Browsing by Subject "Case Study"

Now showing 1 - 10 of 24
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    Answering the Call to Action: COVID-19 Curriculum Design by Students for Students
    (Wolters Kluwer, 2020-07-08) Roll, Rebekah; Chiu, Megan; Huang, Christina; Medicine, School of Medicine
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    Asymptomatic Seroconversion of Immunoglobulins to SARS-CoV-2 in a Pediatric Dialysis Unit
    (American Medical Association, 2020-05-14) Hains, David S.; Schwaderer, Andrew L.; Carroll, Aaron E.; Starr, Michelle C.; Wilson, Amy C.; Amanat, Fatima; Krammer, Florian; Pediatrics, School of Medicine
    Dialysis units are at especially high risk of infectious disease transmission, and concern exists about spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dialysis units in Wuhan, China, have reported high coronavirus disease 2019 (COVID-19) prevalence, due in part to unique exposure challenges that limit social distancing efforts, including open bay formats and rotating/multiple nursing assignments. This study describes SARS-CoV-2 seroconversion in patients and health care workers in a pediatric dialysis unit.
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    Building Cohesion in Distributed Telemedicine Teams Findings from the Department of Veterans Affairs National Telestroke Program
    (2020-07-16) Patel, Himalaya; Damush, Teresa M.; Miech, Edward J.; Rattray, Nicholas A.; Martin, Holly A.; Savoy, April; Plue, Laurie; Anderson, Jane; Martini, Sharyl; Graham, Glenn D,; Williams, Linda S.; Richard L. Roudebush VA Medical Center
    Background: As telemedicine adoption increases, so does the importance of building cohesion among physicians in telemedicine teams. For example, in acute telestroke services, stroke specialists provide rapid virtual stroke assessment and treatment to patients at hospitals without stroke specialty care. In the National Telestroke Program (NTSP) of the U.S. Department of Veterans Affairs, a virtual (distributed) hub of stroke specialists throughout the country provides 24/7 consultations nationwide. We examined how these specialists adapted to distributed teamwork, and we identied cohesion-related factors inprogram development and support. Methods: We conducted a case study of the stroke specialists employed by the NTSP. Semi-structured, condential interviews with stroke specialists in the virtual hub were recorded and transcribed. We explored the extent to which these specialists had developed a sense of shared identity and teamcohesion, and we identied factors in this development. Using a qualitative approach with constant comparison methods, two researchers coded each interview transcript independently using a shared codebook. We used matrix displays to identify themes, with special attention to team cohesion, communication, trust, and satisfaction. Results: Of 13 specialists with at least 8 months of NTSP practice, 12 completed interviews; 7 had previously practiced in telestroke programs in other healthcare systems. Interviewees reported high levels of trust and team cohesion, sometimes even more with their virtual colleagues than with local colleagues. Factors facilitating perceived team cohesion included a weekly case conference call, a sense of transparency in discussing challenges, engagement in NTSP development tasks, and support from the NTSP leadership. Although lack of in-person contact was associated with lower cohesion, annual in-person NTSP meetings helped mitigate this issue. Despite technical challenges in establishing a new telehealth system within existing national infrastructure, providers reported high levels of satisfaction with the NTSP.Conclusion: A virtual telestroke hub can provide a sense of team cohesion among stroke specialists at a level comparable with a standard co-located practice. Engaging in transparent discussion of challenging cases, reviewing new clinical evidence, and contributing to program improvements may promotecohesion in distributed telemedicine teams
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    Can post-disaster tourism development improve destination livelihoods? A case study of Aceh, Indonesia
    (Elsevier, 2020-10-21) Liu-Lastres, Bingjie; Mariska, Dini; Tan, Xiaoyuan; Ying, Tianyu; Tourism, Conventions, and Event Management, School of Health and Human Sciences
    Destinations are vulnerable to natural disasters, which can result in damage to infrastructure and built facilities, negative destination images, and a difficult time of recovery. Recently, a growing number of destinations have incorporated tourism development in their disaster relief efforts and used post-disaster tourism as a strategy to enhance local livelihoods and build community resilience. Guided by the Sustainable Livelihoods Framework for Tourism (SLFT), this study analyzed the case of Aceh, Indonesia, a destination that had been struck by a severe natural disaster and developed tsunami tourism as a strategy to recover. The data were collected through focus group interviews among local stakeholders. Based on the SLFT, this study employed a deductive approach to analyze the data and identified six themes. The findings not only validated the applicability of the SLFT to a post-disaster tourism development context, but also revealed how tourism could contribute to various community assets and a resilient destination in the aftermath of a crisis. The study also underscored the importance of local culture and religion during the recovery process. Based on the findings, further discussions are provided regarding the dynamics involving sustainable development, post-disaster tourism, and resilient destinations.
