Parkview Health Research Repository
Not a member yet
774 research outputs found
Sort by
Development of a Competency Model for Placement and Verification of Nasogastric and Nasoenteric Feeding Tubes for Adult Hospitalized Patients.
No full textNasogastric/nasoenteric (NG/NE) feeding tube placements are associated with adverse events and, without proper training, can lead to devastating and significant patient harm related to misplacement. Safe feeding tube placement practices and verification are critical. There are many procedures and techniques for placement and verification; this paper provides an overview and update of techniques to guide practitioners in making clinical decisions. Regardless of placement technique and verification practices employed, it is essential that training and competency are maintained and documented for all clinicians placing NG/NE feeding tubes. This paper has been approved by the American Society for Parenteral and Enteral Nutrition (ASPEN) Board of Directors
Identifying Relative Changes in Social Risk Factors: An Analytic Approach.
No full textBACKGROUND: Individuals often report concurrent social risk factors such as food insecurity, unstable housing, and transportation barriers. Comparing relative changes between pairs of social risk factors may identify those that are more resistant to change.
OBJECTIVE: The objective of this study was to develop a method to describe relative changes in pairs of social risk factors.
RESEARCH DESIGN: This was a prospective cohort study.
SUBJECTS: Participants in a randomized controlled trial of hypertension care in an Urban Indian Health Organization.
MEASURES: We measured 7 social risk factors (housing, transportation, food, clothing, health care, utilities, and debts) at enrollment, 6, and 12 months among 295 participants in the trial. We hypothesized that pairwise comparisons could identify social risk factors that were less likely to change over time. We used conditional odds ratios (ORs) with 95% confidence intervals (CIs) to rank each pair.
RESULTS: Food, clothing, health care, utilities, and debts had more changes between 0 and 6 months relative to housing (OR=2.3, 3.4, 4.7, 3.5, and 3.4, respectively; all 95% CI excluded 1.0). These same social risk factors also had more changes between baseline and 6 months relative to transportation (OR=2.8, 3.4, 4.9, 4.7, and 4.1, respectively; all 95% CI excluded 1.0). Changes in housing and transportation risk factors were comparable (OR=0.7, 95% CI: 0.4-1.4). Relative changes between 6 and 12 months were similar.
CONCLUSIONS: Housing and transportation exhibited fewer relative changes than other social risk factors and might be more resistant to change. Awareness of the relationships between social risk factors can help define priorities for intervention
The Association of Loss of Smell to COVID-19: A Systematic Review and Meta-Analysis.
No full textBACKGROUND: The presence of olfactory dysfunction or loss of smell has been reported as an atypical symptom in patients with coronavirus disease 2019 (COVID-19). We performed a systematic review and meta-analysis of the available literature to evaluate the prevalence of loss of smell in COVID-19 as well as its utility for prognosticating the disease severity.
METHODS: An exhaustive search of the PubMed/Medline, Embase, Web of Science, Cochrane Library, LitCovid NIH, and WHO COVID-19 database was conducted through August 6
RESULTS: A total of 51 studies with 11074 confirmed COVID-19 patients were included. Of these, 21 studies used a control group with 3425 patients. The symptom of loss of smell (OR: 14.7, CI: 8.9-24.3) was significantly higher in the COVID-19 group when compared to the control group. Seven studies comparing severe COVID-19 patients with- and without loss of smell demonstrated favorable prognosis for patients with loss of smell (OR: 0.36, CI 0.27-0.48).
CONCLUSIONS: Olfactory dysfunction or loss of smell is a prevalent symptom in COVID-19 patients. Moreover, COVID-19 patients with loss of smell appear to have a milder course of the disease
Are You Going to Delete Me? Latent Profiles of Post-Relationship Breakup Social Media Use and Emotional Distress.
No full textWhen a relationship ends, former partners must make decisions about their online, often public, connections and history, which involve a complex disentangling process. We examined post-breakup behaviors including monitoring, interacting, deleting posts/photos, deleting the former partner, deleting the partner\u27s family/friends, stopping social media (SM) use, and keeping digital possessions. Participants
Indomethacin Suppository Medication Use Evaluation for Prevention of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis (PEP) in a Community Health System
No full text2021 ASHP Midyear Clinical Meeting / Virtual / Poster
Objective: To evaluate the use and characterize the patient population receiving indomethacin suppositories for PEP with the goal of ensuring appropriate use
User-Centered Design of a Mobile App to Support Peer Recovery in a Clinical Setting
No full textThe use of legal and illegal drugs has grown to such an acute level that it now represents a public health crisis in the United States. To support clinical treatments of substance use disorders (SUDs), formal non-clinical peer recovery support programs pairing coaches with people new to recovery are gaining in popularity. Using a user-centered design approach, we designed a mobile application to support the peer coach recovery program of a health system. The application addresses the needs associated with the coaches’ workflows, encompasses social supports for recoverees, and provides a space for fostering the coach-recoveree relationship. Finally, we then evaluated a prototype with recoverees and program coaches. Through this process, we identified tensions between stakeholder needs and translated these tensions into design features and future design considerations.
