Browsing by Subject "Health and Medical Administration"
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Item 5 Year Strategy: 2009-2014(2008-01-01)Item A Comparison of Medicare Prospective Payment Systems on P.T.C.A. and Stent Outcomes in an Urban Hospital(2001-05-01) Compton, Ben H.; Doug A. Mains; P. E. HilsenrathCompton, Ben H., A Comparison of Medicare Prospective Systems on P.T.C.A. and STENT Outcomes in an Urban Hospital. Master of Public Health (Health Services Administration), May 2001, 57 pp., 10 tables, 1 graph, bibliography, 51 titles. To determine if differences in outcomes exist between Medicare prospective payment systems when doing percutaneous transluminal coronary angioplasty (PTCA) or STENT surgeries. From January 1999 and December 2000, 146 Medicare patients were identified with 35 being outpatient and 111 inpatient. A separate group of 1-day inpatients was used as a comparison for the outpatient group. Results from the comparison reveal that in the three groups, the majority of patients were white, non-Hispanic males who were about 70 years of age. The 1-day inpatient group had the highest profit of all three with about $3,000 while the inpatient group broke even. The outpatient group had no in-hospital deaths or complications while all three had equal amounts of comorbidities. The conclusion is that losses will probably occur if PTCA and STENTs are done outpatient. Possible solutions are moving to an inpatient setting or determining which costs can be reduced in the outpatient setting.Item A Health Assessment of Refugee Children From Former Yugoslovia in Tarrant County(2001-12-01) Podgore, John K.; Marshall, Murial; Rene, Antonio; Sandhu, RaghbirThis study was conducted to provide an assessment of the health status and health care utilization of children from former Yugoslavia living in Tarrant County. Additionally an assessment of barriers and problems encountered by these families in obtaining health care for their children was presented. One hundred thirteen households of refugee families arriving in Tarrant County from 1998 through 2000 participated by answering a 79 item health information questionnaire. The results revealed that most of the refugee families had no regular health care provider to assure continuity of medical care. Lack of access to dental care and inappropriate utilization of hospital emergency facilities were also identified as problems. Insufficient understanding of health insurance issues and inability to access health information were additional problems. Addressing these problems by local and state health care agencies may help to improve health care delivery for these and future refugee children.Item A Phase II Clinical Study to Evaluate the Efficacy and Safety of rhThrombin in Subjects Undergoing Arterial Bypass Surgery and AV Graft Formation for Hemodialysis(2004-12-01) Plascencia, Xochitl; Rustin E. Reeves; Della Weis; Don PeskaThe Association of American Medical Colleges Task Force on Clinical Research defines clinical research as a component of medical and health research intended to produce knowledge essential for understanding human disease, preventing and treating illness, and promoting health (Friedman, 1998). A clinical trial is defined as a research study conducted in humans which is designed to answer specific questions using scientifically controlled conditions with specified methodologies and endpoints (Gallin, 2002). Clinical research trials are essential in determining whether or not a drug is safe and effective. There are four phases that investigational drugs go through before they are allowed to be out in the market. Before beginning phase I of a study, there is usually a pre-clinical research and development phase. During this time the initial synthesis of study drug is accomplished and animal testing takes place. Phase I is the initial introduction of an investigational new study drug into humans. Phase I is usually conducted in healthy individuals and the primary goal is to determine the safety profile of the drug. Phase II trials tend to evaluate safety and initial efficacy. Subjects enrolled in this phase tend to have the disease necessary for use of study drug. Phase III studies are conducted to gather additional information about the effectiveness and safety of the drug and to determine the overall benefit-risk relationship of the drug. Finally, phase IV studies are usually referred to as post-marketing studies. During this phase, additional safety information is identified and the drug’s safety during routine use is evaluated. Each phase can range from two to ten years depending on the complexity of the clinical trial (Gallin, 2002). A phase II, randomized, double blind study of the safety and efficacy of topical recombinant human thrombin in patients undergoing peripheral arterial bypass surgery and arterio-venous graft formation for hemodialysis is the focus of the prospective drug study to be carried out in the surgery department at The University of North Texas Health Science Center. The primary objective of this study is to evaluate the safety and efficacy of recombinant human thrombin when used