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Proceedings Of 2016 Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 42nd annual Aurora Scientific Day research symposium, held May 25, 2016, in Milwaukee, Wisconsin. Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, students and other allied health professionals affiliated with Aurora Health Care, a not-for-profit health system comprised of integrated hospitals and clinics across eastern Wisconsin and northeastern Illinois.

Effect Of Code Status Handout On Resident Physician Comfort During The Admission Process, Krystina Pischke, Jessica Schmid, Jessica J.F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Discussing code status can be a difficult part of the admission process, especially for residents. There have been various research studies looking at interventions to improve end-of-life discussions. However, these studies have focused on well-acquainted physicians and patients. With increasing use of hospitalists for inpatient care, there is increased need for improving code status discussions at admission.

Purpose: To determine if an easy-to-use handout would improve resident comfort with the code status discussion.

Methods: Following a literature search on how to discuss advance directives and end-of-life care, a code status handout was developed. The handout, written at fifth-grade reading …

Path To Resistance: Risk Factors Associated With Carbapenem-Resistant Pseudomonas Aeruginosa, Kushal Patel, Jessica J.F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: An estimated 51,000 health care-associated Pseudomonas aeruginosa infections occur in the United States annually. More than 13% are secondary to non-carbapenem multidrug-resistant strains, which result in 400 yearly deaths. Traditional risk factors for resistance include ICU stay, mechanical ventilation, previous hospitalization and major comorbidities. As microbes evolve, risk factors also may evolve.

Purpose: To determine if traditional and/or new risk factors for P. aeruginosa resistance are valid and predictive of infection with carbapenem-resistant P. aeruginosa.

Methods: We retrospectively studied inpatients and outpatients ≥ 18 years old who presented to an Aurora Health Care facility with a positive P. …

Quality Improvement Of Procedural Services In Family Medicine Residency Clinics, Keisha Rogers, Nora Guschwan, Lisa Sullivan Vedder

Journal of Patient-Centered Research and Reviews

Background: Performing common procedures in our family medicine residency clinics is often a difficult and inefficient process. A 2008 Society of Teachers of Family Medicine consensus statement on procedural training found higher job satisfaction and better financial compensation for family practitioners who performed procedures. Patient satisfaction is likely increased when minor procedures are able to be performed by their primary clinician. This would suggest a disconnect between the known benefits of providing procedural services and the ability of our residency clinics to provide those services in an efficient manner.

Purpose: To assess clinician and staff comfort with performance of common …

Exploring Health Beliefs Among Hispanic Adults With Prediabetes (Poster)., Kyle Shaak Bs, Beth Careyva M.D., Susan E. Hansen Ma, Melanie B. Johnson Mpa, Samantha A. Goodrich, Alicia Rivera, Liselly Diaz, Jessecae K. Marsh Phd, Clare Lenhart Phd, Brian Stello Md

Department of Family Medicine

No abstract provided.

Implementation Of Technology-Based Patient Engagement Strategies Within Practice-Based Research Networks (Poster), Beth Careyva M.D., Kyle Shaak Bs, Geoffrey Mills Md, Phd, Melanie B. Johnson Mpa, Samantha A. Goodrich, Brian Stello Md, Lorraine S. Wallace Phd

Department of Family Medicine

Careyva, B. Shaak, K. Mills, G. Johnson, M. Goodrich, S. Stello, B. Wallace, L. (2016, Nov). Implementation of Technology-Based Patient Engagement Strategies within Practice-Based Research Networks. Poster Presented at: North American Primary Care Research Group, Colorado Springs, CO.

An Interprofessional Clinical Integrations Pilot Program: Integrating Third-Year Pharmd Students Into Family Medicine Clinics, Eric Gilliam, Pharmd, Arian Hilsendager, Fnp, Erin Hagerman, Pa, Benjamin Kirkley, Md, Benjamin Chavez, Pharmd, Kari Franson, Pharmd

JCIPE Conference

Purpose: Pilot an interprofessional student placement model by entrusting Doctor of Pharmacy students to deliver value-added patient engagement within interprofessional clinical environments.

