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Hospitals around Cleveland are beginning to prepare for next year's Republican National Convention and an influx of up to 50,000 visitors. Hospitals are planning to give employees disaster training and emergency medical services must come up with new routes to take patients to hospitals due to the increased crowds and security measures. MetroHealth is scheduled to complete an expansion of its Critical Care Pavilion weeks before the convention.
University Hospitals is scheduled to open the region's second adult Level 1 trauma center on Dec. Authorities say they found marijuana-growing operations at three of the four locations where eight family members in rural southern Ohio were found fatally shot. Students at Piketon High School are still in shock over the death of 16-year-old Christopher Rhoden Jr., who was one of eight people massacred last week. The move will bring the number of personnel to roughly 300, up from about 50 special operations forces currently there. The 23-year-old is accused of hitting his ex-girlfriend, Colleen Crowley, several times while driving from an uptown Dallas bar back to her home in Fort Worth. Former Ohio State players Beanie Wells and Roy Hall will play the role of general manager as they select the best NFL roster, using only the Buckeye players eligible for this yeara€™s draft.
Researchers have claimed the food provided in prisons is better than in NHS hospitals.Experts from Bournemouth University examined the quality of food offered to prisoners and NHS patients.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Division of Medical Genetics, Department of Human Genetics, Emory University School of Medicine, Atlanta, GA.
This study was supported by a cooperative agreement from the Centers for Disease Control and Prevention (5U50-DD000029).
Duchenne muscular dystrophy (DMD) is the most common childhood muscular dystrophy (OMIM #310200). Obtaining an earlier diagnosis of DMD has several benefits to an affected child and his family.
Although newborn screening for DMD has clear benefits, it has not been adopted more widely because DMD does not meet certain criteria used to determine which conditions become part of traditional newborn screening programs17. Offering DMD screening after the newborn period?but before the onset of symptoms?might address many of the ethical concerns raised about newborn screening, while also realizing the benefits of early detection23. Study recruitment took place at four metropolitan Atlanta pediatric clinics from February through September 2007. Parents were given a study packet to review that contained an introductory letter, brochure, consent form, Health Insurance Portability and Accountability Act form, and decliner questionnaire.
The screening test used for this study detected total CK in dried blood spots on filter paper28.
Negative screening test results were mailed to parents approximately 1 to 2 weeks after sample collection.
Investigators from the newborn and infant screening pilot studies developed questionnaires that assessed the experiences of parents and health care providers. From February 1, 2007 through September 30, 2007, the four clinics scheduled a total of 524 infant males for the 12-month well-baby visit. Although parents of 273 infants had consented to screening, blood samples were collected from only 264 males.
Of the 259 parents of the 264 boys (5 pairs of twins) screened, 138 (53.3%) returned completed post-screening questionnaires, about half from the first mailing and half from the second mailing. Twenty-two (31.0%) of the sixty-nine parents who declined participation returned decliner questionnaires (Table 1). Parents whose sons participated in screening and those whose sons did not were asked their three most important reasons for participating in or declining screening.
Questionnaire results indicated that parents were able to make an informed decision about DMD screening when receiving information in the pediatric clinic (Table 3).
Over 95% of parents felt they understood the study information well and their answers to the knowledge questions generally reflected this (Table 3). A large majority of respondents whose sons were screened reported a positive experience, with almost 90% of parents indicating that screening for DMD was worthwhile (Table 4). Approximately 95% of parents reported that the screening experience was not stressful (Table 4). Babies should be screened for as many disorders as possible even if it leads to false alarms. The majority of parents responding to the questionnaire were supportive of DMD screening (Table 4).
A questionnaire was given to providers to evaluate their opinions about the DMD screening program.
Information gathered through the provider questionnaire indicated that the majority of these providers were supportive of DMD screening (Table 4).
This is the first study in the United States to conduct DMD screening after the newborn period through pediatric care providers.