in different types of surgeries. Prior to signing an informed consent, subjects will have to meet inclusion and exclusion criteria set by study protocol. Study specific assessments and procedures will be performed after the informed consent is signed and dated. If bleeding at the anastomosis is found to necessitate intervention, a single application of either rhThrombin or placebo in combination with an absorbable hemostatic sponge to each anastomosis requiring hemostasis will be applied by the surgeon. The safety and efficacy of rhThrombin will be determined by measuring the incidence and severity of adverse events and of laboratory abnormalities. Occurrence of hemostasis within 600 seconds of application of the study drug at the anastomotic surgical site, incidence of anti-rhThrombin product antibodies, and time to hemostasis will also be measured.Item Acculturation and Psychological Distress in Mexican-American Health Fair Participants(2004-12-01) Bereolos, Nicole M.; Coggin, Claudia; Franks, Susan; Simpkins, JamesBereolos, Nicole M., Acculturation and psychological distress in Mexican-American health fair participants. Master in Public Health (Health Behaviors), December 2004, 20 pp., 3 tables, 23 titles. Immigrants who have integrated into their host culture along with maintaining their cultural identity have better psychological well-being. Greater degrees of psychological distress in less acculturated immigrants may occur due to stressors associated with the transition. This isolation has prevented providers from addressing their mental health needs. This project studied psychological well-being as its relates to acculturation. Self-report questionnaires were offered at the Hispanic Health Fair in Fort Worth, Texas. Psychological distress was significantly higher for the low acculturated (LA) than the moderately acculturated (MA). Specifically, a higher degree of anxiety for the LA group was found compared to the MA. The difference in depression was not significant, however results suggest that mild psychological distress is likely prevalent in the LA. Results underscore the importance of gaining knowledge about the needs of Mexican-Americans that are rarely seen within traditional health service.Item An Analysis of Texas Hospitals: Assessing the Association between Charity Care, Uncompensated Care, & Community Benefits(2007-05-01) Mitias, Marcus J.; Nuha Lackan; Jeff Talbert; Douglas MainsMitias, Marcus J. An Analysis of Texas Hospitals: Assessing the Association between Charity Care, Uncompensated Care, & Community Benefits. Master of Public Health (Health Management & Policy), May 2007, 47 pp., 5 tables, 11 illustrations, references, 45 titles. The question of whether not-for-profit hospitals are meeting their charitable obligations is once again starting to intensify. Congress is calling for increased scrutiny of not-for-profit hospitals. Similarly, pressure is mounting in Texas where the not-for-profit hospital sector struggles to justify the contributions they make to the community. This cross-sectional study examines the county level association between charity care, uncompensated care expenditures, and community benefits, and hospital structure, and the number of uninsured. Descriptive and multi-linear regression analyses are used to compare hospital charity care and uncompensated care expenditures in Texas. Results indicate the number of uninsured is significantly associated with charity care expenditures and uncompensated care expenditures.Item An Evaluation of Muscle Biopsies in a Managed Care Organization(2001-05-01) Saad, Jill Moore; S. Dan Dimitrijevich; Roderick HookerSaad, Jill Moore., An Evaluation of Muscle Biopsies in a Managed Care Organization. Master of Science (Biomedical Sciences), May 2001, 16 pp., 7 illustrations, Reference List, 17 titles. Objective: The goal of this study was to assess the use of the percutaneous muscle biopsy in diagnosing inflammatory muscle diseases and to examine the benefit of centralizing inflammatory myopathies under one department-rheumatology-within a large health maintenance organization. Methods: A retrospective review of 363 muscle biopsies and histopathology reports, spanning 25 years, formed the basis of this study. The databases used in this study were the medical record, an institutional rheumatology registry, and histopathology reports. Cytoarchitectural abnormalities, necrosis and regeneration formed the basis of muscle disease classification. The histopathology findings were interpreted against the patient’s clinical history, examination, and clinical tests to develop a final diagnosis. Results: Rheumatologists in this location performed two-thirds of the biopsies percutaneously using an intervertebral rongeur and surgeons performed one-third open biopsies. Over time open biopsies were phased out due to preference for the percutaneous method. The average age of all muscle biopsy patients was 45 (3 months to 88 years old) and 55% were male. Polymyositis was the most frequently identified myositis (62%), followed by dermatomyositis (19%), and inclusion body myositis (7%). Conclusion: The use of percutaneous