Nephrology Commons^™

Transplantability In Burdened Populations: A Regional Analysis Of The Robotic-Assisted Kidney Transplant Impact On Access Given Socioeconomic And Demographic Factors, Earnest James Davis Jr.

Dissertations

Introduction/Background

The social contract of health (SCOH) in America that governs healthcare interactions has listed toward provider organizations and away from the patient. End stage renal disease treatment provides an explicatory case to examine an unbalanced SCOH. The study evaluates whether the robot-assisted kidney transplantation (RAKT) technique allows for patients with higher body mass indices and of burdened socioeconomic and sociodemographic status improved access to transplant compared to traditional open kidney transplant (OKT).

Methods

The study set combined extant data for patients transplanted at Chicago from two data sets. Investigators used independent t-tests, chi-squared tests, survival analysis, analysis of frequencies, …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Improving End Stage Renal Disease Quality Incentive Payment Total Performance Scores, Shelly Guyer, Gina Gregg, Bradley Warady

Posters

The End Stage Rena Disease (ESRD) Quality Incentive Program (QIP) promotes high quality, transparent, cost-efficient care in outpatient dialysis facilities by establishing performance standards that are linked to payment.

The development of a subject matter expert and the sharing of ESRD QIP knowledge resulted in buy-in from dialysis staff and physicians leading to a higher total performance score and the avoidance of payment reduction.

Original Parts: Aging And Reckoning With Cystic Fibrosis Related Kidney Disease, Alexandra Ch Nowakowski

Patient Experience Journal

Kidney disease increasingly impacts people with cystic fibrosis (CF) as adult patients continue to survive longer. Yet the literature on CF related kidney disease focuses little on amplifying the voices of people aging with the condition. This article presents perspectives on CF related kidney disease from a medical sociologist who is themselves managing these issues. It (1) gives an overview of relevant literature and trends in epidemiological data on kidney disease and CF, (2) details the author’s own process of adjusting to progressive changes in renal function, and (3) outlines opportunities for clinicians to make a positive impact for patients …

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

Honors Theses

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 …

Racial Differences In Renal Replacement Therapy Initiation Among Children With A Nonglomerular Cause Of Chronic Kidney Disease., Derek K. Ng, Marva Moxey-Mims, Bradley A. Warady, Susan L. Furth, Alvaro Muñoz

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: African American (AA) adults with chronic kidney disease (CKD) have a faster progression to end-stage renal disease and are less likely to receive a kidney transplant. It is unclear whether AA children experience renal replacement therapy (RRT) for end-stage renal disease sooner than non-AA children after accounting for socioeconomic status (SES).

METHODS: Among children with nonglomerular CKD in the Chronic Kidney Disease in Children study, we investigated time to RRT (i.e., first dialysis or transplant) after CKD onset using parametric survival models and accounted for SES differences by inverse probability weights.

RESULTS: Of 110 AA and 493 non-AA children …

Effects Of Acceptance Of Disability On Death Or Dialysis In Chronic Kidney Disease Patients: A 3-Year Prospective Cohort Study, Hsin-Hung Chiang, Hanoch Livneh, How-Ran Guo, Mei-Ling Yen, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Acceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan.

Methods: 262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the …

Dialysis Rationing And The Just Allocation Of Resources: A Historical Primer., Teri Browne

Teri Browne

No abstract provided.

Handbook Of Health Social Work, Teri Browne

Teri Browne

No abstract provided.

Benefits And Barriers: An Exploratory Study Of Nephrology Social Work Field Education, Teri Browne

Teri Browne

No abstract provided.

The Relationship Between Social Networks And Pathways To Kidney Transplant Parity: Evidence From Black Americans In Chicago, Teri Browne

Teri Browne

No abstract provided.

Technological Iatrogenesis: The Manifestation Of Inadequate Organizational Planning And The Integration Of Health Information Technology., Patrick Albert Palmieri

Patrick Albert Palmieri

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and cost effective health services. However, HIT presents the proverbial double-edged sword in generating solutions to improve system performance while facilitating the genesis of novel iatrogenic problems. Incongruent organizational processes give rise to technological iatrogenesis or the unintended consequences to system integrity and the resulting organizational outcomes potentiated by incongruent organizational–technological interfaces. HIT is a disruptive innovation for health services organizations but remains an overlooked organizational development (OD) concern. Recognizing the technology–organizational misalignments that result from HIT adoption is …

Safety Culture As A Contemporary Healthcare Construct: Theoretical Review And Research Assessment, Patrick Albert Palmieri

