Parkview Health Research Repository
Not a member yet
774 research outputs found
Sort by
Mental Health and Technology Conference: Teens and Screens
No full textDiscussions on the impact technology can have on teen mental health.
1. Welcome
2. Tech-obsessed teens are still human: How do teens want to communicate during times of stress?
3. Reaching youth where they are
4. Utilizing pharmaceutical precision: The journey from informative guessing to informative decision-making
5. Youth online - where they may go, what they may be doing and how this may impact mental and behavioral health
x. Youth and digital harm: Designing organizational and family-based solutions for harmful behaviors online
6. Panel discussion and closing
Contemporary management of severe influenza disease in the intensive care unit.
No full textDespite continued efforts to optimize vaccination composition, severe influenza disease requiring intensive care unit (ICU) admission remains a clinical issue. Influenza epidemics and pandemics worldwide continue to challenge clinicians with managing infected patients requiring ICU care. While routine use of antiviral therapy is deployed in ambulatory outpatients, their use in the ICU in patients with hypoxemic respiratory failure is less well established. Additionally, these therapies primarily target the neuraminidase protein, while contemporary research is increasingly demonstrating potential therapeutic benefits of targeting the hemagglutinin protein. These data have given rise to a growing interest in the use of immune modulating therapies for treatment of severe influenza. Additionally, pandemic outbreaks have revealed the growing need for salvage management, wherein lies the potential role for venovenous extracorporeal membrane oxygenation therapy in refractory respiratory failure. In this report, we review the contemporary ICU care of the severe influenza patient
Modeling Personas for Older Adults with Heart Failure
No full textProceedings of the Human Factors and Ergonomics Society Annual Meeting
In the early stages of the design process, designers often benefit from the use of personas, or archetypes of target users presented in a vivid way to highlight design-relevant characteristics. In the growing efforts to create health information technology (HIT) for older adults, empirically derived personas could help orchestrate more user-centered design activities. However, there is a lack of ready-to-use personas for older adult HIT users and more so for those designing in specific domains such as heart failure self-care. This paper presents personas of older adults derived from qualitative analysis of interviews with 24 older patients with heart failure. Analyses unearthed key dimensions distinguishing patients based on their dispositions towards the self-management of their chronic condition, including locus of control, relationship with the health/support system, information needs, and activities of self-care. Two personas are presented: Direction Follower and Researcher, with subtypes for the latter codified as Investigator and Explorer. Our work contributes to future design of systems including HIT to support chronically ill older adults
Digital pancreatoscopy in the evaluation of main duct intraductal papillary mucinous neoplasm: a multicenter study.
No full textBACKGROUND: The aim of this study was to investigate the outcomes of digital pancreatoscopy in main duct intraductal papillary mucinous neoplasm (MD-IPMN).
METHODS: This was a multicenter retrospective study. Outcomes analyzed were safety, incremental pathology yield compared with previous cross-sectional/endoscopic ultrasound (EUS) imaging, and whether the surgical procedure was dictated by the pancreatoscopy.
RESULTS: A total of 31 patients were enrolled from six tertiary care centers. Overall, 42 % of cases had findings on pancreatoscopy that were not seen on cross-sectional imaging or EUS. Digital pancreatoscopy dictated the type of surgery performed in 13 patients (42 %) who underwent surgery. However, in patients with a diffusely dilated pancreatic duct (\u3e 10 mm), the pancreatoscopy dictated the type of surgery in 77 % of cases vs. 17 % of cases in the focally dilated pancreatic duct group (10/13 vs. 3/18;
CONCLUSION: Digital pancreatoscopy should be considered in the diagnostic algorithm of MD-IPMN in patients with a diffusely dilated pancreatic duct and without any focal lesions seen on cross-sectional imaging or EUS
Clear cell adenocarcinoma subtype is an independent predictor of better survival in patients with lung adenocarcinoma
Get PDFBackground:
Clear cell adenocarcinoma (CCA) has been considered as a rare subtype of lung adenocarcinoma. However, the 2011 World Health Organization (WHO) classification of lung adenocarcinoma proposed to discontinue CCA due to lack of available data with clinical significance. The role of CCA in patient prognosis needs to be investigated by using large data sources.
Methods:
Lung adenocarcinoma patients were queried from The Surveillance, Epidemiology, and End Results Program (SEER) database and were divided into CCA and ‘not otherwise specified’ category (NOS). Cancer-specific survival was studied according to gender (male, female), age (0-69,70+), SEER specific stage A system (localized, regional and distant), year of diagnosis (1973-2000, 2001-2013), surgery (yes, no), and radiation therapy (yes, no) using Kaplan–Meier curves. Statistical difference was estimated with log-rank test using JMP software. Multivariate analysis was used to study independent predictors of cancer-specific survival.
