Food Insecurity in an Urban Pregnancy Cohort

2021 ◽  
Author(s):  
Kirby Sullivan ◽  
Meghan St John ◽  
Emily DeFranco ◽  
Elizabeth Kelly
Keyword(s):  
Food Insecurity ◽  
Linear Models ◽  
Medical Center ◽  
Adjusted Relative Risk ◽  
Annual Household Income ◽  
Department Of Agriculture ◽  
Maternal Characteristics ◽  
Key Points ◽  
Study Population ◽  
The University

Objective Food insecurity is a prominent problem and has been implicated in adverse maternal and neonatal outcomes. This study aims to describe the food insecure population in an urban academic health center perinatal cohort. Study Design We enrolled 451 postpartum inpatients at the University of Cincinnati Medical Center who completed a questionnaire and were then categorized as food insecure based on U.S. Department of Agriculture standardized survey questions. Generalized linear models estimated the relative influence of maternal characteristics on food insecurity. Results Among the study population (n = 426), 18.6% (95% confidence interval: 15.2–22.4%) were classified as food insecure. Factors with increased adjusted relative risk on food insecurity include annual household income <$40,000, obesity, and smoking. Food insecure women also reported lower levels of love, satisfaction, and joy, and higher levels of despair. Conclusion We recommend the use of a validated screening tool on all pregnant women with the associated psychosocial stressors and social determinants of health. Key Points

Program Evaluation Results of a Structured Group Exercise Program in Individuals with Multiple Sclerosis

2010 ◽  
Vol 12 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Mary E. Charlton ◽  
Kelley Pettee Gabriel ◽  
Terry Munsinger ◽  
Lorene Schmaderer ◽  
Kathleen M. Healey
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Medical Center ◽  
Exercise Program ◽  
Group Exercise ◽  
Balance Confidence ◽  
Study Population ◽  
Rigorous Study ◽  
The University ◽  
The Impact

Although research-based and anecdotal evidence support the beneficial role of physical activity in symptom management among individuals with multiple sclerosis (MS), the integration of physical activity into the lifestyles of people with disabilities remains a challenge. The purposes of this study were to evaluate the feasibility and perceived effectiveness of a group Jazzercise program that was modified to fit the needs of individuals with MS. The study population included patients diagnosed with definite MS who were receiving care at the University of Nebraska Medical Center. Eleven of 14 initial participants remained in the program after 16 weeks and were mailed a short anonymous questionnaire designed to assess self-reported improvement in balance, confidence, coordination, energy, flexibility, mood, and strength, and to determine satisfaction and motivation to continue the course. Nine of the 11 participants (82%) at week 16 returned the survey. Of the nine respondents, all (100%) reported improvements in mood and energy, seven (77.8%) reported improvements in confidence, six (66.7%) reported improvements in flexibility and strength, and five (55.6%) reported improvements in balance and coordination. All nine respondents indicated that they enjoyed the class and were motivated to continue the program. The results provide justification for continued evaluation of this unique structured group exercise program in individuals with MS. A larger sample size and a more rigorous study design are needed to further examine the impact of the program on physiologic and psychosocial factors in individuals with MS.

scholarly journals Liquid materials for biomedical research: a highly IT-integrated and automated biobanking solution

2019 ◽  
Vol 43 (6) ◽  
pp. 347-354 ◽  
Author(s):  
Daniela Popp ◽  
Romanus Diekmann ◽  
Lutz Binder ◽  
Abdul R. Asif ◽  
Sara Y. Nussbeck
Keyword(s):  
Life Cycle ◽  
Medical Center ◽  
Research Results ◽  
Long Term Storage ◽  
Medical Centers ◽  
It Systems ◽  
Complete Life Cycle ◽  
The University ◽  
Term Storage

Abstract Various information technology (IT) infrastructures for biobanking, networks of biobanks and biomaterial management are described in the literature. As pre-analytical variables play a major role in the downstream interpretation of clinical as well as research results, their documentation is essential. A description for mainly automated documentation of the complete life-cycle of each biospecimen is lacking so far. Here, the example taken is from the University Medical Center Göttingen (UMG), where the workflow of liquid biomaterials is standardized between the central laboratory and the central biobank. The workflow of liquid biomaterials from sample withdrawal to long-term storage in a biobank was analyzed. Essential data such as time and temperature for processing and freezing can be automatically collected. The proposed solution involves only one major interface between the main IT systems of the laboratory and the biobank. It is key to talk to all the involved stakeholders to ensure a functional and accepted solution. Although IT components differ widely between clinics, the proposed way of documenting the complete life-cycle of each biospecimen can be transferred to other university medical centers. The complete documentation of the life-cycle of each biospecimen ensures a good interpretability of downstream routine as well as research results.

