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 …

Clinician's Perspectives On The Feasibility Of Patient Controlled Analgesia In Emergency Departments: A Qualitative Descriptive Study, Natasya Raja Azlan, Caroline Bulsara, Leanne Monterosso, Max Bulsara, Gail Ross-Adjie

Research outputs 2022 to 2026

Background: Despite pain being the most common reason for patients to visit the emergency department (ED), conventional pain management methods are often inadequate. Patient controlled analgesia (PCA), which allows patients to self-administer intravenous analgesia, is widely used across many hospital wards, however, is not routinely used in ED. We aimed to identify clinicians’ perceptions of PCA use in the ED setting. Methods: A qualitative descriptive approach was employed using semi-structured individual interviews conducted with ED clinicians from two hospitals in Western Australia. Interviews were recorded and transcribed. Data was analysed using qualitative content analysis. Results: Data saturation was achieved after …

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 …

Child Physical Abuse, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Congenital Diaphragmatic Hernia, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Verruciform Xanthoma Presenting Within An Ear Piercing, Hannah E. Myers, Subhapradha Rangarajan, Michael B. Roberts, Christopher Buckley, Josh Hammel

PCOM Scholarly Works

Verruciform xanthomas are rare lesions affecting 0.025-0.5% of the population. They present as an asymptomatic, slow growing solitary lesion on the oral mucosa. Commonly misdiagnose as squamous cell carcinoma, verruca vulgaris, leukoplakia, and lichen planus. Presented is a 22 year old male with a painful verruciform xanthoma on the posterior ear lobe in a prior ear piercing.

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.

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 …

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 …

Access To Audiology Care In Rural And Urban Communities: A Methodology Paper, Molly Whitcomb, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

The ability of those affected by hearing loss to access audiology care is imperative as the effects of unmanaged hearing loss are deleterious, and the prevalence is high. Despite the abundance of individuals affected by hearing loss and the implications of the condition when untreated, barriers to access to care remain primarily unresolved, affecting groups disproportionately. These barriers include knowing when a hearing problem warrants intervention, transportation, geographical barriers, a lack of hearing health care providers, affordability, and insurance coverage. Rural and urban communities are each predisposed to a unique set of social determinants of health, which affect their ability …

Development Of An Online Authentic Radiology Viewing And Reporting Platform To Test The Skills Of Radiology Trainees In Low- And Middle-Income Countries, Hubert Vesselle, Justy Antony Chiramal, Stephen Hawes, Eric Schulze, Tham Nguyen, Rose Ndumia, Sudhir Vinayak

Imaging & Diagnostic Radiology, East Africa

Background: Diagnostic radiology residents in low- and middle-income countries (LMICs) may have to provide significant contributions to the clinical workload before the completion of their residency training. Because of time constraints inherent to the delivery of acute care, some of the most clinically impactful diagnostic radiology errors arise from the use of Computed Tomography (CT) in the management of acutely ill patients. As a result, it is paramount to ensure that radiology trainees reach adequate skill levels prior to assuming independent on-call responsibilities. We partnered with the radiology residency program at the Aga Khan University Hospital in Nairobi (Kenya) to …

Control And Management Of Type-Ii Diabetes Among People Living With Hiv (Plwh) Compared To Hiv-Negative Patients And By Clinic Type In The Bronx, Nyc, Aprielle Wills

Dissertations and Theses

ABSTRACT

Control and Management of Type-II Diabetes Among People Living with HIV (PLWH) compared to HIV-Negative Patients and by Clinic Type in the Bronx, NYC

by

Aprielle Wills

Advisor: Heidi E Jones, MPH PHD

Background: The Centers for Disease Control (CDC) estimated that approximately 1.3 million people in the United States (U.S.) were living with an HIV diagnosis by the end of 2021. With advancements of antiretroviral therapy (ART) and improved access to care, HIV has become a chronic condition in the U.S. As PLWH age, they are experiencing higher rates of other chronic conditions, specifically type-II diabetes (type-II …

Examining Well-Being And Healthy Lifestyle Interventions Among Nursing Students Worldwide: A Scoping Review, Christine S. Gipson, Belinda Deal, Michael Skinner

