Medical Specialties Commons^™

A New Opportunity For Memri, Ryan Cloyd, Moriel H. Vandsburger, Jose F. Abisambra

Sanders-Brown Center on Aging Faculty Publications

No abstract provided.

Quality? Safety? Stop Being Naïve., Rana K. Zaban Do, Steven Istephan, Jonathan Serman Md

Clinical Research in Practice: The Journal of Team Hippocrates

The first day of our inpatient medicine rotation, the Emergency Department (ED) admitted a patient to a general medical floor without notifying our rounding team. We used the institution’s system improvement tracking software to draw attention to communication breakdown in the interest of patient safety. This piece illustrates how there is a prominent hierarchy in medicine; it is inherent to the framework of the way in which hospitals function. A discussion ensues with our attending physician supervisor on our patient medicine service. During this discussion, we ponder whether it is possible to impact quality and safety from our position as …

Availability Of Healthcare Resources And Epithelial Ovarian Cancer Stage Of Diagnosis And Mortality Among Blacks And Whites, Swati Sakhuja, Huifeng Yun, Maria Pisu, Tomi Akinyemiju

Epidemiology and Environmental Health Faculty Publications

Background: The purpose of this study is to examine whether racial disparities in epithelial ovarian cancer stage at diagnosis and survival may be explained by geographic availability of healthcare resources among Blacks and Whites.

Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database was used to identify White and Black women ages 40 years and above diagnosed with epithelial ovarian cancer between 2000 and 2010. Data on county-level availability of healthcare resources was obtained from the Area Resource File. Multi-level regression models, overall and stratified by race and age, were used to examine the associations of health care …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

MaineHealth Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Bedtime Fading With Response Cost For Treatment Of Sleep Disturbances In Children With Autism Spectrum Disorder, Sela Ann Sanberg

Theses & Dissertations

As many as 82% of children with Autism Spectrum Disorders (ASD) experience numerous chronic sleep-related problems and at a much higher frequency and severity than their typically developing peers. Behavioral treatments are considered best practice and first-line treatment to address sleep problems. These treatments tend to address one specific sleep-related behavior at a time. Bedtime Fading with Response Cost (BFRC) is a promising intervention that targets a multitude of sleep problems concurrently and has yet to be replicated by more than one investigative team in the home setting with children on the autism spectrum. This study evaluated the effectiveness of …

A Mixed Methods Study Of Hiv-Related Services In Buprenorphine Treatment, Hannah K. Knudsen, Jennifer Cook, Michelle R. Lofwall, Sharon L. Walsh, Jamie L. Studts, Jennifer R. Havens

Behavioral Science Faculty Publications

Background: Opioid use disorder (OUD) is a major risk factor in the acquisition and transmission of HIV. Clinical practice guidelines call for the integration of HIV services in OUD treatment. This mixed methods study describes the integration of HIV services in buprenorphine treatment and examines whether HIV services vary by prescribers’ medical specialty and across practice settings.

Methods: Data were obtained via qualitative interviews with buprenorphine experts (n = 21) and mailed surveys from US buprenorphine prescribers (n = 1174). Survey measures asked about screening for HIV risk behaviors at intake, offering HIV education, recommending all new patients …

Linking Kindling To Increased Glutamate Release In The Dentate Gyrus Of The Hippocampus Through The Stxbp5/Tomosyn-1 Gene, Seth R. Batten, Elena A. Matveeva, Sidney W. Whiteheart, Thomas C. Vanaman, Greg A. Gerhardt, John T. Slevin

Psychology Faculty Publications

Introduction: In kindling, repeated electrical stimulation of certain brain areas causes progressive and permanent intensification of epileptiform activity resulting in generalized seizures. We focused on the role(s) of glutamate and a negative regulator of glutamate release, STXBP5/tomosyn-1, in kindling.

Methods: Stimulating electrodes were implanted in the amygdala and progression to two successive Racine stage 5 seizures was measured in wild-type and STXBP5/tomosyn-1^−/− (Tom^−/−) animals. Glutamate release measurements were performed in distinct brain regions using a glutamate-selective microelectrode array (MEA).

