Medical Education Commons^™

Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel

Doctor of Nursing Practice Final Manuscripts

Abstract

Background

Congenital heart disease (CHD) is the most common birth defect and affects almost 1% of all live births. Treatment anxiety is common among children with CHD who undergo multiple procedures early in their lifetime. Dramatically increased life spans for this cardiac population has led to a shift from focusing on survival to their long-term health outcomes.

Methods:

Administration of the Peds QL Cardiac Module 3.0 assesses health related quality of life (HRQOL) during annual visits to a Cardiac Neurodevelopmental (ND) Clinic by evaluating the level of Treatment Anxiety a patient experiences during healthcare appointments. The questionnaire scores are …

A Guide To Vaccine Policy Change At A National Level, Janelle Bird

Doctor of Nursing Practice Final Manuscripts

Abstract

Health policy is in a near constant state of improvement. In order to solidify those improvements, health policy requires assistance from the upcoming generations of healthcare workers to push for those changes. Due to the outdated vaccination policy in the American Nurses Association (ANA), many states continued to issue exemptions based upon unsupported religious preferences. This helped to worsen the outbreak of measles in 2018-2019. The Previous ANA Policy on Vaccinations as of July 21, 2015 stated the ANA supports immunization exemptions only for the following reasons: Medical contraindications and Religious beliefs. Educate and train future health care professionals …

Use Of Artificial Intelligence To Identify Predictors Of Functional Outcomes In Patients With Facioscapulohumeral Muscular Dystrophy, Natalie K. Katz

Research Days

Background: Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common forms of muscular dystrophy characterized by slowly progressive muscle weakness. Symptoms initially involve the facial and shoulder girdle muscles, with later involvement of the distal lower extremities, pelvic girdle and proximal lower extremities. FSHD type 1 (FHSD1) is the most common form (~95% of individuals) and is caused by deletion of microsatellite repeats in the D4Z4 region on chromosome 4 (4q35). Normal individuals have >10 repeats whereas individuals with FSHD1 have 1-10 repeats. There is significant variability in regards to disease severity, rates of progression and functional outcomes, but …

A Study Examining The Safety And Efficacy Of Ferric Carboxymaltose In A Large Pediatric Cohort, Chandni Dargan Md, David Simon Do

Research Days

Background: Iron deficiency anemia (IDA) is common in the pediatric population with varying high-risk factors. Intravenous (IV) iron supplementation has become more desirable in patients with moderate to severe anemia and in patients who are either unresponsive to or have adverse side-effects secondary to oral iron. Iron sucrose and Iron dextran have been traditionally used in pediatrics while ferric carboxymaltose (FCM) has only been FDA approved in adults. One of the major advantages of FCM is the ease of dosing and efficacy. Though FCM was approved for adults in 2013 and there have been no safety concerns, it is not …

Low Dose Doxorubicin Inhibits Immune Checkpoint Upregulation In Acute Leukemias, Bradley C. Stockard

Research Days

Background: Evasion of drug and immune response in therapy-resistant leukemic stem cells (LSCs) is a major cause of relapse. A previous study has identified an alternative mechanism of action for low-dose doxorubicin (DXR) that inhibits upregulation of immune checkpoints (IC) in LSCs.

Objectives/Goal: The objective of this study is to establish the DXR dose range that will achieve the inhibition of immune checkpoint expression in leukemic cell lines.

Methods/Design: Cells were analyzed for expression of CTLA-4, LAG-3, PD-1, TIGIT, and TIM-3 via flow cytometry. Analysis was performed on days 3, 5, and 8 of treatment at concentrations identified as low, …

A Pediatric Case Of Treatment-Related Myelodysplastic Syndrome While On Therapy For Pre-B All, Sara Mcelroy

Research Days

Background: Treatment-related myelodysplastic syndrome (t-MDS) is a known, but rare, late effect of cancer therapy, specifically radiation, alkylating agents or topoisomerase II inhibitors. When secondary to treatment with alkylating agents, t-MDS typically occurs 4 to 7 years after therapy, and common cytogenetics include chromosomes 5 and 7 abnormalities. Treatment in children with t-MDS is typically allogeneic stem cell transplant, but the prognosis remains poor.

