Medical Specialties Commons^™

Pharmacokinetic Profiles Of Sertraline In Pregnancy As A Predictor Of Postpartum Depressive Symptoms, Sílvia M. Illamola, Zachary N. Stowe, Marc L. Kalin, Michael D. Evans, Catherine M.T. Sherwin, Maged M. Costantine, D. Jeffrey Newport, James C. Ritchie, Angela K. Birnbaum

Pediatrics Faculty Publications

Aim: To characterize pharmacokinetic changes of sertraline and its metabolite during pregnancy and postpartum, and their relationship to maternal postpartum depressive symptoms. Methods: This was a prospective observational, longitudinal study of pregnant women with a major depressive disorder treated with sertraline (N = 185 women, 205 pregnancies). Women were enrolled at <16 weeks' gestation and followed at 4-8 week intervals throughout pregnancy and the first postpartum year. Baseline measures included structured clinical interviews and demographic information. Drug and metabolite concentrations and psychometric measures (study outcomes) (ie, Hamilton Rating Scale for depression - 17 item, Beck Depression Inventory, Edinburgh Postnatal Depression Scale [EPDS], Clinical Global Impression [CGI]) were measured at follow-up visits. Serum sertraline and N-desmethylsertraline exposure were reported asstandardized 24-h concentration-to-dose (C/D) and parent to metabolite (P/M) ratios. Linear mixed-effects and latent trajectory models were used to characterize longitudinal patterns in concentration measures across pregnancy and postpartum, and their association with study outcomes. Results: Mean 24-h C/D ratios showed high variability throughout pregnancy and postpartuM.T.hat were characterized by three trajectories for sertraline and five for N-desmethylsertraline and P/M ratio corresponding to different sertraline pharmacokinetic profiles. At postpartum, sertraline drug exposure was inversely associated with higher EPDS score (P < .05), while N-desmethylsertraline exposure was associated with higher scores for all measured depression scales (P < .001). Higher P/M ratios had higher CGI scores (P < .05) postpartum. Conclusion: Sertraline pharmacokinetic profiles varied across pregnant women and were associated with postpartum depressive symptoms. The use of therapeutic monitoring may provide clinical insight that can be useful for identifying patients with a potential toward depressive symptoms.

Infant Mortality In Ohio, Isabella Bacon, Alexis Jackson

Scholarship in Medicine - All Papers

Introduction: Infant mortality continues to occur at alarming rates that differ among various groups and states. Despite this, there has been a lack of intersectional examination of risk- and protective-factors. Methods: We examine how smoking status, education level, primary care to population ratio, teen birth rates, and urban vs rural status impact infant mortality rates in Ohio, Kentucky, Michigan, and Indiana using County Health Rankings data. Results: Ohio was shown to have no significant difference between urban and rural infant mortality rates; however,  risk-and-protective factors did differ. In urban counties, high school completion, teen birth rates, and primary care ratios …

Revisiting The Faith Trial: A Secondary Analysis Yielding Novel Insights With The Win Ratio, Sofia Bzovsky, Nathan N. O'Hara, Gerard P. Slobogean, Sheila Sprague, Daniel E. Axelrod, Graeme Hoit, Kiara Pannozzo, Mohit Bhandari, Marc Swiontkowski, Emil Schemitsch, Rudolf W. Poolman, The Faith Investigators

Orthopaedic Surgery Faculty Publications

Background: Many orthopaedic trials use any unplanned reoperation as the primary outcome, but this overlooks how patients experience those outcomes. Using a high-quality hip fracture trial, we demonstrate how the relative importance of multiple patient-important outcomes can be effectively incorporated into data analysis, providing a more comprehensive understanding of treatment impact. Methods: This secondary analysis of the Fixation using Alternative Implants for the Treatment of Hip Fracture (FAITH) trial included 1,079 patients aged 50 years or older with a low-energy femoral neck fracture who were randomly assigned to treatment with a sliding hip screw or cancellous screws. The original trial …

