Medicine and Health Sciences Commons^™

Pelayanan Kesehatan Primer Sebagai Gatekeeper Dan Kebijakan Diskusi Peer Review: Antara Kualitas Dan Realitas Untuk Menurunkan Kasus Rujukan Non Spesialistik, Zahrina Zahrina, Royasia Viki Ramadani, Khairun Nisa Il Hulwah, Siti Nurlatifah, Aldi Andalan, Ascobat Gani, Golda Kurniawaty, Ery Setiawan

Jurnal Ekonomi Kesehatan Indonesia

Almost 80% of the source of funds is spent on hospital. This situation indicates the failure of the gatekeeper function in primary health care. Performance-based capitation is implemented to ensure the cost and quality of primary care, with non-specialist referral rate as one of the particular parameters. The peer review policy is a discussion between BPJS Health, District/City Health Services, IDI, provincial and branch Team of KMKB and other relevant stakeholders to determine which diagnoses must be handled at FKTP also to accommodate and improve the capacity of FKTP to handle patients and minimize referral cases. This study aims to …

Menakar Kesiapan Puskesmas Dalam Penuntasan Penanganan Penyakit: Analisa Data Riset Fasilitas Kesehatan 2019, Harimat Hendarwan, Suparmi Suparmi

Jurnal Ekonomi Kesehatan Indonesia

The completion of disease treatment at the health center was important for payment of Capitation Based on Fulfillment of Service Commitment (PCFSC/KBPKP) and the Non-Specialist Case Outpatient Referral (NSOR/RRNS) was one of the key indicators. This study aimed to assess public health center readiness in the completion of disease treatment for those stipulated in Ministerial Decree number 514 of the year 2015. This study used Health Facility Research (Rifaskes) data conducted in 2019 with a total of 9831 health centers as observations. Analysis was conducted by comparing the availability of equipment, laboratories, and medicines with existing regulations. Health center readiness …

Analisis Case Mix Index Pelayanan Rawat Inap Rumah Sakit Yang Bekerja Sama Dengan Bpjs Kesehatan Tahun 2019-2020, Anna Tirawani Ambarita, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

BPJS Health experienced various challenges in achieving Universal Health Coverage / Jaminan Kesehatan Nasional (JKN), including a referral system. According to the 2018 National Health Account, curative spending costs reached 69.1%. The Case Mix Index (CMI) is a benchmark for hospital performance abroad, but Indonesian hospitals have not used it. In 2019, BPJS Health tested CMI in 30 hospitals. The research uses sample data from 2019-2020 based on province, hospital type and ownership. The methods used are anova test, independent T, linear regression and multiple linear regression. The research results show a decrease in cases in 2019-2020. The highest CMI …

Pengaruh Kepemilikan Asuransi Kesehatan Pada Kelompok Miskin Terhadap Utilisasi Pelayanan Kesehatan Di Indonesia: Sebuah Studi Retrospektif, Dian Ira Wanti

Jurnal Ekonomi Kesehatan Indonesia

Health is the main priority of the Indonesian government in order to improve the health status of the Indonesian people in order to become a healthy, qualified and productive society. Health insurance is one of the programs held by the government to make this happen. Health insurance ownership from year to year continues to increase, but this increase is not accompanied by high utilization of health services, both outpatient and inpatient. The low utilization of health services raises the questions of how health insurance ownership affects the utilization of health service utilization. Therefore, this study aims to analyze the impact …

Kemampuan Membayar Iuran Jaminan Kesehatan Nasional Peserta Penerima Bantuan Iuran (Jkn Pbi) Kota Tangerang Tahun 2023, Darwati Darwati, Pujiyanto Pujiyanto, Budi Hidayat

Jurnal Ekonomi Kesehatan Indonesia

The number of National Health Insurance (JKN) participants receiving Contribution Assistance (PBI) in Tangerang City from regional funding continues to increase by around 8.85% per year. On the other hand, the number of JKN participants who are non-wage earners (PBPU) and non-workers (BP) who pay contributions independently has decreased by around 0.7% per year from 2017-2022. One of the implications of this phenomenon is that the regional budget to finance JKN contributions for PBI participants is much larger than the budget for other programs. In 2020, JKN contribution payments for Tangerang City APBD PBI participants amounted to 57.81%, in 2021 …

