The Guthrie journal of the Donald Guthrie Foundation for Medical Research最新文献

{"title":"Fifth Annual Guthrie Research Day","authors":"V. Hickey","doi":"10.53481/001c.36405","DOIUrl":"https://doi.org/10.53481/001c.36405","url":null,"abstract":"The fifth annual Guthrie Research Day was held April 22, 2022, on the Robert Packer Hospital campus in Sayre, PA. The event showcases research and quality improvement projects from fellows and residents of Guthrie as well as medical students from Geisinger Commonwealth School of Medicine (GCSOM) and Lake Erie College of Osteopathic Medicine (LECOM). This year’s Research Day featured 13 oral presentations and 53 posters.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75712219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Brief Intervention to Reduce Mobile Phone Use in College Students","authors":"B. Piper, S. Daily, S. Martin, Maurice W. Martin","doi":"10.53481/001c.35547","DOIUrl":"https://doi.org/10.53481/001c.35547","url":null,"abstract":"Excessive mobile phone use contributes to distracted driving, may increase risk for automobile accidents, and a minority of mobile phone users exhibit behaviors consistent with technological addiction. The purpose of this study was to determine whether cell phone beliefs and behaviors could be changed by a brief educational encounter. The Theory of Reasoned Action provided a lens for viewing attitudes and behavior. A one-week pre-post design with a thirty-day follow-up was used with participants (N = 215, 67.0% female, age = 20.0 + 1.6) assigned to a peer-led intervention or comparison group. The intervention included cell phone educational materials regarding the potential for negative health effects of mobile phone use. A short index of cell phone behavior was developed which showed good internal consistency with a Cronbach’s α of .81. The intervention group “agreed” or “strongly-agreed” more than the comparison group on five of the seven areas of cell phone beliefs and behaviors (P < 0.05, item Cohen’s d = .32 to .47, total d = .50) at one week following receipt of educational materials. We conclude that attitudes and behaviors regarding mobile phones are malleable and susceptible to change in young adults following a brief psychoeducational intervention.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82730313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Coma Secondary to Acute Onset of Hyperammonemia in a Non-Cirrhotic Adult Male Secondary to a Urea Cycle Enzyme Deficiency—a Rare Disease Case Report","authors":"C. Sonier, M. Owens, S. Khurana, Lokendra Thakur","doi":"10.53481/001c.35585","DOIUrl":"https://doi.org/10.53481/001c.35585","url":null,"abstract":"Acute hyperammonemia in adult patients without liver disease is uncommon. Other etiologies are broad and can be difficult to rule out quickly. Urea cycle disorders such as ornithine transcarbamylase (OTC) deficiency are rare and often present in children. Adult-onset cases are rarer. This makes recognizing and treating late-onset urea cycle disorders challenging in the acute setting. We present the case of a 56-year-old male with a history of early onset coronary artery disease, chronic back pain, and heavy tobacco use who was found unconscious at home by a neighbor. He was found to have toxic levels of serum ammonia during further evaluation in the emergency department. Laboratory testing confirmed a diagnosis of OTC deficiency. Genetic analysis further showed a c.-106C>A variant of the OTC gene. Although extremely rare, late-onset urea cycle disorders should be considered when patients present with altered mental status with hyperammonemia of unknown etiology. Furthermore, this case adds evidence that the c.-106C>A OTC gene variant has pathogenic significance.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91157378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Distribution Trends in California Following Recreational Cannabis Legalization","authors":"M. Anyaehie, C. Pardo, D. E. Kaufman, B. Piper","doi":"10.53481/001c.35533","DOIUrl":"https://doi.org/10.53481/001c.35533","url":null,"abstract":"The US opioid overdose epidemic has risen to an all-time high. Prescription opioids often serve as a gateway to illicit opioids, which have appreciable overdose potential. Recent investigations have highlighted the efficacy and safety of cannabis-based products for pain management. Providing alternative pain treatment options may help mitigate the opioid epidemic. The distribution of codeine, fentanyl, hydrocodone, morphine, and oxycodone per 100 000 people and by 3-digit zip codes from 2014 to 2018 in California and Texas were compared. Overdose rates were also evaluated. California legalized recreational marijuana in 2016, but in Texas marijuana is functionally prohibited. Drug weights were obtained from the Automation of Reports and Consolidated Orders System and converted to oral morphine milligram equivalents. Overdose data was retrieved from the Centers for Disease Control’s WONDER database. California and Texas showed significant reductions in cumulative opioid distribution from 2014 to 2018 (− 43.7% and − 27.3%, respectively). Opioid distribution per 100 000 people decreased − 38.9% in California relative to − 26.4% in Texas. Opioid and heroin overdoses increased between 1999 and 2019 by + 11.6% in California but + 272.7% in Texas. This evidence supports marijuana legalization as a mitigating factor to the opioid epidemic and opioid misuse.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75061719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conflict of Interest Disclosure Disparities Among Male and Female Physician Authors of High Impact Cancer Research Journals","authors":"Shuyi Chen, Alivia L. Roberts, Kevin Zhao, Abigail C. Burke, Jesse E. Ritter, Katherine M. Musto, B. Piper","doi":"10.53481/001c.33790","DOIUrl":"https://doi.org/10.53481/001c.33790","url":null,"abstract":"","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"33 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72403181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Systemic Causes of Physician Burnout: Improving Joy in Work","authors":"Katherine Lincoln, Jamie Lopez, M. McGowan","doi":"10.53481/guthriej.2021.03.01","DOIUrl":"https://doi.org/10.53481/guthriej.2021.03.01","url":null,"abstract":"Healthcare provider burnout has been shown to result in lower staff engagement levels and reduced work satisfaction, which correlates with lower patient experience scores, lower productivity, and increased workplace accidents. By making work engaging and restoring joy, healthcare leadership can reframe barriers to reduce burnout. This paper presents the results of an organizational system-wide intervention designed to rethink the approach to lowering burnout by improving joy in work to address provider well-being at the Guthrie healthcare system. System wide and targeted area strategies were used to create change over a 1-year interval of intervention. After endpoint data was collected, eight power items had positive change for this healthcare system. Scheduling and recognition emerged as system wide areas in need of reform.