IU Indianapolis ScholarWorks :: Browsing by Subject "Medical"

Browsing by Subject "Medical"

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Co-occurring trauma- and stressor-related and substance-related disorders in youth: A narrative review
(European Society of Medicine, 2024) Hinckley, Jesse D.; Adams, Zachary W.; Dellucci, Trey V.; Berkowitz, Steven; Psychiatry, School of Medicine
Adolescence is characterized by ongoing neurodevelopment and psychosocial development, resulting in a unique window to the adverse effects of traumatic events and substance use. In addition, trauma- and stressor-related disorders and substance use disorders (SUDs) commonly co-occur in adolescents. Youth with interpersonal violence and who have experienced multiple past traumas, or poly-victimization, are at the highest risk of developing these co-occurring disorders. There is a strong bidirectional relationship between traumatic events and substance use that predisposes youth to developing post-traumatic stress symptoms (PTSS) and SUDs. PTSD and states of substance intoxication and withdrawal also exhibit overlap in symptomatology. High rates of comorbidity may be explained in part by the self-medication hypothesis, that posits that individuals use substances to temporarily alleviate trauma-related symptoms. However, this results in negative reinforcement, often with increasing patterns of substance use and worsening symptoms of hyperarousal, dysphoria, and anxiety. In addition, PTSS and substance use problems share common risk factors and neurobiologic etiology, conceptualized as the susceptibility hypothesis. Youth who experience traumatic events and/or have substance use problems access the healthcare system at multiple levels, including through acute care and crisis services. Notably, substance use in adolescence increases the likelihood of experiencing a traumatic event, and youth presenting to the emergency department for substance-related problems are at higher risk of having a PTSD. Youth presenting for mental health, behavioral, or substance-related problems should be screened for PTSS and substance use problems. Given the strong clinical overlap and bidirectional relationship, evidence-based treatment integrates management of both disorders. An interdisciplinary approach with psychotherapy, psychopharmacologic therapy, and case management is often vital to engaging and maintaining youth in treatment.
The Eugenic Origins of Indiana's Muscatatuck Colony: 1920-2005
(2020-09) Bragg, Abigail Nicole; Nelson, Elizabeth; Morgan, Anita; Cramer, Kevin
This thesis examines the widely unknown history and origins of Muscatatuck Colony, located in Butlerville, Indiana. The national eugenics movement impacted the United States politically, medically, legally, and socially. While the United States established mental institutions prior to the eugenics movement, many institutions, including ones in Indiana, were founded as eugenic tools to advance the agenda of achieving a “purer” society. Muscatatuck was one such state institution founded during this national movement. I explore various elements that made the national eugenics movement effective, how Indiana helped advance the movement, and how all these elements impacted Muscatatuck’s founding. I investigate the language used to describe people that were considered “mentally inferior,” specifically who the “feeble-minded” were and how Americans were grouped into this category. I research commonly held beliefs by eugenicists of this time-period, eugenic methods implemented, and how these discussions and actions led to the establishment of Muscatatuck in 1920. Muscatatuck Colony, though a byproduct of the national eugenics movement, outlived this scientific effort. Toward the mid and late twentieth century, Muscatatuck leadership executed institutional change to best reflect American society’s evolving thoughts on mental health and how best to treat people with mental disabilities. Muscatatuck Colony reveals a complicated narrative of how best to treat or care for people within these institutions, a complex narrative that many mental institutions share.