Surgical Approaches For Thoracic Outlet Decompression In The Treatment Of Thoracic Outlet Syndrome, Stijn B. J. Teijink, Jens Goeteyn, Niels Pesser, Bart F. L. Van Nuenen, Robert W. Thompson, Joep A. W. Teijink

2020-Current year OA Pubs

Thoracic outlet syndrome (TOS) is a controversial and uncommon syndrome. Three different diagnoses can be made based on the compressed structure: arterial TOS, venous TOS, and neurogenic TOS. Diagnosing TOS, especially neurogenic TOS, remains difficult since a single diagnostic tool does not exist. Although this resulted in a lot of confusion, standardization of care and outcome improved daily care practice measures in the last decade. Current treatment algorithms consist of both conservative and surgical treatment approaches, which should be chosen depending on the type of TOS and extend of the complaints. Surgical treatment of TOS is performed via thoracic outlet …

Inhaled Medications For Chronic Obstructive Pulmonary Disease Predict Surgical Complications And Survival In Stage I Non-Small Cell Lung Cancer, Steven Tohmasi, Daniel B. Eaton, Brendan T Heiden, Nikki E. Rossetti, Valerio Rasi, Su-Hsin Chang, Yan Yan, Deepika Gopukumar, Mayank R. Patel, Bryan F. Meyers, Benjamin D. Kozower, Varun Puri, Martin W. Schoen

2020-Current year OA Pubs

BACKGROUND: Lung function is routinely assessed prior to surgical resection for non-small cell lung cancer (NSCLC). Further assessment of chronic obstructive pulmonary disease (COPD) using inhaled COPD medications to determine disease severity, a readily available metric of disease burden, may predict postoperative outcomes and overall survival (OS) in lung cancer patients undergoing surgery.

METHODS: We retrospectively evaluated clinical stage I NSCLC patients receiving surgical treatment within the Veterans Health Administration from 2006-2016 to determine the relationship between number and type of inhaled COPD medications (short- and long-acting beta2-agonists, muscarinic antagonists, or corticosteroids prescribed within 1 year before surgery) and postoperative …

On The Discontinuation Of Enteral Feeding In Head And Neck Cancer: A Case Report, Kyle Fisk, Ana Sanchez

HCA Healthcare Journal of Medicine

Introduction

The goal of palliative care is to preserve the quality of life or patient “comfort” in patients with serious diseases. Palliative care providers serve a wide range of patients: from those who seek curative treatment to those who are actively dying. Given this range, palliative care must mirror the dynamic goals of the patient at different stages of life and treatment. Throughout these stages, a goal of the palliative care provider would be to avoid hastening death; however, this often leads to clinical decisions that directly pit the patient’s comfort against the patient’s life span. This is most salient …

Lazarus Syndrome After Aortic Aneurysm Repair, Kevyn Niu, Jamie Lee Aldakkour, Charles Huyghues-Despointes, Yizhi Lin

HCA Healthcare Journal of Medicine

Introduction

Lazarus syndrome is defined as the spontaneous return of circulation after cessation of cardiopulmonary resuscitation (CPR). Though there have been multiple cases of Lazarus syndrome documented in the literature, it is a significantly underreported phenomenon with less than 100 cases reported in the literature since the first case in 1982.

Case Presentation

After elective aortic aneurysm repair, an 88-year-old with a do-not-resuscitate directive had cardiac arrest, briefly showing post-mortem respiration and pulse. Despite resuscitation efforts including pharmacological intervention and CPR, he passed away within an hour. This case highlights complexities in end-of-life care and warrants exploration of post-mortem physiological …

A Rare Case Of Candida Glabrata Cervical Spondylodiscitis, Angelina Hong, Lily Hyungjung Lim, Ali Tariq Alvi, Pallavi Aneja

HCA Healthcare Journal of Medicine

Introduction

Invasive candidiasis can lead to numerous life-threatening sequelae. Candida glabrata is the second-most common causative species of invasive candidiasis. This species possesses a high risk for persistent infection and candidemia. An uncommon complication of invasive candidiasis is spondylodiscitis and can rarely affect the cervical spine.

