scholarly journals Fertility navigators in female oncofertility care in an academic medical center: a qualitative evaluation

2020 ◽  
Vol 28 (12) ◽  
pp. 5733-5741 ◽  
Author(s):  
M. van den Berg ◽  
S. Nadesapillai ◽  
D. D. M. Braat ◽  
R. P. M. G. Hermens ◽  
C. C. M. Beerendonk
Keyword(s):  
Fertility Preservation ◽  
Medical Center ◽  
Academic Medical Center ◽  
Qualitative Evaluation ◽  
Added Value ◽  
Personal Care ◽  
Academic Medical ◽  
Supportive Role ◽  
Female Fertility Preservation

Abstract Purpose To explore patients’ and professionals’ experiences with fertility navigators in female oncofertility care. Methods Semi-structured in-depth interviews were conducted with nine female cancer patients and six healthcare professionals to explore their experiences. They were recruited from an academic medical center (referral clinic for female fertility preservation care). Data were analyzed using the concepts of grounded theory. Results Patients were satisfied about the supportive role of the fertility navigator in their fertility preservation process: fertility navigators added value as they became “familiar faces” and provided information, emotional support, personal care, and served as patients’ primary contact person. The fertility navigators had a pleasant collaboration with professionals and supported professionals by taking over tasks. To improve the role of fertility navigators, it was suggested that they should always be present in fertility preservation counseling, and attention should be paid to their availability to improve continuity of care. Conclusion Fertility navigators provide personal care, improve satisfaction in patients in their oncofertility process, and support professionals. The overview of issues that need to be addressed when assigning fertility navigators in female oncofertility care combined with the improvement suggestions could be used by other centers when considering implementing fertility navigators.

Role of postgraduate year 2 pharmacy residents in providing weekend antimicrobial stewardship coverage in an academic medical center

2017 ◽  
Vol 74 (6) ◽  
pp. 417-423 ◽  
Author(s):  
Justin Siegfried ◽  
Cristian Merchan ◽  
Marco R. Scipione ◽  
John Papadopoulos ◽  
Arash Dabestani ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

Selective macrophage depletion in the liver does not prevent the development of the sick euthyroid syndrome in the mouse

1996 ◽  
Vol 134 (4) ◽  
pp. 513-518 ◽  
Author(s):  
Anita Boelen ◽  
Marianne C Platvoet-ter Schiphorst ◽  
Nico van Rooijen ◽  
Wilmar M Wiersinga
Keyword(s):  
Kupffer Cells ◽  
Medical Center ◽  
Academic Medical Center ◽  
Thyroid Hormone Metabolism ◽  
Macrophage Depletion ◽  
Liver Macrophages ◽  
Academic Medical ◽  
Selective Depletion ◽  
Sick Euthyroid

Boelen A, Platvoet-ter Schiphorst MC, van Rooijen N, Wiersinga WM. Selective macrophage depletion in the liver does not prevent the development of the sick euthyroid syndrome in the mouse. Eur J Endocrinol 1996;134:513–8. ISSN 0804–4643 A decreased serum triiodothyronine (T3) level is one of the main characteristics of the sick euthyroid syndrome, caused mainly by a decreased 5′-deiodination of thyroxine (T4) in the liver. Cytokines have been implicated in the pathogenesis of the changes in thyroid hormone metabolism during illness. We therefore investigated the role of cytokines produced by the liver macrophages (Kupffer cells) in the development of the sick euthyroid syndrome, which was induced in mice by a single injection of bacterial endotoxin (lipopolysaccharide) or by 24-h starvation. Experiments were carried out with or without previous selective depletion of liver macrophages by intravenous administration of liposome-encapsulated dichloromethylene diphosphonate. Relative to saline-injected pair-fed controls, the administration of lipopolysaccharide caused a decrease of serum T3 and T4 and liver 5′-deiodinase mRNA. Selective depletion of liver macrophages did not affect these changes. Starvation for 24 h decreased serum T3 and T4, associated with a slight decrease of liver 5′-deiodinase mRNA. There were no differences between macrophage-depleted and non-depleted animals in this respect. In summary, selective depletion of liver macrophages did not affect the decrease in serum T3, T4 or liver 5′-deiodinase mRNA induced by lipopolysaccharide or 24-h starvation in mice. We conclude that cytokines produced by Kupffer cells are not involved in the pathogenesis of the sick euthyroid syndrome in this experimental model. A Boelen, Department of Endocrinology, F5-171 Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Patient Safety Trilogy: Perspectives from Clinical Engineering