An Evaluation Of Virtual Supervision Effectiveness Within Department Of Veterans Affairs (Va) Health Professionals Training Programs, Linda M. Kawentel, John P. Donnelly, Kaylee W. Burgan, Gezan M. Yahya, Joanna S. Doredla, Jessica L. Johnson, Kimberly Falco, Marjorie A. Bowman, John Byrne, Nicholas W. Bowersox

Population and Public Health Sciences Faculty Publications

Background Limited information exists on whether virtual training is equivalent to traditional in-person training in supporting the development of clinical providers. Methods A multi-site evaluation using survey methods was conducted with a multidisciplinary group of health professions trainees and supervisors within the Veterans Health Administration to assess the equivalence of two supervision modalities – exclusively in-person supervision and supervision incorporating at least some virtual supervision – on trainee clinical competency development, trainee preparedness to respond to patient emergencies, and effective trainee/supervisor working relationships. Results Trainees who experienced some virtual supervision rated their clinical competency levels as higher than trainees with …

A Novel Maturation Equation For Hepatic Clearance Across Preterm, Term Neonates, Children, And Adults: Application To Paracetamol And Its Metabolite, Yunjiao Wu, Swantje Völler, Sebastiaan C. Goulooze, Karel Allegaert, Catherine M.T. Sherwin, Anne Van Rongen, Daniëlla W. E. Roofthooft, Sinno H.P. Simons, Dick Tibboel, Robert B. Flint, John N. Van Den Anker, Catherijne A.J. Knibbe

Pediatrics Faculty Publications

A preterm and term neonate to adult (PTNA) maturation equation was introduced recently to describe the glomerular filtration rate maturation from birth to adulthood for neonates of varying gestational age. This study aims to evaluate the newly developed PTNA equation against common maturation approaches like allometric scaling (AS0.75), the AS0.75 plus postmenstrual age (PMA)-based Emax (AS0.75 + PMA) equation, and the bodyweight dependent exponent equation (BDE) for the maturation of three hepatic pathways of paracetamol (PCM) from preterm and term neonates up to adults. A population pharmacokinetic analysis was conducted with pooled plasma and urine data of PCM, PCM-glucuronide (PCM-GLU), …

Telehealth And Virtual Supervision Practices For Health Professions Education In The Department Of Veterans Affairs, Nancy D. Harada, Kimberly Falco, Marjorie Bowman, John M. Byrne

Population and Public Health Sciences Faculty Publications

Background Telehealth and virtual supervision practices in health professions clinical education has grown rapidly, including in the Department of Veterans Affairs (VA) which oversees the largest interprofessional training effort in the United States. Telehealth is the provision of healthcare that is provided remotely through telecommunication technology, and virtual supervision is clinical supervision of health professions trainees (HPTs) that occurs through telecommunication technology. In this study we evaluate participation in telehealth and virtual supervision for physician, nursing, and associated health HPTs, and describe prevalent themes concerning HPT perceptions of telehealth and virtual supervision. Methods The survey study cohort included 10,865 HPTs …

Possible Involvement Of Keratinocyte-Derived Microvesicle Particles In Human Photosensitivity Disorders, Risha Annamraju, Madison S. Owens, Anita Thyagarajan, Danielle A. Corbin, Catherine M.T. Sherwin, Jade Bryant, Garrett W. Fisher, Winston R. Owens, Alycia Ketter, Craig A. Rohan, Michael G. Kemp, Robyn K. Crow, Jeffrey B. Travers

Pediatrics Faculty Publications

BACKGROUND: Previous murine studies have implicated acid sphingomyelinase-(aSMase) generated subcellular microvesicle particles (MVP) in photosensitivity. Objective: The current double-blinded placebo-controlled studies examined if a single localized ultraviolet B radiation (UVB) treatment generated more MVP in human subjects with self-identified photosensitivity versus normal controls. A topical 4% formulation of the aSMase inhibitor imipramine applied immediately after UVB blocked the MVP release and erythema responses. Erythema responses at 24 and 72 h in response to multiple UVB fluences and minimal erythema doses (MED) at 24 h and effects of imipramine were also tested.