Case Presentation

The patient is a female in her late 50s with a complex medical history inclusive of chronic obstructive pulmonary disease, chronic pain, multiple abdominal surgeries, prolonged intensive care unit admission, and administration of total parenteral nutrition and broad-spectrum antibiotics who presented with complaints of worsening neck pain. She was last hospitalized 3 …

Impact Of Psychiatry Clerkship Rotation In Attitudes Towards Mental Illness And Psychiatry As A Career Among Medical Students, Jae Kim, Brian Blum, Shivani Kaushal, Sara Khan, Patrick Hardigan, Clara Alvarez Villaba

HCA Healthcare Journal of Medicine

Background

Stigma associated with mental illness (MI) permeates many professions, including healthcare. Recognizing and correcting bias is critical in delivering impartial and beneficial healthcare for all patients. Early educational interventions providing exposure to individuals with MI have shown to be effective at reducing MI stigma. The primary aim of our study was to assess the impact of a psychiatry clerkship on attitudes to MI. A secondary aim was to determine if the psychiatry clerkship influenced medical students’ perceptions of psychiatry as a career.

Methods

A cohort of third-year medical students in Florida was invited to complete an online survey before …

Significance Of Chronic Kidney Disease On Morbidity And Mortality In Hospitalized Patients With Covid-19, Varsha Suresh, Alexis Finer, Aarushi Varshney, Kay Thi Khine, Ishak Mansi, Abdo Asmar

HCA Healthcare Journal of Medicine

Background

Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19.

Methods

We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, …

Engaging Chief Medical Officers To Improve Multidisciplinary Rounds, Gregory Mccormack, Pranav C. Mehta

HCA Healthcare Journal of Medicine

Background

Multidisciplinary rounds (MDRs), a model of care in which multiple members of the care team, representing different disciplines, come together to discuss the care of a patient in real-time. MDRs are a valuable tool for clinical teams to improve patient length of stay (LOS), reduce healthcare-associated infections, and increase care coordination. HCA Healthcare’s data science and performance improvement teams created a data visualization tool called Next-gen Analytics for Treatment and Efficiency (NATE) Tempo to support care teams in managing rounds and barriers.

Methods

A pilot implementation of MDRs using the NATE Tempo tool was initiated in 10 hospitals, accompanied …

Comparison Of The Effects Of The Three Methods Of Massage, Selected Yoga Exercises And Massage-Yoga Combination On The Depression In Elderly Women, Elham Piri, Behnam Ghasemi, Ali Shafizadeh

Baltic Journal of Health and Physical Activity

Introduction: The present study aims to compare the effects of massage, selected yoga exercises and massage-yoga combination methods on symptoms of depression. Materials and Methods: According to the research criteria, 60 available samples were selected and randomly divided into three experimental groups and single control one. The Beck Depression Inventory was completed by the examinees before the intervention, two months after its beginning and one month after ending. Each experimental group received one of the massage interventions, selected yoga exercises and massage-yoga combination for eight weeks, three sessions per week and for a period of 40 minutes per session. The …

Effects Of Attending To A 12-Week Structured Physical Activity Program On Fitness And Self-Perception Levels Of Obese Primary Schoolchildren, Yetkin Utku Kamuk, Spiridon Kamtsios

Baltic Journal of Health and Physical Activity

Introduction: Childhood obesity is a major health problem especially for schoolchildren both physically and mentally. The study was conducted to assess the effects of the structured physical activity (PA) program on the physical fitness (PF) and self-perception levels of obese schoolchildren. Materials and Methods: A total of 67 students aged 9-11 were recruited and the experimental group (n = 27) was attended to exercises once per week for 60 mins for 12 weeks. Self-perception Scale for Children and PF tests were applied as pre- and post-tests. Results: 12-week PA sessions improved obese schoolchildren’s self-perception levels in general self-worth, athletic …