Objectives/Goal: To describe a rare case of a pediatric patient who developed t-MDS while receiving treatment for Pre-B Cell Acute Lymphoblastic Leukemia (pre-B ALL) and to outline the treatment regimen that he received.

Methods/Design: Case Report …

Outcomes Of Infants With Severe Rop At Risk Of Treatment With Avastin Compared To Laser Surgery, Stephen Doxey

Research Days

Background: Retinopathy of prematurity (ROP) is a well-known complication occurring in the most premature infants leading to visual impairment and in the most severe cases associated with retinal detachment and childhood blindness. Factors contributing the development of ROP include chronic hypoxia and disordered vascular genesis primarily through the vascular endothelial growth factor (VEGF) signaling pathway. Infants at risk of developing ROP are screened with serial eye exam and treated with either laser surgery or intraocular injects of bevacizumab (Avastin) to prevent progression of ROP and preserve vision. Bevacizumab, an inhibitor of VEGF signaling, may have positive effects on preventing ROP …

Pediatric Pulmonary Artery Aneurysms Causing Pulmonary Hemorrhage: A Case Of Transcatheter Intervention While On Va Ecmo Support, Igor Areinamo

Research Days

Background: The incidence of pulmonary artery aneurysm (PAA) in children remains unknown. There are few reports of a transcutaneous interventional approach to address this type of pathology. Management of PAAs while on VA ECMO has not been described in pediatrics.

Objectives/Goal:

Methods/Design:

Case: 9-year-old previously healthy male presented with MRSA associated ARDS and sepsis requiring urgent VA ECMO cannulation. Chest CT done on ECMO day 22 showed development of right sided PAAs. Patient had an episode of significant pulmonary hemorrhage. Angiogram demonstrated two fusiform right PAAs, one of which had ruptured and was bleeding into the lung parenchyma. Patient had …

Activation Of Aryl Hydrocarbon Receptor Signaling In Human Trophoblasts Alters Markers Of Growth And Differentiation, Asmaa Alsousi

Research Days

Background: It is estimated that 1.7% of pregnant women smoke during their pregnancy globally, with the highest levels observed in Europe at 8.1%, and lowest in Africa at 0.8. The association of maternal cigarette smoking with increased risk of poor birth outcomes such as preterm birth, congenital anomalies, and neonatal mortality is well-established. In addition, evidence suggests that intrauterine exposure to maternal smoking impacts the risk of developing diseases later in life; however, we still do not understand the exact mechanism(s) leading to these outcomes. Once components of cigarette smoke (CS) cross the placenta and enter the fetal compartment, several …

Phenotypic Characterization Of Jarid2-Related Intellectual Disability: A Case Series, Maxime Cadieux-Dion

Research Days

Background: In recent years, wide implementation of research and clinical next generation sequencing has led to an astonishing number of novel disease-gene assertions. Recently, loss of function variants in JARID2 were reported in 16 patients with a clinically distinct neurodevelopmental phenotype that consisted of neurodevelopmental delay, intellectual disability (ID), learning disability, autism and behavioral abnormalities. Dysmorphic features were seen in most patients and included high anterior hairline, deep-set eyes, full lips, broad forehead, bulbous nasal tip, or depressed nasal bridge. Cleft lip/palate was observed in only 1/16 patients. Most cases were de novo, with only one inherited case from an …

To Care When There Is No Cure: Chronic Illness And Medicine, Skylar Nash

Honors Theses

Millions of people worldwide are suffering from chronic illness at this very moment. Just in the United States, a little less than half of the entire population has been diagnosed with a chronic illness, and a large portion of those patients have been diagnosed with multiple chronic diseases. Those stricken by incurable illness are forced to face and manage their unique illness experience along with the side-effects of the disease itself. For this subset of the population, everyday normal activity can become relatively impossible to work through. There are financial, psychological, social, and physical obstacles to overcome every day that …

C25: The “Spot Sign”: A Predictor Of Hematoma Expansion, Mckenzie Merritt

Annual Research Symposium

No abstract provided.