Results: Naïve Tom^−/− mice had significant increases in KCl-evoked glutamate release compared to naïve wild type as …

Understanding The Blogging Practices Of Women Undergoing In Vitro Fertilization (Ivf): A Discourse Analysis Of Women’S Ivf Blogs, Elizabeth Orr, Susan M. Jack, Wendy Sword, Sandra Ireland, Lois Ostolosky

The Qualitative Report

Infertility and its associated treatments, including in vitro fertilization (IVF), can have a profound impact on the emotional health and well-being of women desiring to become mothers. Researchers have measured the impact of infertility and described the experience of infertility and its treatment, leaving the rich descriptions of the IVF experience as captured in women’s blogs to be explored. This discourse analysis describes the blogging practices of women undergoing IVF, exploring both the content and function of the IVF blog discourse. Data were collected from the text of seven women’s blogs (n=1,149 blog posts) and resulted in four main functions …

A Life Course Examination Of The Physical Environmental Determinants Of Physical Activity Behaviour: A “Determinants Of Diet And Physical Activity” (Dedipac) Umbrella Systematic Literature Review, Angela Carlin, Camille Perchoux, Anna Puggina, Katina Aleksovska, Christoph Buck, Con Burns, Greet Cardon, Simon Chantal, Donatella Ciarapica, Giancarlo Condello, Tara Coppinger, Cristina Cortis, Sara D’Haese, Marieke De Craemer, Andrea Di Blasio, Sylvia Hansen, Licia Iacoviello, Johann Issartel, Pascal Izzicupo, Lina Jaeschke, Martina Kanning, Aileen Kennedy, Jeroen Lakerveld, Fiona Chun Man Ling, Agnes Luzak, Giorgio Napolitano, Julie Anne Nazare, Tobias Pischon, Angela Polito, Alessandra Sannella, Holger Schulz, Rhoda Sohun

Publications

Background: Participation in regular physical activity is associated with a multitude of health benefits across the life course. However, many people fail to meet PA recommendations. Despite a plethora of studies, the evidence regarding the environmental (physical) determinants of physical activity remains inconclusive. Objective: To identify the physical environmental determinants that influence PA across the life course. Methods: An online systematic literature search was conducted using MEDLINE, ISI Web of Science, Scopus and SPORTDiscus. The search was limited to studies published in English (January 2004 to April 2016). Only systematic literature reviews (SLRs) and meta-analyses (MAs) of observational studies, that …

Enduring Chronic Kidney Disease: An Investigation Of Psychosocial Factors And Life Satisfaction In Older Adults Receiving Dialysis Treatment, Bailee Sobotka

Honors Program: Senior Projects (Public)

Chronic kidney disease is a condition during which the kidneys begin to shut down and no longer filter blood efficiently. Once the disease has progressed far enough, dialysis treatments are mandatory to sustain life. To further understand how older adults receiving dialysis treatments cope with their disease, psychosocial factors were evaluated to investigate possible correlations with life satisfaction using a Life Satisfaction Index Z (LSI-Z). Expected correlations with life satisfaction were sociability, financial satisfaction, importance of spirituality, and activities of daily living scores. Interviews were conducted with 30 dialysis patients and results were analyzed using various statistical measures. Significant correlations …

Effectiveness Of Switching Smoking-Cessation Medications Following Relapse, Bryan W. Heckman, K. Michael Cummings, Karin A. Kasza, Ron Borland, Jessica L. Burris, Geoffrey T. Fong, Ann Mcneill, Matthew J. Carpenter

Psychology Faculty Publications

Introduction—Nicotine dependence is a chronic disorder often characterized by multiple failed quit attempts (QAs). Yet, little is known about the sequence of methods used across multiple QAs or how this may impact future ability to abstain from smoking. This prospective cohort study examines the effectiveness of switching smoking-cessation medications (SCMs) across multiple QAs.

