Medical Specialties Commons^™

Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson

Doctor of Nursing Practice Scholarly Projects

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …

Expanding Awareness Of Tbi Resources In The North Country, Nicholas W. Krant

Family Medicine Clerkship Student Projects

Disability, emotional dysregulation and financial stress are only some of the issues that many patients who suffer TBI encounter. While resources are available to alleviate some of these burdens on patients who suffer TBI in New York's North Country, patients often struggle to find these resources. This project endeavors to create a resource for patients, family members and practitioners to find available resources.

How To Create This Gynecological Task Trainer, Jami Monico, Karen S. Carlson

Posters and Presentations: Obsetrics & Gynecology

This document contains instructions for how to create a gynecological task trainer with a 3D-printed uterus and silicone cervix.

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

Rare Tumors: Opportunities And Challenges From The Children's Oncology Group Perspective., Kris Ann P. Schultz, Murali Chintagumpala, Jin Piao, Kenneth S. Chen, Rachana Shah, Robyn D. Gartrell, Emily Christison-Lagay, Farzana Pashnakar, Jesse L. Berry, Allison F. O'Neill, Lauren M. Vasta, Ashley Flynn, Sarah G. Mitchell, Brittani Kn Seynnaeve, Jeremy Rosenblum, Samara L. Potter, Junne Kamihara, Carlos Rodriguez-Galindo, Douglas S. Hawkins, Theodore W. Laetsch

Manuscripts, Articles, Book Chapters and Other Papers

While all childhood cancers are rare, tumors that are particularly infrequent or underrepresented within pediatrics are studied under the umbrella of the Children's Oncology Group Rare Tumor committee, divided into the Retinoblastoma and Infrequent Tumor subcommittees. The Infrequent Tumor subcommittee has traditionally included an emphasis on globally rare tumors such as adrenocortical carcinoma, nasopharyngeal carcinoma, or those tumors that are rare in young children, despite being common in adolescents and young adults, such as colorectal carcinoma, thyroid carcinoma, and melanoma. Pleuropulmonary blastoma, gonadal stromal tumors, pancreatic tumors including pancreatoblastoma, gastrointestinal stromal tumor, nonmelanoma skin cancers, neuroendocrine tumors, and desmoplastic small …

Protocol For Intervention Development To Improve Adolescent Perinatal Mental Health In Kenya And Mozambique: The Inspire Project, Kethakie Lamahewa, Sally Griffin, Nadine Seward, Marleen Temmerman, Jonathan West, Málica De Melo, Elizabeth Raby, Aline Alonso, Bethan Burnside, Fernando Chissale

Obstetrics and Gynaecology, East Africa

Introduction: Mental health interventions have traditionally been developed by clinicians and researchers without the meaningful engagement and partnership with those who would receive, deliver, and fund them. Recent progress has highlighted the importance of the co-design of interventions, through stakeholder participation, as a means of increasing the integration of mental health interventions into existing health, education, and social care systems. This protocol describes the pre-implementation phase of the INSPIRE (Innovative approaches to adolescent perinatal wellbeing) project which aims to identify challenges, and design and test interventions to promote mental wellbeing and good mental health of adolescent girls during pregnancy and …

Word Reading, Reading Comprehension, And Eye Movements During Reading In Chinese Persons With Aphasia, Xiaobin Wang

Theses and Dissertations

Individuals with aphasia (IWA) often exhibit challenges in single word reading as well as in reading comprehension. Recently, eye-tracking technology has become instrumental in delving deeper into reading behaviors. Specifically, it has illuminated the differences in word reading and comprehension abilities among aphasic English speakers. However, there is a noticeable scarcity of research focusing on these aspects among Chinese IWA. The current study aimed to contrast the abilities of Chinese IWA and neurotypical controls in reading single words, with an emphasis on types like regular, irregular, and pseudowords, and reading comprehension abilities. Further, this study investigated the patterns of eye …

Supra-Additive Effect Of Chronic Inflammation And Atherogenic Dyslipidemia On Developing Type 2 Diabetes Among Young Adults: A Prospective Cohort Study, Yulong Lan, Dan Wu, Zhiwei Cai, Yuancheng Xu, Xiong Ding, Weiqiang Wu, Shaocong Lan, Lan Chen, Zheng Guo, Lois Balmer, Xingang Li, Manshu Song, Shouling Wu, Jingli Gao, Wei Wang, Youren Chen

Research outputs 2022 to 2026

Background: Both elevated inflammation and atherogenic dyslipidemia are prominent in young-onset diabetes and are increasingly identified as biologically intertwined processes that contribute to diabetogenesis. We aimed to investigate the age-specific risks of type 2 diabetes (T2D) upon concomitant chronic inflammation and atherogenic dyslipidemia. Methods: Age-stratified Cox regression analysis of the risk of incident diabetes upon co-exposure to time-averaged cumulative high-sensitivity C-reactive protein (CumCRP) and atherogenic index of plasma (CumAIP) among 42,925 nondiabetic participants from a real-world, prospective cohort (Kailuan Study). Results: During a median 6.41 years of follow-up, 3987 T2D developed. Isolated CumAIP and CumCRP were significantly associated with incident …