Results:
A total of 198,042 patients with the diagnosis of lung adenocarcinoma were found in the SEER database of which 921 patients were diagnosed with CCA. CCA histology was significantly associated with an early year of diagnosis, younger age, early stage, surgery, and lack of radiation. Kaplan–Meier curves showed that patients with CCA histology, age 0-69, year of diagnosis 2001-2013, female gender, localized disease, undergoing surgery, and lack of radiation had significantly better cancer-specific survival (p
Conclusions:
Patients with CCA histology have superior survival according to our SEER analysis, suggesting its unique role in prognosis despite its removed from 2011 WHO classification
Improved Safety and Efficacy of Small-Bore Feeding Tube Confirmation Using an Electromagnetic Placement Device.
No full textBACKGROUND: Early enteral nutrition has been shown to decrease complications and improve patient outcomes. Post pyloric feeding is recommended for patients with gastric intolerance or at high risk for aspiration. Feeding tube placement can be challenging and pose risk of pulmonary complications. Reliance on radiographic confirmation for feeding tube placement exposes the patient to radiation. Electromagnetic placement device (EMPD) may offer a method to minimize pulmonary complications, increase successful placement, and decrease radiation exposure to the patient.
OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of using EMPD verification, instead of routine abdominal radiographic confirmation, for small-bore feeding tube placement.
RESULTS: Variables evaluated were adverse events, utilization of radiographs for confirmation, and success rate of feeding tube placement in the ordered location. Two time frames were reviewed. In a 1-year period, 3754 small-bore feeding tubes were placed using EMPD, with zero adverse events noted. Radiographic confirmation was utilized in 0%-29.2% of the EMPD placed tubes. Successful placement of feeding tubes using EMPD ranged from 94%-99.6%. During a 5-year period, 7081 EMPD feeding tubes were evaluated. One adverse event, pneumothorax, occurred during the placement of these 7081 tubes, for a rate of 0.014%.
CONCLUSION: Feeding tube placement confirmation is safe and efficacious via EMPD providing an effective method of feeding tube placement with a success rate \u3e94% into the desired location. EMPD is an accurate verification method of distal tip location, eliminating the need for routine abdominal radiographic confirmation
Evaluation of acute kidney injury with vancomycin therapy in adult
No full textPoster Presentation
Objective: To evaluate the outcomes and risk of acute kidney injury (AKI) associated with a pharmacy-driven vancomycin dosing protocol at a community hospital
Evaluation of pharmacist involvement in outpatient transitional care management
Get PDFPresentation given at Great Lakes Pharmacy Residency Conference 201
Abstract 16894: Innovation in Cardiac Care: Direct Transmission of Remote Implantable Cardioverter Defibrillator Data to Patients through Their Electronic Personal Health Records
No full textCORE 5. MYOCARDIUM: FUNCTION AND FAILURE: SESSION TITLE: EMERGING TECHNOLOGIES III
Introduction: Remote monitoring of implantable cardioverter defibrillators (ICDs) has improved the quality of care through timely delivery of critical device data to healthcare providers. Despite its efficacy and satisfaction among providers and patients, the ICD monitoring data is not directly available to patients. The purpose of this study was to exhibit the feasibility of transmitting data to an electronic personal health record (ePHR) in a patient-friendly format. We believe providing patients access to their ICD data will help promote patients’ engagement in their health care, improve patient provider communication and clinic workflow.
METHODS: The study followed 21 cardiac patients undergoing remote monitoring for their St. Jude Medical ICD device. We used the Implantable Device Cardiac Observation profile, a standard based mechanism to send transmission data to compatible electronic health records and ePHRs, based upon IEEE 11073-10103. Patients were able to view all remote transmission data, including scheduled and alert initiated, instantaneously as a readable report in their NoMoreClipboard ePHR account. The Patient Activation Measure survey was used to assess patient engagement at baseline and 3 months. Further semi-structured interviews were conducted at 3 months to explore patient perspectives regarding the ICD data they received. In addition, 103 healthcare providers were surveyed to determine perspectives on potential benefits and concerns about sending patients data.
RESULTS AND CONCLUSIONS: All patients (67 ± 14 years, 100% White, 5% Hispanic/Latino, 76% male) successfully received the ICD data in their ePHR. Of the 21 patients, 29% showed improved patient engagement (p=0.11). Patients showed great interest in receiving the ICD data but desired additional knowledge to better understand the report. An interim analysis of 34 providers showed that 74% believe patient access to ICD data will allow for better patient care, though 44% believe it may increase clinic workflow. In conclusion, the study suggests there is potential value in directly transmitting ICD data to patients for improving patient care. Further investigation is necessary to find the impact of sending ICD data electronically on patient health and quality of life