RESULTS: Small cohorts of 10 adult self-identified photosensitive subjects …

Infection And Nonunion Rates In Open Fractures, Roman M. Natoli, Lucas S. Marchand, Sofia Bzovsky, Jennifer E. Hagen, Mark J. Gage, Christina A. Stennett, Nathan N. O’Hara, Kyle J. Jeray, Brad Petrisor, Sheila Sprague, Gerard P. Slobogean, Jeffrey Wells, Mohit Bhandari, Anthony D. Harris, C. Daniel Mullins, Lehana Thabane, Amber Wood, Gregory J. Della Rocca, Joan Hebden, Lyndsay M. O’Hara, Robert Zura, Christopher Lee, Joseph Patterson, Michael J. Gardner, Jenna Blasman, Jonah Davies, Stephen Liang, Monica Taljaard, The Flow Investigators, The Prep-It Investigators

Orthopaedic Surgery Faculty Publications

Background: Infection and nonunion are common sequelae of open fractures. Studies have shown infection and nonunion rates ranging from 2% to 52% and 12% to 17%, respectively. The present article describes the rates of surgical site infection (SSI) and delayed union/nonunion following open fractures in a large contemporary series of patients from prospective clinical trials with adjudicated outcomes. Methods: A descriptive analysis was performed with use of patient data from the FLOW, Aqueous-PREP, and PREPARE-Open studies. These studies, published within the past 10 years, included multiple international trauma centers and shared definitions for SSI and delayed union/nonunion. SSI and delayed …

Fascia Iliaca Compartment Block And Pericapsular Nerve Group Block Effect On Opioid Consumption In Hip Fracture Patients, David A. Brueggeman, Garrhett G. Via, Prachi Lele, Andrew W. Froehle, Michael J. Prayson, Scott J. Hadaway

Orthopaedic Surgery Faculty Publications

Background Effective pain control and reduced opioid consumption improve hip fracture outcomes. Fascia iliaca compartment blocks (FICB) effectively and safely manage acute hip fracture pain while reducing opioid consumption. Alternatively, pericapsular nerve group (PENG) blocks may provide similar analgesia while better-preserving motor function by targeting the highly innervated anterior hip capsule and sensory branches of the femoral, obturator, and accessory obturator nerves. Evidence for PENG's effectiveness is limited. The present retrospective study compared pain and MME in hip fracture patients receiving FICB (n = 1596) or PENG (n = 254), vs. a no-block (NB; n = 287) reference group. Methods …

Flipping The Curriculum For Resident Didactics: In-Training And Certifying Examination Scores In An Internal Medicine Residency, Luke Mccoy, Ronald J. Markert, Elysha Thoms, Olivia Noall, Kathryn Burtson

Internal Medicine Faculty Publications

Purpose The flipped classroom (FC) model is increasingly used in undergraduate medical education, where it has been associated with improved knowledge acquisition. However, its impact on graduate medical education (GME) remains underexplored. We hypothesized that implementing a flipped didactics curriculum in our internal medicine residency program would improve performance on the Internal Medicine In-Training Examination (IM-ITE) and the American Board of Internal Medicine Certifying Examination (IM-CE). Methods In 2017, we transitioned from a traditional lecture-based (LB) curriculum to a flipped model. Noon conferences were replaced with problem-based learning (PBL) sessions three days per week, with additional active learning formats used …

Emerging Therapeutic Potential Of Fisetin For Nephrotoxicity, Kidney Injury, And Nephropathy: A Systematic Review, Saeed Mohajeri, Alizamen Salehifard Jouneghani, Saeid Heidari-Soureshjani, Catherine M.T. Sherwin, Faramarz Beigi

Pediatrics Faculty Publications

INTRODUCTION/OBJECTIVE: Kidney diseases cause high morbidity and mortality worldwide. This study investigated the mechanistic effects of Fisetin (FIS) on nephrotoxicity, kidney injury, and nephropathy induced by drugs, toxic chemicals, diabetes, lupus, diet, ureteral obstruction, and ischemic situations.

