Public Health Commons^™

Evaluation Of The Role Of Prolactin To Prevent Diabetic Retinopathy, Suliman A. Suliman

Digital Journal of Clinical Medicine

Abstract:

Introduction: Diabetic retinopathy (DR) is a one of the long-term complications of DM and constitutes the leading cause of blindness in working-age individuals and affects a majority of diabetic patients by 20 years after disease onset.

Objective: The aim of this study it investigation of the potential role of prolactin in the prevention of Diabetic retinopathy.

Methods: The study was conducted on 90 diabetic patients who were divided into a group that included 37 patients without retinopathy and a group that included 27 patients with non-proliferative retinopathy and 26 patients with proliferative retinopathy who attended the Endocrinology clinic and …

The Crucial Role Of Community Medicine In Improving Public Health, Malik Maaz Ahmad, Imran Ahmed Khan, Neha Priyanka

Digital Journal of Clinical Medicine

Community medicine, also known as Social and Preventive Medicine, is a specialized field of medicine that focuses on promoting and protecting the health and well-being of communities and populations. Unlike other medical specialties that primarily focus on individual patients, community medicine takes a broader approach, addressing the health needs of entire populations. The specialty of community medicine plays a vital role in clinical practice and public health. Its focus on prevention, population health, and evidence-based medicine makes it an essential discipline in improving the health and well-being of communities. Community-based medical education is of vital relevance in the modern change …

Umbrella Review As A Data Collection Tool: Towards Observation, Analysis, And Empirical Transformation Of Qualitative Drivers Describing Healthcare Workforce Shortage Factors Into Quantitative Data To Support Medical Education Interventions In A Global Challenge., Fabio Galli, Marco Grech

Digital Journal of Clinical Medicine

A healthcare workforce shortage of 18 million is expected by 2030, against a global demand of 80 million, and it is difficult to analyse and monitor the real drivers driving this personnel shortage on a global level. The transformation of qualitative data into quantitative data can be a strategy in this global challenge, that can implement the medical education intervention strategies.

Atypical Immune Response: Acquired Hemolytic Anemia In A Non-Hodgkin Lymphoma Patient With Unusual Findings, Mannan Mangal

Digital Journal of Clinical Medicine

Acquired hemolytic anemia, caused by external factors like autoimmune disorders or infections, includes rare cases of Cold Agglutinin Syndrome (CAS), a cold-antibody-mediated condition affecting 1 in 1 million annually. This report highlights a unique case of CAS in a patient with Non-Hodgkin lymphoma and polyclonal gammopathy, contrasting with the typical presentation of warm-reactive autoantibodies and monoclonal antibodies. The patient presented with weakness, breathlessness, and splenomegaly, with laboratory findings showing a hemoglobin level of 5.8 g/dL and elevated ferritin. Imaging revealed mesenteric lymphadenopathy and thickening of the cecum, suggesting possible lymphomatous involvement. Non-Hodgkin lymphoma was confirmed via lymph node biopsy. This …

Group Approach: Inter-Institute Interactive Sessions For Psychiatry Postgraduate Residents On Mastering The Art Of Prioritization In Everyday Learning., Abhay Koul, Murali M R, Kishor M, Narendra Kumar M S

Digital Journal of Clinical Medicine

Collaboration and knowedge-sharing are essential in Psychiatry as complex mental health challenges require innovative solutions. Inter-institute interactive sessions are important platforms, providing psychiatry postgraduate residents with opportunities to connect, exchange ideas, and advance their understanding of the field collectively. Inter-institution sessions help break the geographic barriers between institutions and build bridges that foster collaboration, networking, and professional growth. There is hardly any literature available on these aspects. The Department of Psychiatry, JSS Medical College, Myusru organized an interactive session between psychiatry post-graduates of JSS Medical College and Mysore Medical College. Students were informed about the rules of the group approach …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

The Benefits Of Prenatal Education Via Virtual And Mobile Applications Before, During, And After Pregnancy: A Quality Improvement Project, Lindsay Farland

Master's Theses and Capstones

Background: The advancements of technology has led to a substantial increase in the use of pregnancy applications among expecting parents. Studies indicate that a majority of pregnant individuals utilize virtual education platforms for various purposes, including accessing information on nutrition, exercise, baby development, and pregnancy symptoms. Despite the potential benefits, participation in these platforms remains low, emphasizing a need for enhanced resources and engagement strategies. Research shows that engagement with antenatal education through mobile applications can lead to improved maternal and fetal outcomes, such as reduced rates of caesarean births and fewer complications related to hypertension or preeclampsia.

