University Of Missouri-Kansas City Research Articles

Clean intermittent catheterisation determinants and caregiver adherence in paediatric patients with spinal dysraphism and spinal cord injury in a paediatric spinal differences clinic: a mixed methods study protocol

IntroductionClean intermittent catheterisation (CIC) is the standard of care for treating neurogenic lower urinary tract dysfunction (NLUTD), the most common bladder dysfunction in children diagnosed with spinal dysraphism (SD) and...

Supporting underrepresented students in health sciences: a fuzzy cognitive mapping approach to program evaluation

BackgroundThe Students Training in Academia, Health, and Research (STAHR) Program at the University of Missouri-Kansas City (UMKC) strives to help students from low-income families that have experienced educational challenges due to poverty and prepare them to enter, persist, and graduate from a health sciences degree program at UMKC. Students in the program participated in fuzzy cognitive mapping (FCM) sessions to ensure that all voices of the program were heard to improve program implementation, and student success, and contribute to an equitable educational environment.MethodsFuzzy Cognitive Mapping sessions for the 2020–2021 cohort of students (n = 52) were conducted to assess the strengths and weaknesses in program implementation, especially through the beginning of the COVID-19 pandemic. Students’ maps were coded by a team of researchers and then confirmed using confirmatory factor analysis.ResultsStatistical analyses reveal that mentorship, workshops, and social support helped students to work toward their goal of obtaining a professional health sciences degree, while a lack of time, remote learning, and outside stressors inhibited their opportunities for success.ConclusionsThe findings from a multipronged analysis of mapping data demonstrate the value of this innovative approach to the field, especially when looking to incorporate student voices.

Cranio-cervical abnormalities in moderate-to-severe osteogenesis imperfecta - Genotypic and phenotypic determinants.

Cranio-cervical anomalies are significant complications of osteogenesis imperfecta (OI), a rare bone fragility disorder that is usually caused by mutations in collagen type I encoding genes. To assess cranio-cervical anomalies and associated clinical findings in patients with moderate-to-severe OI using 3D cone beam computed tomography (CBCT) scans. Cross-sectional analysis of CBCT scans in 52 individuals with OI (age 10-37 years; 32 females) and 40 healthy controls (age 10-32 years; 26 females). Individuals with a diagnosis of OI type III (severe, n = 11), type IV (moderate, n = 33) and non-collagen OI (n = 8) were recruited through the Brittle Bone Disorders Consortium. Controls were recruited through the orthodontic clinic of the University of Missouri-Kansas City (UMKC). OI and control groups were similar in mean age (OI: 18.4 [SD: 7.2] years, controls: 18.1 [SD: 6.3] years). The cranial base angle was increased in the OI group (OI: mean 148.6° [SD: 19.3], controls: mean 130.4° [SD: 5.7], P = .001), indicating a flatter cranial base. Protrusion of the odontoid process into the foramen magnum (n = 7, 14%) and abnormally located odontoid process (n = 19, 37%) were observed in the OI group but not in controls. Low stature, expressed as height z-score (P = .01), presence of DI (P = .04) and being male (P = .04) were strong predictors of platybasia, whereas height z-score (P = .049) alone was found as positive predictor for basilar impression as per the Chamberlain measurement. The severity of the phenotype in OI, as expressed by the height z-score, correlates with the severity of cranial base anomalies such as platybasia and basilar impression in moderate-to-severe OI. Screening for cranial base anomalies is advisable in individuals with moderate-to-severe OI, with special regards to the individuals with a shorter stature and DI.

Target Aortic Stenosis: A National Initiative to Improve Quality of Care and Outcomes for Patients With Aortic Stenosis.

Target Aortic Stenosis: A National Initiative to Improve Quality of Care and Outcomes for Patients With Aortic Stenosis.