METHODS: To identify pertinent articles published before Oct 1, 2024, a comprehensive electronic search was performed across several databases, including MEDLINE/PubMed, Embase, Cochrane Library, Web of Science, and Scopus. After establishing clear inclusion and exclusion criteria, studies that met the research objectives were selected. Data were extracted and analyzed, documenting study characteristics, methodologies, and biological mechanisms.

RESULTS: Antioxidant benefits were evident with increased …

Vaginismus: Causes, Diagnosis, And Treatment Options, Heather Thomas

Best Integrated Writing

This paper provides a current review of the diagnosis, causes, and treatment outcomes for vaginismus. Of particular interest are predisposing factors, like a lack of sex education and a sexually restrictive upbringing, for the development of this disorder. Controversies surrounding US-based diagnostic criteria for female sexual dysfunction are also reviewed, and up-to-date and novel treatment options, like vaginal Botox injections, are described.

Fourth Annual Research Symposium Program With Abstracts, Office Of Research Affairs, Boonshoft School Of Medicine

Boonshoft School of Medicine Research Symposium

The program booklet is a compilation of abstracts from oral and poster presentations at Wright State University's Fourth Annual Boonshoft School of Medicine Medical Research Symposium held on April 16, 2025.

Prediction Of Lacosamide Concentrations To Support Dose Optimization During Pregnancy, Jessica M. Barry, Sílvia M. Illamola, Page B. Pennell, Catherine M.T. Sherwin, Kimford J. Meador, Angela K. Birnbaum

Pediatrics Faculty Publications

Objective: We aimed to quantify and predict lacosamide exposure during pregnancy by developing a pregnancy physiologically-based pharmacokinetic model, allowing the prediction of potential dose increases to support maintaining a patient's preconception lacosamide concentrations. Methods: Models for nonpregnant adults and pregnant female patients were constructed using physiochemical and pharmacological parameters identified from literature review. Evaluation of plasma concentration data from human males was digitized froM.T.he literature. Concentration data in nonpregnant and pregnant human females were available froM.T.he Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study, a longitudinal observational study which followed 11 nonpregnant and 16 pregnant women receiving lacosamide. …

Pharmacokinetic Effect Of Disease Severity And Use Of Extracorporeal Membrane Oxygenation In Critically Ill Asian Patients Receiving Vancomycin, Charul Avachat, Pi Lien Hung, Angela K. Birnbaum, Daniel P. Healy, Catherine M.T. Sherwin, Alex C. Lin

Pediatrics Faculty Publications

Purpose: Vancomycin is an essential antibiotic for the treatment of severe gram-positive bacterial infections, including methicillin-resistant Staphylococcus aureus (MRSA). In critically ill patients, particularly children, attaining the appropriate dosage is crucial to avert drug resistance and ensure therapeutic efficacy. This study sought to investigate the pharmacokinetics of vancomycin in critically ill Asian pediatric patients and evaluate the influence of extracorporeal membrane oxygenation (ECMO) and disease severity on vancomycin clearance. Methods: This retrospective analysis examined data from 90 critically ill Asian patients residing in Kaohsiung, Taiwan, encompassing 263 data points gathered over 2 years. A one-compartment pharmacokinetic model with first-order elimination …

Priority Competencies For Designated Education Officers In The Veterans Health Administration, Duane R. Bidwell, Anita Samuel, Ronald M. Cervero, Steven J. Durning, Sherri L. Stephan, Erin L. Patel, Marjorie A. Bowman, Holly S. Meyer