Methods—Adult smokers (aged ≥ 18 years) participating in International Tobacco Control surveys in the United Kingdom, U.S., Canada, and Australia (N=795) who: (1) completed two consecutive surveys between 2006 and 2011; (2) initiated a QA at least 1 month before each survey; and (3) provided …

Pro-Angiogenesis Therapy And Aging: A Mini-Review, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Apart from major illnesses and chronic afflictions, the elderly experience lesser ailments, such as muscle weakness, cold intolerance, and transient memory lapses. Physical signs in the aged include wrinkled skin and the slow healing of skin abrasions. These ailments and signs are grouped together because they may be due in part to an age-linked, waning microcirculation. A reduced capillary density (CD) throughout the body of aged people and animals has been reported in over 40 papers. The reduced CD is due in turn to declining levels of angiogenic growth factors (AGFs) throughout the body during old age, as documented in …

An Initial Application Of A Biopsychosocial Framework To Predict Posttraumatic Stress Following Pediatric Injury, Meghan L. Marsac, Nancy Kassam-Adams, Douglas L. Delahanty, Jeffrey Ciesla, Danielle Weiss, Keith F. Widaman, Lamia P. Barakat

Pediatrics Faculty Publications

Objectives—Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association.

Method—Participants were 96 children hospitalized for injury and assessed at 3 …

How Canada Can Help Global Adolescent Health Mature, Ashley Vandermorris, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: There is an emerging focus on adolescent health within the global health community as we come to recognize that the adolescent years are formative in determining health and health-related behaviours across the life-course. Such attention is not only relevant on the global scale but is imperative in Canada as well.

Main body: This commentary provides a brief review of recent investments targeting global adolescent health and presents five potential avenues for action which emerged out of the recent Canadian Partnership for Women and Children’s Health (CanWaCH) Global Adolescent Health conference. These avenues are: (1) Demand data; (2) Embrace complexity; …

Posttraumatic Reactions To Psychosis: A Qualitative Analysis, Weili Lu, Kim T. Mueser, Stanley D. Rosenberg, Philip T. Yanos, Neisrein Mahmoud

Publications and Research

The current study aimed to evaluate the potentially traumatic aspects of psychotic symptoms and psychiatric treatment of psychosis using qualitative methods. Participants included 63 people with first episode psychosis or multiple psychotic episodes recruited from an inpatient psychiatric unit and an urban state psychiatric hospital in the North East region of the United States. Quasi-structured interviews were used to explore those aspects of symptoms and treatment that were perceived as traumatic Emotional reactions to the most traumatic aspect of symptoms and treatment, during and after the event, were also examined. Participants described a number of traumatogenic aspects of psychotic symptoms, …

“That Pain Is Genuine To Them”: Provider Perspectives On Chronic Pain In University Student Populations, Alexandra C.H. Nowakowski, Kaitlyn E. Barningham, Charlyn D. Buford, Martin Laguerre, J. E. Sumerau

The Qualitative Report

We explored provider attitudes about and experiences in chronic pain management for university student populations. Our central question was: “What do providers at a large university campus health care center experience in the process of offering pain management services?” We explored instrumental, behavioral, emotional, and attitudinal dimensions of our participants’ experiences using a qualitative case study approach. Data were gathered through semi-structured interviews with 10 health care providers at the student health center for a large research university in Florida. Interviews captured providers’ background and experiences in providing pain management to student patients with diverse needs. We used grounded theory …

The Effects Of Insurance Status On Pediatric Traumatic Brain Injury Outcomes: A Literature Review, Anthony Fabio, Austin Murray, Michelle Mellers, Stephen Wisniewski, Michael Bell

Journal of Health Disparities Research and Practice

Objective: To review the literature that describes the effects of insurance status on traumatic brain injury (TBI) outcomes among pediatric patients to understand how policies related to access to health insurance changes TBI outcomes. Method: This review was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA). A search of OVID Medline was conducted in May of 2016 for all years for peer-reviewed articles that included keywords related to “brain injuries” and “insurance status”. Articles were included if authors conducted a separate analysis of children aged 0 to 18. Articles were excluded if the TBI was the …

