Medical Education Commons^™

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Student Research Posters

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care based training, with …

Management Of Opioid Use Disorder In Primary Care, Carolyn Jeffries

Capstone Showcase

The prevalence of opioid use disorder (OUD) in the United States, and worldwide, has drastically increased in the span of 2-3 years. OUD is considered chronic condition and as such requires routine care over a lifetime. This makes OUD patients excellent candidates to be managed by primary care providers (PCPs). This article discusses the various barriers to treatment of OUD in a primary care setting as well methods and models that aim to mitigate these barriers. We will also review how to take a detailed assessment of an OUD patient, mainstays of medication assisted treatment (MAT), and management of side …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Electronic Cigarettes And Young Adults: Use Of Screening Tools And Provider Knowledge, Kayla Erin Chelf

DNP Projects

Background: Electronic Cigarette (e-cigarette) use is now more common than traditional cigarette use in adolescents and young adults (Dinardo & Rome, 2019). There is concern that the lack of screening for use and knowledge about the health consequences of e-cigarette use is driving this growth.

Objective: The purposes of this project were to (1) assess baseline e-cigarette knowledge and screening practices from healthcare professionals, and (2) evaluate changes in knowledge after delivery of an educational intervention about e-cigarettes.

Methods: In this quasi-experimental study a seven-question survey on screening practice and knowledge concerning e-cigarettes in young adults was posted on the …

Beyond Breathless: Unravelling The Enigma Of Pulmonary Arteriovenous Malformations, Sri Mounya Jampala, Jagadish Kumar K Dr., Manjunath V G, Nandish H R

Digital Journal of Clinical Medicine

Pulmonary Arteriovenous Malformations (AVMs) are abnormal connections between the pulmonary arteries and veins, leading to a direct shunting of blood without passing through the normal capillary bed. These AVMs can be associated with a rare genetic disorder called Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome. HHT is an autosomal dominant disorder characterized by the development of fragile telangiectasias in various organs, including the skin and mucous membranes. These telangiectasias are prone to bleeding, leading to recurrent nosebleeds and mucocutaneous bleeding. In patients with HHT, the most common site of AVMs is in the lungs. Pulmonary AVMs can cause …

Stroke: A Neurological Complication In Covid-19., Abhigna M, Vikram Patil

Digital Journal of Clinical Medicine

No abstract provided.

The Trichobezoar Enigma: Untangling The Intricacies Of Rapunzel Syndrome, Debabrata Sahu, Dr Rajkishor Sahu

Digital Journal of Clinical Medicine

Rapunzel Syndrome is a rare manifestation of trichobezoar, characterized by the presence of hair strands extending beyond the stomach and into the duodenum. Trichobezoars typically develop in individuals with a history of trichotillomania, a compulsive behavioral disorder involving hair-pulling, combined with trichophagia, the ingestion of hair. While trichobezoars predominantly form within the stomach, their occurrence in the jejunum is infrequent. This condition is more commonly observed in adolescent females.

The formation of bezoars within the gastrointestinal tract is typically attributed to anatomical changes. However, in cases where no such anatomical abnormalities are present, psychiatric disorders like trichotillomania can lead to …

Modified Electroconvulsive Therapy As Maintenance Treatment, Jatin Kumar, Kishor M, Murali M R

Digital Journal of Clinical Medicine

Depression is the most common psychiatric condition that significantly affects the quality of life of individual affected with it and it can present with various signs and symptoms. It usually presents with persistent and pervasive sadness of mood, anhedonia, sleep disturbance, reduced appetite, reduced concentration, multiple somatic symptoms, and suicidal thoughts. In this case report a 61-year-old gentleman presented with sadness of mood, loss of interest, sleep disturbance, multiple body aches, and abdominal pain which varied from 2 to 6 weeks. He had failed to respond to multiple classes of antidepressants, mood stabilizers, and antipsychotics. However, he would respond well …