scholarly journals Clinical and echocardiographic trends in percutaneous balloon mitral valvuloplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ofir Koren ◽  
Asaf Israeli ◽  
Ehud Rozner ◽  
Nassem Darawshy ◽  
Yoav Turgeman
Keyword(s):  
Heart Failure ◽  
Medical Center ◽  
Success Rates ◽  
Mitral Valvuloplasty ◽  
Percutaneous Balloon Mitral Valvuloplasty ◽  
Developing Heart ◽  
Percutaneous Balloon ◽  
Study Population ◽  
Procedural Success ◽  
Over Time

Abstract Background The prevalence of Rheumatic Mitral Stenosis (MS) has significantly changed over the last decades. We intend to examine patient demographics, Echocardiographic characteristics, procedural success rates, and complications throughout 30-years. Methods We conducted a single-center descriptive observational study. The study population consists of patients undergone percutaneous balloon mitral valvuloplasty (PBMV) at Emek Medical Center in Israel from January 1990 to May 2019. Results Four hundred seventeen patients underwent PBMV during the study period and were eligible for the study. Age did not change significantly over time (p = 0.09). The prevalence of Male and patients who were smoking and had multiple comorbidities such as hypertension, dyslipidemia, ischemic heart disease, and chronic kidney disease became increases over time (p = 0.02, p = 0.02, p = 0.001, p = 0.01, p = 0.02, and p = 0.001, respectively). Wilkins score and all its components increased over time, and the total score was higher in females (p = 0.01). Seventy-nine (18.9%) patients had complications. The rate of complications did not change over decades. Patients with Wilkins score > 8, post-procedural MR of ≥2, and post-procedural MVA < 1.5 had the highest risk for the need of Mitral valve replacement (MVR) surgery in 2 years following PBMV (3.64, 4.03, 2.44, respectively, CI 95%, p < .0001 for all). The median time in these patients was 630 days compared to 4–5 years in the entire population. Patients with Post-procedural MR of ≥2 and post-procedural MVA < 1.5 had ten times risk for developing heart failure (HR 9.07 and 10.06, respectively, CI 95%, P < .0001). Conclusion Our research reveals trends over time in patients’ characteristics and echocardiographic features. Our study population consists of more male patients with multiple comorbidities and more complex and calcified valvular structures in the last decade. Wilkins score > 8, post-procedural MR of ≥2, and post-procedural MVA < 1.5 cm2 were in-depended predictors for the time for surgery and heart failure hospitalization.

scholarly journals Empirical Evidence for Professional Practice and Public Policies: An Exploratory Study on Social Exclusion in Users of Primary Care Social Services in Spain

2019 ◽  
Vol 16 (23) ◽  
pp. 4600 ◽  
Author(s):  
Giménez‐Bertomeu ◽  
Domenech‐López ◽  
Mateo‐Pérez ◽  
de‐Alfonseti‐Hartmann
Keyword(s):  
Primary Care ◽  
Social Exclusion ◽  
Social Services ◽  
Professional Practice ◽  
Social Inclusion ◽  
Social Acceptance ◽  
Life Trajectories ◽  
The Social ◽  
Study Population ◽  
The University

This study examines the social exclusion characteristics of a sample of users of primary care social services in two local entities in Spain. The objective of this study was to identify the intensity and scope of social exclusion in an exploratory way and to look at the typology of existing exclusionary situations to inform policy making and professional practice. Data from 1009 users were collected by primary care social services professionals, completing the Social Exclusion Scale of the University of Alicante (SES-UA). The dimensions with the greatest levels of social exclusion in the study population were those related to work/employment, income and education and training. The dimensions with an intermediate level of exclusion were those related to housing and social isolation. Social acceptance, family and social conflict and health were the dimensions with the lowest levels of exclusion. The analysis also showed the existence of five significantly different groups, that showed five different life trajectories along the continuum between social exclusion and social inclusion. The results show the importance and utility of developing professional and policy intervention protocols based on research evidence, with the objective of improving the quality of life of the users.

scholarly journals An Interesting and Productive Research and Clinical Career

2020 ◽  
Vol 39 (3) ◽  
pp. 182-188
Author(s):  
Samuel M. Cohen
Keyword(s):  
High School ◽  
Clinical Medicine ◽  
Medical Center ◽  
Basic Research ◽  
Nebraska Medical ◽  
Good Fortune ◽  
University Of Wisconsin ◽  
Productive Research ◽  
The University