University of Missouri Kansas City: A Step Toward Data Disaggregation and Gap Analyses for the Assessment of Student Learning Outcomes Faculty Fellows Program

Assessment UpdateVolume 35, Issue 3 p. 6-14 Article University of Missouri Kansas City: A Step Toward Data Disaggregation and Gap Analyses for the Assessment of Student Learning Outcomes Faculty Fellows Program Billie Anderson, Billie AndersonSearch for more papers by this authorDea Marx, Dea MarxSearch for more papers by this authorKim McNeley, Kim McNeleySearch for more papers by this authorDiane L. Filion, Diane L. FilionSearch for more papers by this authorKelline S. Cox, Kelline S. CoxSearch for more papers by this author Billie Anderson, Billie AndersonSearch for more papers by this authorDea Marx, Dea MarxSearch for more papers by this authorKim McNeley, Kim McNeleySearch for more papers by this authorDiane L. Filion, Diane L. FilionSearch for more papers by this authorKelline S. Cox, Kelline S. CoxSearch for more papers by this author First published: 29 May 2023 https://doi.org/10.1002/au.30347Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References Field, A., Miles J., and Z. Field. 2014. Discovering Statistics Using R. SAGE Publications. Knaflic, C. N. 2015. Storytelling with Data: A Data Visualization Guide for Business Professionals. John Wiley and Sons, Inc. Montenegro, E., and N. A. Jankowski. 2017. Equity and Assessment: Moving Towards Culturally Responsive Assessment. (Occasional Paper No. 29.) Urbana Illinois: University of Illinois and Indiana University, National Institute for Learning Outcomes Assessment. Volume35, Issue3May/June 2023Pages 6-14 ReferencesRelatedInformation

Assessing the effectiveness of a collaborative educational initiative engaging different learners.

Journal of Dental EducationAccepted Articles ADVANCING THROUGH INNOVATION Assessing the effectiveness of a collaborative educational initiative engaging different learners Chih-Yun Tao DDSMS, Corresponding Author Chih-Yun Tao DDSMS [email protected] Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Kansas City, MO, USA Correspondence Dr. Chih-Yun Tao, Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Room 3113, 650 E 25th Street, Kansas City – MO, 64108, United States. Email: [email protected]Search for more papers by this authorKeerthana Satheesh DDSMSFACD, Keerthana Satheesh DDSMSFACD Associate Professor and Chair of Periodontology, University of Missouri Kansas City, Kansas City, MO, USASearch for more papers by this authorRobert A. Levine DDS, Robert A. Levine DDS Clinical Professor in Periodontology & Implantology, Kornberg School of Dentistry at Temple University, Philadelphia, PA, USASearch for more papers by this authorIrina F. Dragan DDSDMDMS, Irina F. Dragan DDSDMDMS orcid.org/0000-0002-4045-8564 Adjunct Associate Professor of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USASearch for more papers by this author Chih-Yun Tao DDSMS, Corresponding Author Chih-Yun Tao DDSMS [email protected] Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Kansas City, MO, USA Correspondence Dr. Chih-Yun Tao, Assistant Clinical Professor of Periodontology, University of Missouri Kansas City, Room 3113, 650 E 25th Street, Kansas City – MO, 64108, United States. Email: [email protected]Search for more papers by this authorKeerthana Satheesh DDSMSFACD, Keerthana Satheesh DDSMSFACD Associate Professor and Chair of Periodontology, University of Missouri Kansas City, Kansas City, MO, USASearch for more papers by this authorRobert A. Levine DDS, Robert A. Levine DDS Clinical Professor in Periodontology & Implantology, Kornberg School of Dentistry at Temple University, Philadelphia, PA, USASearch for more papers by this authorIrina F. Dragan DDSDMDMS, Irina F. Dragan DDSDMDMS orcid.org/0000-0002-4045-8564 Adjunct Associate Professor of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USASearch for more papers by this author First published: 02 April 2023 https://doi.org/10.1002/jdd.13213 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as https://doi.org/10.1002/jdd.13213 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Accepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset version of record will appear in the future. RelatedInformation

