Browsing by Author "Stephanian, Brooke"

Now showing 1 - 5 of 5
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    A Glimpse into Menstrual Health Literacy in Appalachian Ohio
    (American Medical Women's Association (AMWA) 108th Annual Meeting, 2023-03-24) Cook, Myanna; Yeend, Brianna; Karki, Sabin; Stephanian, Brooke; Richcreek, Stephanie
    Evidence supports that health literacy is intricately linked to education level. Appalachian Ohio reports the second lowest percentage of postsecondary education in Appalachian states, which falls 10% below the national average. Coshocton, Ohio is located in North Central Appalachia and is classified as a high poverty rural area. Prior research has established that youth across the United States often lack adequate menstrual health education, which could lead to delayed recognition of serious health issues. Currently, the Ohio Department of Education does not require menstrual education as part of broader sexual health education in schools. Given the low rates of higher education, and thus health literacy, along with lack of state required menstrual education, low levels of menstrual health literacy might disproportionately affect this area. Within the same month at an outpatient clinic in Coshocton, Ohio, two adolescent females and their mothers, who also grew up in Appalachian Ohio, presented with menstrual concerns. Both parties expressed concerns about early menarche, cycle length, menstrual flow, and clots. In both cases, the patients were experiencing clinically normal menstruation. The patients and their mothers were counseled on normal range menses. Research surrounding menstrual health literacy in rural areas is lacking. The presented cases may point to a pattern of inadequate menstrual education in Coshocton, Ohio, as the patients and parents were unaware of normal menstrual patterns. In order to progress patient care, further research should aim to discern whether this area and greater Appalachia demonstrate lower levels of menstrual health literacy. Patients in Appalachia demonstrate lower education levels, which is correlated to lower health literacy. These cases highlight potentially inadequate menstrual education in Coshocton, Ohio. Further research and improved menstrual education should be pursued in the area.
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    Advancing AI in Medical Education: Understanding the Malpractice Landscape
    (2024-04-26) Stephanian, Brooke; Karki, Sabin; Schantz, Eli
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    Ethical Boundaries in AI-Driven Medical Education: Safeguarding Patient Data
    (2024-04-26) Karki, Sabin; Stephanian, Brooke; Schantz, Eli
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    The state of global surgery assessment and data collection tools: A scoping review
    (Wiley, 2024) Gianaris, Kevin; Stephanian, Brooke; Karki, Sabin; Gupta, Shailvi; Ratnayake, Amila; Kushner, Adam L.; Groen, Reinou S.; Medicine, School of Medicine
    Background: There has been a proliferation of global surgery assessment tools designed for use in low- and middle-income countries. This scoping review sought to categorize and organize the breadth of global surgery assessment tools in the literature. Methods: The search was conducted using PubMed from October 2022 to April 2023 according to PRISMA extension for scoping review guidelines. The search terms were (("global surgery"[All Fields]) AND ("assessment"[All Fields]) OR (data collection)). Only tools published in English that detailed surgical assessment tools designed for low- and middle-income countries were included. Results: The search resulted in 963 papers and 46 texts described unique tools that were included for the final review. Of these, 30 (65%) tools were quantitative, 1 (2%) qualitative, and 15 (33%) employed mixed-methods. 25 (54%) tools evaluated surgery in general, whereas 21 (46%) were focused on various surgical subspecialties. Qualitatively, major themes among the tools were noted. There was significant overlap of many tools. Conclusions: Nonspecialty surgery was represented more than any specialty surgery and many specialties had little or no representation in the literature. Ideally, local leadership should be involved in surgical assessment tools. Different methodologies, such as checklists and observational studies, aimed to target varying aspects of surgery and had distinct strengths and weaknesses. Further efforts should focus on expanding tools in neglected specialties.
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    Unveiling Prescribing Patterns: A Systematic Review of Chronic Opioid Prescriptions After Head and Neck Cancer Surgeries
    (Wiley, 2025) Karki, Sabin; Stephanian, Brooke; Ramirez, Mirian; Moore, Michael G.; Campbell, David A.; Chen, Diane W.; Sim, Michael W.; Yesensky, Jessica A.; Mantravadi, Avinash; Farlow, Janice L.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: This study aims to review opioid prescribing changes for pain management in head and neck cancer (HNC) surgery patients, given the recent focus on Enhanced Recovery After Surgery protocols. Data sources: MEDLINE, Embase, and CENTRAL, covering 1998 to 2023. Review methods: We selected studies that evaluated opioid prescribing patterns post-major HNC surgery in various settings, including tertiary care hospitals and community hospitals. Primary outcomes considered were prevalence and patterns of opioid use post-surgery, as well as related outcomes such as chronic use and side effects. Results: Of 1278 abstracts, 24 studies involving 17,027 patients from the United States, China, and Canada met inclusion criteria. Quality was assessed using the MINORS scale, with an average score of 9.9 for non-comparative studies and 20.0 for comparative studies. Persistent opioid use post-surgery, defined as ongoing prescriptions 90 days after treatment, was noted in 15.4% to 64% of patients. Two studies reported adverse events, with up to 16% of patients experiencing side effects. Risk factors for chronic use included preoperative opioid use, tobacco use, higher cancer stage, adjuvant treatment, and demographic factors. Correlations were found between larger opioid prescriptions and shorter survival in advanced cancers. There was notable variability in patient-reported pain control. Conclusion: Persistent opioid use post-HNC surgery is common, with variable efficacy and risk of adverse effects. Tailoring pain management to individual risk factors and focusing on multimodal analgesia could reduce the risks of continued opioid use. Future prospective studies are required to identify optimal pain management strategies.