Except for my commute, everything is the same: the shared lived experience of health sciences libraries during the COVID-19 pandemic
(Medical Library Association, 2022) Ragon, Bart; Whipple, Elizabeth C.; Rethlefsen, Melissa L.; Ruth Lilly Medical Library, School of Medicine
Objective: To understand the experience of academic health sciences libraries during the pandemic using a phenomenological approach. Methods: This study used a multisite, mixed-method approach to capture the direct experience of academic health sciences libraries as they evolved during the COVID-19 pandemic. Phase one of the study involved administering a qualitative survey to capture to capture current evolutions of programs and services. The survey for phases two (August 2020) and three (February 2021) contained eight questions asking participants to share updates on their evolution and experiences. Results: Qualitative data were analyzed using open coding techniques to ensure emergent themes were allowed to surface. Additional post-hoc sentiment analysis ascertained the frequency of positive and negative words in each data set. Of the 193 possible AAHSL libraries, 45 (23.3%) responded to the April 2020 survey, 26 to the August 2020 survey, and 16 to the February 2021 survey. Libraries represented 23 states and the District of Columbia. The majority of libraries closed in March 2020. The ease of transferring library services to a remote environment varied by type of service. For the quantitative analysis, ten distinct areas were analyzed using text coded as “Staff” as a lens for understanding the connection between codes. Conclusion: Innovations by libraries during the early stages of the pandemic are having a long-term impact on library culture and the delivery of services. Even as libraries returned to in-person services, elements of telecommuting, using online conferencing software, safety precautions, and monitoring of staff well-being persisted.
Integration of Case-Based Dialogue to Enhance Medical Students' Understanding of Using Health Communication to Address Social Determinants of Health
(Dove Press, 2023-03-15) King, Jalysa; Taylor, Jennifer; Medicine, School of Medicine
Background and objectives: With the ever-growing diversity within our communities, it is imperative that we integrate social determinants of health (SDOH) such as racial disparity, economic instability, lack of transportation, intimate partner violence, and limited social supports, and the importance of health literacy into undergraduate medical education. By incorporating evidence-based curriculum on the disproportionality within healthcare faced by racial and ethnic minorities, we have the opportunity to develop more culturally sensitive providers. The purpose of this study was to assess the impact of a case-based debrief experience on medical students' knowledge about how social determinants of health can impact health and healthcare within a family medicine clinical setting and their intent to practice in an underserved community. Methods: We utilized a retrospective paired-sample t-test analysis of program data from 640 third-year medical students who engaged in a family medicine clerkship between July 2020, and April 2022. For inclusion in the study, students must have engaged in a case-based exercise and corresponding small group debrief around the impact of social determinants of health on patient care. Results: We found a statistically significant improvement in students' reported knowledge about SDOH, as well as the confidence and intent to work with and care for individuals of diverse cultural and socioeconomic backgrounds. Conclusion: Medical students must have the knowledge and self-efficacy to understand how social determinants of health can impact health and healthcare within a family medicine clinical setting. As a result of integrating more active learning strategies such as the case-base and debrief experience, students may have a more robust medical education experience.
INTERNal Experience: How Previous Medical Trauma Influences Identity
(2018) Chilman, Bailee; Misluk, Eileen
This arts-based phenomenological study intended to extend themes from Jarrett’s (2016) artsbased phenomenological study, which explored the evolving identity of a graduate art therapy student. The researcher/participant of this study specifically explored how her past medical trauma continues to influence her current personal and professional identity development, while at her current clinical internship at a pediatric hospital. This participant replicated Jarrett’s (2016) methodology by completing the Twenty-StatementTest (TST), following the creation of artwork for six weeks. Upon the completion of data collection, the participant took part in a semi-structured interview with an independent reviewer. The purpose of the independent reviewer was to aid in the process of the interpretive phenomenological systematic analysis, which included the TST responses to recognize and categorize themes to further understand certain influences of one’s personal and professional identity. The researcher utilized three of the four categories that Jarrett (2016) identified; familial, sociocultural, and educational, as a framework for the early development of data analysis. The researcher extended categories in this study to include medical and trauma influences. As a result of this process, further themes evolved in the understanding of how traumatic experiences influence one’s identity. The researcher’s pediatric medical experience influenced the artwork and TST. The results of the interpretive phenomenological systematic analysis indicated that the following eight themes influenced the participant’s personal and professional identity: giving, self, success, interpersonal relationships, mother, somatic experiences, values and memories.