2013 ◽  
Vol 47 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Izabella Gieras ◽  
Paul Sherman ◽  
Dennis Minsent
Keyword(s):  
Patient Safety ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Engineering ◽  
Veterans Health ◽  
Health Administration ◽  
Healthcare Technology ◽  
Academic Medical ◽  
Clinical Engineers

This article examines the role a clinical engineering or healthcare technology management (HTM) department can play in promoting patient safety from three different perspectives: a community hospital, a national government health system, and an academic medical center. After a general overview, Izabella Gieras from Huntington Hospital in Pasadena, CA, leads off by examining the growing role of human factors in healthcare technology, and describing how her facility uses clinical simulations in medical equipment evaluations. A section by Paul Sherman follows, examining patient safety initiatives from the perspective of the Veterans Health Administration with a focus on hazard alerts and recalls. Dennis Minsent from Oregon Health & Science University writes about patient safety from an academic healthcare perspective, and details how clinical engineers can engage in multidisciplinary safety opportunities.

scholarly journals The Procedure Coordinator: A Resident-Driven Initiative to Increase Opportunity for Inpatient Procedures

2018 ◽  
Vol 10 (5) ◽  
pp. 583-586 ◽  
Author(s):  
Matthew Gorgone ◽  
Brian McNichols ◽  
Valerie J. Lang ◽  
William Novak ◽  
Alec B. O'Connor
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Medical Providers ◽  
Procedural Training ◽  
Academic Medical ◽  
Attending Physician ◽  
Attending Physicians ◽  
The Impact ◽  
Training Opportunities

ABSTRACT Background  Training residents to become competent in common bedside procedures can be challenging. Some hospitals have attending physician–led procedure teams with oversight of all procedures to improve procedural training, but these teams require significant resources to establish and maintain. Objective  We sought to improve resident procedural training by implementing a resident-run procedure team without routine attending involvement. Methods  We created the role of a resident procedure coordinator (RPC). Interested residents on less time-intensive rotations voluntarily served as RPC. Medical providers in the hospital contacted the RPC through a designated pager when a bedside procedure was needed. A structured credentialing process, using direct observation and a procedure-specific checklist, was developed to determine residents' competence for completing procedures independently. Checklists were developed by the residency program and approved by institutional subspecialists. The service was implemented in June 2016 at an 850-bed academic medical center with 70 internal medicine and 32 medicine-pediatrics residents. The procedure service functioned without routine attending involvement. The impact was evaluated through resident procedure logs and surveys of residents and attending physicians. Results  Compared with preimplementation procedure logs, there were substantial increases postimplementation in resident-performed procedures and the number of residents credentialed in paracenteses, thoracenteses, and lumbar punctures. Fifty-nine of 102 (58%) residents responded to the survey, with 42 (71%) reporting the initiative increased their ability to obtain procedural experience. Thirty-one of 36 (86%) attending respondents reported preferentially using the service. Conclusions  The RPC model increased resident procedural training opportunities using a structured sign-off process and an operationalized service.

Potential role of abbreviated MRI for breast cancer screening in an academic medical center

2019 ◽  
Vol 25 (4) ◽  
pp. 604-611 ◽  
Author(s):  
Vandana Dialani ◽  
Irene Tseng ◽  
Priscilla J. Slanetz ◽  
Valerie Fein‐Zachary ◽  
Jordana Phillips ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Potential Role ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