Cerebral Venous Thrombosis In Pregnancy : A Case Report, Dr Sumuk M S Sr, Dr Anupama Marnal B A Sr, Dr Mamatha S Professor And Head Of The Department, Poornima M Associate Professor

Digital Journal of Clinical Medicine

Cerebral venous thrombosis (CVT) is a rare complication encountered in pregnancy. Symptoms of CVT include headache, limb paresis, seizures , disturbed consciousness , visual disturbances. We present our 25 years old pregnant patient who presented with unsteadiness of gait , weakness and numbness of all four limbs, vomiting headache , giddiness due to which it was difficult for her to perform her daily activities. After the differential diagnostic examinations, we recognised cerebral venous thrombosis. After anti-coagulant treatment , the symptoms resolved. We would like to convey that such symptoms in pregnant women we should always think of CVT.

Relationship Between Femoral Artery Intima-Media Thickness And Atherosclerosis In Patients With Chronic Kidney Disease- A One Year Hospital-Based Cross-Sectional Study, Dr. Somashekhar Sogi, Dr. Ravi Sarvi, Dr. Pradeep Goudar, Dr. Mallikarjun Karishetti, Dr.V.V Hattiholi, Dr.Meenakshi Sarvi

Digital Journal of Clinical Medicine

Introduction: Chronic kidney disease (CKD) is one of the leading causes of morbidity and mortality worldwide. CKD and Peripheral arterial disease both independently increase the risk for cardiovascular disease (CVD) events and contribute significantly to morbidity and mortality. There is limited data about the co-relation between ultrasound measures of the femoral artery in peripheral vascular disease (PVD) & renal functional status. This research hence will help us in the establishment of a relationship between femoral intima-media thickness (fIMT) with CKD. Also, IMT assessment might help in earlier detection of atherosclerotic plaques & hence PVD.

Materials and methods: A cross sectional …

Hyperdiploid Chromosomes In Patients With B Cell Acute Lymphoblastic Leukemia, Anjali Shastry

Digital Journal of Clinical Medicine

Introduction: Hyperdiploidy (more than 50 chromosomes) is an important cytogenetic abnormality found in B cell acute lymphoblastic leukemia (B cell ALL). The presence of hyperdiploidy > 50 is considered to be a good prognostic marker since it has increased sensitivity to standard chemotherapy. Patients with hyperdiploidy have the longest disease-free survival compared with any other cytogenetic group.

Aim of study:

To estimate prevalence of hyperdiploid chromosomes in patients with B cell ALL through conventional karyotyping and Fluorescent in situ hybridization (FISH).

Materials and methods:

Retrospective study was done on 200 bone marrow samples diagnosed with B cell Acute lymphoblastic leukemia …

Dengue Fever With Normal Platelet Count In A Patient With Β-Thalassemia Trait: A Case Report, Pankaj Kumar Jain, Manoj Seval, Vikas Meena, Rajesh Yadav

Digital Journal of Clinical Medicine

Dengue fever is an arboviral infection typically characterized by thrombocytopenia and hemoconcentration. However, hematological manifestations may differ in patients with underlying hemoglobinopathies. We report a case of 18-year-old female diagnosed with dengue fever (IgM ELISA positive), presented with persistent fever, vomiting, and myalgia. Laboratory evaluation revealed moderate microcytic anemia (Hb 9.7 g/dL, MCV 54.7 fL) with a low Mentzer index (8.7). High-performance liquid chromatography confirmed β-thalassemia trait (HbA2 4.6%). Contrary to the typical presentation of dengue, the patient had elevated platelet counts at admission (584,000/µL), which remained within normal to high range during hospitalization. This case highlights that dengue infection …

Effect Of Relaxation Intervention On Stress Levels And Cognitive Skills In Professional Students, Sandhra Sabu, Ravikiran Kisan, . Swapnali

Digital Journal of Clinical Medicine

Background: Medical Professional training is likely to encounter a variety of hassles and stress in relation to the developmental tasks associated with transition from school life to professional college life. The vast syllabus, peer competition for academic performance, continuous evaluation, and long duration of the training makes medical education stressful. Many students feel a need to relieve stress and it is a necessity to equip students with proven techniques to reduce stress and cope up with the situation. Proper cognitive functioning has been found to be an important factor for academic performance.