Data from our study and from Germany demonstrate the benefits and limitations of infant screening in comparison with newborn screening for DMD. The consideration of DMD newborn or later infant screening represents a recent shift in thinking about benefits not only to the affected child, but also to the family and society3233. Future studies will need to address several issues before DMD screening by pediatric providers can be incorporated into routine practice. This is the first study in the United States to conduct DMD screening after the newborn period. The job candidate has the medical degree but their experience has primarily involved research so this doctor has had to make it very clear they are interested in consulting and research and not practicing medicine as a Physician. In this sample, the writer uses the internship at Northwestern University as an individual job. Like any quality research position, this individual had their work published and listed their publications and related presentations on page 2 of the resume. Provide medical care and conduct wellness exams for individuals and medicare beneficiaries. Provide education for the prevention of serious diseases and assist patients in the management of acute and chronic medical conditions. Diagnose patients, order diagnostic tests and provide referrals for specialized treatment or rehabilitation.
Collaborate with clinical staff and specialty Physicians on multiple discipline treatments and coordinated care efforts. Solid understanding of non-pharmaceutical patient care aids and non-prescription pharmacy products. Research Assistant Resume ExampleResume example from recent graduate with experience as Research Assistant.
They say people in hospital are losing out on nutrition because they are not being helped with eating or having their diet monitored. She also said that patients suffered because they may have no appetite as a result of their illness, and might also not get help with eating and drinking. The purpose of this study was to assess the desirability of Duchenne muscular dystrophy (DMD) screening, the effectiveness of the consent process, and the feasibility of conducting DMD screening in a pediatric office. Infant males who attended a 12-month routine well-child visit at a participating pediatric clinic were screened for DMD.
DMD screening is feasible in a pediatric office when conducted as part of a research study. In particular, DMD does not have an accepted medical treatment that prevents or reverses disease manifestations.
Information could be provided to parents after they have had time to bond with their infant and to consider the potential consequences of receiving positive screening results.
As a result, two DMD screening studies were conducted: (1) a pilot newborn screening study in Ohio27,and (2) a pilot infant screening study in metropolitan Atlanta.
Male infants who attended the 12-month routine well-child visit at one of the participating pediatric clinics were eligible for the study.
Study staff then discussed the study materials with all parents during the visit, answered questions, and obtained consent.
Data were verified and then imported into Statistical Package for the Social Sciences (SPSS) version 15.0. Study staff approached 352 parents of 361 of these infants about participation in the study.


The nine infants without samples either had left prior to receiving the fingerstick or already had the fingerstick for the anemia test at a previous visit and no extra blood had been collected for DMD screening.
Responses that were reported by a minimum of 10% of participants and decliners are summarized in Table 2.
Although about 20% of parents did not feel they had much time to review the materials, over 95% felt they understood the written information at least well enough or better and about 70% felt the written information was helpful to them in making a decision about participating.
Another indication of a positive experience was that the majority of parents also reported that they would screen future sons and recommend screening to other parents.
The low stress experienced by parents came as little surprise, as none of the parents received a positive screening result. Parents were interested in the option of DMD screening, particularly when performed along with routine testing. Providers thought DMD screening could be incorporated easily into practice and that collecting blood, a role that the office staff routinely performed, was not a burden. In Germany, where screening occurred through pediatric providers, parents were given information in the birthing hospitals and at pediatricians’ offices89. Screening after the newborn period enables some of the ethical issues surrounding newborn screening for DMD to be addressed. Traditionally, benefits have focused on early medical interventions that improve the health outcome of affected children17. Although providers broadly supported screening, their questionnaire results must be interpreted with caution because clinic staff was not involved in the more time-consuming aspect of obtaining consent from parents. Investigators conducting future infant screening studies should utilize clinic staff in conducting recruitment and obtaining parental consent, recruit a larger number of participants to determine the experience and test the follow-up of families with positive DMD results, evaluate the cost of screening, and ensure the participation of clinics (pediatric, family practice, and community clinics) that serve diverse pediatric populations. This is a good reference sample for any doctor or higher level medical professional or doctor’s that have a background in health care research. The headline is followed by a brief summary of qualifications that outlines skills in communications, analysis and implementation. The job seeker lists the research project initiatives and uses bullet points to highlight key actions and achievements including the ability to gain funding for further research.
