Emergency Medicine

Sustainable Global Health Education Frameworks

Faculty Mentor’s Name: Dr. Elizabeth DeVos
Email: elizabeth.devos@jax.ufl.edu
Phone Number: (904) 244-4405
Project Category: Literature Review
International Component or Travel: Potentially
If your project has an international component please give details (where, when, data collection involved, etc.): This project does not require international travel but relates to our international education programs. If travel restrictions are lifted this summer, we may explore opportunities for interested students to conduct additional aspects of this project abroad.

Research Project Description:
This project is for a student interested in Global Health and/or medical education. The student will assist in updating literature reviews and preparation of reports related to the long-standing global health service learning trips and sustainable and “fair-trade” global health education and completing a manuscript describing the UF case study of aligning global health opportunities with best practice guidelines for all global health education programming. Student may participate in designing additional educational scholarship related to the implementation of coursework for global health electives. Previous students have presented iterations of this work as poster projects at the Consortium of Universities for Global Health.

Social Determinants of Health Associated with Hospitalization, Morbidity and Mortality of COVID-19 Patients

Faculty Mentor’s Name: Dr. Shama Patel
Email: shama.patel@ufl.jax.edu
Phone Number: (203) 675-3300
Project Category: Clinical
International Component or Travel: No

Research Project Description:
The novel SARS Co-V2 (COVID-19) emerged in December of 2019 becoming a pandemic impacting the United States most severely. Florida has been hit hard by COVID-19 and as of November 24, 2020, Duval County has had 40,898 cases with 569 deaths. The ecological, health, social and molecular components of the disease are still being discovered. As information is being learned more questions are being raised. One area that needs more study is the ecologic and social factors that put individuals at increased risk for not only contracting the virus but for long term morbidity and mortality.

Social determinants of health (SDOH) are social and economic conditions, such as income, education, employment, and social support, that influence the health of individuals and communities. Social, economic and political context give rise to a person’s socioeconomic position, which results in stratification according to income, education, occupation, gender and race/ethnicity which leads to differences in material circumstance, behaviors, biological and psychosocial factors including the person’s intersection with the health system and ultimately has an impact on equity in health and overall wellbeing. The structural determinants of health operate through intermediary determinants of health to shape health outcomes. These factors have yet to be studied fully in the context of COVID-19.

Jacksonville, FL, like many other cities throughout the country, have differential health outcomes based on SDOH. SDOH have been identified and quantified by the Department of Health (https://reports.mysidewalk.com/d3dc8633ae) but to date no association to COVID-19 admission, morbidity and mortality has been studied. This study will begin to fill this gap by looking at selected SDOH, beyond race/ethnicity, to determine the association on hospitalizations, morbidity, and mortality of COVID-19 patients. A retrospective analysis of predetermined SDOH variables of COVID-19 related hospital admissions, morbidity, and mortality at UF-Health Jacksonville from March 2020 to November 2020 will be done for this study.

Assessment of Pediatric Race, Ethnicity, and Language Proficiency Data

Faculty Mentor’s Name: Dr. Colleen Gutman
Email: ckays21@ufl.edu
Phone Number: (352) 283-5757
Project Category: Clinical
International Component or Travel: No

Research Project Description:
In the United States, there are striking disparities in health outcomes by race, ethnicity, and language proficiency. Patients who are not white-non-Hispanic and who are limited English proficient (LEP) experience higher rates of adverse events and poor health outcomes. Collecting accurate data on patient race, ethnicity, and language proficiency is essential to high quality research to develop interventions that eliminate these disparities. In 2009, the Institute of Medicine issued a call for standardized collection of patient race, ethnicity, and language proficiency across health care entities. In this report, individual self-report was listed as the preferred method to define an individual’s race, ethnicity, and language proficiency. Despite this, there continue to be substantial discrepancies between patient and third-party reported race and ethnicity. Additionally, despite validated measures to identify LEP patients, these are poorly implemented into many healthcare systems. The accuracy race, ethnicity, and language proficiency has not been well-studied in pediatric populations. In this study, we aim to assess the agreement between pediatric emergency department patients’ race and ethnicity as documented in the medical record and as identified by the caregiver. We will also assess the agreement between language as documented in the medical record and language proficiency as reported by the parent. This information will be instrumental in designing future interventions to improve and standardize data collection in pediatric emergency department patients, and to better understand the unique interplay of race, ethnicity, and language proficiency in the parent-patient dyad. MSRP students will be involved in all aspects of the project, including data collection through the administration of tablet-based surveys to participants, data analysis, presentation and publication of results.

QI Violence in the ED

Faculty Mentor’s Name: Dr. Cristina Zeretzke-Bien
Email: zeretzke@ufl.edu
Phone Number: (504) 239-1262
Project Category: Basic
International Component or Travel: No

Research Project Description:
QI Project – Violence in the Emergency Department: Terri Davis MD, Cristina Zeretzke-Bien MD, , Liam Holtzman MD

Problem: Violence in Emergency Departments around the country is increasing as overall societal violence is increasing. The emergency department is the health safety net of society and takes all who walk in the doors, regardless of their ability to cooperate. Violence, including verbal threats, physical attacks, and weapons, places staff’s lives at risk. Decreasing violence requires a multi-faceted approach. Residents are able to intervene quickly in multiple ways and with improved training may increase hospital safety.

– determine resident current experience with violence in the emergency department
– determine resident current knowledge of de-escalation techniques
– train residents in new/additional de-escalation techniques
– train residents on best physical and chemical restraint methods

Project Plan:
– survey residents on their interactions with violent patients {completed}
– survey residents on current knowledge of de-escalation techniques
– educate residents on de-escalation techniques through lecture
– educate residents on de-escalation techniques through a simulation experience
– educate residents on Run, Hide, Fight in lecture experience
– educate residents on Run, Hide, Fight through a simulation experience
– test residents after the educational experiences to determine improvement in knowledge
– post education tests on Run, Hide, Fight will be the same questions as in the UF video on the topic created for all UF staff, but an additional survey will be added to assess whether simulation or lecture provided better understanding and retention

Lipid and Lipoprotein Dysregulation in Sepsis

Faculty Mentor’s Name: Dr. Cristina Zeretzke-Bien
Email: zeretzke@ufl.edu
Phone Number: (504) 239-1262
Project Category: Translational
International Component or Travel: No

Research Project Description:
We are looking for a motivated medical student to participate in our clinical and translational research study of lipids and lipoproteins metabolism in sepsis at UF JACKSONVILLE. This study involves clinical enrollment of critically ill adult patients with sepsis from the ED or ICU Setting as well as laboratory analysis of patients specimens. The student will be involved in the entire spectrum of the research study, from clinical enrollment to laboratory experience, and will have the opportunity to develop and test their own study hypothesis with a goal of presenting at a national meeting and being a manuscript co-author. In addition, students will have exposure to the specialty of Emergency Medicine.

Additional project details: Cholesterol and lipid metabolites are present in sepsis and are highly biologically active regulators of inflammation, but currently the changes in lipid and lipoprotein homeostasis during sepsis are not well understood. This project will investigate the changes in lipid and lipoprotein function, oxidation, metabolites, and changes in gene expression to further our understanding of dysregulated lipid and lipoprotein metabolism in sepsis. We will analyze a bank of samples and make associations with important clinical outcomes (early death, chronic critical illness and sepsis recidivism) as supported by our published work, and will confirm our findings in a small prospective cohort of sepsis patients.