Polypharmacy Among Prescription Drug Users
(The Center for Health Policy, 2017-08-01) Omenka, Issac; Greene, Marion S.
Polypharmacy, i.e., the misuse of multiple prescription drugs or prescription medication with other substances, is highly problematic. Whether unintentional or deliberate, misuse of multiple drugs can lead to adverse effects including addiction; drug-drug interactions; and overdose, potentially resulting in death. Polypharmacy is not uncommon; almost 84 percent of prescription drug misusers receiving substance abuse treatment in Indiana reported using at least one additional substance, most commonly alcohol or marijuana.
Providing Pediatric Palliative Care Education Using Problem-Based Learning
(Mary Ann Liebert, 2018-01) Moody, Karen; McHugh, Marlene; Baker, Rebecca; Cohen, Hillel; Pinto, Priya; Deutsch, Stephanie; Santizo, Ruth O.; Schechter, Miriam; Fausto, James; Joo, Pablo; Pediatrics, School of Medicine
BACKGROUND: The Institute of Medicine and the American Academy of Pediatrics has called for improvement in education and training of pediatricians in pediatric palliative care (PPC). Given the shortage of PPC physicians and the immediate need for PPC medical education, this study reports the outcomes of a problem-based learning (PBL) module facilitated by academic general and subspecialty pediatric faculty (non-PPC specialists) to third year medical students. Objectives/Setting: To test the effectiveness of a PPC-PBL module on third year medical students' and pediatric faculty's declarative knowledge, attitudes toward, perceived exposure, and self-assessed competency in PPC objectives. DESIGN: A PBL module was developed using three PPC learning objectives as a framework: define core concepts in palliative care; list the components of a total pain assessment; and describe key principles in establishing therapeutic relationships with patients. A PPC physician and nurse practitioner guided pediatric faculty on facilitating the PPC-PBL. In Part 1, students identified domains of palliative care for a child with refractory leukemia and self-assigned questions to research and present at the follow-up session. In Part 2, students were expected to develop a care plan demonstrating the three PPC objectives. MEASUREMENTS: Measures included a knowledge exam and a survey instrument to assess secondary outcomes. RESULTS: Students' declarative knowledge, perceived exposure, and self-assessed competency in all three PPC learning objectives improved significantly after the PPC-PBL, p = 0.002, p < 0.001, and p < 0.001, respectively. There were no significant differences in faculty knowledge test scores from baseline to follow-up, but scores were generally high (median >80%). Students and faculty rated palliative care education as "important or very important" at baseline and follow-up. CONCLUSIONS: This study suggests that key concepts in PPC can be taught to medical students utilizing a PBL format and pediatric faculty resulting in improved knowledge and self-assessed competency in PPC.
Supporting University-wide Institutional Change in Global Health Volunteerism: A Case in Progress
(2018-04-16) Price, Mary F.; Leslie, Stephanie; Mulholland, James; Christy, Lisa; Custer, Jennifer; Brann, Maria; Besing, Kari L.
Vaccine considerations for adult dermatology patients on immunosuppressive and immunomodulatory therapies: a clinical review
(University of California, 2021-09-09) Tan, Alice J.; Streicher, Jenna L.; Merola, Joseph F.; Noe, Megan H.; Dermatology, School of Medicine
Adults with chronic inflammatory skin disease are at increased risk of vaccine-preventable illnesses and infections, likely because of the underlying disease itself and also their treatment with immunosuppressive and immunomodulatory medications. Despite the association between these agents and increased susceptibility to infection, vaccination rates in dermatology patients remain low. Although preventative care such as vaccinations is typically managed by primary care providers, dermatologists serve a critical role in spreading awareness of the specific risks of immunosuppressive and immunomodulatory agents and promoting understanding of individualized vaccine recommendations. In this review, we provide evidence-based information on vaccine recommendations for adult dermatology patients, specific to age and medication use.

Browsing by Subject "Medical"

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