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"307 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79879970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Violations to the 80-hour Work Rule with Electronic Health Record to Establish Rapid Culture Change, Does It Work?","authors":"E. Yeung, D. Golden, J. Miner, S. Marica, B. Cagir","doi":"10.53481/guthriej.2021.03.02","DOIUrl":"https://doi.org/10.53481/guthriej.2021.03.02","url":null,"abstract":"Objectives: In our free-standing general surgery residency program, it was noted over the past decade that we had an exorbitant number of resident work hours violations. This resulted in multiple citations from the Accreditation Council for Graduate Medical Education (ACGME) with subsequent probation. To restore accreditation requirements and provide trainees with a balanced learning environment, work hours were restructured. Reporting of work hours in the residency management software was authenticated by the organizational Electronic Health Record (EHR). This quality improvement project evaluated the effectiveness of compliance to the 80-hour work rules in a single rural surgical training residency program with the aid of EHR. Methods: The hours are actively monitored in the residency management software, New-Innovations (NI) and cumulative weekly reports were created. With the design, residents were scheduled to work a maximum of 13 hours per day beginning at 0600 and operating room (OR) time concluding by 1700. During each 4-week rotation, residents were assigned one Friday call, one Saturday call and four hours of transitional call. The primary outcome of this project was the number of resident violations to the 80 hours rule before and after implementation of those measures. The secondary outcomes were the residents’ comparative academic and clinical performances. This project also evaluated the overall cultural change and satisfaction with the program using ACGME survey data. Results: Compared with the non EHR era (2013-2015), the number of violations during the EHR era decreased significantly. (Mean non EHR= 167.3, EHR = 24.6) (p =0.0009) Case volumes and board pass rates were a central focus throughout the changes. No decrease in operative volume was noted for graduating residents (N = 8, non EHR= 1,062, Mean EHR = 1,110) (p = 0.5). Over the three years since the changes, the board pass rates have improved from 64% to 80% in Certifying Examination (CE) (N = 8, Passing % non EHR = 64%, EHR = 80%) (p = 0.03) Qualifying Examination (QE) (N = 8, Passing % non EHR = 100%, EHR = 93%) (p =0.1). Conclusion: Reduction in work hour violations can be achieved with a reliable schedule, promotion of accurate reporting by residents, and monitoring through EHR reports. Adherence to work hour guidelines is essential for resident well-being and a healthy and conducive clinical learning environment without diminishing operative experience.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83128684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Trends in Elder-Elder Caregiving in the United States: 1997 – 2014","authors":"S. VanDeMark","doi":"10.53481/guthriej.2021.11.18","DOIUrl":"https://doi.org/10.53481/guthriej.2021.11.18","url":null,"abstract":"Caregiving is a difficult field to study due to the subjective nature of the data. Insufficient research exists exploring the situation of elder-elder caregiving (where the caregiver is 64 years old or older and caring for a care recipient, who is also 64 years old or older.) This article investigates this relationship to better understand changes in caregiving specific to this population. METHODS: Statistical tests were performed on publicly available data sets from the National Alliance for Caregiving. Data sets were collected via telephone and internet surveys in 1997, 2004, 2009, and 2014, from a random sample of caregivers. RESULTS: 989 responses were analyzed. ANOVA and post-hoc tests found a significant statistical difference (p < 0.0001) between the mean age of elder-elder caregivers for all years when compared to 2014. The largest increase in mean age of elder-elder caregivers was from 70 years old in 2004 to 74 years old in 2014. No correlation was found between elder-elder caregiver age and level of burden experienced due to caregiving. The average length of time of elder-elder caregiving was approximately five years. CONCLUSION: The lack of prior investigation on this population may be concealing the needs of elder-elder caregivers. Further research could help society prioritize education and inform action plans to assist elder-elder caregivers, so that a.) they have a higher quality of life near the end of life, and b.) their caregiving workload does not shift to institutional health care settings.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85772330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Career Coaching Model: A Descriptive, Interim Program Evaluation for Undergraduate Medical Student Career Advising","authors":"Christin Spatz, Kara Romanowski, Jordan Wolfheimer, Tanja Adonizio","doi":"10.53481/rseg4469","DOIUrl":"https://doi.org/10.53481/rseg4469","url":null,"abstract":"","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87782515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Polyneuropathy, A Review of the Need for Early Diagnosis and Treatment","authors":"Richard V. Welles","doi":"10.3138/guthrie.72.1.013","DOIUrl":"https://doi.org/10.3138/guthrie.72.1.013","url":null,"abstract":"Diabetic neuropathies include polyneuropathies and mononeuropathies such as cranial neuropathies, limb and trunk mononeuropathies, and plexopathies caused by multiple processes including vascular, mechanical, and metabolic. Early diagnosis, which may be difficult, allows for early and intensive intervention. History, neurologic examination, and electrodiagnostic studies are standard in evaluation, with other studies dependent on the initial findings. Narcotics, antidepressants, clonidine, anticonvulsants, electrotherapy, and acupuncture may be effective in therapy. Careful control of glucose levels is important in prevention and slowing the progress of diabetic neuropathy.","PeriodicalId":83043,"journal":{"name":"The Guthrie journal of the Donald Guthrie Foundation for Medical Research","volume":"20 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81727356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}