C17: Programmed Cell Death Ligand- 1 Expression As A Prognostic Indicator In Oral Squamous Cell Carcinoma, Dr. Samar Saeed Khan

Annual Research Symposium

No abstract provided.

Physical Activity Patterns Among Adults With Arthritis And Diabetes Who Receive Self-Management Education, A. M. Hall, J. R. Churilla, D. C. Segura, M. R. Richardson, T. M. Johnson

Showcase of Osprey Advancements in Research and Scholarship (SOARS)

Project of Merit Winner

PURPOSE: To examine the physical activity (PA) patterns among adults with arthritis and diabetes who receive self-management education. METHODS: Sample (n=28,860) included adults (≥ 18 years of age), with arthritis and diabetes who participated in the 2019 Behavioral Risk Factor Surveillance System. Categories of PA were classified as highly active (HACT), moderately active (MACT), low activity (LACT), and inactive (INACT). Multinomial logistic regression analyses adjusted for age, gender, body mass index, race, smoking status, and socioeconomic status. RESULTS: When compared to a referent group of inactive adults, our findings suggest that adults with arthritis and diabetes …

Time To First Blood Glucose Determination And Administration Of Intravenous Glucose At Birth In Extremely Low Birth Weight Infants, Jihan Esmail, Ramasubbareddy Dhanireddy Md

Longitudinal Scholar's Project

Background: Extremely low birth weight (ELBW) infants are prone to hypoglycemia unless intravenous glucose is administered within an hour (golden hour) of life. These infants often require resuscitation at birth, but monitoring and intervention for hypoglycemia may be delayed.

Objectives: (1) Study the time to first blood glucose determination and IV glucose administration at birth in ELBW infants, (2) determine the incidence of hypoglycemia, <47mg/dl, and severe hypoglycemia, <40mg/dl, at admission, (3) determine risk factors for hypoglycemia, and (4) compare clinical outcomes at discharge between hypoglycemic and euglycemic infants.

Methods: 244 ELBW (≤1000g birth weight) infants born during Jan 2017- Feb 2020 at the Regional One Health NICU, Memphis, TN were included in the study. Data collected included maternal and infant clinical, demographic, and outcomes …

Hyperglycemia During The First Three Days Of Life Increases The Risk Of Retinopathy Of Prematurity In Extremely Low Birth Weight Infants, Jihan M. Esmail, Ramasubbareddy Dhanireddy Md

Longitudinal Scholar's Project

Background: The association between hyperglycemia and ROP has been inconsistent in previous studies. Extremely low birth weight (ELBW) infants are at high risk for ROP. They also experience hypoglycemia initially and hyperglycemia while receiving IV glucose infusion. The effect of initial hypoglycemia on hyperglycemia associated ROP risk is unknown.

Objective: To study the effect of initial hypoglycemia and subsequent hyperglycemia during the first three days of life on the incidence of ROP and severe ROP in ELBW (birth weight ≤1000g) infants.

Methods: Clinical and demographic data were collected from 227 ELBW infants born during the years 2017-2019 at the Regional …

Wellness Review 2020, Part 2, Brian Ferguson, Martin Huecker

Journal of Wellness

Introduction: This article comprises Part 2 of the Journal of Wellness review of 2020 wellness literature (July – December). In this review, JWellness editors continue the goal of offering a cohesive summary of recent publications within the wellness domain. We summarize new science and resilience initiatives published outside of JWellness that seek understanding of either burnout and its prevention or thriving in the medical community.