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of the …

Examining The Durability Of Peers For Adolescents With Asd: Maintenance Of Neurological And Behavioral Effects, Bridget Kathleen Dolan

Dissertations (1934 -)

To date, there are no known published studies that have assessed the maintenance of treatment effects in the context of neurological changes and their relationship to behavioral outcomes following a social skills intervention for adolescents with Autism Spectrum Disorder (ASD). The few studies that have incorporated long-term assessment into their design have focused exclusively on sustained behavioral responses to treatment. Individuals with ASD across the lifespan exhibit aberrant neural activity, which is thought to underlie social skill deficits noted in persons on the spectrum. Thus, this study sought to examine the impact of a social skills intervention, the Program for …

Abnormal Dendritic Maturation Of Developing Cortical Neurons Exposed To Corticotropin Releasing Hormone (Crh): Insights Into Effects Of Prenatal Adversity?, Megan M. Curran, Curt A. Sandman, Elysia Poggi Davis, Laura M. Glynn, Tallie Z. Baram

Psychology: Faculty Scholarship

Corticotropin releasing hormone (CRH) produced by the hypothalamus initiates the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the body’s stress response. CRH levels typically are undetectable in human plasma, but during pregnancy the primate placenta synthesizes and releases large amounts of CRH into both maternal and fetal circulations. Notably, placental CRH synthesis increases in response to maternal stress signals. There is evidence that human fetal exposure to high concentrations of placental CRH is associated with behavioral consequences during infancy and into childhood, however the direct effects on of the peptide on the human brain are unknown. In this study, we used a …

My Crown And Glory: Community, Identity, Culture, And Black Women’S Concerns Of Hair Product-Related Breast Cancer Risk, Dede K. Teteh, Susanne B. Montgomery, Sabine Monice, Laura Stiel, Phyllis Y. Clark, Eudora Mitchell

Health Sciences and Kinesiology Faculty Articles

Breast cancer (BC) incidence rates for Black and non-Hispanic White women have recently converged; however, Black women continue to die at higher rates from the disease. Black women also use hair products containing hormonally active chemicals at higher rates than other races and ethnic groups. Studies now link chemical components in hair and personal care products to breast cancer risk. Using a community-based participatory research approach, this qualitative study explored community concerns about the role of hair products on breast cancer risk. Focus groups and key informant interviews using triangulation to assure relevant perspectives (women with and without breast cancer …

Prevalence And Prognostic Features Of Ecg Abnormalities In Acute Stroke: Findings From The Siren Study Among Africans, Abiodun M. Adeoye, Okechukwu S. Ogah, Bruce Ovbiagele, Rufus Akinyemi, Vincent Shidali, Francis Agyekum, Akinyemi Aje, Oladimeji Adebayo, Joshua O. Akinyemi, Philip Kolo, Lambert Tetteh Appiah, Henry Iheonye, Uwanuruochi Kelechukwu, Amusa Ganiyu, Taiwo O. Olunuga, Onoja Akpa, Ojo Olakanmi Olagoke, Fred Stephen Sarfo, Kolawole Wahab, Samuel Olowookere, Adekunle Fakunle, Albert Akpalu, Philip B. Adebayo, Kwadwo Nkromah, Joseph Yaria, Philip Ibinaiye, Godwin Ogbole, Aridegbe Olumayowa, Sulaiman Lakoh, Benedict Calys-Tagoe, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background

Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans.

Objectives

The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study.

