1997 research outputs found
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How Much Will My Child’s Operation Cost? Availability of Consumer Prices from US Hospitals for a Common Pediatric Orthopaedic Surgical Procedure
No full textContext: We aimed to determine the availability of price estimates from hospitals in the United States for a pediatric orthopaedic surgical procedure (closed reduction and pinning of a distal radius fracture), and identify variations in price estimates across hospitals. Objective: Primary objective was to determine if consumers could obtain the price estimates for the procedure. Second, we sought to identify variation in price estimates across hospitals. Design: This prospective investigation used a scripted telephone call to obtain price estimates for the surgery procedure. Setting: We used the 2016-2017 U.S News and World Report rankings to identify 50 “top-ranked” hospitals for pediatric orthopaedic surgery. We identified one “non-top-ranked” hospital from each state using the physician directory from the Pediatric Orthopaedic Society of North America. All hospitals were categorized according to region based on state divisions, and teaching status. Methods: Price estimates were requested using a standardized script, where the investigator posed as the mother of a child who required the procedure. Estimates were recorded for each hospital as well as the number of calls and the time required to obtain pricing. Results: 44% of the 101 hospitals provided a complete price estimate. The mean price estimate for top-ranked hospitals (11,866) (p=0.020). Differences in price estimates were due to hospital fees (p=0.003), not surgeon fees. A longer duration of time was required to obtain estimates from top-ranked hospitals than non-top-ranked hospitals (8.2±9.4 vs. 4.1±5.1 days, p=0.024). Conclusions: Top-ranked hospitals charge approximately 50% more than non-top-ranked hospital. Difference in price estimates between ranked and non ranked hospitals were due estimated hospital fees. It took a top-ranked hospital an average of 8.2 days to complete the request
Urinary Complications After Omitting Bladder Catheterization During Atrial Fibrillation Ablation
No full textContext: Indwelling Urinary Catheterization (IUC) is among the most common procedures performed in the inpatient setting. Because there are risks associated with IUC, efforts to reduce its use when unnecessary should be made. Objective: Assess patient urinary and overall health outcomes after atrial fibrillation (Afib) ablation with and without IUC. Design: Retrospective cohort study of patients undergoing Afib ablation for paroxysmal atrial fibrillation between March 1 2017 and August 20 2018 at St Vincent Indianapolis Hospital. Setting: St Vincent Indianapolis is a tertiary referral center. All procedures were performed in the inpatient setting. All patients included in this study were over 18 years of age. The only exclusion criteria was for patients on dialysis at the time of procedure. Methods: Operative characteristics and patient identifying information were queried using Current Procedural Terminology (CPT) codes in the specified time frame. Patient characteristics and postop outcomes were assessed by manual chart review. Differences between patients who received IUC and patients who did not were assessed using Chi-Squared test for categorical data and Unpaired Student’s t-test for continuous data. Results: For our composite primary outcome of any urinary complication in the 7 days after procedure, 14 of 297 (4.71%) patients who underwent IUC developed complications, versus 0 of 92 who were not catheterized (P = 0.034). 1 patient developed urine retention, 3 were recatheterized, 6 developed UTI, 7 developed hematuria, 2 developed urethral pain, and 1 developed urethral trauma. Conclusions: Our study found a reduced rate of urinary complications after undergoing Afib ablation without IUC. Overall rates of complications were lower than expected. There is an ongoing randomized control trial investigating this same question that will ensure ascertainment of patient outcomes and reduce bias in patient assignment to treatment groups
Analyzing the Efficacy of Natural Baby Soaps for the Elimination of Bacterial Colonization on Bath Toys
Get PDFRecent studies have discovered that water-retaining bath toys harbor a high amount of potential pathogens due to available nutrients in baby soaps. Unfortunately , these bath toys can be a source for infection or disease for the children playing with them. In order to investigate the efficacy of baby soaps on the elimination of bacteria on bath toys, rubber ducks were coated with E. coli and then were washed with an organic or non-organic baby soap. It was hypothesized that organic soap would be more efficient at eliminating bacteria due to its antibacterial properties. Through this experiment, it was found that organic baby soaps have a higher possibly of eliminating the bacteria
Effects of Technology in the College Classroom
Get PDFStudents have become dependent on technology and do not always use it of educational purposes during class. Boredom and lack of interest are common reasons given by students for cell phone use in class. (Olufadi, 2015). Several studies have examined technology usage and it’s effects in the classroom. One study found that higher overall usage of cell phones was correlated with lower GPAs. This study tracked the total amount of time phones were used in and out of school (Felsioni & Godoi, 2017). However, other studies report no impact of classroom phone use on learning. For example, students using phones during a class lecture and students not using phones had the same average lecture quiz scores. (Elder, 2013).
