Medical Specialties Commons^™

The Coronavirus And The Risks To The Elderly In Long-Term Care, William Gardner, David States, Nicholas Bagley

Articles

The elderly in long-term care (LTC) and their caregiving staff are at elevated risk from COVID-19. Outbreaks in LTC facilities can threaten the health care system. COVID-19 suppression should focus on testing and infection control at LTC facilities. Policies should also be developed to ensure that LTC facilities remain adequately staffed and that infection control protocols are closely followed. Family will not be able to visit LTC facilities, increasing isolation and vulnerability to abuse and neglect. To protect residents and staff, supervision of LTC facilities should remain a priority during the pandemic.

A Descriptive Study Of Racial Inequalities In Mortality From Hepatocellular Cancer Before And After Licensure Of Lifesaving Drugs For Hepatitis C Virus In The United States, Robert S Levine, Maria C Mejia, Jason L Salemi, Sandra J Gonzalez, Muktar H Aliyu, Baqar A Husaini, Roger J Zoorob, Charles H Hennekens

Faculty, Staff and Students Publications

BACKGROUND: Since 1979, mortality from hepatocellular cancer (HCC) has doubled in the United States (US). Lifesaving drugs, prohibitively expensive for some, were approved and marketed to treat hepatitis C virus (HCV), a major risk factor for HCC, beginning in 1997. After the prior introduction of other lifesaving innovations, including active retroviral drug therapy for human immunodeficiency virus and surfactant for respiratory distress syndrome of the newborn, racial inequalities in their mortalities increased in the US. In this descriptive study, we explored racial inequalities in mortality from HCC before and after licensure of HCV drugs in the US.

METHODS: The US …

Reasons For Facebook Usage: Data From 46 Countries, Marta Kowal, Piotr Sorokowski, Agnieszka Sorokowska, Małgorzata Dobrowolska, Katarzyna Pisanski, Anna Oleszkiewicz, Toivo Aavik, Grace Akello, Charlotte Alm, Rizwana Shaikh

Department of Paediatrics and Child Health

No abstract provided.

Promoting Resilience In Self-Management (Prism): Adverse Childhood Experiences And Impacts On Emotion Regulation, Kasey Ann Macedo

Honors Scholar Theses

PRISM (Promoting Resilience in Self-Management) is a mindfulness-based intervention that aims to strengthen emotion regulation skills among individuals by employing cognitive behavioral therapy components. The purpose of the current study is to identify the relationship between adverse childhood experiences (ACEs) and depression, as well as to examine the changes in emotion regulation strategies of participants by comparing pre and post test data. The participants were voluntarily recruited from the Cornerstone Foundation, a homeless shelter, food pantry, and community center in Vernon, CT. The 13 participants completed PRISM through four weeks of two-hour workshop sessions in a small-group format. Results indicate …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

Finding Common Threads: How Patients, Physicians And Nurses Perceive The Patient Gown, Christy M. Lucas, Cheryl Dellasega

Patient Experience Journal

Evidence-based care is standard practice in medicine, but the patient gown has fallen outside the scope of scholarly research. The current gown renders a patient vulnerable, diminishing patients’ sense of identity, agency, and dignity with its one-size-fits-none design. The impact on providers is similarly neglected. Our objective was to explore how patients and providers derive meaning from patient gowns. A convenience sample at an academic medical center was interviewed utilizing a standardized framework developed by a medical student and two PhD-prepared researchers with experience in qualitative methods. The study was inductive in nature, seeking to understand perceptions of the patient …

Giving Credence To The Experience Of X-Linked Hypophosphatemia In Adulthood: An Interprofessional Mixed-Methods Study, Melissa Hughes, Carolyn Macica, Catherine Meriano, Maya Doyle

Journal of Patient-Centered Research and Reviews

Purpose: X-linked hypophosphatemia (XLH) is a rare X-linked dominant metabolic bone disease, often diagnosed in childhood but causing increasing physical debilitation and pain in adulthood. Physical comorbidities of XLH in adulthood include pervasive and early-onset degenerative arthritis, mineralizing enthesophytes and osteophytes, osteomalacia and pseudofracture, dental abscesses, and hearing loss.