Honors, Awards and Community services provide additional details that demonstrate this individuals high level of character. John Kasich say they are launching collaborative strategies to deprive Donald Trump the delegates needed to win the Republican nomination.
The research suggests further problems are caused because meals are likely to be at a set time, when patients may be having tests or treatment.
Parents and providers completed post-screening questionnaires to assess their experiences with and attitudes toward screening.
Approximately 78% of parents indicated support of voluntary DMD screening and 91% of providers were in favor of screening for DMD.
Infant screening for DMD eventually could be offered in pediatric health care provider offices as an optional public health service outside of newborn screening.
DMD is an X-linked condition that affects males primarily and might or might not occur in the presence of a family history3. In the 1970s, early diagnosis became possible through detection of elevated creatine kinase (CK) in dried blood spots10.
Although experts recommend supportive therapies for DMD that slow progression and increase well-being, little evidence is available to suggest earlier access to these therapies?particularly those started in the newborn period?improves clinical outcomes1819202122. Screening could be offered at the age when affected boys would still be presymptomatic and most parents would not have had additional children26.
Here we report results from the infant DMD screening study, in which parents were offered DMD screening for their infant sons at the 12-month pediatric clinic visit. To avoid the increased risk for false-positive screens, infants were excluded if they were seeing a pediatrician because of illness. Parents were given the option to have the sample held for 2 weeks while they took additional time to review the study packet.
As the American Academy of Pediatrics recommends testing infants 12 months of age for anemia29, this visit was ideal for DMD screening because a sample could be obtained using blood from the same fingerstick.
The decliner questionnaire evaluated factors that influenced refusal of screening for parents who received information about the study, but declined participation. The institutional review boards (IRBs) of Emory University and CDC approved the study protocol.
Mothers were the parents who usually completed the questionnaire and most indicated they were married.
Nearly 95% of participants also reported that whoever spoke with them about screening was at least somewhat helpful in explaining the DMD screening program and they felt they were given enough time to ask questions. Written comments of parents indicated that they liked the convenience of including DMD screening with other tests, particularly as no additional needle stick was needed. The majority of providers also thought it was not a burden obtaining consent; however, as they were not involved in gaining parental consent, this could not be verified through practice.
Parents were then able to request screening during one of the well-baby visits from 4 weeks to 1 year of age. Parents could have more time to consider screening in a less hectic environment; our study showed that most parents who chose screening had enough time and were able to understand the risks and benefits of DMD screening. However, in 2005, along with proposing updated criteria and a set of 29 core conditions for newborn screening, the American College of Medical Genetics recommended that benefits to the family, providers, and public also should be considered after the best interest of the child34. Having had clinic staff involved in educating potential participants would have enabled all parents of eligible infants to be educated about DMD screening and would have better reflected how screening would be carried out in routine practice. Parents understood the risks and benefits of screening so that they could make informed choices. He worked tirelessly to improve the lives of children and families affected by genetic conditions and he will be greatly missed. Professor John Edwards said about 40% of patients entering hospital were already malnourished, and this did not tend to improve during their stay.
About 75% of parents correctly answered three of five questions testing their knowledge of DMD screening. Signs of DMD often appear before a child is 3 years of age and include gross motor delay, muscle weakness, and difficulty walking and running4.
Since then, several DMD screening pilot studies and programs have occurred worldwide12810111213141516.