Methods: …

Nursing Education On Sleep Health And Its Impact On Insulin Resistance In Adolescents, Salamasina Tufa

Nursing | Student Research Posters

Sleep is essential for human physical restoration, cognitive function, and emotional well-being. Recent studies have discovered that sleep is also important for proper endocrine system health, and problems with sleep may directly put a person at risk for Type II Diabetes Mellitus (T2DM) (Tsuneki et al., 2016). A precursor to T2DM is insulin resistance (IR), which is when insulin is not effective in bringing glucose into the cells for energy. (Centers for Disease Control and Prevention [CDC], 2024). Sleep disorders, poor sleep quality, and short sleep duration contribute to IR by harming the body’s cells, making them less responsive to …

Evidence Synthesis Methodology: Promoting Reproducible Methodology Through Modified Assignments, Laura Lipke, Neyda Gilman

Library Created Resources

Initially, systematic reviews in healthcare served to synthesize findings from clinical studies, aiding comprehensive access to the most effective treatments within evidence-based practice. Over time, their scope has broadened beyond treatment effectiveness, leading to a surge in publication. Consequently, many health science faculty now assign systematic reviews in classrooms without a full grasp of the standardized process, leaving students ill-equipped due to insufficient guidance and resources.

While mastering systematic review techniques is crucial for evidence-based practice, faculty can opt for modified assignments to foster a deeper understanding of the review process. These modified tasks, can be completed within a semester, …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Implementation Of Prognosticator Algorithm For Initiation Of Serious Illness Discussions And Improving The Rate Of Palliative And Hospice Referrals, Joy Isebor

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Context: Early serious illness conversations related to end-of-life and goals of care with seriously ill patients have been associated with improving patients' outcomes and quality of care (Bernacki et al., 2015). However, initiating these serious illness discussions has been challenging in the home-based primary care setting.

Objectives: To train and support home-based primary care clinicians in integrating best practices in serious illness discussions and decision-making engagement among patients sixty-five and older with serious illnesses, optimize the alignment between patient goals and the medical care they receive, improving their quality of life and the rate of palliative care and hospice referrals. …

Obesity Management Guideline For The Correctional Setting, Rumi Y. Sato

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Obesity can cause multiple chronic conditions, including cancer and death. Los Angeles jail primary care clinics do not address obesity management despite health hazards, rising costs, and high obesity rates in correctional facilities. The Centers for Medicare and Medical Services (CMS) obesity-management guidelines are over ten years old and outdated. The aim of this Doctor of Nursing Practice (DNP) project was to update the CMS obesity-management guideline with the newest intense behavioral therapy (IBT) evidence to assist the correctional multidisciplinary healthcare team. This project took place in a Los Angeles correctional facility's primary care clinic. A detailed literature review gathered …

The Impact Of Multidisciplinary Just-In-Time Training On Confidence In The Delivery Of Care In The Humanitarian And Disaster Response Environment, Jennifer Verstreken

DNP Scholarly Projects

Background: Team Rubicon International deploys emergency medical teams with little targeted training on the health and illness patterns common to the geographic region and the type of disasters to which they respond, such as cholera, malaria, and malnutrition. These high-risk, low-incidence illnesses are infrequently seen in Western medical practices. Medical, nursing, and paramedical training programs address these illness patterns in the curriculum. Still, a lack of consistent exposure to the care and treatment of patients with these illnesses can lead to a lack of knowledge and confidence in delivering appropriate care.