Methods: This mixed-methods analysis included physical findings, diagnostic imaging, occupational and physical therapy assessments, and semi-structured interviews by social work to understand the functional outcomes and lived experience of XLH in adulthood, through connections between qualitative data obtained by social work and occupational therapy with the quantitative findings from other disciplines. …

Perceived Impact Of Non-Contact Boxing On Daily Life And Occupational Participation At Home Among Individuals With Parkinson's Disease, Kristen E. Bignal

Student Capstone Papers

The aim of this project was to determine whether individuals with Parkinson's disease perceive an impact on their daily life and occupational participation at home secondary to participation in non-contact boxing.

Semi-structured open-ended interview questions were conducted with 17 participants (3 female) who have been diagnosed with Parkinson's disease for(i.e., self-care, home and health maintenance, sleep, intimacy, social and leisure interests, etc.) in the home environment. Interviews were transcribed and analyzed utilizing thematic analysis.

Data analysis derived three overarching themes including psychological benefits, sense of community, and framework to develop routines. Subsequent research exploring how non-contact boxing directly impacts specific …

Cardiovascular Recovery From Emotional Stress: An Operationalization Of Equanamity Following Mindfulness-Based Emotional Stress, Emma Mcbride

Theses and Dissertations

Theoretical models of mindfulness suggest that meditation may improve health, in part, by regulating stress physiology, including faster recovery of heart rate (HR) and blood pressure (SBP/DBP) after emotional stress. Furthermore, improved cardiovascular recovery (CR) may be a marker of equanimity, defined as increased acceptance of and reduced reactivity to stress. No studies have tested this hypothesis, partly because methodology for assessing CR remains controversial. Using a novel operationalization of equanimity and several methods of measuring CR, this project investigated whether (1) equanimity is associated with improved CR, (2) Mindfulness-Based Stress Reduction (MBSR) is associated with improved CR, and (3) …

When Rationing Becomes Part Of Clinical Decision-Making, Christopher A. Hopper, Mitra Bahaee

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical practice-based reflection on Noack DP, Newton G. Compared to maximal current management standards, oscillating positive expiratory pressure devices have not been shown to improve clinically relevant outcomes in COPD patients with acute exacerbation. Clin. Res. Prac. 2017;3(2):eP1516. doi: 10.22237/crp/149886732.

Sleep Deprivation And High-Fat Diet During Adolescence Protect Stress Effects On Object Memory During Adulthood, Karina Glushchak

Honors Scholars Collaborative Projects

No abstract provided.

Clinical Support: An Unconventional Request – Providence’S 100 Million Masks Initiative, Carrie Grinstead, Heather J. Martin, Laurie Schwing (Ed.)

Articles, Abstracts, and Reports

In early March, Seattle, WA, was the epicenter of the US COVID-19 pandemic. Providence St. Joseph Health had seen the first reported US case of COVID-19 on January 20 [1] and quickly found itself responding to a growing crisis, with little information about how best to care for patients while protecting frontline staff.

On March 16, 2020, Providence System Library Services received an email from senior leadership with the subject line: “Urgent – An Unconventional Request.” We were asked to pause all other work to search for viable mask patterns that could be easily and quickly made at home by …

A Crisis Is A Terrible Thing To Waste: Recovering A Sense Of Agency In Coronavirus Times, Steven F. Freeman

School of Continuing and Professional Studies Coronavirus Papers

No abstract provided.

Evaluation Of An Advanced Quality Improvement Program, Arjun M. Dangre Bds Mph, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Texas Children’s Hospital implemented the Advanced Quality Improvement and Patient Safety Program (AQI) in 2009, designed to train clinicians and staff to develop leaders in quality improvement to improve patient care, lower costs, change culture, and lead improvement initiatives at the organization. Evaluations of the AQI programs measured the program’s effectiveness in achieving its goals and objectives. This paper describes the Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety program (AQI,) the program’s evaluation processes, and show the results of the evaluation of the AQI programs using evaluation surveys completed by QI participants over the span of 13 successful …

