Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes …

Why A New Journal?, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

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Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Time to clinical stability is a well-defined early clinical outcome in hospitalized patients with community-acquired pneumonia, but it has not been evaluated in patients with ventilator-associated pneumonia (VAP). The objective of this study was to compare time to clinical stability in patients with MRSA VAP treated with linezolid versus vancomycin.

Methods: This was a secondary analysis of the IMPACT-HAP study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. A patient was considered to reach clinical stability the day that the following four criteria were …

A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin

The University of Louisville Journal of Respiratory Infections

Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority of including …

January 2017, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Telemedicine And Primary Care Obesity Management In Rural Areas– Innovative Approach For Older Adults?, John A. Batsis, Sarah N. Pletcher, James E. Stahl

Dartmouth Scholarship

Background:

The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity.

Discussion:

We describe the challenges in the implementation and delivery into real-world settings. The challenges in rural settings that have the fastest growing elderly population, high obesity rates, …

An Investigation Of Professionalism Reflected By Student Comments On Formative Virtual Patient Encounters, Ting Dong, William Kelly, Meredith Hays, Norman B. Berman

Dartmouth Scholarship

Background: This study explored the use of virtual patient generated data by investigating the association between students’ unprofessional patient summary statements, which they entered during an on-line virtual patient case, and detection of their future unprofessional behavior.

Method: At the USUHS, students complete a number of virtual patient encounters, including a patient summary, to meet the clerkship requirements of Internal Medicine, Family Medicine, and Pediatrics. We reviewed the summary statements of 343 students who graduated in 2012 and 2013. Each statement was rated with regard to four features: Unprofessional, Professional, Equivocal (could be construed as unprofessional), and Unanswered (students did …

Implementation Of Best Practice Of Simulation Design, Sharon Faye Creed-Hall

Nursing Theses and Capstone Projects

The use of simulation has increased in the academic setting. The placement for nursing students for clinical sites has become increasingly difficult. In order to meet the demands of clinical sites, State Boards of Nursing have created standards where simulation can replace clinical rotation. Most State Board of Nursing require the school of nursing to meet the International Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSM, use a theory for debriefing, and show proof of current simulation education for the educators. The Simulation Design project implemented the National League for Nursing (NLN) Jeffries Simulation Theory, the …

Toward A Discourse Community For Telemedicine: A Domain Analytic View Of Published Scholarship, Louiza Patsis

Selected Full Text Dissertations, 2011-

In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of …

Telemedicine And Its Utilization In The Management Of Chronic Heart Failure Patients, Adejoke Sotome, Chirra Pooja

Theses, Dissertations and Capstones

Introduction: Telemedicine is well developed and very useful for heart failure patients in emergencies. Many cases of heart failures are due to inability of reaching the physicians on time and failure of assessing the patient disease condition at earlier stage.

Methodology: The methodology for this study was a literature review. Electronic databases used included EBSCO Host, Google Scholar, Academic Search Premier, PubMed, ProQuest, and Marshall Digital Scholar. A total of 32 sources were referenced.

Results: This literature review examined several studies and research articles on the significance of Telemedicine in the treatment of chronic heart failure patients with …

Feasibility And Usability Of Tele-Interview For Medical Residency Interview, Ali Pourmand, Hayoung Lee, Malika Fair, Kaylah Maloney, Amy Caggiula

Emergency Medicine Faculty Publications

Every year in the United States, medical students and residency programs dedicate millions of dollars to the residency matching process. On-site interviews for training positions involve tremendous financial investment, and time spent detracts from educational pursuits and clinical responsibilities. Students are usually required to fund their own travel and accommodations, adding additional financial burdens to an already costly medical education. Similarly, residency programs allocate considerable funds to interview-day meals, tours, staffing, and social events. With the rapid onslaught of innovations and advancements in the field of telecommunication, technology has become ubiquitous in the practice of medicine. Internet applications have aided …

How Leaders Market And Commercialize Healthcare Technology Innovation, Roxie Mooney, Rocky J. Dwyer Dr.