Purpose: This quality improvement project aimed to determine if …

Addressing Healthcare Disparities Faced By Aging Down Syndrome Populations, Rhea Mistry

Pitzer Senior Theses

Down syndrome (DS) is a chromosomal genetic condition that impacts the development of the body and brain. The life expectancy of individuals with DS has drastically improved over the decades, increasing from 9 years in 1929 to 25 years in 1983 and further reaching 60 years by 2002. Individuals with DS face a variety of prominent co-occurring health conditions that are subject to change over time, including cognitive, visual, and hearing impairments, sleep apnea, cardiovascular defects, Down syndrome regression disorder, and dementia. Despite this increase in life span, DS is still most familiar to pediatric care providers, resulting in healthcare …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Introducing Comprehensive Sexuality Education And Hiv Prevention And Treatment Methods Through Pop-Up Clinics To Secondary School Girls In Kwazulu-Natal, South Africa, Eliza I. Tobin, Joaquin Carlos Pinga, Caitlyn Stanya

Capstone Showcase

Human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system leading to people living with HIV (PLHIV) immunodeficient and more susceptible to other infections or diseases (UNAIDS, 2023b). This can lead to acquired immunodeficiency syndrome (AIDS) within 8-10 years of infection (UNAIDS, 2023b). HIV does not always present symptoms, making it hard for people to identify their HIV status without proper screening. The lack of awareness around a person’s status has led HIV to spread worldwide. In addition to the worldwide spread of HIV, there is no cure for the disease, however, antiretroviral therapy (ART) is mainly used …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Grading Of Malnutrition Among Under 5 Children Residing In Urban Slum In Mysuru Using Who Classification And Indian Academy Of Pediatrics (Iap) Classification: A Comparative Study, Ravali Annaram Dr, Amogha Shree Dr, Saurish Hegde Dr, Krishnaveni Y S Dr

Digital Journal of Clinical Medicine

Background

Malnutrition in Indian children under five is widespread, driven by insufficient food intake and diseases like diarrhoea and respiratory infections. Factors such as food security, maternal literacy, and healthcare access influence malnutrition rates. Growth monitoring utilizes WHO standards globally and IAP guidelines in India. Implementing these charts improves early identification and management of malnutrition, crucial for addressing childhood health challenges in India. This study compare the prevalence of malnutrition in WHO classification with Indian Academy of Paediatrics (IAP) classification among under 5 children residing in urban slum.

Methodology

A community based cross-sectional study was conducted among children aged 6 …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Training Underrepresented Minority Students For Careers In Public Health Leadership – Public Health Leaders Fellowship Program, Jigsa Tola

College of Graduate Studies: Theses & Dissertations

Background: Shortage and lack of diversity in the United States public health workforce is well documented and remains a challenge to meaningfully improving the health of the population. Although the diversity of the public health workforce has implications for access, care quality, and career opportunities in low-income communities, there is no strong mechanism by which minorities are trained to replenish the workforce. Morehouse College’s Public Health Leaders Fellowship Program (MC-PHLFP) is a cooperative program with the Centers for Disease Control and Prevention (CDC) to train undergraduate students for careers in public health leadership.

Purpose: The purpose of this research is …

Comparing The Use And Effectiveness Of In-Person And Remote Physical Education Delivery During The Covid-19 Pandemic, Kempson Onadeko, Timothy J Walker, Derek W Craig, Jacob Szeszulski, Andjelka Pavlovic, Laura F Defina, Harold W Kohl

Faculty, Staff and Student Publications

BACKGROUND: Physical Education is a key component to improve youth health, but there is limited information on Physical Education delivery in different formats.

PURPOSE: We compared PE formats (in-person versus remote) across evaluation aspects: weekly minutes; perceived effectiveness; and student-to-teacher ratio.

METHODS: We distributed questionnaires (2020-2021 school year) to school contacts who represented NFL Play 60 FitnessGram

RESULTS: Among 165 schools, 10% (n=17) offered in-person instruction, 31% (n=51) offered remote instruction, and 59% offered both (n=97). Results revealed higher in-person PE minutes (77.2±7.3) compared to remote minutes (67.1±14.6), but results were not significantly different (p=0.19). School contacts reported significantly more …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Scope And Limitations Of Chatgpt In Research And Academic Writing, Shyam Pyare Singh, Imran Ahmed Khan, Shaila Kumari Mitra

Digital Journal of Clinical Medicine

Background: ChatGPT has proven to be an invaluable tool, enabling human-like interactions, and facilitating knowledge exchange. It possesses the ability to generate coherent and contextually relevant responses based on the input it receives. In essence, ChatGPT responds to anything in a conversational manner and provides an output that looks like human writing. However, with the rapid advancement of medical research, there is an increasing concern that ChatGPT may be abused to create articles devoid of clinical reasoning and critical thinking.