Knowledge, Attitude, And Perception Of The General Public Towards The Impact Of Hemoglobinopathies On Pregnancy Outcomes: A Questionnaire-Based Study, Kumud Dhankhar, Kiran Dahiya, Shobha Chikkavaddaragudi Ramachandra, Akila Prashant

International Journal of Health and Allied Sciences

Background: Knowledge about hemoglobinopathies in the general public is unsatisfactory. Many couples are unaware of their carrier status and a child can be born with unexpected, serious hemoglobinopathies. Willingness to participate in screening programs can substantially help in bringing down the birth of children affected with hemoglobinopathies. To understand the knowledge, attitude, and perception of the general public on various hemoglobinopathies and their pregnancy outcomes we performed a questionnaire-based descriptive survey. Methods: After obtaining approval from the institutional ethics committee and validation by an expert panel we circulated a Google form consisting of 21 questions via WhatsApp which was made …

Implementation Of Standardized Patient Education To Improve Adherence With Colonoscopy For Colorectal Cancer Screening, Melissa Leal Hearn, Melissa M. Hessock, Tara L. Hahn

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer deaths among men and women in the U.S. CRC is preventable and manageable when detected early. Approximately 30% of average-risk Americans are overdue for colonoscopy screening. Colonoscopy screenings can reduce death by 67%. Current evidence suggests CRC screening education improves screening uptake among men and women at average-risk age.

LOCAL PROBLEM: The setting of this practice improvement project was a private colorectal surgery practice in South Texas, serving primarily Hispanic/Latino and Caucasian patients. Cancellation rates before colonoscopy were 16.8%, and there was no standardized education for CRC …

Acceptance, Awareness, Attitude, And Practices Toward Heart Transplantation: A Saudi Based Survey, Walid Abukhudair, ​​Ahmad Zaki ​ Hafiz, ​​Mohammed Abdullah ​ Alosaimi, ​​Fares Abu ​ Alaynayn, ​​Fahad Abdullah ​ Alosaimi, ​​Rehab Ahmed ​ Karam, ​​Tamer Mohamed ​ Abdelrahman

Journal of the Saudi Heart Association

Introductions: The awareness of brain death and heart donation (HD) among the Saudi population remains limited, coupled with negative attitudes toward heart donation, resulting in a significant gap between the demand for donor hearts and the available supply. This study aimed to comprehensively understand the current perceptions, attitudes, and practices of the Saudi population regarding HD, as well as identify the obstacles. The ultimate goal was to strengthen the local donor pool. Methods: A cross-sectional study was conducted from March to May 2023, employing a self-administered internet survey. The survey collected demographic information, assessed awareness, attitudes, and practices related to …

Decreasing Perioperative Medication Errors With Standardized Labeling Education, Stephanie Mccain, Emily Almond, Anna Wong, Julie Bonom

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Medication errors are prevalent within the perioperative setting (Wahr et al., 2017). The anesthesia provider is the sole professional in charge of the medication process in the operating room, which results in fewer safety checks than in other healthcare settings (Nanji et al., 2016).

LOCAL PROBLEM: The proposed scholarly project aimed to reduce medication errors at an academic medical center in the Southeast using an educational module focused on standardized narcotic syringe labeling. The participants were anesthesia providers in the operating room at the project site.

METHODS: The Evidence-Based Practice Improvement model was used to guide the development, implementation, …

Assessing Tracheostomy As A Risk Factor For Hearing Loss In Neonates With Bronchopulmonary Dysplasia, Emma Hershey, Terrence Pleasant, Andrew Benvenuto, Katie Kuboushek, Clare Furuta, Patricia Purcell

Journal of Early Hearing Detection and Intervention

Objectives: This study compares the risk of hearing loss in children with bronchopulmonary dysplasia (BPD) based upon whether the child required tracheostomy.

Method: A retrospective chart review was conducted that included all children diagnosed with BPD from 2013–2020 at a single tertiary medical institution. Primary outcome was presence of hearing loss. Children without follow-up audiogram were excluded from analysis. Risk comparison was made using hazard analysis; Cox regression model controlled for exposure to ototoxic medications.

