scholarly journals A Model for Syphilis Screening in the Emergency Department

2020 ◽  
pp. 003335492096730
Author(s):  
Justin A. Yax ◽  
Joshua D. Niforatos ◽  
Daniel L. Summers ◽  
Margaret H. Bigach ◽  
Christine Schmotzer ◽  
...  
Keyword(s):  
Emergency Department ◽  
African American Men ◽  
Medical Center ◽  
The United States ◽  
University Hospitals ◽  
Syphilis Screening ◽  
Sex With Men ◽  
Testing Algorithm ◽  
The University

The incidence of syphilis infections is on the rise, particularly among African American men and men who have sex with men, and it is reaching epidemic levels in these communities throughout the United States. Although syphilis is relatively inexpensive to treat and cure and is a predictor for HIV incidence among men and transgender women who have sex with men, rates of co-screening for syphilis are low in the emergency department setting, with a dearth of literature on this topic since the 1990s and early 2000s. In this case study, we describe an operational model for routine syphilis screening implemented in June 2017 at the University Hospitals Cleveland Medical Center in Cleveland, Ohio. We describe the advantages of screening using a reverse testing algorithm rather than the traditional method and the necessity of partnering with the Cleveland Department of Public Health for both diagnostic and follow-up logistics.

‘A Routh O’ Auld Nick-Nackets’ – the antiquarian collection of John Rae

2015 ◽  
Vol 36-37 (1) ◽  
pp. 163-183
Author(s):  
Paul Taylor
Keyword(s):  
United States ◽  
Nineteenth Century ◽  
Social Context ◽  
Moral Education ◽  
The United States ◽  
Representative Case ◽  
National Museums ◽  
The Individual ◽  
The University

John Rae, a Scottish antiquarian collector and spirit merchant, played a highly prominent role in the local natural history societies and exhibitions of nineteenth-century Aberdeen. While he modestly described his collection of archaeological lithics and other artefacts, principally drawn from Aberdeenshire but including some items from as far afield as the United States, as a mere ‘routh o’ auld nick-nackets' (abundance of old knick-knacks), a contemporary singled it out as ‘the best known in private hands' (Daily Free Press 4/5/91). After Rae's death, Glasgow Museums, National Museums Scotland, the University of Aberdeen Museum and the Pitt Rivers Museum in Oxford, as well as numerous individual private collectors, purchased items from the collection. Making use of historical and archive materials to explore the individual biography of Rae and his collection, this article examines how Rae's collecting and other antiquarian activities represent and mirror wider developments in both the ‘amateur’ antiquarianism carried out by Rae and his fellow collectors for reasons of self-improvement and moral education, and the ‘professional’ antiquarianism of the museums which purchased his artefacts. Considered in its wider nineteenth-century context, this is a representative case study of the early development of archaeology in the wider intellectual, scientific and social context of the era.

Validating the primary provider theory in emergency medicine

2008 ◽  
Vol 21 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Joseph S. Guarisco ◽  
Stefoni A. Bavin
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Pay For Performance ◽  
Medical Center ◽  
Waiting Times ◽  
Emergency Department Visits ◽  
Business Success ◽  
Content Type ◽  
The Impact

PurposeThe purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.Design/methodology/approachThe case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.FindingsThe findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.Practical implicationsThese findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.Originality/valueThere are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

scholarly journals Impact of Two-Step Testing Algorithm on Reducing Hospital-Onset Clostridioides difficile Infections

2021 ◽  
Vol 1 (S1) ◽  
pp. s42-s43
Author(s):  
Bhagyashri Navalkele ◽  
Wendy Winn ◽  
Sheila Fletcher ◽  
Regina Galloway ◽  
Jason Parham ◽  
...  
Keyword(s):  
Medical Center ◽  
Molecular Testing ◽  
Toxin A ◽  
Clostridioides Difficile ◽  
Contact Isolation ◽  
Academic Center ◽  
Mississippi Medical ◽  
True Infection ◽  
Testing Algorithm ◽  
The University