To begin, I wish to thank the Academy of Toxicological Sciences for bestowing this honor on me. I have had a rewarding career in basic research and clinical medicine, beginning with research in high school and always planning on becoming a physician. I have had the good fortune of having outstanding mentors, wonderful parents, and a supportive and intuitive wife and family. This article provides a brief overview of some of the events of my career and individuals who have played a major role, beginning with the M.D./Ph.D. program at the University of Wisconsin, pathology residency and faculty at St. Vincent Hospital, Worcester, Massachusetts, a year as visiting professor at Nagoya City University, and my career at the University of Nebraska Medical Center since 1981. This could not have happened without the strong input and support from these individuals, the numerous students, residents and fellows with whom I have learned so much, and the more than 500 terrific collaborators.

scholarly journals Toxic Stress in a Mid-Sized Urban Community: An Initial Needs Assessment of Families with Children in Maywood, IL

2021 ◽  
Vol 12 ◽  
pp. 215013272110301
Author(s):  
Erin McCune ◽  
Jennifer Wojtowicz ◽  
William Adams ◽  
Garry Sigman ◽  
Collette Williams ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Needs Assessment ◽  
Medical Center ◽  
Health Resources ◽  
Community Organizations ◽  
Social Needs ◽  
Toxic Stress ◽  
Adverse Health Outcomes ◽  
Point Increase ◽  
Survey Responses

Background Loyola Medical Center is located in Maywood, IL, a community that faces high rates of poverty, violence, and barriers to healthcare. These factors can contribute to toxic stress, which has been shown to negatively impact children’s health. Objectives The goal of this project was to partner with community organizations to obtain a baseline needs assessment from families in Maywood regarding sources of toxic stress and to identify interventions of interest. Methods In total, 75 anonymous surveys were collected from the Loyola Outpatient Center Pediatric Clinic and a Maywood community center. Survey responses were statistically analyzed in order to determine toxic stressors most commonly impacting families in Maywood as well as interventions of most interest to the community. Results There were 78 respondents for a response rate of approximately 71%. The most common stressors were smoking in the home (33.3%), food insecurity (29.5%), and exposure to violence (26.9%). In this sample, Black respondents were 11.5 times more likely than non-Black respondents to report that their child was exposed to violence in the community – even after controlling for concern about their child’s behavior which served as a surrogate measure of the child’s exposure to toxic stress (P = 0.001). Further, those living with food insecurity were 7.40 times more likely to report that access to food and transportation vouchers were important ( P < .001). For every 1-point increase in the total toxic stress score, respondents were 1.35 times more likely to report that increasing access to mental health resources was important to them, though this was not significant ( P = .10). Conclusion The data demonstrate that toxic stressors, health risks and unmet social needs are prevalent in the Maywood community, which puts local children at risk for future adverse health outcomes. With this information, pediatricians at Loyola Medical Center can work with community organizations to allocate resources to address toxic stressors in Maywood.

Drug Alert Experience and Salience during Medical Residency at Two Healthcare Institutions

2021 ◽  
Vol 12 (02) ◽  
pp. 355-361
Author(s):  
Kinjal Gadhiya ◽  
Edgar Zamora ◽  
Salim M. Saiyed ◽  
David Friedlander ◽  
David C. Kaelber
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Medical Center ◽  
Internal Medicine Resident ◽  
Clinical Decision ◽  
University Of Pennsylvania ◽  
Teaching Hospitals ◽  
Medicine Resident ◽  
Internal Medicine Residents ◽  
The University

Abstract Background Drug alerts are clinical decision support tools intended to prevent medication misadministration. In teaching hospitals, residents encounter the majority of the drug alerts while learning under variable workloads and responsibilities that may have an impact on drug-alert response rates. Objectives This study was aimed to explore drug-alert experience and salience among postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) internal medicine resident physicians at two different institutions. Methods Drug-alert information was queried from the electronic health record (EHR) for 47 internal medicine residents at the University of Pennsylvania Medical Center (UPMC) Pinnacle in Pennsylvania, and 79 internal medicine residents at the MetroHealth System (MHS) in Ohio from December 2018 through February 2019. Salience was defined as the percentage of drug alerts resulting in removal or modification of the triggering order. Comparisons were made across institutions, residency training year, and alert burden. Results A total of 126 residents were exposed to 52,624 alerts over a 3-month period. UPMC Pinnacle had 15,574 alerts with 47 residents and MHS had 37,050 alerts with 79 residents. At MHS, salience was 8.6% which was lower than UPMC Pinnacle with 15%. The relatively lower salience (42% lower) at MHS corresponded to a greater number of alerts-per-resident (41% higher) compared with UPMC Pinnacle. Overall, salience was 11.6% for PGY-1, 10.5% for PGY-2, and 8.9% for PGY-3 residents. Conclusion Our results are suggestive of long-term drug-alert desensitization during progressive residency training. A higher number of alerts-per-resident correlating with a lower salience suggests alert fatigue; however, other factors should also be considered including differences in workload and culture.

Sign in / Sign up

Export Citation Format

Share Document