Patrick Albert Palmieri

GOAL. To analyze the theoretical underpinnings of safety culture and to provide an assessment about the state of safety culture research in healthcare. METHODS. First, we reviewed the concept of safety culture, including its origination, disciplinary influences, and associated theoretical tenets. By describing the literature and discussing the interchangeable use of the terms “safety attitude,” “safety climate,” and “safety culture,” we are able to present the conceptual attributes associated with safety culture and present a definition of safety culture. Then, we discuss the psychometric properties for the most widely used instruments in healthcare. The article concludes with a discussion of …

Safety Culture As A Contemporary Healthcare Construct: Theoretical Review, Research Assessment, And Translation To Human Resource Management., Patrick Albert Palmieri

Patrick Albert Palmieri

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures in order to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established via modification in employee safety perspective and work behavior, human resource professionals need to contribute to this developing organizational domain. The IOM …

Effect Of Donor Ethnicity On Kidney Survival In Different Recipient Pairs: An Analysis Of The Optn/Unos Database., C O. Callender, W S. Cherikh, P Traverso, A Hernandez, Tolulope A. Oyetunji, D Chang

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Previous multivariate analysis performed between April 1, 1994, and December 31, 2000 from the Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) database has shown that kidneys from black donors were associated with lower graft survival. We compared graft and patient survival of different kidney donor-to-recipient ethnic combinations to see if this result still holds on a recent cohort of US kidney transplants.

METHODS: We included 72,495 recipients of deceased and living donor kidney alone transplants from 2001 to 2005. A multivariate Cox regression method was used to analyze the effect of donor-recipient ethnicity on graft and patient …

Attribution Theory And Healthcare Culture: Translational Management Science Contributes A Framework To Identify The Etiology Of Punitive Clinical Environments, Patrick Albert Palmieri

Patrick Albert Palmieri

The Institute of Medicine’s seminal report, To err is human: Building a safer health system, established the national patient safety framework and initiated interest in changing the traditionally punitive healthcare culture. This paper reviews a multidisciplinary literature and offers an attribution framework to explicate the organizational processes that contribute to an industry-wide culture where clinicians are routinely blamed for adverse patient events. Attribution theory is concerned with the manner in which people explain the behaviors of others or themselves by assigning causality for events. To date, attribution theory, though well established in the management literature, has yet to be translated …

Screening, Diagnosis, And Treatment Of Depression In Patients With End-Stage Renal Disease, Scott D. Cohen, Lorenzo Norris, Kimberly D. Acquaviva, Rolf A. Peterson, Paul L. Kimmel

Kimberly D. Acquaviva, PhD, MSW

Depression is common in patients with end-stage renal disease and has been linked to increased mortality. Screening for depression in the general medical population remains controversial; however, given the high prevalence of depression and its significant impact on morbidity and mortality, a strong case for depression screening in patients with end-stage renal disease can be made. Several studies have been performed to validate the more common depression screening measures in patients with chronic kidney disease. The Beck Depression Inventory, the Hamilton Rating Scale for Depression, the Nine-Question Patient Health Questionnaire, and the Center for Epidemiologic Studies Depression Scale are some …

Technological Iatrogenesis: New Risks Force Heightened Management Awareness, Patrick Albert Palmieri

Patrick Albert Palmieri

Iatrogenesis is a term typically reserved to express the state of ill health or the adverse outcome resulting from a medical intervention, or lack thereof. Three types of iatrogenesis are described in the literature: clinical, social and cultural. This paper introduces a fourth type, technological iatrogenesis, or emerging errors stimulated by the infusion of technological innovations into complex healthcare systems. While health information technologies (HIT) have helped to make healthcare safer, this has also produced contemporary varieties of iatrogenic errors and events. The potential pitfalls of technological innovations and risk management solutions to address these concerns are discussed. Specifically, failure …

Religious Problem Solving And Coping With End Stage Renal Disease, Eva Bella Martinez

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the impact of end-stage renal disease life-related couple/family stressors and strains on marital satisfaction, parental satisfaction, life satisfaction, and depression on end-stage renal disease patients and their spouses, as well as quality of life for patients. Also, it examined the moderating effects of three styles of religious problem-solving on the relationship between the ESRD couple/family stressors and strains and the outcome variables. Data included a sample of two hundred subjects and their spouses. Subjects were recruited from seven dialysis centers in southern California. Both patients and spouses were given survey questionnaires (i.e. Personal History Inventory, Religious Problem-Solving …