Population and Public Health Sciences Faculty Publications

Designated Education Officers (DEOs) at Veteran Health Administration (VHA) hospitals are senior educational leaders tasked with oversight of all clinical training at a particular facility. They prioritize dozens of tasks and responsibilities each day, from educational policy and strategy to staff management, financial planning, onboarding of trainees, and facility planning and management. Clarifying priority competencies for the role can help executives recruit, appoint, and evaluate capable personnel and promote effective, efficient performance. Using a federally developed method of competency analysis, researchers consulted a panel of subject-matter experts to identify priority competencies for DEOs, using data from a 2013 study that …

Use Of Ai In Family Medicine Publications: A Joint Editorial From Journal Editors, Sarina Schrager, Dean A. Seehusen, Sumi M. Sexton, Caroline Richardson, Jon Neher, Nicholas Pimlott, Marjorie A. Bowman, José E. Rodríguez, Christopher P. Morley, Li Li, James Domdera

Population and Public Health Sciences Faculty Publications

There are multiple guidelines from publishers and organizations on the use of Artificial Intelligence (AI) in publishing.1–5 However, none are specific to family medicine. Most journals have some basic AI use recommendations for authors, but more explicit direction is needed, as not all AI tools are the same.

Beyond The Numbers: A Qualitative Exploration Of Patient Perspectives On Postpartum Care And Maternal Mortality, Kristen A. Waters

Master of Public Health Program Student Publications

Introduction

Montgomery County faces one of Ohio's highest maternal mortality rates, with notable disparities by race. Despite their importance in reducing maternal deaths, up to 40% of women nationwide do not attend a postpartum care (PPC) visit. While well researched guidelines exist regarding the content and timing of PPC visits, there is a lack of patient perspective on this topic, specifically in the Black-identifying population in an area with a significant burden of maternal mortality.

Methods

Semi-structured interviews and focus group sessions were conducted with 31 participants of maternal health community events in Dayton, OH. Participants were asked their opinions …

A Quality Improvement Project To Improve Provider Awareness Of Breastfeeding Resources, Rachel St. Bernard, Allie Vela, Rose A. Maxwell, Kelly Nagy

Obstetrics and Gynecology Faculty Publications

Breastfeeding is widely acknowledged for its significant benefits for mother and child. Despite the many advantages for breastfeeding, disparities in breastfeeding rates persist, particularly among non-Hispanic Black women in Montgomery County, OH. Rates for babies born in 2020 were low for those who were ‘ever’ breastfed (NH-Black 68.8% vs white 76.6% for ‘ever’ breastfed at hospital discharge) and even lower for those who were exclusively breastfed (NH-Black 38.2% vs. NH-white 57.9% exclusively breastfed at hospital discharge).1 Ohio's breastfeeding initiation rate remains among the lowest in the nation ranking 41st out of 50 states and falling short of the Healthy People …

Comparison Of Four Vaginal Antiseptic Preparation To Reduce Bacteria Colony Counts In Patients Undergoing Vaginal Surgery: A Randomized Trial, James R. Saelens, Adam J. Langer, Andrew N. Boeckley, Natalie M. Castillo, Julie A. Desouza, Jennifer L. Drerup, Kelly M. Muterspaw, Hannah M. Stump, Rose A. Maxwell, Geoffrey D. Towers

Obstetrics and Gynecology Faculty Publications

Introduction: Surgical site infections (SSI) remain a prominent complication of gynecologic procedures. The only FDA approved compound for preoperative vaginal preparation is povidone-iodine. Direct comparison of commonly used agents is needed to inform appropriate standards of care. The objective of this study is to compare the effectiveness of 10% povidone-iodine (PI), 4% chlorhexidine gluconate (CHG), baby shampoo (BS), and 3% para-chloro-meta-xylenol (PCMX) preparations for reducing bacterial and fungal colony counts and minimizing postoperative irritation after vaginal surgery. Materials and Methods: This is a single-blind, RCT conducted between 2018 and 2023 in patients 18 years or older who were undergoing surgeries …

