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Excerpt: The conclusions in the study by Sanford et al. (2011) were not supported by their findings. The main conclusion states that preparing students to be comfortable with cancer patients of all severities will provide students with the necessary skills to gain confidence in their cancer patient care. However, the above study did not test or explore this issue. That is, students were not given any particular preparation so that their level of confidence could be explored. Students were simply told to share their good and bad experiences during their routine clinical education. The above conclusion reaches beyond the study findings into an area of conjecture, but the conjecture is presented as a well-supported finding from the study.

Background: Emergence of SARS-CoV-2 pandemic has shifted the focus on infectious diseases and their healthcare and economic burden. However, chronic diseases have been a major focus for over two decades. Four risk behaviors or factors have played a critical role in increasing rates of chronic diseases, and one of such risk factors is physical inactivity that leads to obesity. Obesity has always been associated with chronic conditions, however their association among hospitalized patients is limited. Methods: This study utilized the National Inpatient Sample Data 2019 (NIS 2019) after recoding necessary variables. The study outcome was obesity, defined using ICD-10 diagnosis with a documented BMI ≥ 30kg/m2. The study covariates include patient demographics (age at admission, sex, race) patient behavioral characteristics (drug abuse, smoking, and alcohol ), aspirin use, and comorbid conditions (depression, dementia, chronic lung disease, hypertension, and diabetes with or without complications). Logistic regression analyses were conducted to identify the patient demographics, behavioral characteristics, and comorbid conditions associated with obesity among hospitalized patients in the US. Odds ratios and 95% confidence intervals were reported,with P-value <0.05. Results: The study sample included 6,043,654 hospitalized patients. Among all inpatients, 17.7% of patients reported being obese. The average age at admission was 58.4 (Std 20.16) years, 57.1% were females. Inpatients with diabetes (27.6%) were 135% more likely of having obesity compared with those without diabetes (aOR 2.35, CI 2.35-2.36, p<0.0001). Furthermore, 53.7% of inpatients had hypertension and were 97% more likely to be obese than those without hypertension (1.97, 1.97-1.98, p<0.0001). Similarly, 12.8% of those with depression are 33.1% more likely to be obese than those without depression. Also, 14.5% of inpatients who used aspirin were 10.9% more likely to be obese than those who did not use aspirin. About 21.1% of hospitalized patients had chronic lung disease, and were 8% more likely to be obese than those without chronic lung disease (1.08, 1.07-1.09, p<0.0001). On the other hand, 16.8% of inpatients were smokers and were 7.3% less likely to have obesity than non-smokers (0.73, 0.726-0.730, p<0.0001). Also, 5.43% of inpatients were noted to have abused alcohol and are 6.70% less likely to be obese (0.67, 0.67-0.67, p<0.0001). Furthermore, 6.38% of inpatients had dementia, and are 4.01% less likely to be obese than those without dementia. Conclusion: Obesity remains an important global public health concern. The study found that hospitalized patients with underlying hypertension, chronic lung disease or diabetes, and use of aspirin were strongly associated with obesity. Thus, it is imperative to expand and evaluate the role of current interventions or policies around overweight/obesity to hospitalized patients thereby reducing the existing burdened healthcare system.

A Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level of quality of standardized patients. The following research is examining current processes in standardized patient training and investigating new methods for clinical skills education in SPs. The modality that is selected for training can possibly affect the performance of the actual SP case. This paper explains the results of a study that investigates if there is a difference in the results of an SP performance assessment. This difference can be seen when comparing a virtual human modality to that of a pre-recorded human modality for standardized patient training. The sample population navigates through an interactive computer based training module which provides informational content on what the roles of an SP are, training objectives, a practice session, and an interactive performance assessment with a simulated Virtual Human medical student. Half of the subjects interact with an animated virtual human medical student while the other half interacts with a pre-recorded human. The interactions from this assessment are audio-recorded, transcribed, and then graded to see how the two modalities compare. If the performance when using virtual humans for standardized patients is equal to or superior to pre-recorded humans, this can be utilized as a part task trainer that brings standardized patients to a higher level of effectiveness and standardization. In addition, if executed properly, this tool could potentially be used as a part task trainer which could provide savings in training time, resources, budget, and staff to military and civilian healthcare facilities.

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<p> Diabetes is a chronic disease that affects more than 2 million Canadians. In order to reduce the risk of complications, people with diabetes must monitor their symptoms and actively manage diet, exercise, and medication. Patient priority is defined as the patient's implicit or explicit ordering of importance, ease and frequency of preventative or treatment activities for managing diabetes. In this study, we report on the findings of a questionnaire of diabetes patient priorities. The primary purpose of this study was to identify patient priorities and their relationships for managing diabetes from a patient's perspective. Multivariate analysis techniques were applied to find the patterns within the ratings of importance, ease and frequency for seventeen diabetes care activities. Multivariate analysis is used when more than one measurement is taken on a given experimental unit and all the measurements need to be considered together so that one can understand how they are related and what the essential structure is. In our study, the multivariate techniques used were MANCOVA, multivariate regression, and factor analysis. Due to the missing values, simple and multiple imputations were necessary. This study acts as a pilot study for a future, larger study about patient priorities.</p> / Thesis / Master of Science (MSc)

In this project stroke data were analyzed with the use of survival techniques and incomplete principal component cox analysis. The data set resulted from a multi-center randomised controlled trial coordinated by investigators from the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton with 438 patients. It was found that among stroke survivors, congestive heart failure along with other cardiac impairments post the major risks. Other factors found to be important were patient age, previous TIAs, presence of ulcers, diabetes and sex. / Thesis / Master of Science (MS)

Physicians are usually the first contact in the health care system for persons with dementia and their family caregivers. Although specialists typically make the diagnosis, it is the family physician who is key to confirming the diagnosis for dementia, explaining what it means physically, emotionally, and describing what to expect as the disease progresses. Our knowledge about interaction between persons with dementia and their physicians is based largely on the caregiver's view while few studies have investigated the physician's perspective. Persons with dementia have been underrepresented in research pertaining to the issue of diagnosis disclosure. The aim of this exploratory study was to examine the attitudes of family physicians and individuals with early stage dementia about the diagnostic process. The effects of a companion on a medical encounter were also investigated. Data were compiled from responses of 14 family physicians to a structured questionnaire containing highly selective questions, as well as in-depth interviews with 9 individuals with dementia. Using a conflict theoretical framework, the results show that family physicians do inform patients of a diagnosis for dementia. Although the majority of individuals with dementia are satisfied with their family physicians' communication, they were dissatisfied in terms of referral to community resources. Persons with dementia also felt that they received less than ideal care, particularly from specialists, in terms of how the diagnosis was disclosed. Overall, physicians and persons with dementia rated the influence of a third person in the medical encounter as positive. Physicians in this study continued to use an illness-centered approach rather than a patient-centered approach that acknowledges the patient as a person with unique needs and a life-story. Future research thus needs to address the development of a patient-centered model in which the understanding of the subjective experience of the person with dementia is essential. / Thesis / Master of Arts (MA)

Thesis (Ed.M.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01