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Bravo-Jaimes K, Costello BT, Reza N, Sanghavi M, Tamirisa KP, Mehta LS, Mamas MA, Taub CC, Volgman AS, Mieres JH, Ijioma NN, Douglas PS, Hayes SN, Bullock-Palmer RP. A Practical Guide to Address Harassment and Bullying in Cardiology. JACC Case Rep 2023; 22:101988. [PMID: 37790768 PMCID: PMC10544275 DOI: 10.1016/j.jaccas.2023.101988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Affiliation(s)
- Katia Bravo-Jaimes
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Briana T. Costello
- Division of Cardiology, The Texas Heart Institute Center for Cardiovascular Care, Baylor St. Luke’s Medical Center, Houston, Texas, USA
| | - Nosheen Reza
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Monika Sanghavi
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Laxmi S. Mehta
- Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom
| | - Cynthia C. Taub
- Section of Cardiovascular Medicine, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | | | | | | | - Pamela S. Douglas
- Duke Clinical Research Institute, Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Sharonne N. Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Douglas PS, Mack MJ, Acosta DA, Benjamin EJ, Biga C, Hayes SN, Ijioma NN, Jay-Fuchs L, Khandelwal AK, McPherson JA, Mieres JH, Roswell RO, Sengupta PP, Stokes N, Wade EA, Yancy CW. 2022 ACC Health Policy Statement on Building Respect, Civility, and Inclusion in the Cardiovascular Workplace. J Am Coll Cardiol 2022; 79:2153-2184. [DOI: 10.1016/j.jacc.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Douglas PS, Mack MJ, Acosta DA, Benjamin EJ, Biga C, Hayes SN, Ijioma NN, Jay-Fuchs L, Khandelwal AK, McPherson JA, Mieres JH, Roswell RO, Sengupta PP, Stokes N, Wade EA, Yancy CW. SOCIAL DETERMINANTS OF MORTALITY FROM COVID-19, A RETROSPECTIVE STUDY OF 6,000 PATIENTS. J Am Coll Cardiol 2022. [PMID: 35307518 PMCID: PMC8972426 DOI: 10.1016/s0735-1097(22)03144-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cené CW, Leng XI, Faraz K, Allison M, Breathett K, Bird C, Coday M, Corbie‐Smith G, Foraker R, Ijioma NN, Rosal MC, Sealy‐Jefferson S, Shippee TP, Kroenke CH. Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women's Health Initiative Study Findings. J Am Heart Assoc 2022; 11:e022907. [PMID: 35189692 PMCID: PMC9075097 DOI: 10.1161/jaha.120.022907] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. Methods and Results This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women's Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993-1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08-1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07-1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611.
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Affiliation(s)
- Crystal W. Cené
- University of North Carolina at Chapel HillNC,now with University of California, San DiegoLa JollaCA
| | | | | | | | | | | | - Mace Coday
- University of Tennessee Health Science CenterMemphisTN
| | | | - Randi Foraker
- Washington University in St. Louis School of MedicineSt. LouisMO
| | | | | | | | - Tetyana P. Shippee
- Division of Health Policy and ManagementUniversity of MinnesotaMinneapolisMN
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Ijioma NN, Don C, Arora V, Edgar L, Hawkins B, Monteleone P, Tcheng JE, Helmy T. ACGME Interventional Cardiology Milestones 2.0-an overview: Endorsed by the Accreditation Council for Graduate Medical Education. Catheter Cardiovasc Interv 2021; 99:777-785. [PMID: 34708916 DOI: 10.1002/ccd.29975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022]
Abstract
This document provides an overview of the rationale, development, interpretation, and practical suggestions for implementation of the new Accreditation Council for Graduate Medical Education (ACGME) Interventional Cardiology (IC) Milestones 2.0. Previously, IC programs used the general ACGME Milestones for internal medicine. The IC Milestones version 2.0 updates the ACGME competencies to be specific to training in IC. In 2019 an ACGME working group consisting of IC program directors, a lay representative, and representatives from the American Board of Internal Medicine met to develop the IC Milestones version 2.0. The ACGME IC Milestones 2.0 establishes a framework for formative feedback for trainees within domains of patient care, medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. The 2021 IC Milestones 2.0 provides a framework for IC mentors and trainees to identify areas for improvement or commendation help stimulate meaningful educational discussions, and provide the basis for self-reflection and self-improvement.
