Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Does The Electronic Health Record Improve The Timeliness Review And Notification Of Medical Laboratory And X-Ray Test Results?, Ruby Estes

Applied Research Projects

The medical community struggles with timeliness issues throughout the different healthcare environments in many areas of patient care. The demands of meeting patient care needs is great everywhere. One area that can lead to extreme adverse outcomes and affects patient safety is failure to review and follow-up on medical test results timely. In addition the lack of timely follow-up and treatment can lead to medico-legal implications for all healthcare professionals involved in the patients care. Some timeliness issues have been attributed to understaffed healthcare institutions, lack of trained staff, and in many instances inefficient and insufficient processes. This is an …

Quality Management: A Global Case Study In Organ Transplantation, Cassie L. Rodriguez

Master's Projects and Capstones

Every year the US and European countries face an epidemic of organ failure from a multitude of reasons: cancer, genetic predisposition, exposure to harmful chemicals in home or surrounding areas or through drinking, drugs and smoking. Another problem faced, is the ratio of organ donors to organ recipients. Over 121,000 patients are on the waiting for an organ transplant, and a fraction of those waiting will die because of time. The Hanover Medical school and department of quality management, have created an integrated approach to organ transplant avenues. Quality management is a systematic guide for organ transplantation that allows all …

Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: Anthracycline and trastuzumab are common breast cancer treatments. While improving survival, they elevate risk of congestive heart failure. The incidence of cardiotoxicity (CTx) with these therapies varies in the literature from 10% to 59%, higher than those reported in clinical trials (4%–10%) that excluded patients with preexisting cardiovascular comorbidities. Studies have failed to establish consensus on the risk factors for CTx associated with these therapies.

Purpose: We aim to determine the incidence and risk factors of CTx in breast cancer patients treated with anthracycline and/or trastuzumab at Aurora Health Care.

Methods: A retrospective review of patients with breast cancer …

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

Robins-I: A Tool For Assessing Risk Of Bias In Non-Randomised Studies Of Interventions, Jonathan A.C. Sterne, Miguel A. Hernán, Barnaby C. Reeves, Jelena Savovic, Nancy D. Berkman, Meera Viswanathan, David Henry, Douglas G. Altman, Mohammed T. Ansari, Isabelle Boutron, James R. Carpenter, An-Wen Chen, Rachel Churchill, Jonathan J. Deeks, Asbjørn Hróbjartsson, Jamie Kirkham, Peter Jüni, Yoon K. Loke, Theresa D. Pigott, Craig R. Ramsay, Deborah Regidor, Hannah R. Rothstein, Lakhbir Sandhu, Pasqualina L. Santaguida, Holger J. Schünemann, Beverly Shea, Ian Shrier, Peter Tugwell, Lucy Turner, Jeffrey C. Valentine, Hugh Waddington, Elizabeth Waters, George A. Wells, Penny F. Whiting, Julian Pt Higgins

Publications and Research

Non-randomized studies of the effects of interventions are critical to many areas of healthcare evaluation, but their results may be biased. It is therefore important to understand and appraise their strengths and weaknesses. We developed ROBINS-I (“Risk Of Bias In Non-randomized Studies - of Interventions”), a new tool for evaluating risk of bias in estimates of the comparative effectiveness (harm or benefit) of interventions from studies that did not use randomization to allocate units (individuals or clusters of individuals) to comparison groups. The tool will be particularly useful to those undertaking systematic reviews that include non-randomized studies.

Developing Novel Machine Learning Algorithms To Improve Sedentary Assessment For Youth Health Enhancement., Gowtham Kumar Golla, Jordan A. Carlson, Jun Huan, Jacqueline Kerr, Tarrah Mitchell, Kelsey Borner

Manuscripts, Articles, Book Chapters and Other Papers

Sedentary behavior of youth is an important determinant of health. However, better measures are needed to improve understanding of this relationship and the mechanisms at play, as well as to evaluate health promotion interventions. Wearable accelerometers are considered as the standard for assessing physical activity in research, but do not perform well for assessing posture (i.e., sitting vs. standing), a critical component of sedentary behavior. The machine learning algorithms that we propose for assessing sedentary behavior will allow us to re-examine existing accelerometer data to better understand the association between sedentary time and health in various populations. We collected two …

Changing Diagnostic Methods And Increased Detection Of Verotoxigenic Escherichia Coli, Ireland, Thomas Rice, Noreen Quinn, Roy D. Sleator, Brigid Lucey

Department of Biological Sciences Publications

The recent paradigm shift in infectious disease diagnosis from culture-based to molecular-based approaches is exemplified in the findings of a national study assessing the detection of verotoxigenic Escherichia coli infections in Ireland. The methodologic changes have been accompanied by a dramatic increase in detections of non-O157 verotoxigenic E. coli serotypes.