Mental Health Effects Of The Covid-19 Pandemic On Aging Lesbian, Gay, Bisexual, Transgender, And Queer Populations., Iliza Minaya, Samuel Raine, Arkene Levy, Chasity B O'Malley

HPD Articles

INTRODUCTION: The COVID-19 pandemic affected numerous subpopulations of people in unique ways. This study evaluated the impact of the COVID-19 pandemic on the mental health status of Broward County's aging lesbian, gay, bisexual, transgender, and queer (LGBTQ) seniors and identified strengths, weaknesses, and opportunities for interventions to enhance positive mental health outcomes. The study was performed from April 2021 through July 2021.

METHODS: Online surveys measuring anxiety, depression, social support, and resilience were delivered by email to 47 residents of Wilton Manors, Florida. Study data were collected and collated using research electronic data capture tools with bivariate analysis using the …

Chronic Hepatitis B: A Summarized Anecdote Of Complexities In Natural History, Treatment, And Complications, Nicholas Noverati, Jay W. Jun, Vivan Yan, Dina Halegoua-De Marzio, Hie-Won Hann

Division of Gastroenterology and Hepatology Faculty Papers

Chronic hepatitis B is still a disease process that affects millions around the world. Serologies used to diagnose and follow the progression (or resolution) of the disease can be confusing for clinicians. Further, throughout years of treatment, there may be nuances in presentation that complicate management even further. In this short communication, we highlight six themes in response to treatment and outcomes, including complications. We have the unique perspective of following many patients over extended periods of time at our institution, which has brought these themes to life in order that they can be shared with other clinicians who may …

Comparing Ait And Eft In Reduction Of Negative Emotions Associated With A Past Memory: A Randomized Control Study, Gregory Brown, Kavita Batra, Emily Dorin, Raveena Bakhru, Andrew Han, Arianna Palermini, Robert Sottile, Sherine Khanbijian, Michael Hower

Psychiatry & Behavioral Health Faculty Research

Advanced Integrative Therapy [AIT] is an Energy Psychology-based system of intervention utilized by psychotherapists since the late 1990s. Recently, a study investigated the perceptions of therapists regarding the effectiveness of AIT in reducing negative emotions related to past traumatic events. Emotional Freedom Techniques (EFT) are a set of well-researched Energy Psychology based interventions which have been established as an effective intervention for post-traumatic stress disorder. This study is the first to compare the effectiveness of AIT to EFT in reducing negative emotions associated with a particular memory in a sample of college and professional students, who were randomly assigned to …

The Role Of Diagnostic Laparoscopy In Management Of Non-Specific Abdominal Pain: A Prospective Observational Study, Suraj Pai, Ashfaque Mohammed

Manipal Journal of Medical Sciences

Non-specific abdominal pain (NSAP) presents a diagnostic challenge due to its varied etiologies and often inconclusive clinical and radiological findings. Diagnostic laparoscopy has emerged as a valuable minimally invasive tool that allows direct visualization of the abdominal cavity, facilitating early and accurate diagnosis. This study evaluates the role of diagnostic laparoscopy in patients presenting with NSAP, highlighting its diagnostic accuracy, safety profile, and impact on clinical management. Evidence suggests that laparoscopy not only aids in identifying underlying pathologies—ranging from appendicitis and gynecological disorders to early peritonitis—but also reduces unnecessary laparotomies and hospital stay duration. Additionally, therapeutic interventions can often be …

A Prioritized Patient-Centered Research Agenda To Reduce Disparities In Telehealth Uptake: Results From A National Consensus Conference, Kristin L. Rising, Mackenzie Kemp, Amy E. Leader, Anna Marie Chang, Andrew J. Monick, Amanda Guth, Tracy Esteves Camacho, Gregory Laynor, Brooke Worster

Department of Emergency Medicine Faculty Papers

Introduction: We hosted a national consensus conference with a diverse group of stakeholders to develop a patient-centered research agenda focused on reducing disparities in telehealth use.