Walden Faculty and Staff Publications

This study investigates what strategies technology development marketing leaders utilized to commercialize a new product innovation in the healthcare market. Analysis of data generated 3 major themes: strategies implemented during the prelaunch phase, strategies implemented during the pilot customer phase, and strategies implemented in the broader market launch phase of the CoI process. Findings from this study may contribute to maximizing commercial success and the diffusion of new product innovations in healthcare, which might lead to better patient outcomes and enhanced ways of practicing medicine.

The Calm Project: Teaching Mindfulness Meditation In Primary Care Using Computer-Based Application, Vanessa Norton

Nursing Theses and Capstone Projects

Mindfulness-based interventions (MBI) have been studied extensively and the evidence is now credible that even brief techniques, delivered electronically using web-based applications (apps), easily accessed by smart phone, computer, or tablet, are consistently effective at anxiety reduction as well demonstrating efficacy in other commonly occurring comorbidities such as depression, stress, and panic symptoms. The purpose of this DNP project was to examine feasibility and the effect of the app, Calm.com, on anxious adult patients in primary care, using the Recovery Alliance Theory as its theoretical foundation. This pilot study was longitudinal, using a pre-test/post-test measurement of the Generalized Anxiety Disorder …

Using Rapid Reviews In Nursing And Midwifery Research: An Example From A Study Commissioned To Inform Policy-Making, Denise O'Leary, Mary Casey, Laserina O’Connor, Diarmuid Stokes, Gerard Fealy, Denise O’Brien, Rita Smith, Martin Mcnamara, Claire Egan

Articles

Aim: To illustrate the potential use of rapid review approaches in nursing and midwifery research by presenting a worked example from a study conducted to inform policy decision making.

Background: Rapid reviews, which can be defined as outputs of a knowledge synthesis approach that involves modifying or omitting elements of a systematic review process due to limited time or resources, are becoming increasingly popular in health research. This paper provides guidance on how a rapid review can be undertaken and discusses the strengths and challenges of the approach.

Data source and research design: Data from a rapid …

Macra And Rural Hospitals, Erica Kelley, Rhea Lipscomb, Jennifer Valdez, Nitesh Patil, Alberto Coustasse Dr.Ph, Md, Mba

Management Faculty Research

Introduction: Every year, the cost of healthcare within the United States has continued to increase while the quality of patient care has decreased. To reconstruct the delivery of care, Congress has introduced the Medicare Access and CHIP Reauthorization Act of 2015 which has reinvented Medicare physician reimbursement systems. The purpose of this research was to study the Medicare Access and CHIP Reauthorization Act and its implementation to determine how it would financially impact rural hospitals.

Methodology: The methodology for this study consisted of a qualitative literature review. Twenty-seven research publications were utilized throughout the study. Data limited to the English …

4th Ichita And 13th It Forum Call For Papers, Western Michigan University

International Conference on Health Information Technology Advancement Brochures

Conference held November 2-3, 2017 at the Fetzer Center at Western Michigan University with the theme "Exploring Health IT Innovation and Cyver Security in the Digital Era."

Investigating Problems Associated With Patient Care Reports And Transferring Data Between Ambulance And Hospitals From The Perspective Of Emergency Medical Technicians, Smiljana Cuk

College of Graduate Studies: Theses & Dissertations

Many hospitals have switched to electronic records but emergency medical services continue to use some paper-based reports. Ambulances that have electronic-based systems use them only internally because they are not integrated with hospitals’ systems. This study investigated problems with paper-based, computer-based reports, and transferring patients and their information from an ambulance to the emergency department. Emergency medical technicians were interviewed using qualitative methods. After coding and analyzing their answers, results showed that all emergency medical technicians would like to see a change from paper to electronic transfer of information and that it was difficult to write the report while riding …

Sms Parent Action Intervention (Span): A Pilot Study To Assess The Feasibility Of Using Text Messaging To Promote Child Health On An American Indian Reservation, Julia M. Malich

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Purpose: Childhood obesity and its associated health risks are widely recognized as a major public health crisis in the United States (Johnson & Johnson, 2014; Proctor, 2008; Rogers et al, 2013; Vinci et al, 2016) and worldwide (Elías-Boneta, Toro, Garcia, Torres, & Palacios, 2015). Among children in low-income families, American Indian/Alaska Native (AIAN) children have the highest prevalence of obesity (21.1%) compared to other racial/ethnic groups (14.74% overall) (Pan et al, 2015). Parents play an important role in introducing healthy foods and encouraging physical activity in young children (Birch & Ventura, 2009; Lindsay et al., 2006; Natale et al., …