Induction Of Dusp9 In Xenografts From Human Breast Cancer Cell Lines Increases Mammary Cancer Stem Cells, Albert Barrios, Meher Parveen, Phd, Easter Thames, Melanie Baker, Shelha Pervin, Phd

Journal of Health Disparities Research and Practice

Breast cancer remains a complex disease that kills 40,000 women every year. Initiation and progression of breast cancer is influenced by heterogeneous groups of cells, including mammary cancer stem cells (MCSCs). Progression of this dreadful disease is driven by many signaling pathways among which MAPK pathway is highly prominent. Since targeting prominent kinases in MAPK pathway has been unsuccessful to control breast cancer, it is important to examine the phosphatases that regulate the activity of these kinases.

Using xenograft model from breast cancer cell lines, our lab has found that during the initial stages of xenograft development (week 1-4, 100-200mg …

Barriers And Facilitators To Deaf Trauma Survivors’ Help-Seeking Behavior: Lessons For Behavioral Clinical Trials Research: A Master’S Thesis, Melissa L. Anderson

Melissa L. Anderson

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility in the design of study methodology. To inform such considerations, we conducted a secondary analysis of a mixed-methods study that explored 16 Deaf trauma survivors’ help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that can be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged are what we would expect of any research participant, Deaf or hearing – a need for communication access, empathy, respect, strict …

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu

Pharmacy Faculty Articles and Research

Socially responsible technologies are designed while taking into consideration the socioeconomic, geopolitical and environmental limitations of regions in which they will be implemented. In the medical context, this involves making therapeutic platforms more accessible and affordable to patients in poor regions of the world wherein a given disease is endemic. This often necessitates going against the reigning trend of making therapeutic nanoparticles ever more structurally complex and expensive. However, studies aimed at simplifying materials and formulations while maintaining the functionality and therapeutic response of their more complex counterparts seldom provoke a significant interest in the scientific community. In this review …

"What's App?" Utilizing Evidence Based Medicine Apps In The Clinical Setting, Kathryn C. O'Donovan

BU Well

The medical community has utilized evidence-based medicine, or EBM, in practice for decades, and healthcare personnel are used to the idea of utilizing research and statistics to determine the treatment of patients. However, as technology advances, the use of electronics and EBM apps has increased in the clinical setting. While there are advantages to clinicians having resources at their fingertips as they talk with patients, there are also hurdles that could harm or offend patients. So as healthcare inevitably becomes more and more electronic, can providers strike the balance needed to effectively use EBM apps in practice to provide optimum …

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Asking Questions, Seeking Improvements, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

The author connects the rapid growth of scientific journals to the inquisitiveness of committed health professionals and their persistent efforts to improve patient care.

Postoperative Pain Management In Children Of Hispanic Origin: A Descriptive Cohort Study, Rebecca Brown, Michelle A. Fortier, Sheeva Zolghadr, Padma Gulur, Brooke N. Jenkins, Zeev N. Kain

Psychology Faculty Articles and Research

BACKGROUND:

It has been established that pain is frequently undertreated in children following outpatient surgery. Very few studies, however, have investigated this phenomenon in ethnically diverse populations.

METHODS:

This study included 105 families of children aged 2 to 15 years of Hispanic origin and low income undergoing outpatient tonsillectomy and adenoidectomy surgery. Participating parents completed baseline and demographic packets. Recorded postoperative pain ratings and administration of analgesics at home for 1 week were collected during home visits.

RESULTS:

Despite the high (70%; 99% confidence interval [CI], 57%–82%) incidence of significant pain in the first 24 hours home, 32% (95% CI, …

Asking Questions, Seeking Improvements, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The author connects the rapid growth of scientific journals to the inquisitiveness of committed health professionals and their persistent efforts to improve patient care.

The Respiratory Protection Effectiveness Clinical Trial (Respect): A Cluster-Randomized Comparison Of Respirator And Medical Mask Effectiveness Against Respiratory Infections In Healthcare Personnel., Lewis J. Radonovich, Mary T. Bessesen, Derek A.T. Cummings, Aaron Eagan, Charlotte A. Gaydos, Cynthia Gibert, Geoffrey J. Gorse, +8 Additional Authors

Medicine Faculty Publications

BACKGROUND: Although N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts.

METHODS: The Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

The Physician’S Perspective On The Impact Of Interpretive Services On The Physician- Patient Relationship, Amrita Pandey

Williams Honors College, Honors Research Projects

The basis of the physician-patient relationship relies heavily on communication. It has been known that conversation between physician and patient is important in both diagnosing and providing therapeutic support. However, according to the US Census Bureau twenty percent of the US population does not use English as their first language. These residents face language barriers on a daily basis, including when they are being treated medically. The aim of this study was to research the physician’s perspective on the use of interpretive services and how it impacts the physician- patient relationship. The research consisted of surveying physicians who encounter patients …

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

The Health Exception, Monica E. Eppinger

All Faculty Scholarship

The abortion doctrine laid out in Roe v. Wade permits a procedure necessary to preserve the life or the health of the pregnant woman, setting out what has come to be called the “life exception” and the “health exception.” This Article investigates the background and antecedents of the health exception, identifying three periods of formation and change up to the drafting of the Model Penal Code in 1959. It argues that theories of health lie at the heart of legal doctrine, shaping common-law treatment of abortion and persisting in nineteenth- and twentieth-century statutes. This account reveals origins of a health …