De Novo Frameshift Variants In The Neuronal Splicing Factor Nova2 Result In A Common C-Terminal Extension And Cause A Severe Form Of Neurodevelopmental Disorder, Francesca Mattioli, Gaelle Hayot, Nathalie Drouot, Bertrand Isidor, Jérémie Courraud, Maria-Victoria Hinckelmann, Frederic Tran Mau-Them, Chantal Sellier, Alica Goldman, Aida Telegrafi, Alicia Boughton, Candace Gamble, Sebastien Moutton, Angélique Quartier, Nolwenn Jean, Paul Van Ness, Sarah Grotto, Sophie Nambot, Ganka Douglas, Yue Cindy Si, Jamel Chelly, Zohra Shad, Elisabeth Kaplan, Richard Dineen, Christelle Golzio, Nicolas Charlet-Berguerand, Jean-Louis Mandel, Amélie Piton

Faculty, Staff and Students Publications

The neuro-oncological ventral antigen 2 (NOVA2) protein is a major factor regulating neuron-specific alternative splicing (AS), previously associated with an acquired neurologic condition, the paraneoplastic opsoclonus-myoclonus ataxia (POMA). We report here six individuals with de novo frameshift variants in NOVA2 affected with a severe neurodevelopmental disorder characterized by intellectual disability (ID), motor and speech delay, autistic features, hypotonia, feeding difficulties, spasticity or ataxic gait, and abnormal brain MRI. The six variants lead to the same reading frame, adding a common proline rich C-terminal part instead of the last KH RNA binding domain. We detected 41 genes differentially spliced after NOVA2 …

Medical Trust In Pediatric Care In The United States, Talia Feldscher

Independent Study Project (ISP) Collection

Trust is a critical aspect of the patient-provider dynamic, but in the U.S., its importance is overlooked in many medical settings, especially among those from low socio-economic groups. As the disparities in American healthcare are being recognized on a larger scale, it is necessary to further uncover why this is the case, and how to begin to remedy this disparity. This study presents an original qualitative data set of perspectives from four current health/mental health practitioners, based on their experiences with their pediatric patients, and how the concept of trust is critical to their service provision. Supported by literature, this …

An Overview Of Supply-Chain Logistics In International Humanitarian Aid: Finding Challenges And Solutions, Arjun Ganga

Independent Study Project (ISP) Collection

Humanitarian supply chain logistics concern the flow of goods and services in public health delivery. Such supply chains operate in both general development contexts and in acute crisis situations. In this paper, I give an overview of supply chains and then explore some of the challenges and potential solutions in delivering goods and services effectively and efficiently. Specifically, I analyze procurement, maintaining quality goods, incentivizing countries to act, collaboration, verification, possible losses in the supply chain, and ensuring appropriate use of product. I conclude that although humanitarian supply chains pose unique challenges, there is surprising efficiency in the system. This …

(Des)Cuidando A Quienes Nos Crían: Una Exploración Cualitativa Del Abordaje Para El Diagnóstico, La Prevención Y El Tratamiento De La Depresión Posparto En La Ciudad Autónoma De Buenos Aires (2020) / (In)Adequate Care For Those Who Raise Us: A Qualitative Exploration Of The Approach To Diagnosis, Prevention And Treatment Of Postpartum Depression In The City Of Buenos Aires (2020), April Hopcroft

Independent Study Project (ISP) Collection

Aunque el embarazo y la maternidad están representadas como periodos de alegría, la llegada de un bebé es una transición significativa en la vida que también puede provocar sentimientos de ansiedad y depresión. La depresión posparto (DPP) es un trastorno de estado de ánimo que plantea consecuencias graves para ambas madre y bebé. Dada la vacancia de investigación en la Argentina, este trabajo pretende analizar el abordaje actual de intervención de la DPP en la Ciudad Autónoma de Buenos Aires. Los objetivos específicos son: 1) identificar y describir el proceso de diagnóstico, prevención y tratamiento, y 2) indagar las percepciones …

Las Perspectivas Y Experiencias De Los Profesionales Del Campo De La Reproducción Asistida En La Ciudad Autónoma De Buenos Aires Y Bahía Blanca En El Año 2020. / The Perspectives And Experiences Of The Professionals In The Field Of Assisted Reproduction In The Autonomous City Of Buenos Aires And Bahía Blanca In 2020., Calder Hollond

