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Browsing by Author "Scheive, Melanie"
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Item Assessment of patient follow-up from student-run free eye clinic to county ophthalmology clinic(Springer Nature, 2022) Scheive, Melanie; Rowe, Lucas W.; Tso, Hanna L.; Wurster, Patrick; Kalafatis, Nicholas E.; Camp, David A.; Yung, Chi Wah Rudy; Ophthalmology, School of MedicineThe Ophthalmology Student Interest Group at Indiana University School of Medicine provides a free student-run eye screening clinic for an underserved community in Indianapolis. Patients with abnormal findings are referred to the ophthalmology service of the local county hospital for further evaluation. This retrospective chart review studied 180 patients referred from our free eye clinic to follow up at the ophthalmology service of a local county hospital from October 2013 to February 2020. This study investigated factors impacting follow-up of patients by analyzing demographics, medical history, insurance coverage, and final diagnoses at follow-up. Thirty-five (19.4%) of 180 patients successfully followed up at the local county hospital with an average time to follow-up of 14.4 (± 15.9) months. Mean patient age was 51 (± 13.6) with nearly equal numbers of males and females. The most common diagnoses at follow-up included refractive error (51.4%), cataract (45.7%), and glaucoma (28.6%). Patients with diabetes diagnoses or Healthy Indiana Plan insurance coverage had increased probability of follow-up. This study reveals gaps in timely follow-up to the local county hospital, demonstrating the current limitations of our free clinic in connecting patients to more definitive care and the need for an improved referral process.Item Capabilities and Limitations of Student-Led Free Vision Screening Programs in the United States(Association for Research in Vision and Ophthalmology (ARVO), 2024) Devanathan, Nirupama; Scheive, Melanie; Nawash, Baraa S.; Selvam, Amrish; Murphy, Alec; Morrow, McKenna; Anant, Shruti; Chen, Nickolas; Martin, Elizabeth A.; Kruger, Jessica S.; Yung, Chi-Wah Rudy; Johnson, Thomas V.; Ophthalmology, School of MedicinePurpose: The Consortium of Student-Led Eye Clinics (CSLEC), founded in 2021, administered a comprehensive survey to document the types of services, most common diagnoses, and follow-up care protocols offered by student-led free vision screening programs (SLFVSP) in the United States. Methods: An 81-question institutional review board (IRB)-approved survey was administered to student-led vision screening eye clinics from October 1, 2022 to February 24, 2023. Results: Sixteen SLFVSPs were included in the final analysis, of which 81% (n = 13) conducted variations of fundoscopic examinations and 75% (n = 12) measured intraocular pressure. Cataracts and diabetic retinopathy were reported as the most frequent diagnoses by the majority of SLFVSPs (n = 9, 56%); non-mobile SLFVSPs more commonly reported cataract as a frequent diagnosis (P < 0.05). Most patients screened at participating programs were uninsured or met federal poverty guidelines. Prescription glasses were offered by 56% of the programs (n = 9). SLFVSPs that directly scheduled follow-up appointments reported higher attendance rates (66.5%) than those that only sent referrals (20%). Transportation was the most cited barrier for follow-up appointment attendance. Conclusions: SLFVSPs, one community vision screening initiative subtype, vary significantly in scope and capabilities of identifying vision threatening disease. The follow-up infrastructure is not uniformly robust and represents a key target for improving care delivery to at-risk populations. Translational relevance: The CSLEC aims to develop a consensus-based standardization for the scope of screening services, offer guidelines for diagnostic criteria, promote real-time data stewardship, and identify means to improve follow-up care mechanisms in member communities.Item Development of Undergraduate STEM Students through Global Service-Learning in a Medical Context(Office of the Vice Chancellor for Research, 2016-04-08) Scheive, Melanie; Fore, Grant; Sorge, BrandonGlobal service-learning and study abroad programs have the potential to affect students’ personal, social, and professional development. The exact ways in which this development is influenced by international medical service-learning has not been thoroughly explored in the literature. This study analyzes the motivations, experiences, and outcomes of undergraduate STEM students participating in a weeklong international medical service-learning and study abroad trip to Las Canas, Dominican Republic. Participants had various backgrounds, STEM majors, and career goals. Utilizing a mixed-methods research approach consisting of observations, interviews, participant reflections, and pre- and post-trip surveys, several of the meaningful motivations, experiences, and outcomes for the participants were identified. Additionally, two case studies were produced by qualitatively collecting data from multiple sources and reporting the description and themes of the cases. The specific aims of this study were understanding: 1) the individual experiences during a health science-based study abroad trip that are instrumental in refining and solidifying STEM interest; and 2) the personal, social, and professional student-level outcomes produced by an international medical service-learning experience. Through the case studies, the combined impact of past and trip experiences was explored as it relates to experiential learning and identity development. For case study participants Brianna and Hannah, the trip combined multiple experiences that were relevant to their career goals, such as working with underserved populations and involvement with global health.Item How to Stop People from Going Blind from Glaucoma Using Early Cataract Surgery/Refractive Lensectomy and Microinvasive Glaucoma Surgery(Dovepress, 