Clostridioides difficile infection (CDI) is one of the leading causes of hospital–onset infections. Clinically distinguishing true CDI versus colonization with C. difficile is challenging and often requires reliable and rapid molecular testing methods. At our academic center, we implemented a 2-step testing algorithm to help identify true CDI cases. The University of Mississippi Medical Center is a 700+ bed academic facility located in Jackson, Mississippi. Hospital-onset (HO) CDI was defined based on NHSN Laboratory Identified (LabID) event as the last positive C. difficile test result performed on a specimen using a multistep testing algorithm collected >3 calendar days after admission to the facility. HO-CDI data were collected from all inpatient units except the NICU and newborn nursery. HO-CDI outcomes were assessed based on standardized infection ratio (SIR) data. In May 2020, we implemented a 2-step testing algorithm (Figure 1). All patients with diarrhea underwent C. difficile PCR testing. Those with positive C. difficile PCR test were reflexed to undergo enzyme immunoassay (EIA) glutamate dehydrogenase antigen (Ag) testing and toxin A and B testing. The final results were reported as colonization (C. difficile PCR+/EIA Ag+/Toxin A/B−) or true CDI case (C. difficile PCR+/EIA +/Toxin A/B +) or negative (C. difficile PCR−). All patients with colonization or true infection were placed under contact isolation precautions until diarrhea resolution for 48 hours. During the preintervention period (October 2019–April 2020), 25 HO-CDI cases were reported compared to 8 cases in the postintervention period (June 2020–December 2020). A reduction in CDI SIR occurred in the postintervention period (Q3 2020–Q4 2020, SIR 0.265) compared to preintervention period (Q4 2019–Q1 2020, SIR 0.338) (Figure 2). We successfully reduced our NHSN HO-CDI SIR below the national average after implementing a 2-step testing algorithm for CDI. The 2-step testing algorithm was useful for antimicrobial stewardship to guide appropriate CDI treatment for true cases and for infection prevention to continue isolation of infected and colonized cases to reduce the spread of C. difficile spores.Funding: NoDisclosures: None

scholarly journals SYNTHESIS OF THE ORGANIZATION OF TREATMENT, RESEARCH AND TEACHING (CASE STUDY AT THE UNIVERSITY HOSPITAL IN AACHEN)

2021 ◽  
pp. 349-358
Author(s):  
Maryna Lienkova ◽  
Irina Bulakh
Keyword(s):  
Medical Center ◽  
Multidisciplinary Treatment ◽  
University Hospital ◽  
Survey Analysis ◽  
University Hospitals ◽  
Medical Institutions ◽  
Hospital Patients ◽  
Student Training ◽  
Treatment Research ◽  
The University

The article considers and analyzes the existing in the world, but new for Ukraine, type of healthcare institutions - a university hospital, which today is an example of one of the largest and best university hospitals in Germany - the Medical Center of the University of Aachen. The planning and functional structure of the university hospital and special design approaches that contributed to its design and development are analyzed. The purpose of the article is to illustrate an innovative approach for our state to the organization of medical institutions and to emphasize the importance of their implementation in the domestic healthcare system. The research methodology is based on the systematization and analysis of data from various information sources, as well as on the method of sociological survey (analysis of reviews). The article considers the features of the structure of the University Hospital Aachen, namely the multidisciplinary treatment, research and student training, which are combined in one institution. According to hospital patients, the only drawback of this structure is the frequent long wait for visitors. This is probably due to the significant daily flow of patients of varying complexity and, consequently, the shortcomings of the managerial approach. However, at the same time, the hospital has many advantages, which were highlighted in the article.  

Commentary: An African Perspective on the Doha Round Negotiations

2005 ◽  
Vol 5 (4) ◽  
pp. 1850076
Author(s):  
Kwame Bawuah-Edusei
Keyword(s):  
Medical Center ◽  
The United States ◽  
University Hospital ◽  
Community Leader ◽  
Washington Dc ◽  
Medical Sciences ◽  
Energy Company ◽  
Army Hospital ◽  
Howard University ◽  
The University

An African commentary on the Doha Development Round. Kwame Bawuah-Edusei is Ambassador of Ghana to Switzerland and Austria and Permanent Representative of Ghana to the UN offices and international organizations in Geneva, including the WTO. He obtained his MD degree in 1982 at the University of Science and Technology, School of Medical Sciences, Kumasi Ghana, worked in Ghana for two years, and later studied in the United States. He specialized in Family Medicine at Howard University Hospital, Washington DC, and worked as a physician for the Dewitt Army Hospital in Fort Belvoir, Virginia. He subsequently practiced at Educe Medical Center in Alexandria, Virginia. During this period he was active in promoting business in his native Ghana and extensively involved in humanitarian work in the deprived Northern part of his country. He became a community leader in North America and was instrumental in institutionalizing democracy in Ghana. He became a Director of the EO group, an energy Company, and President of Educe Incorporated in Ghana.

