Publications
Department of Medicine faculty members published more than 3,000 peer-reviewed articles in 2022.
2015
2015
2015
2015
PURPOSE
The purpose of this qualitative study was to evaluate breast cancer survivors' (BCS) responses to a self-management survivorship care transition intervention in the formative development of such an intervention. The experience of BCS is marked by uncertainty and anxiety about subsequent care, and a desire for more information about future care needs and late effects of treatment. Self-management strategies have demonstrated improved outcomes in chronic illness, and may address the unmet needs of breast cancer survivors.
METHODS AND SAMPLE
Five focus and discussion groups each were conducted at a single site in the Southeastern United States with a total of twenty breast cancer survivors. BCS were presented with a description of a survivorship transition intervention that encouraged self-management. Groups were led by a trained moderator using a semi-structured guide with 7 open-ended questions about their care transition experience and response to the proposed intervention. A theoretically-derived, concept-guided coding strategy was developed after review of transcripts. Iterative constant comparative methods were used to ensure that transcripts were reviewed exhaustively for emerging codes and relationships.
KEY RESULTS
Three dominant themes emerged around readiness for self-management: 1) the breast cancer experience as a catalyst for self-management; 2) fear of recurrence as a catalyst for self-management; and 3) the impact of the meaning of breast cancer on individual readiness for self-management.
CONCLUSIONS
These findings contribute to further development of a conceptual model and interventions built on BCS self-management to improve the survivorship experience.
View on PubMed2015
Idiopathic pulmonary fibrosis (IPF) is an incurable condition that is characterized by progressive pulmonary fibrosis, architectural distortion of the lung and loss of gas exchange units. Until recently, there was no effective treatment for this condition. However, there were two landmark trials published earlier this year, which have changed the management of this condition. Pirfenidone (Assessment of Pirfenidone to Confirm Efficacy and Safety in Idiopathic Pulmonary Fibrosis trial) and nintedanib (Efficacy and Safety of Nintedanib in Idiopathic Pulmonary Fibrosis-1 and -2 trials) have both demonstrated positive outcomes in patients with IPF. In this perspective, we critically discuss the role of these agents in IPF and in the broader pulmonary fibrosis population.
View on PubMed2015
2015
BACKGROUND
Healthcare-associated Legionnaires' disease (LD) is a preventable pneumonia with a 30% case fatality rate. The Centers for Disease Control and Prevention guidelines recommend a high index of suspicion for the diagnosis of healthcare-associated LD. We characterized an outbreak and evaluated contributing factors in a hospital using copper-silver ionization for prevention of Legionella growth in water.
METHODS
Through medical records review at a large, urban tertiary care hospital in November 2012, we identified patients diagnosed with LD during 2011-2012. Laboratory-confirmed cases were categorized as definite, probable, and not healthcare associated based on time spent in the hospital during the incubation period. We performed an environmental assessment of the hospital, including collection of samples for Legionella culture. Clinical and environmental isolates were compared by genotyping. Copper and silver ion concentrations were measured in 11 water samples.
RESULTS
We identified 5 definite and 17 probable healthcare-associated LD cases; 6 case patients died. Of 25 locations (mostly potable water) where environmental samples were obtained for Legionella-specific culture, all but 2 showed Legionella growth; 11 isolates were identical to 3 clinical isolates by sequence-based typing. Mean copper and silver concentrations were at or above the manufacturer's recommended target for Legionella control. Despite this, all samples where copper and silver concentrations were tested showed Legionella growth.
CONCLUSIONS
This outbreak was linked to the hospital's potable water system and highlights the importance of maintaining a high index of suspicion for healthcare-associated LD, even in the setting of a long-term disinfection program.
View on PubMed2015