Roughly 8-10 million patients complaining of chest pain come to an Emergency Department (ED) annually in the United States. Quickly determining if you are having a heart attack is critical for improving your chances of survival. Cardiac troponin is a protein that is used as a biomarker (biological marker) to indicate damage to the heart muscle. Cardiac troponin lab tests that are currently used in the United States do not have the ability to detect low levels of troponin. There are more sensitive troponin tests that are primarily used outside the US, that are able to detect lower levels of cardiac troponin within 90-180 minutes instead of 5 or 6 hours. This allows for the early identification of individuals at a higher risk for heart damage and these patients benefit from early diagnosis and treatment. Delaying the treatment of a heart attack increases the chance of dying or being permanently disabled. This study will collect blood samples from people coming to the Emergency Department complaining of chest pain in order to measure this troponin lab test's ability to accurately detect troponin levels.
The primary investigators/residents have noted during clinical rotations that a significant number of GBS unknown mothers at SRHS are being treated with intrapartum antibiotics even without the presence of risk factors, presumably to decrease postpartum/neonatal length of stay.
Our study, a retrospective chart review, will determine whether or not length of stay is affected by treating GBS unknown mothers with intrapartum antibiotics in the absence of the aforementioned risk factors.
Potential benefits include the cost-effectiveness of decreased length of stay for these patients as well as decreased exposure to nosocomial infections for neonates. However, antibiotic stewardship and patient safety are also considerations. Another potential option for these patients is rapid GBS testing with PCR which can provide results in 1-2 hours compared with 24-48 hours for the standard culture. PCR is not currently available at SMC.
A sample of patients will be drawn from a cross-sectional cohort of pre- and post-abdominal and cardiothoracic transplant recipients from March 2018 through May 2018. 10 to 15 minute key informant interviews will be conducted with patients to ascertain their views and perceptions related to adherence pre- and post-transplant and use of technolgy. This data will be used to educate the transplant community about adherence from the patient's perspective.
Focus groups or talking circles are formed in community neighborhoods to facilitate input on common patient experiences. Insights on patient perceptions related to physician office visits and after visit self care are obtained in groups of 8-12 participants.
This is a study to develop a test for radiation exposure in the event of a nuclear event such as the detonation of a nuclear device or widespread radiation exposure. We will collect blood samples from a variety of different types of human subjects whose current medical status could possibly have an effect on the results of the test, such as trauma, burns, infections or a damaged immune system or young children. The goal is to ensure that these conditions do not affect the results of the test.
The objective of this proposal is to evaluate teleconsent, a novel telemedicine informed consent system, in order to study the advantages of teleconsent, the barriers to its adoption, and its impact on the informed consent process. The goal of this work is to improve the adoption of this technology and improve the overall research process, with reduction in travel burden on research participants and regulatory burden on clinical investigators. Facilitating enrollment into clinical trials will in turn accelerate the development of new treatments.
Protein S is a protein that is very important to the blood clotting process. When people don't have enough Protein S they run the risk of developing blood clots. This study is collecting samples from people who may have abnormal Protein S levels in order to develop a new way of checking the Protein S levels. This test is looking specifically for FREE Protein S. The free protein S is Protein S that is not bound or "tied up" and is therefore more ready to do its job in the clotting process.
Studies have shown that cancer patients may be at high risk for financial problems because of the cost of treatment. These financial problems can be stressful and sometimes might cause patients to avoid or refuse treatment. We want to measure how often financial problems happen in patients with colorectal cancer, using questionnaires that collect information about finances and quality of life. In order to get a full picture of the financial impact of colorectal cancer, we also want to collect credit reports for all patients in this study.
Transforming health care and outcomes for children with rare diseases is difficult within the current health care system. There is great variation in care delivery, inadequate and slow application of existing evidence, and ineffective use of available data to generate new knowledge. Individual care centers have inadequate numbers of patients for robust learning and improvement. In order to redesign the system, changes must take place at multiple levels, including the patient and family, clinician, practice and the network. The purpose of this project is to design, develop, and test further refinements to an improvement and research network focused on HLHS, the most severe congenital heart defect, and to use a registry to simultaneously improve clinical care, redesign care delivery systems and to conduct quality improvement, health services, outcomes, and comparative effectiveness research. The purpose of this initiative, specifically, is to improve care and outcomes for infants with HLHS by: 1) expanding the established NPC-QIC national registry to gather clinical care process, outcome, and developmental data on infants with HLHS between diagnosis and 12 months of age, 2) improving implementation of consensus standards, tested by teams, into everyday practice across pediatric cardiology centers, and 3) engaging parents as partners in improving care and outcomes. We utilize a quality improvement methodology, known as the adapted learning collaborative model, which expedites the implementation of tools and strategies that facilitate changes such as systematic care coordination, cardiovascular monitoring, and nutritional monitoring into every day practice. The NPC-QIC registry is used to document the impact of these changes on various care processes and outcomes (e.g., mortality rate, readmissions, and weight gain).
A majority of patients diagnosed with cancer are over age 65, yet most cancer treatments are developed in a younger population. Older cancer patients are more likely to experience side effects. There is no standard way to treat chemotherapy side effects in older patients. A Geriatric Assessment (GA) can be used to predict who is at risk for side effects but there is no standard way to decrease this risk. Also, there is not agreement on how information from a GA can be used to develop ways to prevent or treat side effects.
The purpose of this study is to find out if the GA can help improve and develop a standard approach for reducing and/or preventing chemotherapy side effects in older cancer patients. The GA is intended to determine an older patient's level of independence taking into account health conditions, physical performance (walking, leg strength, and balance), nutrition, social support and memory. Several tests as well as questionnaires are used. The combined results establish what is called a patient's functional age, which may be quite different from the actual age. Functional age can help better predict a patient's tolerance of and likely response to cancer treatments as well as provide other important age-related information not routinely captured by cancer doctors. If you decide to participate in this study, you will receive the GA.