Given the lack of early, definitive treatment, some parents might not want to know if their newborn has DMD. Infants with a family history of DMD also were excluded, as these infants and their families would have required a more extensive genetic evaluation. Approximately 78% of the sampled parents identified themselves as White and 13% as Black or African American. About three-quarters (74.6%) of respondents answered at least three of the five questions correctly. Most parents thought screening should be optional, but they were evenly divided on the timing of screening, with half preferring it to be part of newborn screening and the other half preferring it to be done with other tests later in infancy. Scheuerbrandt et al reported that 14.4% of infant boys born in West Germany in 1983 were screened for DMD, with 65% of screening occurring at the first well-baby check at 4-6 weeks. Later time points for screening also provide additional time for parent–child bonding to occur and clearly delineate between optional and mandatory screening. Recently, the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children, the committee that reviews and recommends conditions for inclusion on newborn screening panels, published evaluation criteria that also consider benefits beyond those of the child35.
Kemper and Bailey recently surveyed pediatricians on their knowledge and attitudes toward FXS screening by posing scenarios of screening at birth through traditional newborn screening or at 12 months of age through pediatric providers36.
Currently, DMD newborn screening is only being conducted in Antwerp (Francois Eyskens, personal communication, November 7, 2011). As a result, DMD newborn screening programs typically have been voluntary and have focused primarily on benefits of early diagnosis to the family.
A toll-free number and a website were available to parents wanting more information about the study. Two extra drops of blood were collected on a separate filter paper card to be used for DMD screening. Follow-up telephone calls were made to ensure receipt of study results and to remind parents to complete the questionnaire.
Parents could complete and return it during the appointment or in a preaddressed stamped envelope. To assess differences between groups, t tests for continuous data and chi-squares for categorical data were computed.


To determine whether the amount of time between screening and completion of the survey influenced the number of questions answered correctly, knowledge question results were compared between parents who answered the questionnaire from the first mailing and those who answered from the second mailing. Although a majority of parents thought that identifying infants through screening was important, one-third did not think that screening for more conditions was indicated if it also increased the number of parents receiving false-positive results. Nurse practitioners, physician assistants, medical assistants, and laboratory technicians accounted for the rest of providers.
At that time, they estimated that half the birthing hospitals in West Germany were providing information on screening.
Grosse et al describe this new paradigm shift as a change from viewing newborn screening as an urgent and immediate public health need (a public health emergency) to a public health service33. While clinics where recruitment occurred served diverse patient populations, those with larger minority populations had a higher number of patients who did not keep, rescheduled, or cancelled their appointments, making recruitment more difficult at these locations.
FXS is similar to DMD in that both are genetic conditions for which (1) affected children are brought to medical attention through delays in development, (2) supportive therapies exist but there is no cure, and (3) diagnostic delay is common. However, if infant screening for DMD and other childhood-onset conditions eventually is to be offered in pediatric provider offices as an optional public health service outside of newborn screening, future studies will need to assess the feasibility of DMD screening in routine practice by having providers play a larger role in educating and obtaining consent from parents. Neonatal screening for Duchenne muscular dystrophy: a novel semiquantitative application of the bioluminescence test for creatine kinase in a pilot national program in Cyprus. A delay of more than 2 years between symptom onset and diagnosis is common because early signs are variable and nonspecific to DMD4. Even so, ethicists have asked whether parents can be informed adequately about the risks and benefits of screening for DMD when receiving information during the busy newborn period23. Following blood collection, the card was transported by study staff to the Emory Biochemical Genetics Laboratory where the CK testing was performed. The provider questionnaire was designed for providers in participating clinics to assess their attitudes and opinions about DMD screening and its incorporation into their clinical practice. Approximately 80% of the sample described themselves as White, and 13% as Black or African American. All respondents indicated that they had completed either a 4-year college degree or post-graduate study. All providers specialized in pediatrics and were in private practice in the metropolitan Atlanta area. However, infant screening has several drawbacks when compared with newborn screening for DMD. While DMD does not fulfill criteria for newborn screening under the old paradigm of a public health emergency, it could be considered for screening if done as a public health service. Only about half of the participants completed the post-screening questionnaire and only about 20 decliners and 20 providers completed their questionnaires. Their results showed that 55% of respondents were supportive of FXS screening when infants were 12 months of age; however, 34% thought routine visits were too busy to include screening and only 39% felt comfortable discussing FXS with patients. It is evident that larger studies and more public discussion need to occur before routine DMD infant screening can become a reality.
