scholarly journals OpenAthens odyssey: challenges of implementing federated authentication for a multi-institutional user population

2021 ◽  
Vol 109 (4) ◽  
Author(s):  
Joanne Romano ◽  
Nha Huynh
Keyword(s):  
Case Report ◽  
Medical Center ◽  
Health Resources ◽  
Health Sciences ◽  
Online Resources ◽  
Preparation Methods ◽  
Texas Medical ◽  
Single Sign On ◽  
Active User ◽  
Authentication System

Background: The Texas Medical Center (TMC) is home to one of the world’s largest cohorts of faculty, students, researchers, and clinicians who rely on seamless and immediate access to digital biomedical and health resources. This group is served by the TMC Library, with a collection that includes over 380,000 ebooks and 59,000 ejournals. In 2018, the TMC Library implemented OpenAthens, a federated authentication system to replace a locally hosted instance of EZproxy.Case Presentation: The TMC Library is unique in its multi-institutional user population, which presents distinct challenges in adopting a single sign-on authentication system. Our project involved OpenAthens technical support, information technology teams from six academic institutions, and over thirty publishers. Implementation included the creation of an OpenAthens parent account, an active user directory, a resource catalog, and installation of our OpenAthens credentials at each publisher site. Because the TMC Library serves multiple institutions, OpenAthens built a custom login page and a portal to support both single sign-on and a generic username and password option. This case report discusses the reasons why OpenAthens was chosen, the preparation methods for implementation, the various challenges encountered and resolved, and recommendations for other health sciences libraries considering this system.Conclusions: The OpenAthens system provides important benefits: granular usage reports, single sign-on access, and data to negotiate reduced pricing for online resources. With prior knowledge and preparation, health sciences libraries can successfully implement OpenAthens with customizations tailored to their specific resources and user population.

Clinical Implications of the Center of Balance for a Veteran with Traumatic Brain Injury

2015 ◽  
pp. 280-289
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Benign Paroxysmal Positional Vertigo ◽  
Medical Center ◽  
Treatment Plan ◽  
Successful Outcome ◽  
Model Case ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: It is known that traumatic brain injury (TBI), even of the mild variety, can cause diffuse multisystem neurological damage. Coordination of sensory input from the visual, vestibular and somatosensory pathways is important to obtain proper balance and stabilization in the visual environment. This coordination of systems is potentially disrupted in TBI leading to visual symptoms and complaints of dizziness and imbalance. The Center of Balance (COB) at the Northport Veterans Affairs Medical Center (VAMC) is an interprofessional clinic specifically designed for patients with such complaints. An evaluation entails examination by an optometrist, audiologist and physical therapist and is concluded with a comprehensive rehabilitative treatment plan. The clinical construct will be described and a case report will be presented to demonstrate this unique model. Case Report: A combat veteran with a history of a gunshot wound to the skull, blunt force head trauma and exposure to multiple explosions presented with complaints of difficulty reading and recent onset dizziness. After thorough evaluation in the COB, the patient was diagnosed with and treated for severe oculomotor dysfunction and benign paroxysmal positional vertigo. Conclusion: Vision therapy was able to provide a successful outcome via improvement of oculomotor efficiency and control. Physical therapy intervention was able to address the benign paroxysmal positional vertigo. The specific evaluation and management as pertains to the aforementioned diagnoses, as well as the importance of an interprofessional rehabilitative approach, will be outlined.