Methods: Attendees were purposively invited to participate in a 2-day virtual conference. The group developed a prioritized research agenda focused on reducing disparities in telehealth uptake, with discussion informed by findings from a scoping review. All work was conducted in partnership with a Steering Committee of national experts in telehealth and patient-centered care (n = 5) and a community-based Telehealth Advisory Board with experience with telehealth use and barriers (n = 8).

Results: Sixty …

Foreword From Editor - 14th Edition, Yandi Andri Yatmo

ASEAN Journal of Community Engagement

This edition of AJCE brings together discussions on the various roles and effectiveness of research and community engagement programs in strengthening local identity, developing skills, and enhancing quality of life towards a resilient society. Expanding such roles, this issue consists of four research articles, one review article, and three case-based articles. The authors of this edition emerge from the background of language, engineering, economy, policy, education, and health, providing different outlooks and methods in overseeing the processes of community-related programs.

Promoting Health Improvement Of Indonesian Migrant Workers And Their Children In Kuala Lumpur, Malaysia, Mitoriana Porusia, Listiana Masyita Dewi, Dewi Pertiwi Dyah Kusudaryati, Yuli Widyastuti, Lia Kicky Mahmudi, Wulan Prasesti, Fahwa Nyssa Insyiroh, Niken Diah Haryanti, Muhammad Fathan Nuralam, Nastiti Farasvita Putri, Miranda Azahra, Rafif Ryandra Izdhihar, Zulia Setiyaningrum, Siti Sabariah Buhari

ASEAN Journal of Community Engagement

This article discusses the health promotion program among Indonesian migrant workers and their children living in Kuala Lumpur, Malaysia, aiming for a better awareness of their health condition. In particular, this article describes and analyzes the community engagement program in Sekolah Indonesia Kuala Lumpur (SIKL) and Muhammadiyah Malaysia (PCIM) to provide health education and screening. Based on the preliminary study, Indonesian migrant workers and their families have limited access to healthcare facilities and programs. The program covers topics such as healthy reproduction and sexual vigilance for the youth, well-being and healthy lifestyles, as well as the importance

of basic health …

Participant Engagement In A Community Health Worker-Delivered Intervention And Type 2 Diabetes Clinical Outcomes: A Quasiexperimental Study In Mexicanamericans, Belinda M. Reininger, Juliana Z. Lopez, Maria E. Zolezzi, Minjae Lee, Lisa A. Mitchell-Bennett, Tianlin Xu, Soo Kyung Park, Mayra V. Saldana, Lubeth Perez, Joseph B. Mccormick

Health & Biomedical Sciences Faculty Publications

Objectives This study helps to fill the existing research gap related to participant engagement in behavioural interventions and diabetes management. We examined type 2 diabetes control over time among Mexican Americans by level of engagement in a chronic care management (CCM) program that included community health worker (CHW)-delivered multilevel interventions. The programme complemented clinical care and promoted behaviour changes to improve diabetes self-management.

Design Quasiexperimental study.

Setting The study was implemented in the Rio Grande Valley region in the USA. Recruitment was conducted in clinics and community events. All other visits were provided in participant homes and community locations.

Participants …

P53r245w Mutation Fuels Cancer Initiation And Metastases In Nash-Driven Liver Tumorigenesis, Denada Dibra, Mihai Gagea, Yuan Qi, Gilda P Chau, Xiaoping Su, Guillermina Lozano

Faculty, Staff and Student Publications

Obesity is a significant global health concern. Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH) are common risk factors for hepatocellular carcinoma (HCC) and are closely associated with metabolic comorbidities, including obesity and diabetes. The TP53 tumor suppressor is the most frequently mutated gene in liver cancers, with half of these alterations being missense mutations. These mutations produce highly abundant proteins in cancer cells which have both inhibitory effects on wildtype (WT) p53, and gain-of-function (GOF) activities that contribute to tumor progression. A Western diet increases p53 activity in the liver. To elucidate the functional consequences of Trp53 mutations in …

