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The IUPUI Center for Translating Research Into Practice illustrates and fosters interdisciplinary and cross-disciplinary research targeting goals which work toward the betterment of people’s lives across communities, our state, and beyond.
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Item 1-year mortality following contrast-induced nephropathy(2013) Mitchell, Alice M; Jones, Alan E; Tumlin, James A; Kline, Jeffrey A.Objective: The aim of this study was to determine the 1-year mortality risk subsequent to Contrast-Induced Nephropathy (CIN) following CECT imaging, relative to other well-recognized predictors of mortality. Methods: We followed a prospective, consecutive cohort of ambulatory patients who received intravenous contrast for CECT for the outcome of death from any cause within 1 year. In a multivariate analysis, we compared CIN with other predictors of mortality: active malignancy, coronary artery disease (CAD), congestive heart failure (CHF) and age ≥70 years. Anticipating that terminal cancers would account for the majority of deaths in this population, we also analyzed the subset of patients without an active malignancy at the time of enrollment. Results: We followed 633 patients and 46 died (7%, 95%CI: 5-9%) within 1 year. The incidence of CIN was 11% (95%CI: 8-14%). Active malignancy (HR 9.2, 95%CI: 5.1-16.8), CIN (HR 2.4, 95%CI: 1.3-4.6), CHF (HR 2.1, 95%CI: 1.0-4.2), CAD (HR 2.2, 95%CI: 1.0-5.5) and age ≥70 years (HR 1.8, 95%CI: 1.0-3.8) were significant predictors of all-cause mortality. Among patients without active malignancies, the mortality rate was 4% (25/580, 95%CI: 3-6%) and CIN (HR 4.0, 95%CI: 1.7-9.6) and age ≥70 years (HR 3.7, 95%CI: 1.4-9.7) were significantly associated with death, whereas CAD (HR 2.5, 95%CI: 0.8-7.7) and CHF (HR 1.8, 95%CI: 0.6-5.3) were not. Conclusions: The development of CIN following CECT is associated with an increased likelihood of death at 1 year among patients with and without active malignancies, comparable to CAD, CHF and advanced age.Item 1. #Bookstagram; 2. Why the Library?(2022-10-21) O'Keefe, Alex; Bortell, Alex; Vine, Liz; Moffett, PaulPRESENTATION 1 ABSTRACT: #Bookstagram: Implementing Collaborative Social Media Training in the Library - Alex O'Keefe and Alex Bortell, School of the Art Institute of Chicago. Social media has become an integral component of outreach, providing a distinct voice for the library. Recognizing the importance of student workers’ perspectives and the fact that they are at the forefront of content creation in their own lives, the John M. Flaxman Library piloted a Student Worker Content Creators program. Making institutional Instagram content modernizes students’ professional development and provides skills they can use beyond the library. Through the program, students learn to design appropriate content while collaboratively shaping training implementation. The individualized and independent approach gives students agency to learn through hands-on processes, while their honest feedback improves the quality of the experience. The presenters will discuss developing training through collaborative modifications and the outcomes for one student worker. They will also share advice based on their successes and failures for others who are interested in building a content creators program or generally creating collaborative training processes.Item Item 137. The Impact of Past Year Difficult Worries On Recency of Adolescent Mental Health Outcomes By Gender, Age, Sexual Orientation And Race/Ethnicity – Results From A Nationally Representative Probability Survey of U.S. Adolescents 14-17 Years(Elsevier, 2019-02-01) Hensel, Devon J.; Herbenick, Debby; Fu, Jane; Dodge, Brian; Beckmeyer, JonathonItem 192. Health Equity Starts with Us: Recommendations from the Indiana Clinical and Translational Sciences Institute Racial Justice and Health Equity Task Force(Cambridge University Press, 2022) Sotto-Santiago, Sylk; Tucker Edmonds, Brownsyne; Wiehe, Sarah; Moe, SharonOBJECTIVES/GOALS: The Indiana CTSI Strategy Committee charged the Racial Justice and Health Equity Taskforce to identify priorities with short-term and long-term goals consistent with the I-CTSI mission. In addition, I-CTSI leadership asked for a general description of current state and the resources necessary to achieve the proposed goals. METHODS/STUDY