Background: Beginning in January 2016, pharmacy education standards mandate students actively engage in early patient care experiences with interprofessional teams, thus necessitating new models by which students collaborate with providers in the provision of patient care.

Intervention: Between May and August 2016, two family medicine clinics are incorporating 65 third-year pharmacy students into shared medical patient care visits during an interprofessional-provider introductory pharmacy practice experience (IP Provider IPPE) pilot program. Students engage with patients and …

When It Isn’T Always Lyme: Expanding The Differential Diagnosis For Acute-Onset Polyarthralgia In The West Virginia Eastern Panhandle, Natalie A. Moffett, Rosemarie Lorenzetti

Marshall Journal of Medicine

This case presentation discusses a 36 year-old female animal care worker presenting with an acute-onset polyarthropathy during the summer months in a Lyme endemic region. Though she appeared to be a good candidate for the diagnosis of Lyme borreliosis, her screening serology reported negative results and alternative diagnoses were considered. Her subsequent diagnosis with parvovirus B19 acts to remind the general practitioner to have confidence in the accuracy of a negative Lyme screen and, upon negative result, to expand the differential to include less common infections including parvovirus B19. It also highlights the need to remember parvovirus B19 in a …

Syrian Refugee Women In Jordan: Family Planning Preferences And Barriers In A Host Community, Hilary Smith

Independent Study Project (ISP) Collection

The aims of this pilot study were to research and analyze the availability of birth control and family planning resources among Syrian refugee women at a reproductive age. This study took place in the host community of Karak, Jordan. Syrian women are a vulnerable population based solely on their gender. But being refugee women makes them more vulnerable and sometimes, their needs do not get met. This study is important because it will look into reproductive health aspects for this vulnerable population to ensure that there is satisfaction among women about their own health. This cross-sectional study sought to answer …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Access Is Not Enough: Family Planning In Dar Es Salaam, Claire Burrus

Independent Study Project (ISP) Collection

Population growth is a large problem, both globally and at local levels. The global population is growing at an unsustainable rate, particularly in developing nations. Tanzania, as a developing nation, is one of the fastest growing countries in the world, and as a result, faces many hardships related to high population. The Tanzanian government, non-governmental organizations, and private institutions have made attempts to address these concerns by encouraging family planning. Even so, the national population continues to rise. Many social and cultural factors have contributed to this phenomenon. This study was performed in the Women’s Clinic at Sanitas Hospital in …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

Nutritional Status And Physical Abuse Among The Children Involved In Domestic Labour In Karachi Pakistan: A Cross-Sectional Survey., Saima Zainab, Muhammad Masood Kadir

Community Health Sciences

OBJECTIVE:

To determine the prevalence of physical abuse among domestic child labours and to assess the nutritional status by calculating the Body Mass Index of children involved in domestic labour in Karachi.

METHODS:

A cross sectional study was conducted in the squatter settlements of Karachi. Questionnaire based interviews were conducted to capture physical abuse with 385 children who worked as domestic labour in the household of their employer. The ages of the children were between 10 to 14 years belonging to both genders. The children were enrolled in study by snow-ball sampling technique.

RESULTS:

The overall prevalence of physical abuse …

Availability, Affordability, And Consumption Of Fruits And Vegetables In 18 Countries Across Income Levels: Findings From The Prospective Urban Rural Epidemiology (Pure) Study., Victoria Miller, Salim Yusuf, Clara K. Chow, Mahshid Dehgha, Daniel J. Corsi, Karen Lock, Barry Popkin, Sumathy Rangarajan, Rasha Khatib, Scott A. Lear, Prem Mony, Manmeet Kaur, Viswanathan Mohan, Krishnapillai Vijayakumar, Rajeev Gupta, Annamarie Kruger, Lungiswa Tsolekile, Noushin Mohammadifard, Omar Rahman, Annika Rosengren, Alvaro Avezum, Andrés Orlandini, Noorhassim Ismail, Patricio Lopez-Jaramillo, Afzalhussein Yusufali, Kubilay Karsidag, Romaina Iqbal, Jephat Chifamba, Solange Martinez Oakley, Farnaza Ariffin, Katarzyna Zatonska, Paul Poirier, Li Wei, Bo Jian, Chen Hui, Liuxu Xu, Bai Xiulin, Koon Teo, Andrew Mente

Community Health Sciences

BACKGROUND:

Several international guidelines recommend the consumption of two servings of fruits and three servings of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such low intake is related to availability and affordability.