2022-03-15) Laroche, Daniel; Scheive, Melanie; Ophthalmology, School of MedicineGlaucoma continues to be a leading cause of blindness worldwide for the same reasons as in the past several decades, including the lack of early detection, improper treatment, and non-adherence to therapy. Medical therapy continues to be the first-line therapy even as surgical techniques are improving in their safety and efficacy. To turn the tide in preventing blindness from glaucoma, attention must be focused on targeted patient education, screening, effective treatment, and addressing health disparities. To achieve this, early safer cataract surgery and microinvasive glaucoma surgery must be considered as a first-line therapy in addition to medical therapy to best lower both intraocular pressure and the medication burden.Item Patient Perception of Physician Attire in a Military Ophthalmology Clinic(Cureus, 2021-01-04) Scheive, Melanie; Gillis, John, II.; Gillis, Sarah; Legault, Gary L.; Ophthalmology, School of MedicineThe purpose of this study is to investigate patient preferences of physician attire in an outpatient military ophthalmology clinic to determine how these preferences affect patients' perceptions of physician competence and their overall clinical experience. Materials and methods This study is a prospective survey administered to patients at the ophthalmology clinic at Brooke Army Medical Center. USA. Patients who were willing to participate in a volunteer survey were included in this study. Demographic information and survey questions were utilized in this study along with words and pictures for patients to select a preference in physician attire in the clinic setting (scrubs, military uniform, or civilian professional attire) and surgical setting (surgical cap or a surgical bouffant). The survey asks patients if physician attire impacts patient confidence in physician abilities (yes or no) and if surgeon attire impacts the likelihood of the patient taking the surgeon's advice (yes or no). Results The demographic distribution includes 57-77 years old participants (53%), females (61%), retirees (49%), and dependent spouses (40%). The racial distribution includes 46% - Caucasian, 20% - African American, 22% - Hispanic, 6 - % Asian, and 6% - other. Most patient appointment types were established follow-up (77%) with only 12% new and 11% walk-in. The survey results (N=308) indicate that most patients (64%) did not have a preference in physician clinical attire, while 22% preferred scrubs, 11% preferred military uniform, and 3% preferred civilian attire. Most patients (66%) did not have a preference for surgical headwear, while 27% preferred the surgical cap, and 7% preferred the surgical bouffant. Only 9% of the patients surveyed indicated that physician attire impacted their confidence in their physician's ability, and 12% reported that attire impacted the likelihood of taking advice. Conclusions Most patients in an outpatient military ophthalmology clinic do not have a preference for physician attire or surgical headwear when surveyed. The majority of patients did not feel physician attire impacted their perception of physician's ability or their likelihood of taking advice. When indicating a preference, patients tended to prefer scrubs to outpatient civilian attire or military attire and trended towards preferring surgical cap over surgical bouffant for headwear.Item A seven-year analysis of the role and impact of a free community eye clinic(BMC, 2021-12-02) Rowe, Lucas W.; Scheive, Melanie; Tso, Hanna L.; Wurster, Patrick; Kalafatis, Nicholas E.; Camp, David A.; Thau, Avrey; Yung, Chi Wah Rudy; Ophthalmology, School of MedicineBackground: The Indiana University Student Outreach Clinic (IUSOC) Eye Clinic is a monthly student-run eye clinic that provides free visual screening to the Near East Side community of Indianapolis, IN, USA. Screening includes assessments of visual acuity, intraocular pressure, peripheral visual fields, refraction, and non-mydriatic fundus photography. Methods: This is a retrospective chart review of 875 patients seen at the IUSOC Eye Clinic from October 2013 to February 2020. Data on demographics, insurance coverage, ocular history, physical examination, suspected diagnosis, referral status, and glasses provided were collected and analyzed. Results: 875 patients were seen at the IUSOC Eye Clinic from October 2013 to February 2020. 39.2% of the patients seen at the clinic reported being uninsured. 61.4% of patients were found to have visual acuity of 20/40 or worse, while 51.3% of patients were found to have a near visual acuity of 20/40 or worse. 20.3% of patients were referred to the local county hospital for further evaluation by an ophthalmologist, 14.4% of patients received free glasses prescriptions, and 27.9% of patients received free reading glasses. Common reasons for referral for further ophthalmology evaluation included glaucoma, decreased visual acuity, and diabetic retinopathy. An estimated value of services provided over the seven years of the clinic was 1271 relative value units. Conclusion: The IUSOC Eye Clinic fills an important role in advancing ocular health and preventing irreversible blindness in an underserved Indianapolis community. Additionally, the clinic demonstrates an educational model for involving medical student volunteers.Item Understanding the INDA Student Summer Camp Experience(Office of the Vice Chancellor for Research, 2014-04-11) Scheive, Melanie; Fore, Grant; Sorge, BrandonSERI conducted an evaluation of IUPUI’s Nanotechnology Discovery Academy (INDA) for students (n=47) during the summer of 2013. SERI evaluators utilized an explanatory sequential mixed methods evaluation plan comprised of surveys (pre- and post-), observations, and four student focus groups. Using a mixed methods approach facilitates a dialogue between quantitative representations of change and the everyday experiences and perceptions of participating students, thereby constructing