Independent Study Project (ISP) Collection

En este informe se realiza una exploración del campo de la reproducción asistida en Argentina en 2020 a través de entrevistas personales con seis profesionales en el campo. Estos profesionales vienen de Capital Federal y Bahía Blanca y ofrecen perspectivas diversas en el estado del campo en este momento, los cambios que han pasado en los últimos años, y una mirada hacia el futuro. Este informe utiliza una metodología cualitativa y exploratoria, y un diseño observacional transversal. Además, emplea una muestra no probabilística y un diseño descriptivo para introducir el tema de reproducción asistida en Argentina y después analizarlo a …

¿Es Suficiente La Ley De Parto Respetado? Una Investigación Sobre El Parto Respetado Y La Intervención Médica, A Partir De Las Opiniones De Los Profesionales De La Salud Y Una Organizacion De La Sociedad Civil En La Ciudad Autónoma De Buenos Aires, Argentina / Is The Respected Birth Law Enough? An Investigation On The Respected Birth And Medical Interventions Through The Opinions Of Health Professionals And A Civil Society Organization In The Autonomous City Of Buenos Aires, Argentina, Jennifer Rufino

Independent Study Project (ISP) Collection

A través de los años, la medicalización y los avances en el campo de medicina ha garantizado un nivel de seguridad para el proceso del embarazo y el parto. Sin embargo, la intervención médica también ha producido una discusión sobre el aumento de cesáreas, el significado del parto respetado, y los derechos de la mujer. Esta investigación exploró las opiniones de los profesionales de salud y una organización de la sociedad civil sobre la ejecución del parto respetado y el aumentado de la tasa de cesáreas en la Ciudad Autónoma de Buenos Aires, Argentina. Dada la situación de aislamiento social …

Encuadrar El Aborto: Un Estudio De Caso De Dos Medios Impresos Porteños Durante El Debate En El Congreso Nacional De Argentina En 2018 / Framing Abortion: A Case Study Of Two Buenos Aires Print Media During The Debate In The Argentina National Congress In 2018, Emma Lohman

Independent Study Project (ISP) Collection

En 2018 el Proyecto de Ley de la Interrupción Voluntaria del Embarazo fue presentado al Congreso Nacional de Argentina por la Campaña Nacional por el Derecho al Aborto Legal, Seguro y Gratuito, desatando un debate en todo el país sobre el tema. Dado que los medios impresos desempeñaban un rol importante en la conversación, me interesa investigar cómo dos medios impresos de Buenos Aires, el diario La Nación y la publicación comunitaria mensual Revista Cítrica encuadraron el aborto en sus artículos publicados entre junio y agosto de 2018. Utilizando una metodología cualitativa y teniendo en cuenta que los marcos realizan …

Our Multi-Pandemic, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

Application of systems thinking to identify and understand complex problems and to discover innovative ways to intervene has been advocated separately within public health, education, finance, and many other spheres of society. We need it now for the multi-pandemic.

No Double Trouble: How To Reopen The Economy., Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

This policy introduces a measure of choice, consonant with our culture. Those younger than 65 can make their own personal tradeoffs between heath and livelihood, while older people, knowing that the virus will be spreading more quickly through the population will be even more cautious, thus preventing their early deaths. We return decisions to people while ensuring that the sum total of decisions does not overwhelm our hospitals. One felicitous result of this policy is that the virus will spread more quickly through the healthier population. This means that when the elderly re-engage in social life they will encounter fewer …

Dementia: Types, What They Are And How They Differ, Jessica N. Schnetzer

Honors Thesis

Dementia: types, what they are and how they differ centers on the known and unknown complexities of dementia. Dementia is a very complex cognitive disease that consumes the brain, an organ of which we know very little about. Even so, this common disorder is actively being researched and is the topic of special interest of this thesis research. Described are Alzheimer’s disease, Creutzfeldt-Jakob disease, Frontotemporal dementia, Huntington’s disease, Korsakoff’s syndrome, Lewy body dementia, Parkinson’s dementia, and Vascular dementia, focusing on what they are, their specific risks, diagnosis, treatment, and their differing progressions. Guidance of this study provided by thesis director …

Over-Medicalization And Criminalization Of Birth In The United States: Exploring The Outcomes, Meg Wallace 20