METHODS:

We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity …

Recent Strategies To Improve Community Case Management Of Diarrhea Among Children Under Five In Developing Countries, Fauziah Rabbani, Aysha Zahidie

Community Health Sciences

No abstract provided.

Burden And Associated Factors For Caregivers Of The Elderly In A Developing Country, S Sabzwari, A Munir Badini, Z Fatmi, T Jamali, S Shah

Department of Family Medicine

The elderly population in South Asia is growing. In Pakistan trained caregivers are scarce and culturally not acceptable. This study assessed the level of stress experienced by caregivers of the elderly and determined the association of care giving burden with different characteristics of the elderly. A cross-sectional, questionnaire based study was conducted using nonprobability purposive sampling. All consenting participants aged 60 years and above needing help with at least one activity of daily living or two instrumental activities of daily living were included. 350 participants were assessed for perceived care giver burden. Care providers were mostly female (68.9%). Half (50.3%) …

Outpatient Antibiotic Prescribing Among United States Nurse Practitioners And Physician Assistants., Guillermo V Sanchez, Adam L Hersh, Daniel J Shapiro, James F. Cawley, Lauri A Hicks

Prevention and Community Health Faculty Publications

We examined US nurse practitioner (NP) and physician assistant (PA) outpatient antibiotic prescribing. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). Antibiotic stewardship interventions should target NPs and PAs.

Obesity, An Emerging Epidemic In Pakistan-A Review Of Evidence., Sana Tanzil, Tanzil Jamali

Community Health Sciences

BACKGROUND:

In Pakistan, the disease pattern is facing a huge changeover from acute and communicable diseases to the non-communicable diseases. Moreover, an emerging epidemic of obesity is still under recognized in Pakistan. A detailed review and dissemination of the existing knowledge to determine the extent of burden of obesity can help understand this important public health issue.

METHODS:

A detailed literature review was conducted through PubMed search engines, regarding obesity burden in Pakistan. The original peer reviewed research articles, reports of WHO in English language, non-government organizations reports were included in the review. "Obesity AND Pakistan" were used as a …

Ischemic Strokes: Observations From A Hospital Based Stroke Registry In Bangladesh., Nirmalenduk Bikash Bhowmik, Aamir Abbas, Mohammad Saifuddin, Md. Rashedul Islam, Rumana Habib, Aminur Rahman, Md. Amirul Haque,, Zahid Hassan, Mohammad Wasay

Department of Medicine

Background. Stroke is an important morbidity for low and middle income countries like Bangladesh. We established the first stroke registry in Bangladesh. Methods. Data was collected from stroke patients who were admitted in Department of Neurology of BIRDEM with first ever stroke, aged between 30 and 90 years. Patients with intracerebral hemorrhage, subarachnoid and subdural hemorrhage, and posttrauma features were excluded. Results. Data was gathered from 679 stroke patients. Mean age was 60.6 years. Almost 68% of patients were male. Small vessel strokes were the most common accounting for 45.4% of all the patients followed by large vessel getting affected …

Association Of Tobacco Use And Other Determinants With Pregnancy Outcomes: A Multicentre Hospital-Based Case-Control Study In Karachi, Pakistan., Shafquat Rozi, Zahid Ahmad Butt, Nida Zahid, Saba Wasim, Kashif Shafique

Community Health Sciences

OBJECTIVES:

The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan.

DESIGN:

A multicentre hospital-based case-control study.

SETTING:

Four leading maternity hospitals of Karachi.

PARTICIPANTS:

A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48 hours of delivery from wards. Cases were women with adverse birth outcomes and obstetric complications, while controls were women who had normal uncomplicated delivery.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, …