Methods: From the interval of 01 July – 31 Dec 2020, PubMed was queried for empirical research studies, review articles, and editorials in accordance with the following algorithm: an article was required to …

Common Questions And Misconceptions About Creatine Supplementation: What Does The Scientific Evidence Really Show?, Jose Antonio, Darren G Candow, Scott C Forbes, Bruno Gualano, Andrew R Jagim, Richard B Kreider, Eric S Rawson, Abbie E Smith-Ryan, Trisha A Vandusseldorp, Darryn S Willoughby, Tim N Ziegenfuss

Faculty, Staff and Students Publications

Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. …

Rising Trend Of Women In Gastroenterology: A Paradigm Shift, Lubna Kamani, Jeanin E Van Hooft

Section of Gastroenterology

No abstract provided.

Dermatology Technique: Mohs Micrographic Surgery, Michelle J. Volis

Mako: NSU Undergraduate Student Journal

This paper aims to educate the readers about a novel surgery approach that is becoming popular among dermatologists. This technique, Mohs surgery, is implemented in order to treat malignant skin cancer types. This paper incorporates the history of Mohs micrographic surgery, the advantages and disadvantages of the procedure, and alternatives to this approach. The main advantage is healthy tissue preservation while disadvantages include holes in fragmented tissue margins and tissue orientation complications.

Open Neuroscience Initiative, Austin Lim

College of Science and Health Full Text Publications

The Open Neuroscience Initiative is a free-to-use textbook

This project began as a means to overcoming the financial burden that face undergraduate neuroscience students when buying textbooks. By compiling and writing a completely free-to-access textbook that covers the foundations of a typical college introduction to neuroscience course, students would have one less obstacle to overcome in their educational career, allowing them to focus their valuable time and attention on learning rather than finances. To make this project a reality, I began with a humble tweet in May 2019 that managed to gain a tiny bit of traction among the neuroscience …

Current Standards Of Postgraduate Surgical Education And Training In Pakistan: Time To Bridge The Gaps In Lieu Of National Necessity, Sabah Uddin Saqib, Abdul Hakeem Memon, Omair Saleem, Amir Hafeez Shariff

Section of General Surgery

The provision of good-quality surgical care is a salient feature of every public health system. Pakistan is ranked among low and middle-income countries where the burden of surgical disease is rapidly increasing, but the capacity of the health system has not expanded at the same pace to cater current needs. One of the key components is the dearth of trained surgical specialists and lack of easy access to surgical care. College of Physicians and Surgeons, Pakistan is the main certifying institution for surgeons, while public and private teaching hospitals bear the burden of responsibility for surgical education and training. The …

An Innovation In Flipped Class Room: A Teaching Model To Facilitate Synchronous And Asynchronous Learning During A Pandemic, Rehana Rehman, Syeda Sadia Fatima

Department of Biological & Biomedical Sciences

Objective: To conduct an on line Flipped Class Room (FCR) to facilitate synchronous (in class activity) and asynchronous learning [Virtual Learning Environment (VLE)] and acquire feedback of the learning experience from medical students at Aga Khan University.
Methods: This interventional study was conducted with year II students undergoing Endocrine Reproduction Module at the Aga Khan University during April 13 to May 22, 2020. Pre reading material and pretest was shared with the students via Virtual Learning Environment (VLE) one week before the class. Microsoft Teams was used to conduct online session by two facilitators, where student discussion on case studies …

Genomic Education – Bench To Bedside: A Novel Approach To Teaching Genetic Diagnosis, J. Keith Williams, Michael M. Segal, Lynn K. Feldman

Internet Journal of Allied Health Sciences and Practice

Problem: Teaching genetic diagnosis is required in all medical schools and physician assistant programs. However, with thousands of relevant findings and thousands more rare diseases, lectures and narrative resources are inadequate for the task. Whatever information that is taught is easily forgotten and does not carry over into the clinic. Many rare disease patients suffer through “diagnostic odysseys” (3 to 30 years to correct diagnosis). Approach: We used a commercially available diagnostic decision support system (DDSS) that encompasses all Mendelian disorders with known genes, together with other conditions in their differential diagnosis, and a case-based educational approach to teach diagnostic …

Paradigm Shift In The Surgical Training: The Era Of Innovation, Simulation And Beyond, Syed Shahabuddin, Shiraz Hashmi, Yasir Khan, Shahid Ahmed Sami

