Browsing by Author "Harris, Jonathan"

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    Deconstructing Professionalism​
    (2023-04-28) Schantz, Eli; Mansoori, Afsheen; Hicks, Clayton; Harris, Jonathan
    The notion of professionalism informs policy-making at all levels of medical practice, from national organizations and licensing boards to hospital disciplinary committees. The creation of policies to promote professionalism, however, is made all the more complex in the context of undergraduate medical education, where the notion of professionalism not only acts to govern behavior, but also to shape the professional identity of physicians-in-training. Given the importance of such policies, our goal here is to characterize, both descriptively and prescriptively, how the notion of professionalism manifests in the policies governing undergraduate medical education. First, we present a review of the professionalism policies currently in effect at Indiana University School of Medicine (IUSM). Following this review, we turn to argue that these policies suffer from two significant shortcomings: (i) the frequent use of circular definitions, giving rise to considerable ambiguity, and (ii) pronounced conflict between policies which seek justice and policies which maintain institutional power structures. We conclude that these conceptual inadequacies represent significant barriers which can both hinder the professional growth of medical students and hamper their ability to navigate their professional obligations, and we offer a number of recommendations for refining and reforming these policies.
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    Forces associated with launch into space do not impact bone fracture healing
    (Elsevier, 2018-02) Childress, Paul; Brinker, Alexander; Gong, Cynthia-May S.; Harris, Jonathan; Olivos, David J.; Rytlewski, Jeffrey D.; Scofield, David C.; Choi, Sungshin Y.; Shirazi-Fard, Yasaman; McKinley, Todd O.; Chu, Tien-Min G.; Conley, Carolynn L.; Chakraborty, Nabarun; Hammamieh, Rasha; Kacena, Melissa A.; Orthopaedic Surgery, School of Medicine
    Segmental bone defects (SBDs) secondary to trauma invariably result in a prolonged recovery with an extended period of limited weight bearing on the affected limb. Soldiers sustaining blast injuries and civilians sustaining high energy trauma typify such a clinical scenario. These patients frequently sustain composite injuries with SBDs in concert with extensive soft tissue damage. For soft tissue injury resolution and skeletal reconstruction a patient may experience limited weight bearing for upwards of 6 months. Many small animal investigations have evaluated interventions for SBDs. While providing foundational information regarding the treatment of bone defects, these models do not simulate limited weight bearing conditions after injury. For example, mice ambulate immediately following anesthetic recovery, and in most cases are normally ambulating within 1-3 days post-surgery. Thus, investigations that combine disuse with bone healing may better test novel bone healing strategies. To remove weight bearing, we have designed a SBD rodent healing study in microgravity (µG) on the International Space Station (ISS) for the Rodent Research-4 (RR-4) Mission, which launched February 19, 2017 on SpaceX CRS-10 (Commercial Resupply Services). In preparation for this mission, we conducted an end-to-end mission simulation consisting of surgical infliction of SBD followed by launch simulation and hindlimb unloading (HLU) studies. In brief, a 2 mm defect was created in the femur of 10 week-old C57BL6/J male mice (n = 9-10/group). Three days after surgery, 6 groups of mice were treated as follows: 1) Vivarium Control (maintained continuously in standard cages); 2) Launch Negative Control (placed in the same spaceflight-like hardware as the Launch Positive Control group but were not subjected to launch simulation conditions); 3) Launch Positive Control (placed in spaceflight-like hardware and also subjected to vibration followed by centrifugation); 4) Launch Positive Experimental (identical to Launch Positive Control group, but placed in qualified spaceflight hardware); 5) Hindlimb Unloaded (HLU, were subjected to HLU immediately after launch simulation tests to simulate unloading in spaceflight); and 6) HLU Control (single housed in identical HLU cages but not suspended). Mice were euthanized 28 days after launch simulation and bone healing was examined via micro-Computed Tomography (µCT). These studies demonstrated that the mice post-surgery can tolerate launch conditions. Additionally, forces and vibrations associated with launch did not impact bone healing (p = .3). However, HLU resulted in a 52.5% reduction in total callus volume compared to HLU Controls (p = .0003). Taken together, these findings suggest that mice having a femoral SBD surgery tolerated the vibration and hypergravity associated with launch, and that launch simulation itself did not impact bone healing, but that the prolonged lack of weight bearing associated with HLU did impair bone healing. Based on these findings, we proceeded with testing the efficacy of FDA approved and novel SBD therapies using the unique spaceflight environment as a novel unloading model on SpaceX CRS-10.
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    Relationship between Pantry Characteristics and Clientele Transportation when Accessing Food Resources in St. Joseph County and Surrounding Areas
    (2023-11-09) Stone, Jackson; Bales, John; Harris, Jonathan; Lassen, David
    Food insecurity affects approximately 13% of the total population in St. Joseph County. To address this need, various food pantries and soup kitchens have been established by local community organizations. The advent of COVID-19, among other economic instabilities, exacerbated many health disparities within our community and further strained many already overstretched local nonprofits. In a survey of 10 local organizations from June to July 2023, we attempt to characterize the experiences and obstacles faced by pantry clients and directors (474 clients and 65 directors surveyed). An unexpected trend appeared as transportation means of clients was gathered: 84% of surveyed clients utilized pantries by car. Furthermore, some pantries were accessed almost exclusively by automobile, while others saw greater traffic from those walking, biking, and bussing. Clearly, means of transportation played a significant role in determining where individuals sought food aid. To explain these observed differences, we evaluate the relationships between transportation and pantry schedule, pantry location relative to bus lines, client choice in food selection, and provision of on-site meals. Our results indicate that the number of adjacent bus lines and distance to the nearest bus stop affect means of transportation to pantries (p<0.001). Furthermore, the presence of on-site meals, operation hours, and service use limits are tied to clients’ transportation method (p<0.001). To ensure equitable access and efficient food distribution, a continued focus on infrastructure and its alignment with pantry accessibility remains a critical aspect to address in the future.