METHODS: A through literature search was conducted on PubMed and Google scholar to find relevant article according to objective.

RESULTS: …

A Real World Study Of Adherence To Insulin In Diabetic Humans-Stadium Study, Dipsanker Chatterjee, Subham Das

Digital Journal of Clinical Medicine

Background:

With an ever-increasing prevalence of diabetes, lack of adherence to insulin treatment in even a small percentage of patients is a major issue and can lead to significant burden on the healthcare system. This survey analysis seeks to investigate the insulin adherence patterns to identify the factors associated with medication adherence.

Methodology:

The current cross-sectional survey was conducted among diabetes patients on insulin treatment. A list of questions about insulin adherence was provided to the participants in the study and the responses were recorded. The data was analysed using Graph Pad Prism.

Results:

Around 23.2 and 18.6 % of …

Internet Addiction: A Growing Threat: A Cross-Sectional Among The Undergraduate Medical Students Of Tertiary Care Hospital, Mysuru, Rakesh M, Diksha Goswami, Sunil Kumar D, Shwethashree M

Digital Journal of Clinical Medicine

Background: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru.

Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1^st to November 30^th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the …

Placenta Accreta Spectrum Disorder As First Trimester Pregnancy Termination Complication; Case Series, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Placenta Accreta Spectrum (PAS) disorder is rare (2% according to ACOG) condition of pregnancy when the placenta grows deeply into myometrium. This leads to failure of placenta to separate normally from myometrium after delivery and leads to massive hemorrhage. The PAS is classified as PA (Placenta Accreta), PI (Placenta Increta) and PP ( Placenta Percreta), on basis of depth of trophoblastic invasion. Increase in no. of cesarean sections, increasing the incidence of PAS. Cesarean scar on uterus promotes placental tissue to invade deeply in subsequent pregnancy. Antenatal scanning and color imaging can detect PAS, at a very early stage. Here …

Gender Equality– A Sustainable Development Goal In Progress At A Medical College And Hospital In South India, Mr. Manoj S M, Kusuma Kasapura Shivashankar, Suma M. Natraj, Praveen Kulkarni

Digital Journal of Clinical Medicine

Background: Gender Equality is one of the most important SDG and attaining it will ensure a peaceful, prosperous and a balanced world with equal opportunities for both women and men. The Indian scenario in the field of women education has changed with mindset of most parents undergoing a paradigm shift and many girls are encouraged to attend schools, colleges and women are allowed to work. Considering the above shift, our study intended to find out if the same was true and SDG-5, Gender Equality was attained or in progress at our medical college and hospital and hence the study.

Methods: …

The Balm Framework Of Clinical Excellence: An Adoptable Model For Sub-Saharan Africa., Taoreed Adegoke Azeez

Digital Journal of Clinical Medicine

Clinical excellence is the ability to provide rigorous, evidence-based, and rewarding care to the right patients. The BALM (brilliance, attitude, leadership, and materials) framework is a novel model for adjudicating clinical excellence. There are a few models and frameworks for evaluating clinical excellence, but each has its flaws and does not consider the peculiarities of economically-challenged regions such as sub-Saharan Africa. Coincidentally, such low-resource areas have an urgent need for a framework to assess clinical excellence because of their low health-related indices. The five-step mode of professional excellence is a well-recognised tool and was the model upon which the BALM …

Alkaptonuria Presenting With Back Pain: A Diagnostic Dilemma, Arnav Salar, Dyuksha Arora, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Alkaptonuria is a rare inborn error of metabolism due to a deficiency of homogentisate 1,2 dioxygenase, resulting in homogentisic acid accumulation in tissues. It is characterised by homogentisic aciduria, ochronosis, and arthritis. We hereby discuss a 46-year-old male who presented with progressive lower back pain and polyarthralgia for ten years, initially diagnosed as ankylosing spondylitis. Characteristic skin pigmentation, ochronosis, and radiological findings led to the correct diagnosis of alkaptonuria. This case highlights the importance of considering alkaptonuria as a differential diagnosis for chronic back pain and arthritis, mainly when sacroiliac joints are spared, and ochronosis is present. While no cure …