Honor Scholar Theses

This paper will examine the effects that over-medicalization and criminalization have had on the state of giving birth in the United States. It will attempt to offer insight on why the United States ranks near the bottom of countries that are considered “developed” in maternal mortality rates and infant mortality rates, despite spending the highest percentage of gross national product on health care. The paper will analyze: the history behind the medicalization of birth in the United States, different methods of over-medicalization, the impacts of unnecessary medical interventions, different incentives driving medicalization, the history of criminalization of pregnant women, the …

Ensuring Accountability To Affected Populations In Humanitarian Settings: "Holding Humanitarian Organizations Accountable To People.", Jazmin Williamson

Independent Study Project (ISP) Collection

Aim: This research aims to examine what guidelines and regulations help ensure that humanitarian organizations are held accountable to their beneficiary populations.

Background: Although people have always been the focus of humanitarian aid, their voice and participation didn't become a centralized part of the conversation until the 1990s and later gained real traction in the early 2000s. During these times, many new foundational documents were created to highlight the "centrality of local participation in aid." Among the documents that enshrined this new principle of population participation included the 1992 Code of Conduct for the International Red Cross and Red Crescent …

Encuentros Intergeneracionales: Continuidades Y Reformulaciones En Las Prácticas Militantes De Las Jóvenes Integrantes De Espacios De Acompañamiento De Aborto En La Amba / Intergenerational Encounters: Continuities And Reformulations In The Activist Practices Of The Young Members Of Abortion Accompaniment Spaces In The Amba, Hannah Robinson

Independent Study Project (ISP) Collection

Debido al acceso restrictivo de los abortos legales, en los últimos diez años los espacios de acompañamiento de personas que quieren interrumpir la gestación se han convertido en un sitio importante de la militancia feminista en Argentina. Estos espacios o colectivos brindan información sobre el uso del medicamento misoprostol para abortar, conectan las personas gestantes con profesionales de salud “amigables” que garantizan el acceso al Interrupción Legal del Embarazo, y proveen apoyo durante el proceso de interrupción. Al mismo tiempo, en los últimos cinco años una marea de jóvenes ha entrado masivamente a la militancia feminista.

A través de la …

The Social Dimensions Of Reproductive Health: Analyzing Disparities In Morocco Through Health Indicators And Social Determinants, Mila Sicorsky

Independent Study Project (ISP) Collection

This paper explores the social dimensions of reproductive health in Morocco through a look at its health indicators and social determinants. Existing literature discusses reproductive health differences that run on economic, social, and cultural lines. In this paper, I shed light on how best to measure and understand these disparities. The research shows that reproductive health in Morocco is most accurately indicated by maternal mortality rates (MMR), access to prenatal and postnatal visits, and access to adequate family planning. It also finds that location of residence, economic status, and women’s status are key social determinants of reproductive health in Morocco. …

Development And Psychometrics Of The English Version Of The Itch Cognitions Questionnaire, Carolyn J. Heckman, Christina Schut, Mary Riley, Anke Ehlers, Rodrigo Valdes-Rodriguez, Jörg Kupfer, Uwe Gieler, Jerod L. Stapleton

Health, Behavior & Society Faculty Publications

BACKGROUND: The aim of this study was to validate the English version of the Itch Cognition Questionnaire in a sample of patients with chronic itch due to psoriasis or atopic dermatitis. An English-language version of an instrument assessing itch-related cognitions is needed since cognitions can contribute to a worsening of itch, and chronic itch is prevalent in English-speaking counties and internationally.

METHODS: The German Itch Cognitions Questionnaire was translated into English, and cognitive interviewing was conducted to finalize item wording. Internal and test-retest reliability, item discrimination, responsiveness to change, and construct, convergent, and discriminant validity were assessed in a national …

Collegiate Rugby Players' Knowledge Of Concussions, Julia E. Bell

Student Theses and Dissertations

This investigation sought to discover if collegiate rugby players who have had a concussion were more knowledgeable about concussions than the players who had not had a concussion. The investigation also looked at the general amount of knowledge that the collegiate rugby players had about concussions, including the effects and prevention measures. This study was performed using a survey distributed to the Arkansas State University club rugby team. The survey consisted of several questions about concussions, the side effects of concussions, and players’ opinions on prevention and education of concussions. The data collection revealed that there were differing amounts of …