Methods: The present study is a cross …

Association Between Surgical Technical Skills And Clinical Outcomes: A Systematic Literature Review And Meta-Analysis, Michael S Woods, Joshua N Liberman, Pinyao Rui, Emily Wiggins, Joan White, Bruce Ramshaw, Jonah J Stulberg

Faculty, Staff and Student Publications

BACKGROUND: A systematic literature review and meta-analysis was conducted to assess the association between intraoperative surgical skill and clinical outcomes.

METHODS: Peer-reviewed, original research articles published through August 31, 2021 were identified from PubMed and Embase. From the 1,513 potential articles, seven met eligibility requirements, reporting on 151 surgeons and 17,932 procedures. All included retrospective assessment of operative videos. Associations between surgical skill and outcomes were assessed by pooling odds ratios (OR) using random-effects models with the inverse variance method. Eligible studies included pancreaticoduodenectomy, gastric bypass, laparoscopic gastrectomy, prostatectomy, colorectal, and hemicolectomy procedures.

RESULTS: Meta-analytic pooling identified significant associations between …

Medical Ethics Principles Underscore Advocating For Human Papillomavirus Vaccine, C Mary Healy, Lara S Savas, Ross Shegog, Rebecca Lunstroth, Sally W Vernon

Faculty, Staff and Student Publications

Studies have consistently shown that vaccination rates against human papillomavirus (HPV) lag far behind other adolescent vaccinations recommended at the same age, resulting in exposing adolescents to unnecessary future risk of infection, and genital and head and neck cancers. Studies also have demonstrated that a major barrier to vaccination is lack of a strong provider recommendation. Factors that providers offer for failing to give a strong recommendation range from perception that the child is not at risk or the need to explain that the vaccine is not mandated (lack of equity and justice) or respect for parental autonomy. We look …

Perceived Stress And Its Relationship To Moral Resilience Among Nurses In The Hail Region, Saudi Arabia, Hamdan Albaqawi, Maha Sanat Alrashidi

Makara Journal of Health Research

Background: This study aimed to determine the relationship between perceived stress and moral resilience among nurses.

Methods: The researcher used a quantitative–comparative correlational study design that utilized a self-administered questionnaire with 393 nurse participants in the Hail Region, Saudi Arabia. Adapted questionnaires were distributed through Google Form survey. Data collection was conducted between October and November 2021.

Results: The nurses were moderately stressed (21.69/30) but morally resilient (2.74/4). Perceived stress scale (p < 0.033) and moral resilience (p < 0.25) were found to be significantly associated with gender. The designated ward and age were not significantly associated with perceived stress and moral resilience. Conversely, the years of experience showed a significant association with perceived stress (p < 0.038) but not with moral resilience (p > 0.255). Finally, no relationship was observed between perceived stress and moral resilience (p > 0.248).

Conclusions: The nurses were perceived …

The Effect Of A Wellness Curriculum On First Semester Jmu Pa Students, Abigail Larson, Jeanine Aberbook

Physician Assistant Capstones, 2020-current

Physician Assistant (PA) programs are rigorous graduate-level medical programs that achieve a Master’s degree but complete an equal number of credits as a Doctorate degree. They are notorious for triggering high levels of stress pre-matriculation as well as upon matriculation. While this is a well-known topic discussed between students and incoming students, it is an under-researched topic. As a result of the lack of research in physician assistant education regarding implementing a wellness curriculum and the desire to reduce stress, anxiety, and depression symptoms in first semester PA student, the faculty and students at James Madison University (JMU) implemented a …

A Case Of Inferior Dislocation Of Right Shoulder, Gauri A. Nair

Digital Journal of Clinical Medicine

Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form. It appears in less than 0.5% of all shoulder dislocations. Patient characteristically presents with an arm locked in upright position - Luxatio erecta. Its etiology, clinical presentation and radiographic findings are distinct. An awareness of associated potential neurovascular injuries and rotator cuff tears is important in this rare entity and should be excluded with high index of suspicion. Preferred modality of treatment depends upon the age of the patient and the extent of neurovascular involvement. …

Personality Disorder Predisposing To Alcohol Dependence, Samarchitha S Ms., Venkatesh Babu Dr., Megha Sadashiv Dr., Sudeep Pk Mr.