POPULATION: The Taskforce applied an inclusive excellence model to the way we look at the I-CTSI structure, policies, and programs while performing an environmental scan within and across I-CTSI partner institutions. In order to reach equitable solutions and consensus, listening tours were held with partner stakeholders guided by the SOAR framework for strategic planning. This approach allowed us to assess current resources, needs, and gaps across the system, along with a baseline of measures currently monitored. Taskforce members openly discussed strengths and opportunities for enhancement of current programs and services. In addition, these conversations offered an opportunity to disrupt existing practices and through collective agency we identified priority areas that promote equity, diversity and inclusion. RESULTS/ANTICIPATED RESULTS: The Taskforce identified recurring themes in conversations with all partners, which led to the formation of three working groups that examined recruitment broadly: workforce, staffing, and research participation; professional development across all stakeholders from community members to I-CTSI staff; and data-centered metrics informing current state, decision-making, and accountability. Recommendations included these priorities, content, and implementation strategies. The Taskforce delivered a report to the I-CTSI leadership fostering the promotion of diversity, equity and inclusion along with a systematic collection of gender, race, and ethnicity data for individuals utilizing I-CTSI services and resources requiring additional metrics and tracking. DISCUSSION/SIGNIFICANCE: The pandemic shed light on the manner in which marginalized groups are rendered particularly vulnerable to death and disease by systemic and structural racism. The I-CTSI recognized that we cannot advance population health without attending to root causes of inequity and that includes our internal structure. We offer a potential model for other CTSAs.Item A 2,300-year-long annually resolved record of the South American summer monsoon from the Peruvian Andes(PNAS, 2011-05-24) Bird, Broxton W.; Abbott, Mark B.; Vuille, Mathias; Rodbell, Donald T.; Stansell, Nathan D.; Rosenmeier, Michael F.Item 2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker(2012-06) Than, Martin; Cullen, Louise; Aldous, Sally; Parsonage, William A; Reid, Christopher M; Greenslade, Jaimi; Flaws, Dylan; Hammett, Christopher J; Beam, Daren M; Ardagh, Michael W; Troughton, Richard; Brown, Anthony FT; George, Peter; Florkowski, Christopher M; Kline, Jeffrey A.; Peacock, W Frank; Maisel, Alan S; Lim, Swee Han; Lamanna, Arvin; Richards, A MarkObjectives The purpose of this study was to determine whether a new accelerated diagnostic protocol (ADP) for possible cardiac chest pain could identify low-risk patients suitable for early discharge (with follow-up shortly after discharge). Background Patients presenting with possible acute coronary syndrome (ACS), who have a low short-term risk of adverse cardiac events may be suitable for early discharge and shorter hospital stays. Methods This prospective observational study tested an ADP that included pre-test probability scoring by the Thrombolysis In Myocardial Infarction (TIMI) score, electrocardiography, and 0 + 2 h values of laboratory troponin I as the sole biomarker. Patients presenting with chest pain due to suspected ACS were included. The primary endpoint was major adverse cardiac event (MACE) within 30 days. Results Of 1,975 patients, 302 (15.3%) had a MACE. The ADP classified 392 patients (20%) as low risk. One (0.25%) of these patients had a MACE, giving the ADP a sensitivity of 99.7% (95% confidence interval [CI]: 98.1% to 99.9%), negative predictive value of 99.7% (95% CI: 98.6% to 100.0%), specificity of 23.4% (95% CI: 21.4% to 25.4%), and positive predictive value of 19.0% (95% CI: 17.2% to 21.0%). Many ADP negative patients had further investigations (74.1%), and therapeutic (18.3%) or procedural (2.0%) interventions during the initial hospital attendance and/or 30-day follow-up. Conclusions Using the ADP, a large group of patients was successfully identified as at low short-term risk of a MACE and therefore suitable for rapid discharge from the emergency department with early follow-up. This approach could decrease the observation period required for some patients with chest pain. (An observational