An Analysis Of Comprehensive Sex Education As A Means Of Reducing Teenage Pregnancy Rates, Ben Hiett, Adriana Parella

Scholarship in Medicine - All Papers

Teenage pregnancy rates have been declining since the 1990s, yet teenage pregnancy remains a pressing public health concern given its associated negative maternal and infant complications. Many experts and advocates have placed an increasing emphasis on school programs that provide teenagers with comprehensive education on healthy sexual functioning, safe sex practices, and effective contraceptive use, pointing to them as a means of reducing unplanned teen pregnancies. However, there is still some debate regarding the effectiveness of comprehensive sex education compared to more limited programs that focus primarily on promoting abstinence. Using data from County Health Rankings and SIECUS, we compared …

Maternal Health Predictors In Ohio, Sritha Donepudi, Humza Khan

Scholarship in Medicine - All Papers

Background: Ohio has continued to have a maternal mortality rate higher than the average which has posed the question of how geographic location, socioeconomic status, and demographics affect these rates.
Objective: This paper aims to investigate the relationship between variables affecting maternal mortality rates in Ohio such as teen birth rates and primary care physician access with where one lives between Rural and Urban areas and their household income in order to provide more information for future research.
Methods: This paper utilized County Health Rankings and statistical and correlation analysis with SPSS to analyze rates across counties in Ohio.
Results: …

The Special Issue “The 20th Anniversary Of Pharmaceuticals—Multi-Targeted Natural Products As Therapeutics” Editorial—Multi-Targeted Therapeutics From Natural Sources: What Do We Know?, Elena Y. Enioutina, Katheleen M. Job, Catherine M.T. Sherwin

Pediatrics Faculty Publications

Herbal and marine products in the form of extracts, infusions, and decoctions have been used for centuries in folk and traditional medicine. Preparations typically contain multiple biologically active compounds. The World Health Organization (WHO) estimated that about 65% of consumers worldwide use natural remedies containing bioactive molecules to treat various diseases [1]. Most single-molecule drugs of natural origin were developed in the middle of the 20th century through the active screening of natural products for bioactive molecules [2]. Examples include artemisinin, cyclosporine, taxol, doxorubicin, and many others. However, at the beginning of the 21st century, we saw a decline in …

An Evaluation Of The Association Between Female Reproductive Health Policy And Children's Health Outcomes, Kira Markowski, Rachel Bobko

Scholarship in Medicine - All Papers

Background: As policy pertaining to female reproductive health and education continues to be a central issue concerning Americans and a divisive focus of political campaigns, it is important to fully understand the ramifications of female reproductive health legislation not only on women’s health outcomes but also the health outcomes of children and adolescents.
Objective: We set out to identify how legislation and policy related to female reproductive health and education impacts the health and well-being of children and adolescents. By evaluating this relationship, we aim to show whether variations in policy correlate with variations in a child’s well-being as lawmakers …

The Relationship Between Socioeconomic Factors And Low Birth Rates In Ohio, Ryan Gora, Hannah Amin

Scholarship in Medicine - All Papers

Background: The incidence of low birth weight (LBW) has not substantially fallen over time despite advances in medical interventions. LBW has been linked to several chronic diseases in adulthood including type 2 diabetes (T2DM) and cardiovascular disease (CVD), making it a particularly salient public health issue.
Objective: To examine socioeconomic factors and diseases associated with LBW in Ohio between 2016-2022.
Methods: Using data from County Health Rankings, we identified socioeconomic factors predictive of LBW in Ohio between 2016-2022. We also examined the relationship between LBW and incidence of T2DM as well as food insecurity (FI). In addition, we investigated how …

Association Between Teaching Clinic Structure And The Readiness Of Ophthalmology Residents To Enter Independent Practice, T. Michael Kashner, Marjorie A. Bowman, Catherine P. Kaminetzky, Andrea D. Birnbaum, John M. Byrne, Paul B. Greenberg, Steven S. Henley, Karen M. Sanders