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Affiliation(s)
- Nkechinyere N Ijioma
- Division of Cardiovascular Disease, Heart & Vascular Institute, Ochsner LSU Health, Shreveport, Louisiana, USA
| | - Creighton Don
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Vishal Arora
- Augusta University Cardiovascular Center, Augusta, Georgia, USA
| | - Laura Edgar
- Accreditation Council for Graduate Medical Education, Chicago, Illinois, USA
| | - Beau Hawkins
- Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Peter Monteleone
- Seton Heart, Ascension Seton Medical Center, Austin, Texas, USA.,Dell School of Medicine, University of Texas at Austin, Austin, Texas, USA
| | - James E Tcheng
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tarek Helmy
- Heart & Vascular Institute, Ochsner LSU Health Shreveport, Shreveport, Louisiana, USA
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Gharacholou SM, Ijioma NN, Lennon RJ, Rihal CS, Bell MR, Brenes-Salazar JA, Sandhu GS, Gulati R, Pellikka PA, Pollak PM, Lane GE, Pillai DP, Munoz FDC, Motiei A, Singh M. Characteristics and long term outcomes of patients with acute coronary syndromes due to culprit left main coronary artery disease treated with percutaneous coronary intervention. Am Heart J 2018; 199:156-162. [PMID: 29754655 DOI: 10.1016/j.ahj.2018.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 02/17/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Patients with acute coronary syndrome (ACS) due to unprotected culprit left main coronary artery disease (LMCAD) treated with percutaneous coronary intervention (PCI) are rare, high-risk, and not represented in trials. Data regarding long term outcome after PCI are limited. METHODS Between January 2000 and December 2014, there were 8,794 patients hospitalized with unstable angina/non-ST elevation myocardial infarction (UA/NSTEMI) or ST-elevation myocardial infarction (STEMI) treated with PCI at our institution; of these, 83 (0.94%) patients were identified as having culprit LMCAD ACS. RESULTS Of the 83 patients with unprotected LMCAD ACS, 40 patients presented with STEMI and 43 patients presented with UA/NSTEMI. As compared to LM UA/NSTEMI, LM STEMI patients were younger and had less hypertension, with a trend towards greater frequency of cardiogenic shock. Distal LM involvement was common in both groups and did not differ by ACS type. In-hospital mortality was 33% in LM STEMI and 9% in LM UA/NSTEMI (P = .009). Over median follow up of 6.3 years, long term survival rates in both groups were similar (46% for STEMI vs 51% for UA/NSTEMI; P = .50 by log-rank). CONCLUSIONS Unprotected culprit LMCAD ACS necessitating PCI is uncommon, occurring in <1% of cases, but is associated with reduced survival, with long term follow-up noting continued and similar risk of death regardless of index ACS type.
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Narang A, Sinha SS, Rajagopalan B, Ijioma NN, Jayaram N, Kithcart AP, Tanguturi VK, Cullen MW. The Supply and Demand of the Cardiovascular Workforce: Striking the Right Balance. J Am Coll Cardiol 2016; 68:1680-1689. [PMID: 27712782 PMCID: PMC5351767 DOI: 10.1016/j.jacc.2016.06.070] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/20/2016] [Accepted: 06/28/2016] [Indexed: 12/27/2022]
Abstract
As the burden of cardiovascular disease in the United States continues to increase, uncertainty remains on how well-equipped the cardiovascular workforce is to meet the challenges that lie ahead. In a time when health care is rapidly shifting, numerous factors affect the supply and demand of the cardiovascular workforce. This Council Commentary critically examines several factors that influence the cardiovascular workforce. These include current workforce demographics and projections, evolving health care and practice environments, and the increasing burden of cardiovascular disease. Finally, we propose 3 strategies to optimize the workforce. These focus on cardiovascular disease prevention, the effective utilization of the cardiovascular care team, and alterations to the training pathway for cardiologists.