Aneurysm of the communicating vein between the left renal vein and left ascending lumbar vein mimicking a retroperitoneal lymphadenopathy: A case report

2020 ◽  
Vol 16 ◽  
Author(s):  
Sevtap Arslan ◽  
Yasin Sarıkaya ◽  
Musturay Karcaaltincaba ◽  
Ali Devrim Karaosmanoglu
Keyword(s):  
Case Report ◽  
Lymph Nodes ◽  
Testicular Cancer ◽  
Renal Vein ◽  
Medical Center ◽  
Left Renal Vein ◽  
Severe Bleeding ◽  
Lumbar Vein ◽  
Ascending Lumbar Vein ◽  
Communicating Vein

Introduction: Aneurysm of the communicating vein between the left renal vein and left ascending lumbar vein is extremely rare with only anecdotal reported cases. Unless detected and recognized promptly, this rare condition may give rise to severe bleeding in patients undergoing retroperitoneal surgery. It may also closely mimic enlarged retroperitoneal lymph nodes, paragangliomas, adrenal masses, or renal artery aneurysms. Case report: In this case study, we reported the imaging findings of this rare entity which was falsely diagnosed as enlarged retroperitoneal lymph node in an outside medical center, reported as to be consistent with metastatic disease, in a patient with newly diagnosed testicular cancer. Conclusion: The aneurysm of the communicating vein should be considered in the differential diagnosis in patients with testicular cancer and other disease processes where lymph nodes are commonly affected.

scholarly journals Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 686-686
Author(s):  
Erin Emery-Tiburcio ◽  
Rani Snyder
Keyword(s):  
Older Adults ◽  
New York ◽  
Health System ◽  
Medical Center ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
New York University ◽  
The Us ◽  
Treatment Plans

Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.

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.

Dysphagia Management in Military Service Members With Polytrauma: Overview and Case Report

2021 ◽  
pp. 1-14
Author(s):  
Laura L. Cord ◽  
Veena Rajpal ◽  
Nancy Pearl Solomon
Keyword(s):  
Case Report ◽  
Multidisciplinary Team ◽  
Military Service ◽  
Medical Center ◽  
Service Members ◽  
Complex Case ◽  
Speech Pathology ◽  
Team Approach ◽  
Swallowing Function ◽  
Swallowing Evaluation

Purpose At Walter Reed National Military Medical Center, service members (SMs) with polytraumatic injuries, usually resulting from blast explosions, are routinely referred to the Speech Pathology Clinic for evaluation of swallowing function. The purpose of this clinical focus article is to advance the speech-language pathologist's (SLP) knowledge of polytrauma and to improve the care of individuals with traumatic injuries, especially related to nutrition and swallowing within a larger multidisciplinary team approach. Case Report Previous research within our center identified common demographic and injury characteristics of SMs with combat-related injuries that led to referrals for swallowing evaluation. An SM with polytraumatic injuries was selected for this case report to illustrate the relevance of the research findings and also the importance of multidisciplinary team support to appropriately manage such complex cases. Evaluations and relevant treatments are described across a 3-month acute care hospitalization, including swallowing and nutritional recommendations at the time of each swallowing evaluation. Discussion Comparisons of polytrauma cases at Walter Reed National Military Medical Center with literature from civilian trauma centers revealed somewhat longer hospitalizations and the particular influence of maxillofacial trauma on dysphagia outcomes. The complex case reported in this article illustrates the importance of multidisciplinary care and coordination, with particular emphasis on the intersecting roles of the SLP and registered dietitian. This report can serve as a guide for SLPs working in trauma settings for developing prognostic statements, treatment plans, and multidisciplinary interaction.

scholarly journals Esophageal Injury Secondary to Severely Embedded Denture: A Case Report

2021 ◽  
Vol 5 (3) ◽  
pp. 362
Author(s):  
Santiyamadhi Subramanyan ◽  
Komathi Ramachandran ◽  
Ing Ping Tang
Keyword(s):  
Case Report ◽  
Open Surgery ◽  
Foreign Bodies ◽  
Health Sciences ◽  
Esophageal Injury ◽  
Review Of The Literature ◽  
Surgical Extraction ◽  
History Of ◽  
Successful Removal ◽  
Esophageal Foreign Bodies