Population and Public Health Sciences Faculty Publications

Our objective is to determine if the structure of Graduate Medical Education teaching clinics is associated with how well ophthalmology residents are prepared to meet the workload demands of independent clinical practice. Resident preparedness to enter independent practice was measured by the Readiness Index. Part of the Department of Veterans Affairs’ new Workload-based Resident Academic Performance measures (WRAP), resident readiness is computed from electronic health records for residents by clinic and service-date. The index compares resident productivity net of supervision and adjusted for care quality to the average productivity of non-supervising ophthalmologists. Readiness comprises a Workload component (ratio of resident …

The Acid Sphingomyelinase Inhibitor Imipramine Enhances The Release Of Uv Photoproduct-Containing Dna In Small Extracellular Vesicles In Uvb-Irradiated Human Skin, M. Alexandra Carpenter, Anita Thyagarajan, Madison Owens, Christina E. Borchers, Jeffrey B. Travers, Michael G. Kemp

Dermatology Faculty Publications

Nucleic acids, lipids, and other cell components can be found within different types of extracellular vesicles (EVs), which include apoptotic bodies (ABs), large extracellular vesicles (LEVs), and small extracellular vesicles (SEVs). Release of LEVs from cells can be reduced by genetic or pharmacological inhibition of the enzyme acid sphinogomyelinase (aSMase), and indeed several studies have demonstrated a role for the clinically approved aSMase inhibitor imipramine in blocking LEV release, including in response to UVB exposure. Given that exposure of keratinocytes to UVB radiation results in the generation of UVR photoproducts in DNA that can subsequently be found in association with …

Association Between Multimorbidity And Postoperative Mortality In Patients Undergoing Major Surgery: A Prospective Study In 29 Countries Across Europe, Starsurg Collaborative, Eurosurg Collaborative

Department of Surgery Faculty Publications

Background Multimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery. Methods This was a pre-planned analysis of a prospective, multicentre, international study investigating cardiovascular complications after major abdominal surgery conducted in 446 hospitals in 29 countries across Europe. The primary outcome was 30-day postoperative mortality. The secondary outcome measure was the incidence of complications within 30 days of surgery. Results Of 24,227 patients, 7006 (28.9%) had one long-term condition and 10,486 (43.9%) had multimorbidity (two or more …

Low-Acuity Pediatric Emergency Department Utilization, Lisa Ziemnik, Noah Parker, Kyra Bufi, Kristen Waters, Jacob Almeda, Adrienne Stolfi

Medical Education Faculty Publications

Objectives: Proper emergency department (ED) utilization is a hallmark of population health. Emergency department overcrowding due to nonurgent visits causes increased stress to healthcare staff, higher costs, and longer wait times for more urgent cases. This study sought to better understand post pandemic reasons caregivers have when bringing in their children for nonurgent visits and devise effective interventions to improve caregiver choice for non-ED care for nonurgent conditions.

Methods: Surveys were conducted at an urban pediatric hospital for Emergency Severity Index (ESI) level 3 to 5 visits. A total of 602 surveys were completed with 8 being excluded from analysis. …

Competency-Based Medical Education And The Education Continuum: Establishing A Framework For Lifelong Learning, Ann E. Burke, Daniel J. Sklansky, Hilary M. Haftel, Andrew Mitchell, Keith J. Mann

Pediatrics Faculty Publications

Competency Based Medical Education (CBME) is built on the concept that the competencies of learners, both graduates and practicing physicians, should ensure they are ready to meet the ever-changing healthcare needs of patients.1, 2, 3 Education outcomes in a CBME system are defined based on the needs of patients, and in healthy CBME systems, there is a paradigm shift from a focus on process and teachers to outcomes and learners.2,4 CBME should occur across the continuum of one's career, from undergraduate medical education through retirement. Furthermore, learners must be accustomed to driving their own educational processes.4,5 This learner-centered perspective requires …