Methods

We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 …

Exploring Overlaps Between The Genomic And Environmental Determinants Of Lvh And Stroke: A Multicenter Study In West Africa, Abiodun M. Adeoye, Bruce Ovbiagele, Philip Kolo, Lambert Appiah, Akinyemi Aje, Oladimeji Adebayo, Fred Sarfo, Joshua Akinyemi, Gregory Adekunle, Francis Agyekum, Vincent Shidali, Okechukwu Ogah, Dan Lackland, Mulugeta Gebregziabher, Donna K. Arnett, Hemant K. Tiwari, Rufus Akinyemi, Ojo Olakanmi Olagoke, Ayodipupo Sikiru Oguntade, Taiwo Olunuga, Kelechi Uwanruochi, Carolyn Jenkins, Patrick Adadey, Henry Iheonye, Lukman Owolabi, Reginald Obiako, Samuel Akinjopo, Kevin Armstrong, Albert Akpalu, Adekunle Fakunle

Epidemiology and Environmental Health Faculty Publications

Background

Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown.

Objectives

We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study.

Methods

SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and …

The Role Of The Heart Score And Clinical Decision Units In Ed Patients With Chest Pain, Gregory Jasani, Jesse M. Pines, Caitlin Carter

Center for Health Care Quality

Every year, millions of patients present to Emergency Departments across the country complaining of chest pain. Even after traditional ED testing which includes electrocardiograms, laboratory testing, and chest radiography, chest pain patients still have a small but real risk of serious illness. The HEART score is a new tool that has been validated to help risk-stratify patients. Clinical Decision Units decrease cost and length of stay without compromising patient safety, allowing for complete evaluations of these patients.

Targeting Ledgf/P75 To Sensitize Chemoresistant Prostate Cancer Cells To Taxanes, Leslimar Rios-Colón

Loma Linda University Electronic Theses, Dissertations & Projects

Prostate cancer (PCa) is the second most diagnosed cancer in males. This disease disproportionately affects African American men, with a higher incidence and mortality compared to other ethnic/racial groups. An aging male population and the complexity of addressing the health disparities associated with this disease puts PCa into the spotlight due to its serious public health implications and the imminent fiscal challenge over the next decades. Chronic prostate inflammation resulting in activation of stress and prosurvival pathways contribute to disease progression and the development of chemoresistance. Lens epithelium-derived growth factor p75 (LEDGF/p75) is a stressresponse protein that promotes cellular survival …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Mindfulness And Law Enforcement: An Effective Approach To Implementing Mindfulness For First Responders, Gina White

Mindfulness Studies Theses

An increasing number of studies show that people employed as first responders in high trauma service jobs tend to experience a high level of stress, at work and after hours. Studies suggest that constant exposure to job related stress leads to both physical and mental dysregulation. This study looks at the effects of implementing mindfulness tools and techniques to those working in law enforcement. Other works on this topic report mindfulness as a successful tool to increase wellbeing to a broad spectrum of populations. The methodology used in this study was designed specifically for first responders. The data findings were …

Exploring Autonomy Support In Shared Decision Making And Patient Activation Of Diabetes Self-Care Behaviors, Carol Mahler Hamersky

Seton Hall University Dissertations and Theses (ETDs)

Introduction:

Chronic disease places a different set of demands on an individual and family. Self-care behaviors and daily decision making is an integral part of diabetes management. According to the CDC (2014), the prevalence of Diabetes is estimated at 29.1 million and an alarming 86 million Americans have Pre-diabetes. Despite a plethora of evidence on the importance of diabetes self-care behaviors on clinical outcomes, studies have highlighted the current disconnect of patients not able to follow self-care behavior recommendations and not asking for help from their health care providers. There is no literature on the impact of an autonomy supported …

Research Brief: "The National Veteran Sleep Disorder Study: Descriptive Epidemiology And Secular Trends, 2000–2010", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the relation between sleep disorder diagnosis and cardiovascular disease, cancer, and mental health disorders among veterans. In policy and practice, physicians should familiarize themselves with signs of and screenings for sleep disorders and should discuss factors that affect sleep with their veteran patients; the VHA should continue recommending policies that help veterans receive a prompt diagnosis and treatment of their sleep disorders, policymakers should fund early intervention programs to help veterans learn how to cope with reintegration, and the VHA should create a database on sleep disorders in veterans. Suggestions for future research include studying veterans …