Free Full text available through Lin
Consolidation Chest Radiation Is Moderately Beneficial in IPE Subgroups of ES-SCLC
No full textCancer Therapy Advisor online piece.
Featuring our research publication: Role of thoracic radiation in extensive stage small cell lung cancer: a NCDB analysis
Practice patterns, techniques, and outcomes of flexible endoscopic myotomy for Zenker\u27s diverticulum: a retrospective multicenter study.
No full textBACKGROUND: Flexible endoscopic myotomy has been increasingly performed for Zenker\u27s diverticulum using various endoscopic techniques and devices. The main aims of this study were to assess practice patterns and compare outcomes of endoscopic myotomy for Zenker\u27s diverticulum.
METHODS: Procedures performed at 12 tertiary endoscopy centers from 1/2012 to 12/2018 were reviewed. Patients (≥ 18 years) with Zenker\u27s diverticulum who had dysphagia and/or regurgitation and underwent endoscopic myotomy were included. Outcomes assessed included technical success, clinical success, and adverse events.
RESULTS: 161 patients were included. Traditional endoscopic septotomy was performed most frequently (137/161, 85.1 %) followed by submucosal dissection of the septum and myotomy (24/161, 14.9 %). The hook knife (43/161, 26.7 %) and needle-knife (33/161, 20.5 %) were used most frequently. Overall, technical and clinical success rates were 98.1 % (158/161) and 78.1 % (96/123), respectively. Adverse events were noted in 13 patients (8.1 %). There was no significant difference in technical and clinical success between traditional septotomy and submucosal dissection groups (97.1 % vs. 95.8 %,
CONCLUSIONS: Flexible endoscopic myotomy is an effective therapy for Zenker\u27s diverticulum, with a low rate of adverse events. There was no significant difference in outcomes between traditional septotomy and a submucosal dissection approach, or with centers with higher volume, though clinical success was higher with the hook knife
Comparing downstream consequences of normal exercise stress echocardiograms and cardiac computed tomography angiography scans in patients suspected of having of obstructive coronary artery disease: a retrospective cohort study of Tricare beneficiaries.
No full textTo compare overall number of downstream tests and total costs between negative exercise stress echocardiograms (ESE) or cardiac computed tomography angiography scans (CCTA) in symptomatic Tricare beneficiaries suspected of having coronary artery disease (CAD). This is a retrospective cohort study examining 651 propensity-matched patients who underwent ESE or CCTA with normal results between 2008 and 2014 at the United States\u27 largest Department of Defense hospital. The total number of additional downstream tests over the next five years was determined. The total costs associated with each arm, inclusive of the initial test and all subsequent tests, were calculated using the 2018 Medicare Physician Fee Schedule. 18.5 percent of patients with a normal ESE result underwent some additional form of cardiac testing over the five years after initial testing compared to 12.8 percent of patients with a normal CCTA. The absolute difference in total number of downstream tests between both study groups was 5.7 percent (p = 0.03). When factoring the costs of the initial test as well as the downstream tests, the ESE group was associated with overall lower costs compared to the CCTA group, 351 United States Dollars (USD) versus 496 USD (p \u3c 0.0001). This study demonstrates that, when compared to CCTA, ESE is associated with a higher total number of downstream tests, but overall lower total costs when chosen as initial testing strategy for suspected CAD
The \u27burn\u27 of ranitidine recall: current insights and mitigation strategies.
No full textRanitidine was one of the most commonly used medications for the treatment of gastroesophageal reflux disease. On 1 April 2020, the US Food and Drug Administration requested all manufacturers to immediately withdraw ranitidine from the market because of concern of higher than acceptable levels of N-nitrosodimethylamine, a potential carcinogen. Herein, we highlight the reason for this recall, along with the effects of this recall on both the patients and healthcare practitioners, and offer insights on management strategies