Recovering the US Hispanic Literary Heritage: A Case Study on US Latina/o Archives and Digital Humanities

2019 ◽  
Vol 48 (1) ◽  
pp. 17-27
Author(s):  
Gabriela Baeza Ventura ◽  
Lorena Gauthereau ◽  
Carolina Villarroel
Keyword(s):  
Digital Humanities ◽  
The United States ◽  
Digital Repository ◽  
Successful Work ◽  
The Us ◽  
Literary Heritage ◽  
History Of ◽  
Personal Archives ◽  
The University

AbstractThis article focuses on the work and efforts put forth by the University of Houston’s Recovering the US Hispanic Literary Heritage program (Recovery) to create the first digital humanities center for US Latina/o Research: #usLdh. Recovery is a program to locate, preserve, and make available the written legacy of Latinas/os in the United States since colonial times until 1960. Through 27 years of successful work Recovery has not only been able to inscribe the excluded history of Latinas/os, but also has created an inclusive and vast digital repository that facilitates scholarship in this area of studies. This article focuses on the importance of recovery work in the writing, teaching, and understanding of history and considers how local personal archives have helped to fill in the gaps of mainstream history. We will detail the goals and challenges of this mission, as well as the importance of educating the community in digital methods that preserve and disseminate minority voices.

Healthcare Epidemiology Practicum Rotation for Postgraduate Physician Trainees in Medicine–Infectious Diseases

2013 ◽  
Vol 34 (10) ◽  
pp. 1114-1116
Author(s):  
Pranavi Sreeramoju ◽  
Maria Eva Fernandez-Rojas
Keyword(s):  
Infectious Diseases ◽  
Infection Control ◽  
Medical Center ◽  
Common Trunk ◽  
University Hospitals ◽  
Hospital System ◽  
University Of Texas ◽  
Core Rotation ◽  
The University ◽  
Healthcare Epidemiology

Practicum education in healthcare epidemiology and infection control (HEIC) for postgraduate physician trainees in infectious diseases is necessary to prepare them to be future participants and leaders in patient safety. Voss et al suggested that training in HEIC should be offered as a “common trunk” for physicians being trained in clinical microbiology or infectious diseases. A 1-month rotation has been recommended previously. A survey by Joiner et al indicated that only 50% of infectious diseases fellows found the infection control training adequate. The objective of this article is to report our 2-year experience with a 1-month practicum rotation we designed and implemented at our institution.The setting is the Adult Infectious Diseases fellowship program at the University of Texas Southwestern Medical Center (UTSW), Dallas, Texas. The fellows have clinical rotations at the Parkland Health and Hospital System, UTSW University hospitals, North Texas Veterans Affairs Health Care System, and Children's Medical Center Dallas. The 2-year program recruits 7 fellows every 2 years. The 1-month core rotation was established in July 2011 and is ongoing. Fellows who completed the rotation during the period July 2011 to April 2013 are included in this study.

Functional Limitations of Patients with End-Stage Ankle Arthrosis

2005 ◽  
Vol 26 (7) ◽  
pp. 537-539 ◽  
Author(s):  
Julie Agel ◽  
J. Chris Coetzee ◽  
Bruce J. Sangeorzan ◽  
Matthew M. Roberts ◽  
Sigvard T. Hansen
Keyword(s):  
Medical Center ◽  
Functional Limitations ◽  
Population Sample ◽  
Operative Management ◽  
The United States ◽  
University Of Minnesota ◽  
Previous Trauma ◽  
End Stage ◽  
The University ◽  
Foot Fractures

Background: Arthritis and other rheumatic conditions are the leading causes of disability among adults in the United States. The purpose of this report was to describe the self-reported functional limitations of a group of patients with end-stage ankle arthrosis. Method: Patients who presented for operative management of end-stage ankle arthrosis at the University of Minnesota and Harborview Medical Center completed a Musculoskeletal Functional Assessment (MFA) as part of their preoperative clinical evaluation. Data from patients evaluated during the time period April, 1995, through May, 2004, were used for this project. Results: Four hundred and twenty-six patients with the diagnosis of end-stage ankle arthrosis completed baseline questionnaires. Six of the 426 patients received care on both ankles during the time of this project. The average age of patients at the time of completion of the questionnaire was 56.7 years. There were 241 men and 185 women. The primary underlying causes identified by the treating surgeon at the time of surgery were primary osteoarthritis with no known prior trauma (66), previous trauma (tibial fracture, foot fractures, or ankle ligamentous disruption) (296), rheumatoid arthritis (24), no known cause (21), and a variety of diseases or infections (19). In all domains, the patients with end-stage ankle arthrosis showed statistically significant differences from a general population sample. Conclusions: The effects of ankle arthritis as demonstrated by this data are severe. Most of these patients were severely limited in function. Without a data-driven understanding of the limitations the patients have, it is difficult to make an effective argument for focused research to solve the problems. Without understanding the patients' needs, it is impossible to assess the effect of treatment. The information in this paper provides a baseline understanding of effect of the current functional limitations of patients with end-stage ankle arthrosis.

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