muscle biopsies using an intervertebral rongeur is the method of choice because of convenience, quality of specimen, low morbidity, and limited discomfort. Centralizing inflammatory muscle diseases within one organization contributes to the efficiency and effectiveness of inflammatory muscle disease management.Item Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community - A Six Month Follow-Up(1999-12-01) Coustasse, Alberto; Antonio Rene; Doug A. Mains; Gilbert RamirezCoustasse, Alberto, Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community – A Six Month Follow-up. Master of Public Health Track, Public Health Administration, December 1999, 22 pp., 9 tables, 9 illustrations, bibliography, 7 titles. The health fair approach was used as a method to establish individual and population health status baselines and to provide a mechanism to follow-up with an elderly population in a rural Texas community. A controlled trial sample of forty-four seniors was initially screened in a primary care clinic in August 1998. Patients were reevaluated at six months and results demonstrated a 46% increase in BMI [Body Mass Index]; 62% remained obese; 62% maintained elevated cholesterol or increased cholesterol values to abnormal values; 61% maintained or increased their BP [blood pressure] to abnormal values. A significant finding was that a change of one unit in the BMI correlated with a change of 19.88 mmHg [millimeter mercury] of SBP [systolic blood pressure] and 18.59 mmHg of DBP [diastolic blood pressure]. The societal economic impact of mortality and morbidity (without the benefit of target interventions) for the initial forty-four seniors was projected at & 74,949. Keywords: Health fairs; obesity; cardiovascular; cost; case management.Item Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care Centers(2004-07-01) Ambavaram, Sukanya; Cipher, Daisha J.; Bayona, Manuel; Coggin, ClaudiaAmbavaram, Sukanya. Behavioral Disturbances, Chronic Pain, and Cognitive Impairment in Long-Term Care. Master of Public Health, July 2004, 45 pp., 8 tables, references. Background- There is increasing interest in finding the relationship between pain, depression, behavioral disturbances and cognitive impairment in patients living in long-term care centers and predicting behavioral disturbances using chronic pain, depression and cognitive impairment as predictors. To date this is the first study identifying the relationship between pain and behavioral problems. Methods- The study population consisted of 412 residents living in 16 long-term care centers in Dallas, TX. Pearson product-moment Correlation was done to find the association between behavioral disturbances and pain, depression and cognitive factors. Multiple regression analysis was performed to obtain best predictors of behavioral disturbances and forward selection procedure to find out best fit model. Conclusion- Statistically significant correlation was achieved between behavioral excess and overall pain. The correlation was statistically significant between behavioral deficit and overall pain, activity interference and depression. Overall pain, activity interference and depression are significantly inter-correlated with each other. Over all pain and activity interference were found to be statistically significant predictors of behavioral excess. Overall pain was found to be statistically significant predictor of behavioral deficit.Item Clinical Research Patient Recruitment and Retention(2008-01-01) Chandler, Jessica; Michael Smith; John R. Burk; Kathy KwaakThe internship practicum requirement for my Masters degree was completed at Texas Pulmonary and Critical Care Consultants P.A., Research. I worked under the direction of John Burk, M.D., and Kathy Kwaak, RN CCRN. These were the principal investigator and study coordinator respectively. While at TPCCC, I learned about both the administrative and clinical aspects of clinical research. I also gained a great understanding of patient recruitment and retention. Along with the knowledge, I used current study data to complete my research project. The primary focus of my practicum was to evaluate different aspects of patient compliance and retention as a result of the form of patient recruitment. Forms of recruitment in this study include TPCCC database and central advertising. I evaluated five studies. I collected information regarding the number of individuals contacted, enrolled, consented, screened, and early terminations for each study. Furthermore, I determined the most effective form of recruitment at TPCCC. I also acquired data, via a questionnaire, regarding patients’ feelings toward research.Item Coffelt, Kenneth M.(1989-07-18) Coffelt, Kenneth M.; Stokes, C. RayMr. Coffelt established the biomedical communications department in 1974 and served as its director until 1986. From 1976 to 1986, he served as assistant to the president, performing the duties of equal employment officer, safety officer, and construction coordinator for the three major buildings constructed on the TCOM campus. Mr. Coffelt served as assistant vice-president for administrative affairs from 1986 until his retirement in 1992. Interviewed by C. Ray Stokes, July 18, 1989.Item Cohen, Benjamin L., D.O.