Nursing Faculty Publications and Presentations

Purpose: The purpose of this scoping review was to identify intervention studies related to well-being and healthy lifestyles in nursing students to identify research gaps in the literature for future research. Methods: The review followed the Joanna Briggs Institute (JBI), JBI Manual for Evidence Synthesis, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. Five databases were searched to retrieve the articles assessed by this review: APA PsycINFO, CINAHL Complete, PubMed, Scopus, and Web of Science. Inclusion criteria included articles with a sample population of nursing students; addressed the well-being, wellness, health, or healthy lifestyle(s) …

U-M School Of Dentistry: Collaborating With Michigan’S Dentists To Move The Profession Always Forward, Jacques E. Nör Dds, Ms, Phd

The Journal of the Michigan Dental Association

Completing his first year as dean of the University of Michigan School of Dentistry Dr. Nor highlights the importance of community-based learning in dental education. Students gain valuable experience through rotations at various clinics across Michigan, including those serving underserved populations. The dean emphasizes the generosity of dentists who mentor students and the importance of the Oath of Aspiring Dentists. The Commission on Dental Accreditation completed its site visit at our school in March. Its findings identified numerous strengths during the formal review that American dental schools must complete every seven years. Demographic data on the incoming class of 2028 …

Dominant Missense Variants In Srebf2 Are Associated With Complex Dermatological, Neurological, And Skeletal Abnormalities, Matthew J Moulton, Kristhen Atala, Yiming Zheng, Debdeep Dutta, Dorothy K Grange, Wen-Wen Lin, Daniel J Wegner, Jennifer A Wambach, Angela L Duker, Michael B Bober, Lisa Kratz, Carol A Wise, Ila Oxendine, Anas Khanshour, Undiagnosed Diseases Network, Michael F Wangler, Shinya Yamamoto, F Sessions Cole, Jonathan Rios, Hugo J Bellen

Duncan NRI Faculty and Staff Publications

Purpose: We identified 2 individuals with de novo variants in SREBF2 that disrupt a conserved site 1 protease (S1P) cleavage motif required for processing SREBP2 into its mature transcription factor. These individuals exhibit complex phenotypic manifestations that partially overlap with sterol regulatory element binding proteins (SREBP) pathway-related disease phenotypes, but SREBF2-related disease has not been previously reported. Thus, we set out to assess the effects of SREBF2 variants on SREBP pathway activation.

Methods: We undertook ultrastructure and gene expression analyses using fibroblasts from an affected individual and utilized a fly model of lipid droplet (LD) formation to investigate the consequences …

Enhancement Of High-Density Lipoprotein-Associated Protease Inhibitor Activity Prevents Atherosclerosis Progression, Maura Mobilia, Alexander A. Karakashian, Khaga R. Neupane, Olivia Hage, Callie Whitus, Abigail Carter, Clairity Voy, Lance A. Johnson, Gregory A. Graf, Scott M. Gordon

Saha Cardiovascular Research Center Faculty Publications

Background and aims: Inflammatory cells within atherosclerotic lesions secrete proteolytic enzymes that contribute to lesion progression and destabilization, increasing the risk for an acute cardiovascular event. Elastase is a serine protease, secreted by macrophages and neutrophils, that may contribute to the development of unstable plaque. We previously reported interaction of endogenous protease-inhibitor proteins with high- density lipoprotein (HDL), including alpha-1-antitrypsin, an inhibitor of elastase. These findings support a potential role for HDL as a modulator of protease activity. In this study, we test the hypothesis that enhancement of HDL-associated elastase inhibitor activity is protective against atherosclerotic lesion progression.

Methods: We …

Exploring The Nexus Of Perfectionism, Physical Activity, And Smartphone Addiction: A Study Among College Adults, Megan Mccarthy

Doctorate in Kinesiology

The purpose of this quantitative research study was to determine the relationship between perfectionism, physical activity, and smartphone addiction among college students. College students are at a pivotal point in their development toward adulthood and understanding the impact of perfectionism, physical activity, and smartphone addiction on their overall well-being is important for their future success. A cross-sectional correlational study via a quantitative survey with the valid measures of the Frost Multidimensional Perfectionism Scale- Brief (FMPS-B), the International Physical Health Questionnaire- Short Form (IPAQ-S), and the Smartphone Addiction Scale- Short Version (SAS-SV) were used for data collection. Results concluded that a …