Triobp Modulates Β-Catenin Signaling By Regulation Of Mir-29b In Idiopathic Pulmonary Fibrosis, Lan Wang, Wenyu Zhao, Cong Xia, Shuaichen Ma, Zhongzheng Li, Ningdan Wang, Linke Ding, Yaxuan Wang, Lianhui Cheng, Huibing Liu, Juntang Yang, Yajun Li, Ivan Rosas, Guoying Yu

Faculty, Staff and Students Publications

Idiopathic pulmonary fibrosis (IPF) is a fatal and devastating lung disease of unknown etiology, described as the result of multiple cycles of epithelial cell injury and fibroblast activation. Despite this impressive increase in understanding, a therapy that reverses this form of fibrosis remains elusive. In our previous study, we found that miR-29b has a therapeutic effect on pulmonary fibrosis. However, its anti-fibrotic mechanism is not yet clear. Recently, our study identified that F-Actin Binding Protein (TRIOBP) is one of the target genes of miR-29b and found that deficiency of TRIOBP increases resistance to lung fibrosis in vivo. TRIOBP knockdown inhibited …

Viral Targeting Of Importin Alpha-Mediated Nuclear Import To Block Innate Immunity, Olivia A Vogel, Jade K Forwood, Daisy W Leung, Gaya K Amarasinghe, Christopher F Basler

2020-Current year OA Pubs

Cellular nucleocytoplasmic trafficking is mediated by the importin family of nuclear transport proteins. The well-characterized importin alpha (IMPA) and importin beta (IMPB) nuclear import pathway plays a crucial role in the innate immune response to viral infection by mediating the nuclear import of transcription factors such as IRF3, NFκB, and STAT1. The nuclear transport of these transcription factors ultimately leads to the upregulation of a wide range of antiviral genes, including IFN and IFN-stimulated genes (ISGs). To replicate efficiently in cells, viruses have developed mechanisms to block these signaling pathways. One strategy to evade host innate immune responses involves blocking …

Quality Improvement In Healthcare: A Practical Guide For Providers (Part 2), Jeremy Ellis

Transformative Medicine

No abstract provided.

Respiratory Syncytial Virus Vaccines For Adults, Maley Zents, Emily Wagner, Mary Hoang, Christina Swiger

Transformative Medicine

Respiratory syncytial virus (RSV) is a virus that causes outbreaks of acute lower respiratory tract infections (LRTI) worldwide. The infections are associated with high rates of hospitalizations, which may lead to death, especially in older adults and young children. Due to the morbidity and mortality associated with RSV, pharmaceutical companies have dedicated research to create a vaccine since the 1960s. Despite setbacks after the failure of the first RSV vaccine, new developments in research have led to the approval of two new vaccines. Ensuring healthcare professionals and patients are well-informed about these vaccines is crucial for facilitating informed, collaborative clinical …

“What Should I Do About This New Left Bundle Branch Block?”, Muhammad Asad Hanif, Muhammad Mohsin Zafar, Aniruddha Singh

Transformative Medicine

No abstract provided.

Impact Of Adding Reduced And Weight-Based Insulin Dosing Options To The Emergency Department And Inpatient Hyperkalemia Order-Set, Elaina Lioudis Pharmd, Bs, Regine Ghoubrial-Waibel Pharmd, Micah Kidd Msn, Rn, Agcns-Bc, Cmsrn

Transformative Medicine

Purpose: To compare the effects of weight-based, reduced, and standard IV insulin doses on potassium reduction and hypoglycemia incidence in the treatment of acute hyperkalemia.

Methods: The hyperkalemia treatment order-set was updated to include reduced and weight-based insulin dose options. Patients ≥ 18 years old with acute hyperkalemia treated with insulin using the order-set were included. Patients with missing data or who started dialysis before follow-up potassium monitoring were excluded. The primary efficacy outcome was reduction in serum potassium. The primary safety outcome was incidence of hypoglycemia and severe hypoglycemia. Secondary outcomes included insulin dose administered, completion of …