The incidence of esophageal impacted denture is proportionately increasing as there is increasing number of people wearing denture in current days. Impacted denture has to be removed as soon as possible because the delay can lead to complications. The successful removal of impacted denture in the esophagus in a patient is reported, with a review of the literature. A 52-year-old Malay lady complained of dysphagia with no history of foreign body ingestion. Following unsuccessful attempts of removal via a rigid esophagoscope, open surgery was performed. Without further delay, the impacted denture was removed by cervical esophagotomy, and the patient recovered uneventfully. Esophageal foreign bodies are usually removed by endoscopy. However, in situations where this appears potentially hazardous, such as with impacted denture, open surgical extraction that is promptly performed is a safer option.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 362-365

Millennials Seeking Healthcare: Examining the Degree to Which Patients Utilize Online Resources (Preprint)

2021 ◽  
Author(s):  
Landon Arensberg ◽  
Jessica Kalender-Rich ◽  
Jaehoon Lee ◽  
Cheryl Gibson
Keyword(s):  
Medical Care ◽  
Baby Boomers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Age Groups ◽  
Online Reviews ◽  
Online Resources ◽  
Cross Sectional ◽  
Academic Medical ◽  
Us Census

BACKGROUND According to the 2020 US Census, a Silver Tsunami is looming with more than 75.4 million persons aged 57-75 (known as “Baby Boomers”) expected to need more costly medical care. Future estimates, however, indicate a much larger wave of individuals is imminent, given the 83.1 million Millennials approaching adulthood who will be seeking medical care. Because Millennials differ from Baby Boomers in several ways, it is important to understand how this population finds their physician to gain insight into what might influence this decision. OBJECTIVE To determine the extent and influence online resources and reviews have on the younger generation as compared to elder generations. METHODS Between the months of May and July 2020 a cross-sectional paper-based survey was conducted at primary care and geriatric clinics located within a large urban academic medical center in the Midwest. RESULTS A sample of 284 patients completed the survey (44.35 ± 17.54 yrs old [range=18-90], 60.6% female, 57.4% white). Of Millennials (respondents aged 22-38 yrs), 67.2% read online reviews before choosing a physician. Millennials were significantly more likely to read online reviews before choosing a physician (P=0.004) and utilize online resources to search for a new physician (P<.001) than older patients. The majority of millennials were likely to be influenced by both negative reviews (59%) and positive reviews (71.3%). Female patients were more likely to read online reviews and use online resources compared to men, but the differences were not significant. CONCLUSIONS Overall, Millennials are much more likely to research online reviews before choosing a physician. Other generations also use online resources to an extent but tend to use personal referrals. Across all age groups, negative online reviews were less influential in decision-making compared to positive ones. Therefore, a presence on review websites and search engines seems to only benefit one’s medical practice to capture the new wave of patients.

News and Announcements

PEDIATRICS ◽  
1976 ◽  
Vol 57 (1) ◽  
pp. 167-168
Keyword(s):  
Continuing Education ◽  
Mexico City ◽  
Medical Center ◽  
Baylor College ◽  
Information Contact ◽  
International Meeting ◽  
Texas Medical ◽  
Pediatric Neurology ◽  
Pediatric Subject ◽  
Guest Speakers

PERCEPTUAL PROBLEMS OF THE PEDIATRIC SUBJECT: Annual pediatric postgraduate symposium, Department of Pediatrics, Baylor College of Medicine, Houston, February 5 and 6, 1976. Guest speakers include: Drs. Roger Fouts, Janet M. B. Hardy, Sarah E. Howell, Doris J. Johnson, Joseph M. Wepman, and Elizabeth Carrow-Woolfolk. Registration fee: $125. For information contact: Office of Continuing Education, Baylor College of Medicine, Texas Medical Center, Houston, Texas 77025 (713-790-4941). FOURTH INTERNATIONAL MEETING IN PEDIATRIC NEUROLOGY AND NEUROSURGERY: Organized by the Neurology and Neurosurgery Service of the Hospital Del Nino IMAN (Mexico City), February 18 to 21, 1976.

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