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Affiliation(s)
- Akhil Narang
- Section of Cardiology, University of Chicago, Chicago, Illinois.
| | - Shashank S Sinha
- Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan
| | - Bharath Rajagopalan
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, New York
| | | | - Natalie Jayaram
- Division of Cardiology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
| | - Aaron P Kithcart
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Varsha K Tanguturi
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael W Cullen
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
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Abstract
The latest iteration of the Core Cardiology Training Statement (COCATS 4) [Corrected] provides a potentially transformative advancement in cardiovascular fellowship training intended, ultimately, to improve patient care. This review addressed 3 primary themes of COCATS 4 from the perspective of fellows-in-training: 1) the evolution of training requirements culminating in a competency-based curriculum; 2) the development of novel learning paradigms; and 3) the establishment of task forces in emerging areas of multimodality imaging and critical care cardiology. This document also examined several important challenges presented by COCATS 4. The proposed changes in COCATS 4 should not only enhance the training experience but also improve trainee satisfaction. Because it embraces continual transformation of training requirements to meet evolving clinical needs and public expectations, COCATS 4 will enrich the cardiovascular fellowship training experience for patients, programs, and fellows-in-training.
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Affiliation(s)
- Shashank S Sinha
- Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan.
| | - Howard M Julien
- Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Selim R Krim
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana
| | | | | | - Andrea J Rock
- Department of Pediatrics, Division of Cardiology, Northwestern University, Chicago, Illinois
| | - Stephanie L Siehr
- Division of Pediatric Cardiology, Stanford University, Palo Alto, California
| | - Michael W Cullen
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
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Reddy YNV, Al-Hijji M, Best PJ, Sinak LJ, Suri RM, Ijioma NN, Aberle SJ, Goyal DG, Singh M. Diagnosis of Free-Wall Rupture by Left Ventricular Angiogram After Inferior ST-Segment-Elevation Myocardial Infarction. Circulation 2015; 132:e31-3. [PMID: 26240267 DOI: 10.1161/circulationaha.115.015951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yogesh N V Reddy
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Mohammed Al-Hijji
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Patricia J Best
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Lawrence J Sinak
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Rakesh M Suri
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Nkechinyere N Ijioma
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Sara J Aberle
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Deepi G Goyal
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN
| | - Mandeep Singh
- From Division of Cardiovascular Diseases (Y.N.V.R., M.A.-H., P.J.B., L.J.S., N.N.I., M.S.), Division of Cardiothoracic Surgery (R.M.S.), and Division of Emergency Medicine (S.J.A., D.G.G.), Mayo Clinic, Rochester, MN.
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Ozumba BC, Obi SN, Ijioma NN. Knowledge, attitude and practice of modern contraception among single women in a rural and urban community in southeast Nigeria. J OBSTET GYNAECOL 2005; 25:292-5. [PMID: 16147740 DOI: 10.1080/01443610500105498] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The contraceptive information and services offered to single women in most developing countries is compromised by stigma attached to premarital sex. This study was to ascertain the knowledge, attitude and practice of contraception among single women in a rural and urban community in southeast Nigeria, using a cross-sectional survey of 279 and 295 single women in Ngwo (rural) and Enugu (urban) community. The mean age of the population was 21.3 years. Contraceptive awareness was more among the urban than rural respondents (90.2% vs 34.1%). The major sources of contraceptive knowledge were mass media (68%) and peer groups (86.3%) for the urban and rural respondents, respectively. Most respondents in both groups had positive attitude towards contraception. More urban than rural respondents (68.3% vs 12.5%) began sexual activity during adolescence and the level of contraceptive use during first coitus were 48.4% and 13.7%, respectively. Of the currently sexually active respondents, 32.5% (rural) and 59.7% (urban) were using a form of modern contraception. Condoms, followed by oral pills were the most popular contraceptive method because they can easily procure them over the counter. Poor contraceptive information, highly critical behavior of family planning providers towards unmarried women seeking contraception and attitude of male partners militate against contraceptive practice. There is need to promote information and education on contraception among single women, their male partners and family planning providers.
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Affiliation(s)
- B C Ozumba
- Department of Obstetrics & Gynaecology, University of Nigeria Teaching Hospital Enugu, Nigeria
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