study of the diagnostic utility of an accelerated diagnostic protocol using contemporary central laboratory cardiac troponin in the assessment of patients presenting to two Australasian hospitals with chest pain of possible cardiac origin; ACTRN12611001069943)Item A 2000 year varve-based climate record from the central Brooks Range, Alaska(Springer, 2009-01-01) Bird, Broxton W.; Abbott, Mark B.; Finney, Bruce P.; Kutchko, BarbaraVarved minerogenic sediments from glacial-fed Blue Lake, northern Alaska, are used to investigate late Holocene climate variability. Varve-thickness measurements track summer temperature recorded at Atigun Pass, located 41 km east at a similar elevation (r2 = 0.31, P = 0.08). Results indicate that climate in the Brooks Range from 10 to 730 AD (varve year) was warm with precipitation inferred to be higher than during the twentieth century. The varve-temperature relationship for this period was likely compromised and not used in our temperature reconstruction because the glacier was greatly reduced, or absent, exposing sub-glacial sediments to erosion from enhanced precipitation. Varve-inferred summer temperatures and precipitation decreased after 730 AD, averaging 0.4°C above the last millennial average (LMA = 4.2°C) from 730 to 850 AD, and 0.1°C above the LMA from 850 to 980 AD. Cooling culminated between 980 and 1030 AD with temperatures 0.7°C below the LMA. Varve-inferred summer temperatures increased between 1030 and 1620 AD to the LMA, though the period between 1260 and 1350 AD was 0.2°C below the LMA. Although there is no equivalent to the European Medieval Warm Period in the Blue Lake record, two warm intervals occurred from 1350 to 1450 AD and 1500 to 1620 AD (0.4 and 0.3°C above the LMA, respectively). During the Little Ice Age (LIA; 1620 to 1880 AD), inferred summer temperature averaged 0.2°C below the LMA. After 1880 AD, inferred summer temperature increased to 0.8°C above the LMA, glaciers retreated, but aridity persisted based on a number of regional paleoclimate records. Despite warming and glacial retreat, varve thicknesses have not achieved pre-730 AD levels. This reflects limited sediment availability and transport due to a less extensive retreat compared to the first millennium, and continued relative aridity. Overall, the Blue Lake record is similar to varve records from the eastern Canadian Arctic that document a cool LIA and twentieth century warming. However, the occurrence and timing of events, such as the LIA and Medieval Warm Period, varies considerably among records, suggesting heterogeneous climatic patterns across the North American Arctic.Item 2014 Indiana Family Medicine Residencies Exit Survey Report(2014-11) Kochhar, Komal; Buente, Bryce; Tandukar, EugeneIn order to plan effective healthcare workforce development initiatives, it is important to understand the reasons why Indiana family medicine residents choose to practice in specific locations. Thus, having a better understanding of the factors that influence how residents choose a practice location will help improve efforts to recruit and retain family medicine physicians in areas of need within the state. The 2014 Indiana Family Medicine Residencies Exit Survey© determines what these physicians plan to do after graduation; and, for those planning to primarily provide clinical care, to determine where they plan to practice. In addition, the survey also obtained overall feedback on the residents’ training and their program’s curricula, as well as ideas and suggestions for improvement.Item 2015 Graduate Medical Education Exit Survey Report(2016-08) Kochhar, Komal; Lozefski, Keith; Yazdanfar, MaryamIn order to plan effective healthcare workforce development initiatives, it is important to understand the reasons why the Indiana University School of Medicine (IUSM) residency and fellowship graduates’ choose to practice in specific locations. This study documented the proportion of residency and fellowship graduates that were planning to practice in areas of need in Indiana. The 2015 IUSM Graduate Medical Education Exit Survey© identified factors affecting graduates’ choice of practice location and gathered feedback on their self-rated level of competency training to serve the rural and underserved populations; assessment of their training program and the six Accreditation Council for Graduate Medical Education (ACGME) competency areas.