Section of Cardiothoracic Surgery

This is an era of transformation of surgical education and training. Modern methods of training are being introduced at a rapid pace and are being adopted in surgical practice not only to improve the outcomes and patient satisfaction, but also to provide an opportunity to develop a new well-structured training curriculum by integrating both traditional and modern approaches to teach and learn surgical skills. Various surgical simulators are in use as training aids and are constantly undergoing further refinement and development. To achieve a smooth transition in surgical training to modern methods, a structured programme has to be developed and …

The Role Of Simulators In Improving Vitreoretinal Surgery Training - A Systematic Review, Taha Muneer Ahmed, Rehman Siddiqui

Medical College Documents

Objective: To conduct an appraisal of current evidence regarding the effectiveness of EyeSi®-based training of vitreoretinal surgery.
Methods: The systematic review was conducted in July 2020, and comprised literature search on Cochrane Library, PubMed and Embase for articles regarding simulation training in vitreoretinal surgery. The shortlisted articles were subjected to qualitative analysis. Existing evidence was assessed, and predictions on how outcomes may be applied to improve vitreoretinal surgery training were made. The risk of bias of each study was calculated in line with the guidelines of the Cochrane Handbook.
Results: Of the 124 articles identified, 7(5.6%) were shortlisted; 5(71.4%) established …

Promotion Of Most Forms Through Education About Importance Of Advance Care Planning In Seriously Ill Patients, Nidhi More

DNP Projects

Abstract

Purpose: To establish the importance of early Advance Care Planning (ACP) and improve the utilization of Medical Orders for Scope of Treatment (MOST) forms in seriously ill patients by educating providers and nurses to identify patients who meet specified criteria. The goals of this intervention are reduction of readmissions and better quality of life for this patient population.

Methods: A quasi-experimental design was used for evaluation of an Educational intervention to promote MOST forms, Advance Directives (AD) and Palliative Care (PC) consults. A retrospective and prospective chart review was conducted to determine the number of patients who met criteria …

Evaluating The Effect Of An Electronic Health Record Patient Portal On The Management Of Hypertension, Ashley Hall

DNP Projects

Background: Hypertension is the leading cause of cardiovascular disease and affects individuals globally, nationally, and locally. Consequences of uncontrolled hypertension include atherosclerosis, heart failure, stroke, and renal disease. The electronic health portal is a patient-specific, interactive tool that has been shown to promote adherence to provider recommendations and improve chronic disease management.

Purpose: The purpose of this project was to determine the effects of education via an electronic healthcare portal on the blood pressure management of adults at a primary care clinic in a small town in Kentucky.

Methods: This study was a one-group pre/post intervention designed to evaluate provider …

Online Medical Education And Examinations During Covid-19: Perspectives Of A Teaching Associate, Syed Mujtaba Baqir, Fatima Mustansir

Department of Biological & Biomedical Sciences

The novel coronavirus disease 2019 (COVID-19) pandemic has not only challenged global health systems but also social, economic, and educational systems. In this short communication, our focus is on its impact on medical education in Pakistan. We discuss the structure of undergraduate medical education in Pakistan; and how it has evolved in the wake of COVID-19. We describe our role as teaching associates (TAs) at the Aga Khan University (AKU); and how it has enabled us to be a part of the transition to online medical education, with a specific focus on online examinations in medical schools.

Racial Disparities In Liver Disease In The Us: Addressing The High Prevalence Of Hepatitis B Infection In The Apia Community, Lindsey L. Trinh, Lindsey Trinh

Scripps Senior Theses

Chronic liver disease and hepatocellular carcinoma are some of the leading causes of death in the United States, resulting in a number of annual deaths that has only increased over the past several decades. A vast proportion of these liver-related deaths is due to chronic hepatitis B infection, which currently affects approximately 1.2 million people in the US. However, the hepatitis B virus does not affect every racial group in the United States equally: Asian Americans experience a disproportionately high prevalence of HBV infection. In fact, even though the APIA community comprises only 4% of the US population, they account …