Publications by authors named "Diane Levine"

There is scant understanding of what supports African emerging adults who are not in employment, education or training (i.e., NEET) to show resilience to NEET-related challenges.

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Successful interdisciplinary research requires proactive efforts by researchers, institutions, funders, and publishers. This article offers practical recommendations at each decision-making level to holistically enhance interdisciplinarity. [Image: see text]

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A 70-year-old man presented with worsening migraines and was referred to a neurologist by their primary care doctor for further workup. Imaging and lab work were benign. The patient then underwent several trials of various first and second-line medications and anti-migraine devices to no avail.

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Background: The COVID-19 pandemic created new challenges and barriers for the work of child protection professionals (CPPs) and intensified existing hardships for families and children, increasing the risk of child maltreatment. As new restrictions and precautions were implemented by governments worldwide to stop the virus from spreading, CPPs had to adapt to a new reality of working remotely. However, limited research has investigated how remote work impacted CPPs and child protection work and how CPPs handled this alternative work style.

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Article Synopsis
  • Interns often struggle with the transition from medical school to residency due to traditional orientation lacking practical skills training.
  • A quality improvement program, including a pilot boot camp and virtual sessions, was implemented to enhance the orientation experience at the Detroit Medical Center.
  • Results showed significant gains in interns' understanding of daily workflows and confidence using the Electronic Health Record, with 93.2% of participants believing the program should continue.
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Objective: Physical inactivity is a significant contributor to many acute and chronic medical conditions. While the dangers of physical inactivity (PA) are well understood and physicians have the desire to address them, a lack of education in exercise prescription (ERx) may be a barrier to properly prescribing exercise to patients. The aim of this research was to determine the effectiveness of an ERx medical education lecture and provide evidence for the need for formal ERx education among students and physicians in training with a secondary goal of further exploring medical student and resident habits and beliefs about PA and ERx.

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Purpose: Bias exists in the internal medicine (IM) clinical learning environment; however, it is unclear how often bias is identified by clerkship directors (CDs), how bias is addressed, and whether best practices exist for identifying or mitigating bias. This study investigated how IM CDs receive and respond to bias reports in the clinical learning environment.

Method: In May 2021, the Clerkship Directors in Internal Medicine (CDIM) created an 18-question survey assessing the frequency of bias reports, macroaggressions and microaggressions, and report outcomes.

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Background: Peripartum mistreatment of women contributes to maternal mortality across the globe and disproportionately affects vulnerable populations. While traditionally recognized in low/low-middle-income countries, the extent of research on respectful maternity care and the types of mistreatment occurring in high-income countries is not well understood. We conducted a scoping review to 1) map existing respectful maternity care research by location, country income level, and approach, 2) determine if high-income countries have been studied equally when compared to low/low-middle-income countries, and 3) analyze the types of disrespectful care found in high-income countries.

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Introduction: Chronic kidney disease (CKD) affects 30 million Americans. Early management focused on blood pressure (BP) control decreases cardiovascular morbidity and mortality. Less than 40% of patients with CKD achieve recommended BP targets due to many barriers.

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Unlabelled: Critical agency (CA) refers to an individual's feeling of power in relation to social inequalities. Research has demonstrated that high CA is associated with positive adolescent outcomes, however, less is known about what supports are important for its development. Moreover, a large majority of the literature is based on studies from the US and various countries in Africa; although the UK is saturated with inequalities there is little research within a UK context.

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Neutropenic enterocolitis (NE) is a rare and life-threatening condition that typically occurs in patients with hematologic malignancies undergoing intensive chemotherapy, radiation therapy, or bone marrow transplant regimens, predisposing them to profound neutropenia. NE can have a nonspecific clinical presentation and mimic other gastrointestinal disorders such as appendicitis, diverticulitis, or inflammatory bowel disease but is associated with very high morbidity and mortality if not diagnosed and treated promptly. We present the case of a middle-aged female with a recent diagnosis of follicular lymphoma who developed neutropenic enterocolitis after undergoing induction chemotherapy for an autologous stem cell transplant (ASCT).

