Health Sciences – Page 8 – UROP Spring Symposium 2021

Health Sciences

Multimodal Retinal Imaging of Usher Syndrome Animal Model of Photoreceptor Degeneration

Ashley Brown Pronouns: she/her/hers Research Mentor(s): Yannis Paulus, Assistant Professor, Tenure Track Research Mentor School/College/Department: Ophthalmology and Visual Sciences, Michigan Medicine Presentation Date: Thursday, April 22, 2021 Session: Session 5 (3pm-3:50pm) Breakout Room: Room 12 Presenter: 5 Event Link Abstract For privacy concerns this abstract cannot be published at this time. Authors: Ashley Brown, Emilie […]

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Multimodal Retinal Imaging of Usher Syndrome Animal Model of Photoreceptor Degeneration

Emilie Gilligan Pronouns: she/her Research Mentor(s): Yannis Paulus, Assistant Professor, Tenure Track Research Mentor School/College/Department: Ophthalmology and Visual Sciences, Michigan Medicine Presentation Date: Thursday, April 22, 2021 Session: Session 5 (3pm-3:50pm) Breakout Room: Room 12 Presenter: 5 Event Link Abstract For privacy concerns this abstract cannot be published at this time. Authors: Emilie Gilligan, Ashley

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THE ASSOCIATION OF VISION, DISABILITY, AND WELLBEING TRAJECTORIES IN OLDER US ADULTS

The National Health and Aging Trends Study (NHATS) is an ongoing national study of the elderly population in the U.S. and is focused on vision impairment (VI) and blindness disability and allows researchers to study the variety of the key disadvantageous consequences linked with VI in older adults. This assessment of VI through NHATS to done through a series of survey questions that require binary responses and past studies to construct a binary indicator of VI an approach that may restrict the precision of the data measurements. To address this, a 6-level measurement of VI was created to validate each of the vision-related questions in the survey. It is expected that there will be a more rapid deterioration experience in the vision of older adults leading to a decline in function and wellbeing when contrasted to those with healthier vision. This study examines the association of vision with changes in injury and wellbeing directions in the elderly. The hypothesis is that a higher level of VI will be strongly connected with declining disability and wellbeing trajectories. Further, we anticipate that the impact of VI on disability and wellbeing will be greater among minority groups such as Black and Hispanic subjects compared to White participants. The results of this study will inform future targeted interventional research to optimize health, wellbeing, and independence for the growing number of older adults with VI.

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Stakeholder perspectives on using patient-reported outcomes: a qualitative study

Stakeholder perspectives on using patient-reported outcomes: a qualitative study Authors: Adam Chalak, Yomei Shaw, Faith Reger, Neda Kortam, Yujia Li, Dinesh Khanna Background/objectives: Patient-reported outcome measures (PROs) are questionnaires that provide patients coping with disease a medium that essentially places them at the forefront of the decision-making and treatment process. The questions aim to measure patient perceptions of symptoms and health status. Quite recently, we have seen a surge in literature based on this healthcare tool in rheumatology. Although reviewing PRO results helps patients and health care providers communicate about impacts of disease on wellbeing, we see a significant lack of clinical implementation in rheumatology. This qualitative study serves as the pilot study for an upcoming clinical trial of strategies to promote PRO use in rheumatology. We conducted interviews with stakeholders to assess the acceptability of study procedures and materials to rheumatology health care providers and patients. Methods: Semistructured interviews were conducted with healthcare providers and patients in rheumatology over video or phone call. Interview transcripts were transcribed and were subsequently analyzed by qualitative coding through NVIVO software. Results: Eight health care providers, two patients, and three research team members participated in the interviews. Based on comments extracted from the interviews, we see that many HCPs and patients find great significance and relevance in the utilization of PRO data in treatment and patient-self management. However, many clinicians note various logistics issues (such as time management, patient motivation, data interpretation, question difficulty) that hinder implementation. Conclusion: This study provides insight on how PRO measures can be integrated more effectively in the clinical setting while also revealing misconceptions on the tool by HCPs.

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Integrating patient-reported outcomes into rheumatology practice

Background: Many patients with rheumatic diseases have symptoms like pain and fatigue in spite of their treatment [1,2]. Patients also often disagree with their health care providers (HCPs) in their perceptions about their disease [3]. One method that helps facilitate better patient-provider communication about symptoms is the use of patient reported outcomes (PROs). PROs are a patient’s self report of their health status or symptoms. Many HCPs in the Division of Rheumatology do not use PROs in their clinical practice. Objectives: The aim of this study is to assess the impacts, barriers, and facilitators of incorporating PROMIS measures for pain, physical function, and sleep disturbance into clinical rheumatology practice.

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Integrating patient-reported outcomes into rheumatology practice

Background: Many patients with rheumatic diseases have symptoms like pain and fatigue in spite of their treatment [1,2]. Patients also often disagree with their health care providers (HCPs) in their perceptions about their disease [3]. One method that helps facilitate better patient-provider communication about symptoms is the use of patient reported outcomes (PROs). PROs are a patient’s self report of their health status or symptoms. Many HCPs in the Division of Rheumatology do not use PROs in their clinical practice. Objectives: The aim of this study is to assess the impacts, barriers, and facilitators of incorporating PROMIS measures for pain, physical function, and sleep disturbance into clinical rheumatology practice.