Increasing fertility preservation counseling prior to chemotherapy.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 225-225
Author(s):  
Candice Schwartz ◽  
Ari Seifter ◽  
Ivy Abraham ◽  
Caitlin Lopes ◽  
Emily Woo ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Medical Center ◽  
Insurance Coverage ◽  
Academic Medical Center ◽  
Post Intervention ◽  
Female Patients ◽  
Academic Medical ◽  
Survey Results ◽  
Prohibitive Cost ◽  
Common Barriers

225 Background: The 2018 ASCO Guidelines recommend that physicians document discussions about fertility with all female patients < 49 years old at the time of cancer diagnosis. Patients interested in fertility preservation (FP) should be referred to Reproductive Endocrinology and Infertility (REI) prior to chemotherapy. Retrospective review of oncology patients at our academic medical center over 6 months found that 33% of females < 49 years old had FP discussion documented. We aimed to increase FP discussions and help expedite referrals to REI from 33% to 75% within 5 months. Methods: All new chemotherapy orders were reviewed weekly. Female patients between ages 18-49 were identified and charts were abstracted for the following: age, race, diagnosis, stage, type and line of chemotherapy, and FP discussion. If FP was not discussed, the physician was contacted in real time via email to address FP with the patient and document the discussion. Charts were reviewed 2-4 weeks later to determine if FP was documented. To better understand barriers to FP documentation, fellows and attendings were surveyed to target future interventions. Results: From Dec. 2018 to Apr. 2019, 6/27 (22%) patients had documented discussions of FP. Post intervention, this number increased to 17/27 (63%) with one referral to REI. Intent of chemotherapy was curative in 56% of patients, and 67% were receiving their first line of chemotherapy. 2/15 (13%) patients receiving curative treatment and 4/12 (33%) patients receiving palliative chemotherapy had documentation of FP, both of which increased with intervention to 8/15 (53%) and 9/12 (75%), respectively. Conclusions: Our intervention successfully increased FP discussion from 33% to 63%, but we did not meet our goal of 75%. Per our survey results, the most common barriers to FP discussion were time constraints, inexperience discussing FP, and perception of prohibitive cost to the patient. We are designing our next intervention to address provider inexperience with FP discussion. This will include education regarding the financial aspects of REI and discussion of the new Oncofertility law in Illinois (HB2617), which ensures insurance coverage for oncofertility as of Jan 2019.

Discovery and Development of Pregabalin (Lyrica): The Role of Public Funding

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012730
Author(s):  
Rachel Barenie ◽  
Jonathan Darrow ◽  
Jerry Avorn ◽  
Aaron Kesselheim
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Public Funding ◽  
Publicly Funded ◽  
Fda Approval ◽  
Academic Medical ◽  
Northwestern University ◽  
Core Project ◽  
Key Terms

Background:Pregabalin (Lyrica), a widely used drug that has generated billions in revenue as a treatment for diabetic neuropathy and other conditions, was originally discovered in an academic medical center, largely supported by public funding.Objective:To define the extent of direct federal public funding that contributed to various stages of pregabalin’s development prior to Food and Drug Administration (FDA) approval.Methods:We identified key research, scientists and organizations involved in the development of pregabalin from its discovery through FDA approval. Using key terms (e.g., its indications and mechanism of action), we searched PubMed for relevant publications and determined whether each publication was based on federal public funding, using the National Institutes of Health RePORTER. For each award prior to the drug’s FDA approval, we scored its potential relatedness to pregabalin’s development based on its title, investigator, and organization, and then examined descriptions of the most relevant awards to aid in defining these relationships. The budgets for all related awards were converted to 2020 dollars.Results:Pregabalin was discovered largely on the basis of publicly funded research at Northwestern University; in 1990, it was licensed to Parke-Davis which further developed it through its FDA approval in 2004. Most key terms were related to the drug and drug-target (n=5) and organizations involved (n=5), followed by patent-listed inventors (n=3). These key terms linked 6,438 core project awards, and we identified 37 NIH awards related to pregabalin’s development: 9 awards through 1990 ($3.3 million) and 28 from 1991-2004 ($10.5 million).Conclusions:Like many other widely-sold medications, the development of pregabalin relied on public-sector as well as industry contributions to its discovery, with relevant NIH awards totaling $13.8 million during its pre-approval development.

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