(1993-12-20) Cohen, Benjamin L.; Hailey, BlakeDr. Cohen, Executive Dean and Vice President of Heath Administration, discusses the school's progress and plans for the future. Interviewed by Blake Hailey, December 20, 1993Item Compare and Contrast Traditional (Paper) and New (Electronic) Clinical Data Collection Systems Perspective of the Investigative Site(2005-05-01) Tsai, David C.; Harold Sheedio; Don Peska; Myoung KimTsai, David C. Compare and Contrast Traditional (Paper) and New (Electronic) Clinical Data Collection Systems-Perspective of the Investigative Site. Masters of Science (Clinical Research Management), April 2006, 83pp., 1 table, 4 figures, bibliography, 12 titles. The emergence of new technology in the form of Electronic Data Capture (EDC) for clinical trials has the potential to overcome the inefficiencies of Traditional Paper Data Capture. However, due to the novelty of Electronic Data Capture Systems in the marketplace, several issues have to be worked out to insure that these systems will be successfully adapted. Among these issues are those concerning personnel training, infrastructure reliability, FDA involvement, and pharmaceutical company acceptance of EDC systems. The emphasis of my clinical research management internship focused on gathering survey responses comparing the two systems in order to determine if the advertise efficiencies of EDC systems were valid.Item Coy, Marion E., D.O.(1981-01-01) Coy, Marion E.; Stokes, C. RayThe founding president of TCOM, Dr. Coy came to TCOM in March 1972 as dean and chief administrative officer. He graduated from Kirksville College of Osteopathic Medicine in 1938 and then served as a general practitioner in Jackson, Tenn., for the next 33 years. A past president of the American Osteopathic Association, Dr. Coy headed the college until it became a state-supported institution in September 1975. From 1975 until his retirement in 1983, he served as professor of osteopathic philosophy, principles, and practice. Interviewed by C. Ray Stokes, Spring and Summer 1981.Item Documentation of Preventive Medicine Practices in a University-Based Primary Care Clinic System: A Pilot Study(2001-05-01) Benavides, John Paul; Benavides, John Paul; Rene, Antonio A.; Marshall, Muriel A.Benavides, John P., Rene, Antonio A., Marshall Muriel A., Singh, Karan P. Documentation of Preventive Medicine Practices in a University-Based Primary Care Clinic System: A Pilot Study. The Significance of tracking preventive services is important when one considers the changing mortality patterns over the past century. Preventable sources of morbidity and mortality, highlighted by smoking and unhealthy nutritional and physical activity patterns, has resulted in over 700,000 deaths a year and provide examples for the need to optimize the delivery of primary prevention. The purpose of this study was to determine the delivery of preventive services in an osteopathic medicine-based university primary care system. Five family practice clinics affiliated with a university-based health science center participated. These clinics serve as ambulatory practice sites for faculty osteopathic physicians, physician assistants, and medical students. There were over 30,000 outpatient visits last year to the five family practice clinics. Differences in Preventive Flow Sheet documentation rates among the different clinics was noted. Female preventive flow sheet documentation was the most commonly performed, but cardiovascular risk assessment was the least documented. Females were also observed to have more preventive service documentation concerning alcohol use, abuse, and addiction.Item Emergency Department Visits and Hospitalizations for Ambulatory Care Sensitive Conditions Among Uninsured Hispanics(2005-05-01) Trevino, Elizabeth; Mains, Doug A.; Rene, Antonio; Gonzales, AdelaTrevino, Elizabeth., Emergency Department Visits and Hospitalizations for Ambulatory Care Sensitive Conditions among Uninsured Hispanics. Doctor of Public Health (Health Management and Policy), May 2005, 83 pp., 10 tables, bibliography, 87 titles. Inequalities in access to health care persist in the US health care delivery system and as the number of uninsured patients in the United States continues to increase, emergency departments around the country are becoming inundated with people seeking non-acute, as well as acute medical care. This study explored whether there are differences of emergency department use and hospitalizations for ambulatory care sensitive (ACS) conditions among uninsured Hispanics as compared to other ethnicities using 2001-2002 National Hospital Ambulatory Medical Care Survey (NHAMCS) data. A weighted sample of 4,210,248 emergency department visits for years 2001-2002 was analyzed using frequencies, Pearson x2 tests, logistic regression and multiple logistic regression to determine whether Hispanics and uninsured Hispanic were visiting the emergency department more frequently than any other ethnic group; uninsured Hispanics were being hospitalized due to the severity of the disease; and determine