Finally, we thank the staff of the four participating pediatric clinics, and the parents and their sons who participated in the study. Despite advances in treatment and diagnostic testing, the average age of diagnosis is 5 years and has not changed in the past two decades4. Additional concerns have been raised about the potential for disrupting parent–newborn bonding upon receiving a presymptomatic diagnosis of a fatal disorder and the burden for parents receiving false-positive results2425. Parents were asked to complete and return the questionnaires only if they had not previously done so.
Pediatricians, physician assistants, nurses, nurse practitioners, and medical assistants involved in sample collection were asked to fill out the questionnaire after completion of the study. Thus, no further testing was performed and all infant males received a negative screening result. No statistical differences in the demographics of the participants and decliners were found.
Overall, these data showed that most parents had a good understanding of the information and also suggested that parents likely had an even better understanding of the risks and benefits of DMD screening at the time they made the decision to screen. While infant screening can occur at routine well-baby visits, established systems and policies are not in place for infant screening to be offered universally.
In that case, other childhood onset conditions, such as fragile X syndrome (FXS), that also are characterized by developmental delay in early childhood, a “diagnostic odyssey”, and a lack of therapies that can reverse or prevent disease also could be considered. The relatively small sample sizes for each type of questionnaire made it difficult to make meaningful comparisons between respondents and further reduced our ability to generalize the results to other populations.
While our study showed a higher proportion (63%) of clinical staff felt comfortable discussing DMD, both studies highlighted the need for provider education if they are to be involved in the screening process. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience.
Also, the later timing of infant screening means that some parents will not learn about their reproductive risks before having another child.
Our results indicated that the majority of parents in our study were interested in DMD screening and likely would have considered screening for other childhood-onset conditions as well. Since all infants had normal CK results, we were unable to evaluate the experiences of parents whose sons screened positive and the laboratory and clinical protocols for follow-up of infants with elevated CK. In future studies, investigators will need to educate pediatric health care providers on DMD screening and provide them with informational resources for their patients. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so. A protocol to follow-up infants with elevated CK (positive screening result) was also developed. Lastly, parents themselves might prefer screening to occur earlier; in our pilot study, half of the parents who participated preferred newborn screening to screening at a later age. Nevertheless, the timing of screening for these conditions might need to be different from those conditions in which screening clearly is a public health emergency.
It also will be important to consult with providers about efficient ways to include screening that minimize the effects on routine practice. Further analysis of parent preferences and experiences is planned through a direct comparison of questionnaire data from the CDC-funded newborn and infant screening studies. Although the public health system already is in place for early identification and follow-up of infants affected by DMD, screening for DMD later in infancy could avoid confusion of mingling mandatory and optional screening at birth and could reduce consent and other ethical concerns23.
Infant screening for DMD and other childhood-onset conditions could be offered in pediatric offices as an optional public health service outside of newborn screening. Delayed diagnosis in Duchenne muscular dystrophy: data from the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet). Screening for Duchenne muscular dystrophy: an improved screening test for creatine kinase and its application in an infant screening program. Consensus recommendation of the 14th workshop sponsored by the European Neuromuscular Center (ENMC). Creatine phosphokinase levels in the newborn and their use in screening for Duchenne muscular dystrophy. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Cardiovascular health supervision for individuals affected by Duchenne or Becker muscular dystrophy. Screening for conditions that do not meet the Wilson and Jungner criteria: the case of Duchenne muscular dystrophy. Points to consider: ethical, legal, and psychosocial implications of genetic testing in children and adolescents. A review of the psychosocial effects of false-positive results on parents and current communication practices in newborn screening. From public health emergency to public health service: the implications of evolving criteria for newborn screening panels. Committee report: Method for evaluating conditions nominated for population-based screening of newborns and children.



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