Optimized Multilayer Perceptron With Dynamic Learning Rate To Classify Breast Microwave Tomography Image, Chulwoo Pack

Electronic Theses and Dissertations

Most recently developed Computer Aided Diagnosis (CAD) systems and their related research is based on medical images that are usually obtained through conventional imaging techniques such as Magnetic Resonance Imaging (MRI), x-ray mammography, and ultrasound. With the development of a new imaging technology called Microwave Tomography Imaging (MTI), it has become inevitable to develop a CAD system that can show promising performance using new format of data. The platform can have a flexibility on its input by adopting Artificial Neural Network (ANN) as a classifier. Among the various phases of CAD system, we have focused on optimizing the classification phase …

Does Gamification Increase Engagement With Online Programs? A Systematic Review, Jemma Looyestyn, Jocelyn Kernot, Kobie Boshoff, Jillian Ryan, Sarah Edney, Carol Maher

Research outputs 2014 to 2021

Background Engagement in online programs is difficult to maintain. Gamification is the recent trend that offers to increase engagement through the inclusion of game-like features like points and badges, in non-game contexts. This review will answer the following question, ‘Are gamification strategies effective in increasing engagement in online programs?’ Method Eight databases (Web of Science, PsycINFO, Medline, INSPEC, ERIC, Cochrane Library, Business Source Complete and ACM Digital Library) were searched from 2010 to the 28th of October 2015 using a comprehensive search strategy. Eligibility criteria was based on the PICOS format, where “population” included adults, “intervention” involved an online program …

A Multi-Model Approach In Developing An Intelligent Assistant For Diagnosis Recommendation In Clinical Health Systems, Christian E. Pulmano, Ma. Regina Justina E. Estuar

Department of Information Systems & Computer Science Faculty Publications

Clinical health information systems capture massive amounts of unstructured data from various health and medical facilities. This study utilizes unstructured patient clinical text data to develop an intelligent assistant that can identify possible related diagnoses based on a given text input. The approach applies a one-vs-rest binary classification technique wherein given an input text data, it is identified whether it can be positively or negatively classified for a given diagnosis. Multi-layer Feed-Forward Neural Network models were developed for each individual diagnosis case. The task of the intelligent assistant is to iterate over all the different models and return those that …

Internet Health Information Seeking And The Patient-Physician Relationship: A Systematic Review, Sharon Swee-Lin Tan, Nadee Goonawardene

Research Collection School Of Computing and Information Systems

Background: With online health information becoming increasingly popular among patients, concerns have been raised about the impact of patients' Internet health information-seeking behavior on their relationship with physicians. Therefore, it is pertinent to understand the influence of online health information on the patient-physician relationship. Objective: Our objective was to systematically review existing research on patients' Internet health information seeking and its influence on the patient-physician relationship. Methods: We systematically searched PubMed and key medical informatics, information systems, and communication science journals covering the period of 2000 to 2015. Empirical articles that were in English were included. We analyzed the content …

The 1939 Dickinson-Belskie Birth Series Sculptures: The Rise Of Modern Visions Of Pregnancy, The Roots Of Modern Pro-Life Imagery, And Dr. Dickinson’S Religious Case For Abortion, Rose Holz

Women's and Gender Studies Program: Faculty Publications

This multidisciplinary essay examines the hugely influential—yet surprisingly overlooked—Birth Series sculptures. Created in 1939 by Dr. Robert L. Dickinson (obstetrician-gynecologist and leader of the Planned Parenthood Federation of America) and sculptor Abram Belskie, they illustrate the process of human development from fertilization through delivery. First displayed at the 1939–1940 World’s Fair in New York City, they were reproduced in a variety of forms and sent out across the United States and overseas. Hardly a brief fad, their popularity persisted into the 1980s. This essay has four purposes. First, it tells the stories of Dickinson and Belskie to appreciate their contributions …

