Medicine staff at Sweet Briar College, a return-to-participation concussion management policy was needed to ensure the safety of the equestrian student-athletes. A quality-improvement project focusing on the development of a “Return-to-Ride” protocol was started in the fall semester of 2016. The Sports Medicine staff collaborated with the Sweet Briar College riding center to create and ensure compliance of the protocol. The intended aim of developing this protocol …

Quality Improvement In Athletic Training Education On Female Athlete Triad, Kristen A. Paloncy-Patel, Melissa R. Penkalski, Shannon M. Hauschildt, Natalie B. Allen

Clinical Practice in Athletic Training

There are significant health risks associated with the female athlete triad (Triad), therefore early detection and prevention is key. Athletic trainers often serve as the frontline defense and can have a crucial role in identifying the Triad. Yet knowledge, confidence, and practice standards in the recognition, referral and treatment is lacking. The purpose of the following Quality Improvement document is to provide athletic trainers with a framework for improving Triad-specific knowledge, confidence, and practice standards. The 2014 Female Athletic Triad Coalition consensus statement provides an evidence-based risk stratification system for detection and referral of the Triad. The Coalition suggests including …

Point-Of-Care Research: Retrospective Analysis Of The Evaluation And Classification Of Tendon Pathology In Athletic Training, Ashley J. Reeves, Russell T. Baker, Scott W. Cheatham, Alan Nasypany

Clinical Practice in Athletic Training

Tendon pathology has been studied across healthcare professions but remains poorly understood. Imaging and clinical findings have been used to diagnose tendon pathology, but these findings are discrepant. It is vital that clinicians use sound clinical judgment to determine the most accurate clinical diagnosis and treatment options given documented clinical findings. The purposes of this study were to assess athletic trainers’: 1) documented clinical findings for patients presenting with tendon pain, 2) use of documented findings to inform clinical diagnosis of tendon pathology, and 3) change in tendon pathology classification when presented with a novel diagnostic term. A total of …

Functional Balance Assessment Of Firefighters During Mass-Screening Examinations, Rachel M. Eiler, Zachary K. Winkelmann, Kenneth E. Games

Clinical Practice in Athletic Training

Firefighters are tactical athletes who are required to complete rigorous tasks as part of their job functions. The focus of this clinical outcomes assessment was to assess functional balance assessment through the use of the anterior reach test with and without personal protective equipment (PPE) during a mass-screening examination. The screening was completed with 61 active firefighters in a local fire department with access to athletic training services. The results of the anterior reach assessment identified a significant difference of a firefighter’s anterior reach when donning and doffing PPE. Anterior reach distances were significantly reduced (P < 0.001) on the right leg with (mean = 55.78 cm ± 7.53 cm) and without PPE (mean = 58.92 cm ± 6.47 cm). Similarly, significant decrements (P = 0.003) in left leg anterior reach distance in firefighters donning (mean = 57.67 cm ± 8.25 cm) and doffing (mean = 59.82 cm ± 6.31 cm) PPE. Clinical application of these findings suggests that healthcare providers working with tactical athletes, specifically firefighters, should consider the risks associated with donning PPE such as functional balance deficits.

Deep Vein Thrombosis In Lower Extremity Of A Female Collegiate Volleyball Athlete: A Case Study, Lucas D. Dargo, Kendra Borton, Rachel Roths, Zachary Dougal

Clinical Practice in Athletic Training

Deep vein thrombosis (DVT) occurs when a blood clot forms in deep veins in the body, usually in the lower extremity. DVT is commonly seen in older or hospitalized patients. This case is unique because the patient is a 20-year-old female division III collegiate volleyball athlete, which is not the typical age or population affected by DVT or clotting disorders. The patient presented with swelling, pain, and decreased knee flexion (3/5) and plantarflexion (4/5) strength in her left lower extremity. These impairments reduced her ability to walk or run. The patient’s athletic trainer (AT) initially diagnosed her with a left …

Posterior Glenoid Dysplasia As A Secondary Finding To Labrum Tear And Subscapularis Strain: A Case Study, S. Andrew Cage, Brandon J. Warner, Diana M. Gallegos

Clinical Practice in Athletic Training

The purpose of this disablement model case study was to describe the case of a collegiate baseball pitcher suffering from a labral lesion and supraspinatus strain that may have been the result of posterior glenoid dysplasia. Despite gross instability and glenohumeral external rotation weakness, the patient was initially able to continue to pitch. While posterior glenoid dysplasia has been described in literature, there have not been studies that have evaluated soft tissue changes that may be associated with this bony morphology abnormality. In this case, the patient reported to the athletic training staff complaining of pain, tightness, and a “clunking” …

Assessment Of Stress Effects On Cognitive Flexibility Using An Operant Strategy Shifting Paradigm, Andrew T. Gargiulo, Xinyue Li, Laura A. Grafe

Psychology Faculty Research and Scholarship

Stress affects cognitive function. Whether stress enhances or impairs cognitive function depends on several factors, including the 1) type, intensity, and duration of the stressor; 2) type of cognitive function under study; and 3) timing of the stressor in relation to learning or executing the cognitive task. Furthermore, sex differences among the effects of stress on cognitive function have been widely documented. Described here is an adaptation of an automated operant strategy shifting paradigm to assess how variations in stress affect cognitive flexibility in male and female Sprague Dawley rats. Specifically, restraint stress is used before or after training in …

Killing Them To Save Us’: Lessons From Politicide For Preventing And Countering Terrorism, Clark R. Mccauley

Psychology Faculty Research and Scholarship

This chapter reviews and extends the analysis of mass political murder advanced by Chirot and McCauley, then applies this analysis to understanding and countering terrorism. The justification for this application is that both politicide and terrorism target civilians in the context of asymmetric conflict. Three generalizations emerge. Politicide and terrorism cannot be understood or countered without (i) studying both sides in the conflict, (ii) separate studies of leaders, perpetrators, and mass sympathizers, and (iii) acknowledgment of the threats and grievances perceived by both sides. The chapter concludes with implications for fighting the war of ideas against jihadist and right-wing terrorists.