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Partial anomalous pulmonary venous return mimics arterial positioning after central line placement for plasmapheresis
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-04)
the left internal jugular vein. A chest x-ray showed a line that terminated to the left of the midline and raised concern for arterial placement (Figure 1). Blood gases from the line were: pH 7.72, pCO2 21 mmHg, pO2 369 mmHg, bicarbonate 28.4 mmol/L....
Nighttime resident supervision and education: results of a national survey of internal medicine residency program directors
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-04)
Over the past several years, the Accreditation Council for Graduate Medical Education (ACGME) has issued new restrictions on resident duty hours while calling for increased supervision to ensure patient safety. To meet these requirements, some...
Perceptions Towards the Discharge Process in a Community Teaching Hospital
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2020-04)
.4[percent] of nurses favored multidisciplinary round versus 4.2[percent] who did not. This was 54.5[percent] vs. 27.2[percent] for case managers and 44.1[percent] vs. 30.2[percent] for the residents (P-value = 0.002). Conclusion: Discharge process...
Rothman Index as a predictor of 30-day hospital readmission
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-04)
Introduction: The Centers for Medicare and Medicaid services financially penalize hospitals for elevated 30-day readmission rates. Identifying patients at high risk for short-term readmission would allow health systems to strategically allocate...
Incidental Portal Vein Aneurysm Found in a Patient with a Diaphragmatic Hernia and Evolving Gastric Volvulus
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2020-04)
large diaphragmatic hernia. Computed tomography (CT) revealed displacement of abdominal contents and 37 mm aneurysm of the main portal vein (image 1,2). Because of the large size of our patients' malformation (37 mm), surgery was pursued in the form...
Mandating vaccination -- is it justified?
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-04)
"The answer is yes…and no. It depends... Personal and Public Obligations: Freedom from oppression, the right to choose, and self-determination are bedrock values upon which our country was founded. They are also central ...
Disseminated cysticercosis
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2021-04)
on neurological and general physical examination were normal. Laboratory findings were notable for peripheral eosinophilia and thrombocytopenia present for a few months, which resolved in subsequent evaluations. Human immunodeficiency virus 1/2 Antigen...
Acute chest syndrome: a narrative review to guide inpatient management
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-04)
better outcome for patients, and the evidence behind using antibiotics, steroids, bronchodilators, nitric oxide, incentive spirometry, as well as the current management of patients with concomitant ACS and SARS-CoV2....
The Failing Right Ventricle : An Internist's Guide to the Diagnosis and Management of Pulmonary Hypertension
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2020-04)
Pulmonary hypertension represents a complex and multifactorial disease with significant implications on patients' morbidity, mortality, and quality of life. The number of patients hospitalized with pulmonary hypertension is increasing. Elevated...
Persistent meningeal signs despite previous treatment for cryptococcal meningitis -- a case report
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2022-07)
Cryptococcal meningitis continues to be a life-threatening fungal infection in patients with HIV. Treatment involves a year of antifungal therapy, and persistent meningeal signs months after treatment initiation are uncommon. ...
A discussion of covid-19 vaccine in relation with traditional chinese medicine belief on weibo
(University of Missouri--Columbia, 2021)
Traditional Chinese medicine has been influencing Chinese people for thousands of years. Vaccine, as a means of western medicine, has been on the controversial side of traditional Chinese medicine. When it comes to disease, many Chinese people make...
Hospital acquired pressure injury in adult orthopedic spine surgery patients: risk factors and risk assessment tools
(University of Missouri--Columbia, 2022)
Approximately 25 percent of all hospital acquired pressure injuries (HAPI) begin in the perioperative area. The study purposes were to identify risk factors in adult surgical patients undergoing orthopedic spine surgery in the prone position...
The nature of evidence utilized in healthcare architectural design decisions at five Midwestern critical access hospitals
(University of Missouri--Columbia, 2020)
study consisting of critical access hospitals that were in the process of or had built a replacement hospital in five Midwestern states, I sought answers to two questions: (1) how do hospital administrators and architects define and use EBD during...
Analyzing access: an analysis of food desert coverage during COVID-19
(University of Missouri--Columbia, 2022)
States. This thesis aimed to identify the ways in which food deserts in the United States are covered being that millions of Americans live in these designated areas. The results show that themes centered on financial context, agriculture, community...
A study to reduce the number of preventable emergency visits at community level
(University of Missouri--Columbia, 2023)
Introduction: Emergency Department overcrowding is a worldwide issue. The impact of increased unnecessary and preventable emergency visits in hospitals leads to reduced quality of care, inability to care for critically ill patients, increased errors...
Pod travel in the pandemic era: social media analytics on travel sentiment and spatial distribution
(University of Missouri--Columbia, 2022)
The outbreak of the COVID-19 pandemic brought an enormous downturn to the overall hospitality and tourism industry. Accordingly, a novel trend emerged, called 'pod travel,' reflecting travelers' needs and behavior shifts. This study aims...
Faculty burnout and its relationship to social and institutional support
(University of Missouri--Columbia, 2020)
The purpose of this sequential explanatory study was to determine if there was a relationship between faculty burnout, social support, institutional support, or salary, as well as establish if any college at a regional ...
Making the invisible, visible : photojournalism and the documentation of the COVID-19 pandemic
(University of Missouri--Columbia, 2023)
leading cause of death in America; more than 1.1 million Americans died because of COVID-19 during this period, accounting for about 16 percent of the world's total fatalities. This study is twofold: 1) it explores 500 photographs published...
An evaluation of an Electronic Medical Record (EMR) based system to characterize and correlate physician burnout and EMR use
(University of Missouri--Columbia, 2021)
Burnout disproportionately affects healthcare workers and continues to rise, contributing to cost, quality, and patient safety risk in an already overburdened United States healthcare system. While the causes of burnout ...
Value addition to acid whey from Greek yogurt processing with millets (kodo and proso) for development of nutritious food products
(University of Missouri--Columbia, 2022)
there is the production of healthy food products using the byproduct and waste streams. Hence, the objective of this project was to increase this statistic, specifically targeting the Greek yogurt industry which produces 2.31 million metric tons of acid whey every year...