Automatic Optimum Atlas Selection For Multi-Atlas Image Segmentation Using Joint Label Fusion, Kofi Agyeman

Dissertations and Theses

Multi-atlas image segmentation using label fusion is one of the most accurate state of the art image segmentation techniques available for biomedical imaging applications. Motivated to achieve higher image segmentation accuracy, reduce computational costs and a continuously increasing atlas data size, a robust framework for optimum selection of atlases for label fusion is vital. Although believed not to be critical for weighted label fusion techniques by some works (Sabuncu, M. R. et al., 2010, [1]), others have shown that appropriate atlas selection has several merits and can improve multi-atlas image segmentation accuracy (Aljabar et al., 2009, [2], Van de Velde …

Hispanic Use Of Alternative Medicine As Demonstrated In Internet Searches, Elad Yom-Tov, William F. Strong, Lupita Rodriguez Strong

Communication Faculty Publications

Objective: We investigated how cultural shifts occur with respect to the use of traditional medicine for influenza-like illness (ILI) within the Latino population near the US-Mexico border.

Methods: We extracted searches of ILI treatments (modern, traditional western, and traditional Hispanic) to the Bing search engine from 5 US states near the US-Mexico border. The incidence of these searches was correlated with county-level demographic data and ILI incidence.

Results: The fraction of queries related to Hispanic medicines is correlated with the distance from the US-Mexico border (Spearman rho = -0.24), which is a slower decay than that observed in the use …

Privacy, Trust, And Data Sharing In Web-Based And Mobile Research: Participant Perspectives In A Large Nationwide Sample Of Men Who Have Sex With Men In The United States, H. Jonathon Rendina, Brian Mustanski

Publications and Research

Background: Modern research is heavily reliant on online and mobile technologies, which is particularly true among historically hard-to-reach populations such as gay, bisexual, and other men who have sex with men (GBMSM). Despite this, very little empirical research has been published on participant perspectives about issues such as privacy, trust, and data sharing.

Objective: The objective of our study was to analyze data from an online sample of 11,032 GBMSM in the United States to examine their trust in and perspectives on privacy and data sharing within online and mobile research.

Methods: Participants were recruited via a social networking site …

Doodle Health: A Crowdsourcing Game For The Co-Design And Testing Of Pictographs To Reduce Disparities In Healthcare Communication, Carrie Christensen, Doug Redd, Erica Lake, Jean P. Shipman, Heather Aiono, Roger Altizer Jr., Bruce Bray, Qing Zeng

Clinical Research and Leadership Faculty Publications

Supplementing patient education content with pictographs can improve the comprehension and recall of information, especially patients with low health literacy. Pictograph design and testing, however, are costly and time consuming.

We created a Web-based game, Doodle Health, for crowdsourcing the drawing and validation of pictographs. The objective of this pilot study was to test the usability of the game and its appeal to healthcare consumers. The chief purpose of the game is to involve a diverse population in the co-design and evaluation of pictographs.

We conducted a community-based focus group to inform the game design. Game designers, health sciences librarians, …

Components Of Effective Cognitive-Behavioral Therapy For Pediatric Headache: A Mixed Methods Approach., Emily F. Law, Sarah E. Beals-Erickson, Emma Fisher, Emily A. Lang, Tonya M. Palermo

Manuscripts, Articles, Book Chapters and Other Papers

Internet-delivered treatment has the potential to expand access to evidence-based cognitive-behavioral therapy (CBT) for pediatric headache, and has demonstrated efficacy in small trials for some youth with headache. We used a mixed methods approach to identify effective components of CBT for this population. In Study 1, component profile analysis identified common interventions delivered in published RCTs of effective CBT protocols for pediatric headache delivered face-to-face or via the Internet. We identified a core set of three treatment components that were common across face-to-face and Internet protocols: 1) headache education, 2) relaxation training, and 3) cognitive interventions. Biofeedback was identified as …

Telehealth And Ehealth In Nurse Practitioner Training: Current Perspectives, Carolyn M. Rutledge, Karen Kott, Rebecca Poston, Christianne Fowler, Tina S. Haney

Ellmer School of Nursing Faculty Publications

Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this …