insights into the complexity of the learning process and its effects. Student learning outcomes and comfort with collaborative learning were measured through pre- and post-question change. A student Nanoscore was determined using survey questions assessing nanotechnology comfort, confidence, and understanding. Both the change in student Nanoscore and their comfort with collaborative learning had statistically significant increases. Qualitative data was used to elaborate on the significance of these changes, suggesting that INDA provided an educational environment that emphasized and improved nanotechnology awareness and collaborative abilities. However, findings from this evaluation also reveal that many participants struggled with the interdisciplinarity of nanotechnology. More specifically, students who had yet to take high school physics reported struggling with INDA content due to their lack of physics knowledge.Item “Understanding the Motivations and Experiences of STEM Students in a Study Abroad Program”(Office of the Vice Chancellor for Research, 2015-04-17) Scheive, MelanieFrom March 14th to 21st of 2015, student members of the IUPUI chapter of Timmy Global Health traveled to Las Canas, Dominican Republic as part of a medical brigade team. Alongside doctors, nurses, dentists, and other medical personnel, participating students played an active, hands-on role in helping to provide primary care services to over 600 patients from the five impoverished communities surrounding Las Canas (Timmy Global Health, 2015). Undergraduate students, many of whom are STEM students, decide to participate in these medical brigade trips for a variety of reasons. The exact motivations and experiences of STEM students participating in health science-related study abroad trips, however, are not adequately explored in current study abroad literature. This research seeks to determine how each participant’s experiences in Las Canas have impacted their perceptions of health science-related careers. The specific aims of this project are concerned with understanding the following: 1) the motivations that influence the decision-making process of STEM students choosing to study abroad; 2) the individual experiences during a health science-based study abroad trip that are instrumental in refining and solidifying STEM interest; and 3) the student-level and community outcomes (e.g. an increase of STEM interest and a positive effect on local health care recipients, respectively) produced by a medical brigade experience. A mixed methods research design —including observations, interviews, participant reflections, and pre-/post-program surveys — was utilized to address this project’s specific aims.Item Using optical coherence tomography angiography as a biomarker of retinopathy severity and treatment for diabetic retinopathy(Molecular Vision, 2022-08-19) Scheive, Melanie; Reinhart, Kathryn L.; Hajrasouliha, Amir R.; Ophthalmology, School of MedicinePurpose: The goal was to evaluate optical coherence tomography angiography (OCT-A) as a biomarker to correlate retinal vessel density (VD) with diabetic retinopathy (DR) severity and visual acuity, as well as track antivascular endothelial growth factor (VEGF) treatment efficacy. Methods: This retrospective cohort study analyzed the automatically quantified VDs of the superficial vascular complex (SVC) and deep vascular complex (DVC), including the whole, foveal, and parafoveal VDs, on quality OCT-A scans in patients diagnosed with DR. A multivariate linear regression and analysis of variance (ANOVA) analysis compared VDs to DR severity, visual acuity, and demographic factors. A linear mixed analysis determined the effects of VD by whether anti-VEGF therapy was given to patients with OCT-A scans at multiple time points. Results: There was a positive correlation of the VDs in both the SVC whole and parafoveal VD and DVC parafoveal VD with decreased DR severity and increased visual acuity (p≤0.001). The DVC whole VD was also positively correlated with increased visual acuity (p<0.001). There was no difference in the VDs associated with anti-VEGF treatment over time. Conclusions: OCT-A VD shows promise for diagnosing and monitoring DR using DR severity and visual acuity. Anti-VEGF treatment had no significant effect (p=0.063) on vascular density in diabetic retinopathy.Item Using optical coherence tomography angiography as a biomarker of retinopathy severity and treatment for diabetic retinopathy(Emory University, 2022-08-19) Scheive, Melanie; Reinhart, Kathryn L.; Hajrasouliha, Amir R.; Ophthalmology, School of MedicinePurpose: The goal was to evaluate optical coherence tomography angiography (OCT-A) as a biomarker to correlate retinal vessel density (VD) with diabetic retinopathy (DR) severity and visual acuity, as well as track antivascular endothelial growth factor (VEGF) treatment efficacy. Methods: This retrospective cohort study analyzed the automatically quantified VDs of the superficial vascular complex (SVC) and deep vascular complex (DVC), including the whole, foveal, and parafoveal VDs, on quality OCT-A scans in patients diagnosed with DR. A multivariate linear regression and analysis of variance (ANOVA) analysis compared VDs to DR severity, visual acuity, and demographic factors. A linear mixed analysis determined the effects of VD by whether anti-VEGF therapy was given to patients with OCT-A scans at multiple time points. Results: There was a positive correlation of the VDs in both the SVC whole and parafoveal VD and DVC parafoveal VD with decreased DR severity and increased visual acuity (p≤0.001). The DVC whole VD was also positively correlated with increased visual acuity (p<0.001). There was no difference in the VDs associated with anti-VEGF treatment over time. Conclusions: OCT-A VD shows promise for diagnosing and monitoring DR using DR severity and visual acuity. Anti-VEGF treatment had no significant effect (p=0.063) on vascular density in diabetic retinopathy.