Digital Journal of Clinical Medicine

No abstract provided.

High-Velocity Fracture: Case Of Displaced Intertrochanteric Fracture Offemur With Spiral Fracture Of Shaft Of Right Femur, Gayathri Sureshkumar Nair

Digital Journal of Clinical Medicine

BACKGROUND

Intertrochanteric fracture is a common orthopedic condition characterized by extracapsular fractures of the proximal femur that occur between the greater and lesser trochanter with predominance in elderly population, especially those with osteoporosis, wherein even a low energy mechanism is enough to cause the fracture.

There is an observed female predominance with ratio between 2:1 and 8:1. [1,2]

Commonly observed symptoms include shortened and externally rotated limb, pain and bony tenderness around the hip joint, inability to bear weight on the affected limb to name a few.

Management depends upon age of patient, nature of the fracture, number of comminuted …

Comparison Of Conventional Pap Smear And Manual Liquid Based Cytology With P16 Marker In Screening For Cervical Cancer In Indian Tertiary Healthcare Setups In Mysuru, Gayathri Sureshkumar Nair, Nandini Manoli, Nandish Manoli

Digital Journal of Clinical Medicine

In India, there are 20.2 per 100000 new cases of Cervical Cancer diagnosed and 11.1 per 100000 deaths annually accounting for more than one fifths of global cervical cancer deaths. [1] Thus, due to an absence of a national immunization program to cover human papillomavirus (HPV) vaccination and lack of accessible cervical cancer screening, the disease is characterized by late detection, lack of access to affordable and quality health care, and high mortality rates. [2]

Papanicolaou Smear Test was a novel invention by Dr George Papanicolaou in the year 1927 which gained maximum popularity in 1950 as a screening test …

Health Care Transition Experiences Of Youth With Intellectual Disabilities In A Post-Secondary Inclusive Program, Faith Duensing

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Between the ages of 18-21 years old, youth and young adults make the transition from pediatric to adult health care. While it may be an easy and seamless transition for some, that is not always the case, especially for youth and young adults with disabilities. Youth with disabilities experience several distinct health disparities compared to their peers without disabilities and these can be carried over to impact their health care transition (HCT) process. The purpose of this study was to learn more about the HCT experiences of young adults with disabilities and their families to learn and develop ways that …

Sex-Related Differences In Violence Exposure, Neural Reactivity To Threat, And Mental Health, Heather E Dark, Nathaniel G Harnett, Danielle R Hurst, Muriah D Wheelock, Kimberly H Wood, Adam M Goodman, Sylvie Mrug, Marc N Elliott, Susan Tortolero Emery, Mark A Schuster, David C Knight

Faculty, Staff and Student Publications

The prefrontal cortex (PFC), hippocampus, and amygdala play an important role in emotional health. However, adverse life events (e.g., violence exposure) affect the function of these brain regions, which may lead to disorders such as depression and anxiety. Depression and anxiety disproportionately affect women compared to men, and this disparity may reflect sex differences in the neural processes that underlie emotion expression and regulation. The present study investigated sex differences in the relationship between violence exposure and the neural processes that underlie emotion regulation. In the present study, 200 participants completed a Pavlovian fear conditioning procedure in which cued and …

Reproducing Statistics Performed In Published Randomized Controlled Trials, Naila H Dhanani, Oscar A Olavarria, Cynthia S Bell, Julie L Holihan, Mike K Liang

Faculty, Staff and Student Publications

INTRODUCTION: Randomized controlled trials (RCT) represent evidence at the lowest potential risk for bias. Clinicians in all specialties depend upon RCTs to guide patient care. Issues such as statistical discordance, or reporting statistical results that cannot be reproduced, should be uncommon. Our aim was to confirm the statistical reproducibility of published RCTs.