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    Catheter Removal on the Same Day of Holmium Laser Enucleation of the Prostate: Outcomes of a Pilot Study
    (Elsevier, 2020-10-09) Agarwal, Deepak K.; Rivera, Marcelino E.; Nottingham, Charles U.; Large, Tim; Krambeck, Amy E.; Urology, School of Medicine
    Objectives: To determine if same day catheter removal is feasible in select population after holmium laser enucleation of the prostate (HoLEP). Methods: We performed an analysis of patients undergoing HoLEP at our institution who underwent same-day catheter removal after HoLEP. All HoLEPs were performed with Moses Optimized for BPH. Patients were dismissed from postoperative recovery unit (POCU) to the clinic for catheter removal and voiding trial. Results: To date, 30 patients have undergone same day catheter removal. Median age is 68.6 years (IQR 61.8-73.3) and preoperative prostate volume 81 ml (IQR 53-114.8). Median enucleation time was 39.5 min (IQR 30.5-53), morcellation time was 5 min (IQR 4-12 min) and enucleated specimen weight was 52.5 g (IQR 33-81). 27 (90%) patients successfully voided on the same day without requiring catheter replacement. All patients were catheter free by POD1. For patients who successfully passed their voiding trial, the median time from the end of the procedure to hospital discharge was 2.6 hours (IQR (2.1-2.9) and from the end of the HoLEP to catheter removal was 4.9 hours (IQR 3.5-6.0). Conclusions: We present for the first time that same day catheter removal is a feasible option in a select population of patients undergoing HoLEP. With more study, this has the potential for transforming the management of BPH, especially larger glands.
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    COVID-19 and hereditary spherocytosis: A recipe for hemolysis
    (Wiley, 2020-07-25) Severance, Tyler S.; Rahim, Mahvish Q.; French, James; Baker, Richelle M.; Shriner, Andrew; Khaitan, Alka; Overholt, Kathleen M.; Pediatrics, School of Medicine
    We describe a patient infected with COVID-19 in the setting of a known chronic illness, HS, and the resulting presentation and medical complications.
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    COVID-19-associated apnea and circumoral cyanosis in a 3-week-old
    (Springer Nature, 2020-08-12) Needleman, Joseph S.; Hanson, Amy E.; Pediatrics, School of Medicine
    Background: Data regarding coronavirus disease 2019 (COVID-19) cases and outcomes in infants are sparse compared to older pediatric and adult populations. Case presentation: We present a three-week-old full-term male with a history of mild hypoxic ischemic encephalopathy (HIE) who was admitted as an inpatient twice for episodes of apnea and perioral cyanosis. The patient tested positive for COVID-19 and negative for other common respiratory viruses at both admissions. Conclusions: To our knowledge, this is the first report of apnea and perioral cyanosis associated with COVID-19 in an infant. This case highlights a previously undocumented COVID-19 presentation and suggests that even mildly symptomatic infants warrant viral diagnostic testing in an effort to prevent further spread of the disease.
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    COVID-19-Associated Bifacial Weakness with Paresthesia Subtype of Guillain-Barré Syndrome
    (American Society of Neuroradiology, 2020-06-25) Hutchins, Katherine L.; Jansen, Jaclyn H.; Comer, Adam D.; Scheer, Richard V.; Zahn, Gregory S.; Capps, Alisha E.; Weaver, Lindsay M.; Koontz, Nicholas A.; Neurology, School of Medicine
    We report a case of bifacial weakness with paresthesia, a recognized Guillain-Barré syndrome subtype characterized by rapidly progressive facial weakness and paresthesia without ataxia or other cranial neuropathies, which was temporally associated with antecedent coronavirus 2019 (COVID-19). This case highlights a potentially novel but critically important neurologic association of the COVID-19 disease process. Herein, we detail the clinicoradiologic work-up and diagnosis, clinical course, and multidisciplinary medical management of this patient with COVID-19. This case is illustrative of the increasingly recognized but potentially underreported neurologic manifestations of COVID-19, which must be considered and further investigated in this pandemic disease.
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    Creating Virtual Spaces to Build Community Among Students Entering an Undergraduate Biomedical Engineering Program
    (Springer Nature, 2020-08-20) Higbee, Steven; Miller, Sharon; Waterfill, Abigail; Maxey, Kayla; Stella, Julie; Wallace, Joseph; Biomedical Engineering, School of Engineering and Technology
    After the transition to online instruction in response to the COVID-19 pandemic, students in our program lamented the loss of connection to their peers, more so than diminished access to faculty, teaching assistants, or other resources. Fortunately, given that the semester was well underway when the transition occurred and few students in our courses were new to our BME program, we feel that students missed out on relatively few formative community-building experiences. This would not be the case for a fall semester of online instruction, however, so we must take action for the sake of our incoming class of undergraduate students. Our experience from spring 2020 and our review of the relevant literature suggest that we can be successful at building community among our new cohort of BME students, regardless of the mode of instruction.
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    Discounting a surgical risk: data, understanding, and gist
    (http://virtualmentor.ama-assn.org//2012/07/ecas1-1207.html, 2012-07-01) Schwartz, Peter H.
    Excerpt: A few days after the surgery, Ms. Reid came in for an emergency appointment with Dr. Feng. It was obvious that she was irate,but her voice could barely be heard above the noise of the clinic. "I thought you said this was rare," she said, shaking a printout of a journal article on the subject. My recurrent laryngeal nerve was injured. I'm a teacher, and I have children! I need my voice. I would have never done the surgery if I knew there was a 4 percent risk that I would lose my voice!" Was Dr. Feng negligent in explaining the risks of surgery to Ms. Reid? Was she required to use precise percentages of risk?