the significant predictors for preventable hospitalizations. Significant differences among the ethnicities studied and emergency department visits during 2001-2002 were found. These differences resulted in favor of African-American. African-American had larger rates of ED visits as compared to Whites and Hispanics. Uninsured African-American were also found as the racial/ethnic group with greater visits for emergency departments. These findings changed when assessing preventable hospitalizations for ACS conditions. A similar direction was found for Whites. Uninsured Hispanics were hospitalized more frequently in triage category less than 15 minutes, indicating the severity of the disease. Age, gender, race/ethnicity and insurance status were found to be significant predictors for preventable hospitalizations. This study revealed a substantial national problem with hospitalizations among uninsured Hispanics that may be prevented with timely and appropriate ambulatory care. The significant finding in this study strongly suggests that although this group did not visit the emergency department as frequently when compared to other ethnicities between 2001-2002, they are doing so when their condition deteriorates to the point to which a visit to the emergency room and hospitalization has become inevitable.Item Enhancing the Care of the Elderly; An Educational Intervention to Improve Nutritional Knowledge of Nursing Home Staff(1998-06-01) Cummings, Dana; Gilbert Ramirez; Claudia Coggin; Antonio ReneCummings, Dana M., Enhancing the Care of Elderly; an Educational Intervention to Improve Nutritional Knowledge of Nursing Home Staff. Master of Public Health, June 1998, 81 p.p., 5 tables, bibliography, 15 titles. Gross deficiencies exist in the quality and quantity of health care personnel taking care of the aged (Hersch, 1989). Eighty to ninety percent of nursing home staff are untrained aides paid the minimum wage to care for one of the sickest and frailest populations in the United States (Patenaude, 1997). The purpose of this study was to determine if short term nutrition education, utilizing principles for adult learners, would result in knowledge improvement in nursing home staff. An interactive, participatory instructional model was implemented into an existing structure of regular staff inservices to answer this question. To test the effectiveness of the intervention a questionnaire was developed using items from previously validated instruments. Using three nursing homes in the Dallas-Fort Worth metroplex, a total of 157 pre-test and 132 post-test questionnaires were completed. A significant increase in overall knowledge from 80.6% at baseline to 96.1% at post-test was found (p [less than] .001). Participants also showed a significant (p [less than] 0.001) overall increase in knowledge for each of the three learning domains; patient care related to nutrition, food and fluid intake of residents, and eating. These findings suggest that employing short-term education to nursing home staff, using principles for adult learners, can improve nutritional knowledge significantly.Item Epidemiological Modeling of a Bioterrorism Event in a Noncombat Environment(1999-07-01) Perkins, Christopher J.; Antonio Rene; Mains; Gilbert RamirezPerkins, Christopher J., Epidemiological Modeling of a Bioterrorism Event in a Noncombat Environment. Master of Public Health (Biomedical Sciences), July, 1999, 60 pp., 8 tables, 4 illustrations, references, 31 titles. The challenge to government, medical and public health officials is to advocate for American citizens the safest environment possible to live and work. A threat to the safety of all Americans has initiated preparations from national, state, and local jurisdictions in an attempt to counter the probability of biological terrorism. Bioterrorism is not only a threat to humans but also a threat to the nation’s water and food supplies. Epidemiological Modeling of a Bioterrorism Event demonstrates the importance in preparations to reduce the number of casualties and fatalities. Using Epidemiological Modeling of bioterrorism events will aid public health and medical personnel in the planning and initiation of appropriate public health actions and medical therapies should such events occur.Item Evaluation of a Hospital Decontamination Protocol for Mass Casualty Patient Surge(2007-05-01) Hood, Joyce L.; Gratton, Terry; Ramphal, Lilly; Larranaga, MichaelHood, Joyce L., Evaluation of a Hospital Decontamination Protocol for Mass Casualty Patient Surge. Master of Public Health (Occupational Health Practice), May 2007, 43 pp., 3 tables, 10 illustrations, references, 25 titles. Recent studies have expressed concern about hospitals’ ability to decontaminate casualties who have been contaminated with chemical, biological or radioactive agents. Since September 11, 2001, more attention has focused on hospital preparedness, but prior to 9/11, most of the focus was on decontamination in the field rather than pre-hospital. The objective of this study was to evaluate the effectiveness of two urban hospitals’ decontamination teams using quantitative methods. Subjects were