Results: There were 177 infants diagnosed with BPD who had sufficient follow-up for inclusion. Thirty-two children (18%) underwent tracheostomy placement. Children with tracheostomy were at …

Botulinum Toxin Type A Injections For Refractory Abdominal Dystonia: A Case Report, William J. Naber Ii, Jodi M. Wilhelm, Kurt A. Kuhlman, Gabriel Howard

Graduate Medical Education Research Journal

Background: A 58-year-old male with chronic bilateral treatment resistant abdominal spasms secondary complications of ascites/ alcoholic cirrhosis. Spasms would occur 4-5 times/day, lasting minutes to hours despite a 2-year course of therapeutic and pharmacological interventions. Due to treatment refraction, 6 uniformly spaced botulinum toxin type A (BTX-A) injections were placed per side, using electromyography for audible intramuscular syringe placement confirmation, while visual confirmation was made via ultrasound. During the initial trial, 6 evenly spaced injections were performed bilaterally, uniformly distributing 80U/side. Injections began bilaterally just medial to the junction of the inferior rib cage border/ anterior axillary line and progressed …

Idiopathic Intracranial Hypertension: A Case Report, Christopher Bugajski Od

Optometric Clinical Practice

Background: Optic nerve head edema is a serious finding for which multiple etiologies need to be considered. When optic nerve head edema is observed bilaterally, among the top differentials is idiopathic intracranial hypertension (IIH), also known as primary pseudotumor cerebri. An emergent magnetic resonance image with and without contrast as well as venography and lumbar puncture with opening pressure measurement must be performed to diagnose and determine management. Case Report: This case specifically features a 30-year-old Caucasian female with bilateral optic disc edema secondary to IIH. In addition to discussing the details regarding this patient’s case, this report …

Adult Ileoileal Intussusception Caused By Diffuse Large B-Cell Lymphoma, Scarlet Louis-Jean, Shire Chaudhry, Stephanie Richards

Journal of Community Hospital Internal Medicine Perspectives

Adult intussusception is a rare diagnosis that can be caused by non-Hodgkin’s diffuse large B-cell lymphoma (DLBCL). In this case report, we discuss a middle-aged man who presented with non-specific symptoms of intussusception and absence of classic B symptoms. He was found to have intussusception secondary to stage IIIE, CD20 positive DLBCL. The patient underwent small bowel resection with anastomosis, followed by 6 cycles of R-CHOP, which resulted in complete remission of his neoplasm. In reporting this case, we hope to further highlight the role of malignancy in intussusception and guidance on appropriate therapy.

Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos

Journal of Wellness

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center.

Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience …

Meaningful Engagement Of Patients And Families In A Complex Trial Of Advance Care Planning In Primary Care, Angela K. Combe, Deborah L. Dokken, Mary M. Minniti, Annette M. Totten

Patient Experience Journal

Engagement of Patient and Family Advisors (PFAs) is increasingly recommended as best practice in research. During the design and conduct of a large trial of advance care planning (ACP) in primary care, we expanded on the funder’s (Patient-Centered Outcomes Research Institute®) requirement for an engagement plan and sought to develop an innovative approach to fostering and sustaining meaningful engagement of PFAs throughout all phases of the trial. Structures were developed that integrated PFAs into planning and provided the foundation for their ongoing participation. A continuous quality improvement approach became the framework for ongoing engagement. This involved setting goals; collecting data …

Informed Consent In Surgical Practice With Patients’ Experiences: A Cross-Sectional Study, Seda Kumru, Pakize Yiğit, Meryem Demirtaş, Hüseyin Fındık

Patient Experience Journal

This study aims to evaluate patients' experiences and perspectives regarding informed consent in surgical practice. Data for this cross-sectional study were collected from 276 patients using a questionnaire developed by Falagas et al. Descriptive statistics were employed for all questions. Statistical tests such as the Mann-Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation analysis were performed, and Cohen's effect sizes were reported. IBM SPSS 23.0 was used for all analyses, and p<0.05 was considered statistically significant. A high score on both The Delivered Information Index and The Patient-Physician Index represents a positive informed consent process. Among the participants, 65.2% indicated that they understood all parts of the consent form. Of all patients, 92.8% reported that information about the specific surgical procedure was provided by physicians. However, 47.5% of the patients reported that they did not feel comfortable with their surgeons. The mean score of the Delivered Information Index was 5.63 (2.38). The mean patient-physician relationship score was 14.38 (3.31). There was a moderate positive correlation between the delivered information index and the patient-physician relationship (r=0.50; p<0.001). In addition, there was a moderate positive correlation between the delivered information index and the time spent on the informed consent process, as well as between the patient-physician relationship and the time spent on the informed consent process (r=0.52; r=0.40, respectively). The study emphasized the lack of communication between patients and physicians, the limitation of information on treatment risks, adverse effects, and alternative treatment options.

Experience Framework

This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/).

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Patient Perspectives Of Health-Related Social Needs Screening In An Urban Academic Adult Primary Care Practice, Antony Nguyen, Joselvin Galeas, Jane Jih

Patient Experience Journal

Health-related social needs (HRSNs) affect health outcomes and healthcare utilization. Patients’ perspectives on the incorporation of HRSN screening in primary care settings is limited. We sought to explore adult primary care patient perspectives of HRSN screening from optional patient-provided free-text comments as part of a pilot self-administered HRSN screening survey on seven domains of HRSNs from the Accountable Health Communities HRSNs Screening Tool. The survey was available in English, Chinese or Spanish with a section titled “Comments” that invited patient respondents to provide anonymous free-text responses. We performed a thematic analysis of the written patient comments. Of the 679 participants …