Our study examined the relationship between levels of classroom off-task technology use and classroom engagement, attitudes and GPA. We predicted a negative correlation between classroom technology use and all measures of classroom engagement and performance
3D Visualization of Brainstem Anatomy in Relation to Lateral Medullary (Wallenberg) Syndrome
Get PDFContext: The purpose of this project was to design a 3-dimensional method for visualizing structures within the brainstem with special attention to those involved in Lateral Medullary (Wallenberg) Syndrome. Wallenberg syndrome is a neurologic disorder involving an infarct in blood supply of the Posterior Inferior Cerebellar Artery. Around 60,000 new cases of Wallenberg syndrome occur each year in the U.S. resulting in a multitude of symptoms and often permanent impairment. Objective: The objective of this project was to observe the brainstem including the lateral medulla in its connection to Wallenberg syndrome. A secondary objective was to provide a resource to medical students as they learn the structure and function of the human brainstem. Design: This project was created using Amira software to extract a 3D model of the brainstem from a freely available CT data-set of a randomized patient. This model was used to create videos demonstrating key structural elements affected in Wallenberg Syndrome and made into a YouTube video available for public use. Setting: The scan data selected for this project was chosen based solely on image quality in order to provide the amount of resolution needed to extract the targeted structures. Methods: Amira is an analytical tool used to highlight anatomical structures in CT (and other imaging) scans within desired tissue parameters and interpolating the selections together to create a 3D structure. Results: The final structure extrapolated from Amira was a completed brainstem with cranial nerve nuclei, sensory and motor tracts, and other important structures impacted by Wallenberg syndrome. We believe these data will be helpful in visualizing other brainstem infarcts and injuries as well as a teaching tool for students in the medical field. Conclusions: Future expansions of this study will include extracting additional structures taken from the CT data as well as descriptions of other normal and abnormal anatomical conditions
Osteocyte-Specific Deletion of the α2δ1 Auxiliary Voltage Sensitive Calcium Channel Subunit
Get PDFContext: Skeletal unloading due to disuse, disease, or aging increases bone loss and the risk of skeletal fracture. Conversely, mechanical loading is anabolic to the skeleton, promoting skeletal integrity through increased bone formation. As calcium influx is the first measurable response of bone cells to mechanical stimuli, voltage sensitive calcium channels (VSCCs) play a critical role in bone formation. Given VSCC activity is influenced by its auxiliary α2δ1 subunit, regulating the gating kinetics of the channel’s pore-forming (α1) subunit and forward trafficking of VSCCs to cell membranes, the α2δ1 subunit may govern anabolic bone responses. Objective & Design: We hypothesized that osteocyte-specific α2δ1 deletion in a mouse model would impair skeletal development, decrease bone formation and mechanosensitivity. Methods: Generation of an osteocyte-specific α2δ1 knockout was accomplished by crossing mice (C57BL/6) harboring LoxP sequences flanking Cacna2d1, the gene encoding α2δ1, with mice expressing Cre recombinase under the control of the Dmp1 (10Kb) promoter (Cacna2d1fl/fl, Dmp1-Cre+). To assess skeletal phenotype and mechanosensitivity, longitudinal whole body and site-specific DXA, in vivo μCT (10wk old), and two weeks of tibial loading (16wks) will be conducted before femurs are collected at 20 wks for mechanical testing, ex vivo μCT, and quantitative histomorphometry. Results & Conclusion: Preliminary analyses show no differences in whole body or site-specific BMD and BMC values between mice over time, suggesting osteocyte-specific α2δ1 deletion may not influence skeletal development. However, key differences in mechanosensitivity following tibial loading are expected given the potential role of α2δ1 in mechanically-induced bone formation
Bovine arch anatomy influences recoarctation rates in the era of the extended end-to-end anastomosis.
No full textOBJECTIVES: Arch branching has never been shown to influence recoarctation after extended end-to-end anastomosis via thoracotomy, yet in each study bovine arch identification is grossly underreported. This study aims to (1) assess chart review reliability in bovine arch identification; (2) determine recoarctation risk with a bovine arch; and (3) explore an anatomic explanation for recurrent arch obstruction based on arch anatomy.
PATIENTS: A total of 49 consecutive patients underwent thoracotomy with extended end-to-end aortic coarctation repair at a single institution (2007-2012).
METHODS: Echocardiograms from these patients were reviewed for arch anatomy and compared with the echocardiographic reports. Recurrent arch obstruction was defined as an echocardiographic gradient across the repair of 20 mm Hg or greater. For cases with angiographic images (n = 17), a scaled clamping distance between the left subclavian artery and the maximal proximal clamp location on orthogonal projections was then calculated across arch anatomies.
RESULTS: Chart review identified 6.1% (3/49) of patients with a bovine arch compared with 28.6% (14/49) on targeted image review. A total of 28.6% (4/14) of patients with a bovine arch had a follow-up gradient of 20 mm Hg or greater. Only 5.7% (2/35) of patients with normal arch branching had a follow-up gradient of 20 mm Hg or greater. The mean clamping index was significantly diminished in patients with bovine arch anatomy.
CONCLUSIONS: Arch anatomy often goes undocumented on preoperative imaging, yet children undergoing extended end-to-end repair with bovine arch anatomy are at a significantly increased risk of recoarctation. This may be due to a reduced clampable distance to facilitate repair. These results should be considered in the preoperative assessment, parental counseling, and surgical approach for children with discrete aortic coarctation
Growing the STEM Teacher Workforce: A Focus Group Study of the Career Considerations of High-Achieving, Underrepresented, High School Students
Get PDFThe low number of underrepresented minority teachers across all disciplines and all grade levels is a well-documented problem facing the nation. These disparities become even more pronounced when examining the STEM teaching workforce. According to a report produced by Horizon Research, Inc. (Banilower et al., 2013), only 8% of high school science teachers and 8% of high school mathematics teachers characterize themselves as non-white. The purpose of this study was to generate an empirically grounded understanding of three aspects of the career considerations of high-achieving, underrepresented minority students (career interests and barriers, the people and organizations that influence career decisions, and the fit between STEM teaching and students’ life goals). Findings show that while most students are not interested in STEM teaching careers, they did find that their life goals aligned with life goals that could be realized with a teaching career
All Things Technology: Q&A with the CIO
No full textHave a question about technology on campus? Want more details about the new Student Information System replacing CAMS? Have a suggestion about how technology could be used in the classroom? If so, you will want to join Ray and the other IT managers for an informal discussion about what and how technology is used on campus