contaminated with equal amounts of visible and invisible simulants in six locations. Residual contamination was measured and the team was debriefed regarding opportunities for improvement. Considerable improvements were noted after de-briefing, but initially the surface area of contamination was not appreciably affected before briefing was done. The effect of shower time and residual contamination was also examined. Hospital decontamination preparedness is minimal at best, even in large urban hospitals, increasing the risk of secondary contamination within the emergency departments.Item Evaluation of the Systematic Clinical Trials Protocol Approval Process at a Matrix Cancer Center(2007-11-01) Bloomer, Tyler; Patricia Gwirtz; Rusty Reeves; Lynn BakerThe National Cancer Institute (NCI) estimates that approximately 555,550 people die of cancer each year in the United States. This is an average of a little more than 1,500 people per days and ranks cancer as the second leading cause of death behind heart disease. In 2007, an astonishing 1,444,920 new cancer cases are anticipated to be diagnosed. It is through scientific research and the necessary employment of clinical trials that advanced are made to fight this dreadful disease. A breakthrough or advancement made in the treatment of cancer begins with basic research of cells and tissues in the laboratory. Once a particular treatment or technique is developed, and proven to be successful in animal models, it can then be evaluated in people through clinical trials. Clinical trials follow a rigorous scientific process to answer specific questions relating to the new newly developed therapy or technique. A clinical trial is the only mechanism to determine the true effectiveness of a promising new therapeutic being investigated. Thus, any unnecessary delays in approving a clinical trial protocol increases the time before that trial can begin enrolling patients and therefore gain approval for new treatment options. The International Conference of Harmonization Good Clinical Practice (ICH GCP) guidance document defines a protocol as “a document that describes the objective(s), design, methodology, statistical considerations, and organization of a trial.” The ICH GCP further goes on to describe that the protocol gives the rationale and background for a trial. The World Health Organization’s (WHO) Handbook for Good Clinical Research Practice states that “the study protocol is the core document communicating trial requirements to all parties who have responsibility to all parties who have responsibility for approval, conduct, oversight, and analysis of the research.” Thus, before any trial can begin accruing patients, its protocol, along with a study’s informed consent, must be thoroughly reviewed and approved by a network of entities to ensure that a study’s protocol outlines a trial that is safe and effective. A recent study conducted at the Vanderbilt-Ingram Cancer Center (VICC) and at a VICC Affiliate Network (VICCAN) sites indicated that two particular processes took longer than all others involved in their clinical trial protocol approval process. These two particular processes were the Scientific Review Committee review process and the Contracts and Grants approval process. This was contrary to what the authors expected, in that, they believed the IRB review and approval process would take the longest. Many of the challenges reported by the authors of the study at the VICC parallel those encountered in the protocol approval process at UT Southwestern. A closer examination of these parameters is needed. The Harold C. Simmons Comprehensive Cancer Center (SCCC) at UT Southwestern Medical Center is a matrix cancer center and relies upon the interactions between other institutions and departments to conduct all phases of its cancer research. Thus, the process involved in approving a clinical trial protocol also rely upon the interactions between other institutions and departments. This is where many challenges and various institutional administrative barriers arise. Therefore, it is the goal of this practicum report to formally evaluate and document the protocol approval process at the SCCC at UT Southwestern. The report will also identify unwarranted time delays in the process and provide feasible resolutions to expediting the overall clinical trial protocol approval process without compromising patient safety or research integrity. At the cessation of this report, a further analysis may be conducted using its findings to determine whether or not these time delays in the process and provide feasible resolutions to expediting the overall clinical trial protocol approval process without compromising patient safety or research integrity. At the cessation of this report, a further analysis may be conducted using its findings to determine whether or not these time delays in approving a study protocol are consistent with approval processes encountered at other institutions and academic health center settings like the Vanderbilt-Ingram Cancer Center and the Simmons Comprehensive Cancer Center.
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