METHODS: PubMed was searched using "randomized controlled trial." Studies were selected using a random number generator. Studies were included if the primary outcome could be reproduced using the data and statistical test reported in the manuscript. The reproduced p-value from our analysis and the published p-value were compared. …

Development And Use Of A Survey Tool To Prioritize And Catalyze Change Surrounding Faculty Wellness In A Department Of Pediatrics, Sarah Rhoads, Alison Riese, Mohammed Faizan, Lloyd Feit, Shuba Kamath, Albert Ross, Katherine Mason

Journal of Wellness

Introduction: Physician wellness is an important factor in the delivery of safe, effective and humanistic patient care. There is compelling data describing the widespread prevalence of physician burnout and its subsequent adverse impact on patient care, healthcare costs, and relationships. Initiatives to improve wellness are necessary to maintain the healthcare work force as well as to ensure high-quality care. This project investigated faculty physicians’ attitudes and priorities regarding physician wellness within the department of Pediatrics at a single-center academic institution.

Methods: A survey was created and distributed via e-mail to all faculty physicians employed within the Department of Pediatrics in …

Understanding The Mental Health Impact And Needs Of Public Healthcare Professionals During Covid-19 In Pakistan : A Qualitative Study, Waqas Hameed, Anam Shahil Feroz, Bilal Iqbal Avan, Bushra Khan, Zafar Fatmi, Noreen Afzal, Hussain Jafri, Mansoor Ali Wassan, Sameen Siddiqi

Community Health Sciences

Objectives: A dearth of qualitative studies constrains in-depth understanding of health service providers' perspectives and experiences regarding the impact of COVID-19 on their mental health. This study explored the mental health impact and needs of of public sector healthcare workers during COVID-19 who working in secondary-level and tertiary-level healthcare settings of Pakistan.
Design: An exploratory qualitative study.
Setting: Twenty-five secondary-level and eight tertiary-level public hospitals of Sindh and Punjab provinces of Pakistan.
Participants: In-depth interviews were conducted with 16 health service providers and 40 administrative personnel. Study data were analysed on NVivo V.11 using the conventional content analysis technique.
Results: …

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Using Social Media To Examine Disabled Veterans’ Adaptive Sports Lived Experience At The National Veterans’ Wheelchair Games, Heather Harding

Graduate Theses, Dissertations, and Capstones

Considered the world’s largest annual rehabilitative wheelchair games event for Veterans in the United States, the National Veterans Wheelchair Games (NVWG or the Games), co-hosted annually by the Department of Veterans Affairs and Paralyzed Veterans of America, is a long-standing event that offers a view into how adaptive sports and recreational activities can impact Veterans with disabilities. This hermeneutic phenomenological qualitative study sought to discover if the Veteran athletes, who participated in the NVWG between 2017 and 2021, described their lived experiences through the lens of their public social media posts on Instagram, and if so, what can be gleaned …

Conference Proceedings: Select Abstracts Presented At Advocate Aurora Scientific Day 2022

Journal of Patient-Centered Research and Reviews

The abstracts published in this supplement were presented at the 48th annual Advocate Aurora Scientific Day on May 25, 2022. This scholarly symposium provides a closed forum for sharing preliminary results from research studies conducted by faculty physicians and nurses, fellows, residents, scientists, and other health professionals associated with U.S. Midwest-based health system Advocate Aurora Health, publisher of the Journal of Patient-Centered Research and Reviews.

Medicine And Motherhood: The Silent Loads, Gehan A. Pendlebury

be Still

This poem articulates the challenging and often misunderstood experience of being a mother in medical school It describes a silent load that often takes a toll on mothers in medicine It describes the feeling of simultaneously being pulled in opposing directions, the pain of missing on special family moments and events The poem offers hope and solidarity for mothers who are enduring this unique experience.