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Health-related Quality of Life Instrument for Inherited Retinal Degenerations, an Advancement in Cost-effectiveness Analysis

Inherited retinal diseases (IRDs) are a diverse group of progressively-worsening genetic diseases that can lead to blindness and irreversible vision impairment. Inherited retinal diseases are one of the leading causes of blindness worldwide. However, IRDs are heterogeneous in their nature and studying them through research can be very difficult. Presently, cost-effectiveness analyses (CEA) in the field of IRDs face multiple limitations which can lead to a degree of uncertainty in results, such as: the variance in disease progression rates amongst different IRD phenotypes, the difficulty of estimating disease-related expenses, and the absence of condition-specific health-related quality-of-life measurement instruments. This study seeks to decrease CEA uncertainty in the field through designing a health-related quality-of-life instrument that can be used in upcoming CEA studies done for IRDs’ novel nearly-approved treatments. Decreasing the uncertainty of CEA done for the novel therapies will assist in decision making related to funding or rejecting these treatments by policy makers. A health utility (health-related quality-of-life) index will be established for the Michigan Retinal Degeneration Questionnaire Utility Index (MRDQ-UI), a patient reported outcome measure that was designed specifically for IRDs. One hundred participants with IRDs will complete MRDQ-UI and will have their health utility values obtained through conducting time-trade off (TTO) interviews. In TTO, patients are asked to trade a specific number of years in perfect vision for a set number of years in their current eye condition. Upon study completion, MRDQ-UI will be an accurate health utility estimator which can be utilized for futuristic CEA studies.

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Neural Mechanisms of Mindfulness-based Cognitive Therapy (MBCT) for Post-Traumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder (PTSD) results from events that are especially frightening, horrible, or traumatic, and is accompanied by symptoms of intrusive thoughts, avoidance, hyperarousal, and guilt. While PTSD is often associated with combat veterans, it can affect anyone who has experienced a traumatic event. Our project, Neural Mechanisms of Mindfulness-based Cognitive Therapy (MBCT) for Post-Traumatic Stress Disorder (PTSD), is looking to utilize mindfulness as a treatment for PTSD and to investigate the neural mechanisms behind symptom improvement. Mindfulness-based therapies have already proven to be effective in treating psychiatric conditions and increased connectivity between the central executive network and default mode network based on previous studies with combat-related PTSD depression, and nonclinical populations. We now want to apply these results to people with civilian PTSD.

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Use of Patient-Reported Outcomes (PROs) in Rheumatology Care: a Scoping Review

Title: Use of Patient-Reported Outcomes (PROs) in Rheumatology Care: a Scoping Review. Authors: Yujia Li, Yomei Shaw, Adam Samer Chalak, Faith Marie Reger, Neda E Kortam, Dinesh Khanna Background: Patient-Reported Outcome measures (PROs) are surveys completed directly by patients, measuring their symptoms, health status, and health-related quality of life. Some believe PROs could help clinicians make better decisions, as it provides valuable information about patients that would otherwise be overlooked, such as sleeping difficulties and fatigue. Objective: The study intends to summarize what is currently known about PRO use in rheumatology care, including the frequency of use, types of measures are used, PRO’s feasibility, acceptability, and factors influencing its adoption. Methods: We performed a scoping review to give an overview of different types of articles and evidence published on PRO use in rheumatology care. Reviews of studies of PRO use in rheumatology or narrative reviews of PRO use in rheumatology were included; articles about the development of measures or assessing the psychometric properties of measures were excluded. Results: We have identified relevant articles based on our search criteria. While we are still developing the search strategy. Conclusion: The results will be used to inform research about the implementation of PRO use in rheumatology care and efforts to promote PRO use in rheumatology care.

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Whole Health Evaluation for Veterans and VA Staff

Whole Health is a care model developed by VA clinics and hospitals in an effort to integrate complementary medicine, prevention, and the uniqueness of each patient to provide healthcare that ultimately focuses on what matters to the patient, rather than what is the matter with them. Such a care model is crucial in the U.S where healthcare often focuses merely on treatment, rather than prevention, and preventable deaths are estimated to make up 20-40% of total deaths caused by the top five causes of mortality. This study aims to expand on the current body of research that evaluates the efficacy of Whole Health, by garnering feedback about various aspects of health and how the program has come about addressing them. The research is conducted through a questionnaire created on the Qualtrics platform, which will be electronically and potentially physically distributed to veterans, caregivers, and staff. Data from the questionnaire will be inputted into an Excel spreadsheet to be later processed and analyzed using SPSS, a quantitative and qualitative statistical analysis software. Previous studies on Whole Health have indicated an improvement in social engagement, physical wellbeing, and perceived stress for patients enrolled in the program. So while results are currently pending, we expect our data to also suggest Whole Health’s adequate provision of care at least within the aspects of wellbeing mentioned above. Analysis of pending results will provide valuable insight for evaluating and potentially informing future changes to the program to better reflect its mission.

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