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Educational equity in medicine cannot be achieved without addressing assessment bias. Assessment bias in health professions education is prevalent and has extensive implications for learners and, ultimately, the health care system. Medical schools and educators desire to minimize assessment bias, but there is no current consensus on effective approaches.

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Background And Objectives: Strong evidence supports efficacy of medications for opioid use disorder (MOUD), but stringent prescribing policies impair access. Many physicians report discomfort prescribing MOUD due to inadequate knowledge. Most medical students believe MOUD training should occur during undergraduate medical education (UME).

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Patients presenting with hyperammonemic encephalopathy are likely to have hepatic encephalopathy. However, valproate (an anticonvulsant and mood stabilizer) can also cause hyperammonemic encephalopathy and belongs on the differential for patients taking it, especially if there are recent contributory medication changes. We present a case report of a 61-year-old woman with valproate-induced hyperammonemic encephalopathy but with an initial valproate level within the therapeutic range (50-100 mcg/dL).

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Purpose The use of telemedicine dramatically increased during the COVID-19 pandemic. Assessing patient satisfaction with this mode of healthcare delivery is an important metric of success as it is broadly implemented across various settings. Of additional importance are the ways social determinants of health impact health outcomes, with the first step in determining the scale of this impact being the identification of contributing factors.

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Purpose: Equity in assessment and grading has become imperative across medical education. Although strategies to promote equity exist, there may be variable penetrance across institutions. The objectives of this study were to identify strategies internal medicine (IM) clerkship directors (CDs) use to reduce inequities in assessment and grading and explore IM CDs' perceptions of factors that impede or facilitate the implementation of these strategies.

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Article Synopsis
  • Air pollution poses significant public health risks, particularly for adolescents, yet its impact on their respiratory health in high pollution areas like Secunda and eMbalenhle, South Africa, remains under-researched.
  • This study gathered air quality data from 2005 to 2019, compared it to national and WHO standards, and surveyed adolescents on health symptoms related to air pollution, revealing a high prevalence of respiratory issues.
  • Key findings showed that particulate matter and ozone frequently surpassed air quality standards, with reported respiratory symptoms ranging from 2% for bronchitis and pneumonia to 42% for allergies, indicating a notable public health concern among the youth in these areas.
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Introduction Undergraduate Medical Education (UME) prepares future residents for many aspects of medical practice, but it is rarely all-inclusive. Death pronouncement (DP), a highly important aspect of clinical training for residents, seems to be inadequately addressed and taught in undergraduate institutions. Studies have indicated that most first-year residents received minimal DP training and felt unprepared for this duty.

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Adolescents are spending significant time online. Consequently, concerns are consistently raised about potential negative impacts on their mental health. Potentially, these concerns minimise their autonomy and reify the construction of the adolescent.

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Introduction: The COVID-19 pandemic has left more than 38% of households food insecure in the United States. Improved education of food security topics in medical school can improve screening for food insecurity and improve health outcomes. The first aim of this study was to address if participation in an experiential integrative service learning program improved medical students' understanding of food insecurity.

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Background: Alongside deficits in children's wellbeing, the COVID-19 pandemic has created an elevated risk for child maltreatment and challenges for child protective services worldwide. Therefore, some children might be doubly marginalized, as prior inequalities become exacerbated and new risk factors arise.

Objective: To provide initial insight into international researchers' identification of children who might have been overlooked or excluded from services during the pandemic.

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Understanding factors that improve patients' healthcare experiences are essential for healthcare providers (HCPs) caring for older adults (OAs). Previous data supports that effective patient-centered care leads to a better understanding of patients' experiences, values, and preferences. The aim of this study was to evaluate OAs views of HCPs attributes and communication skills to better understand patient's views about their HCP interactions.

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