Chen Yi by Leta E. Miller and J. Michele Edwards

Reviewed by: Chen Yi by Leta E. Miller and J. Michele Edwards Peng Liu Chen Yi. By Leta E. Miller and J. Michele Edwards. (Women Composers.) Urbana: University of Illinois Press, 2020. [264 p. ISBN 9780252043543 (hardback), $110; ISBN 9780252085444 (paperback), $28; ISBN 9780252052422 (e-book), price varies.] Glossary, list of works, notes, references, index. Writing a book about the life and music of Chinese American composer Chen Yi is not a simple task, largely because of the composer’s intercultural and transnational life experiences and the musical amalgamation instantiated in her over 150 compositions. Succeeding in such a task requires scholars to possess not only an extensive analytical knowledge of two seemingly divergent musical systems—modern Western compositional techniques and traditional Chinese musical genres and aesthetics—but also a deep understanding of the complicated political and cultural milieu that shapes Chen Yi’s identity. Therefore, the publication of Chen Yi, an illuminating book by American scholars Leta E. Miller and J. Michele Edwards, is by no means a small accomplishment. As the fifth and latest volume in the Women Composers series published by the University of Illinois Press—as well as the only one featuring a non-White composer so far—Chen Yi presents a captivating narrative of the composer’s career and highlights her unique musical identity through concise and insightful readings of nearly thirty selected works. Though lim -ited in its scope due to the series’s general goal of providing “short, readable books about women composers,” Miller and Edwards’s examination of Chen Yi’s life journey and compositional strategies is quite informative and revealing, drawing on current scholarship, the authors’ own research and analysis, and their extensive interviews with Chen Yi, conducted in 2015 and 2016. As an overview of the composer’s music, Chen Yi naturally devotes the majority of its content to an analysis of Chen’s works, bookended by a biographical chapter and a concluding chapter on the political and social issues that influence Chen Yi and her music. In their chronological discussion of Chen Yi’s life in chapter 2, Miller and Edwards place the composer’s unusual musical journey within the broader contexts of history, politics, and pivotal [End Page 230] musical institutions. As the authors note, Chen Yi’s early musical training was almost exclusively Eurocentric until Mao’s “down-to-the-countryside” mandate during the Cultural Revolution, when she was relocated to a small village and had chances to play “revolutionary tunes . . . adapted from folk material” and “embellish the simple tunes with ornamentation” (pp. 14–15). Her taste for traditional Chinese music was further enriched while playing violin in the orchestra of the Guangzhou Beijing Opera Troupe for yangbanxi (“model operas,” or modernized Beijing operas with new plots, character development, staging, and instrumental accompaniment) from 1970 to 1978. Chen Yi not only learned some Chinese instruments, like pipa, jinghu, and ruan, but also gained serious compositional experience by writing music for the opera troupe’s orchestra. Following the end of the Cultural Revolution, Chen Yi received professional training as a composer in two institutions: the Central Conservatory of Music in Beijing (1978–86) and Columbia University in New York City (1986–93). While the former provided Chen Yi a solid foundation in Western compositional techniques and exposure to various types of traditional Chinese music, the latter expanded her knowledge and reinforced her musical identity under the particular influence of Chou Wen-chung’s wenren (ancient Chinese philosopher-artist) spirit. After her doctoral studies at Columbia, Chen Yi’s career as an international composer was officially on the rise, from her three-year residency at the Women’s Philharmonic, where she first became aware of gender inequity in her field, to a transitional period at the Peabody Conservatory, and finally to a tenured position as professor at the University of Missouri–Kansas City (UMKC), which she has held since 1998. Rather than giving a prose narrative of Chen Yi’s career since her appointment at UMKC, the authors choose to highlight selected honors, awards, commissions, and major performances at the end of the chapter. This four-page list only heightens admiration for Chen Yi’s remarkable artistic accomplishments and...

Suture Compared With Staples for Skin Closure After Cesarean Delivery: A Systematic Review and Meta-analysis.

Department of Obstetrics & Gynecology, University of Missouri-Kansas City, Kansas City, Missouri Department of Obstetrics & Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee Guidelines for Letters. Letters posing a question or challenge to an article appearing in Obstetrics & Gynecology should be submitted within 8 weeks of the article’s publication online. Letters received after 8 weeks will rarely be considered. Letters should not exceed 350 words, including signatures and 5 references. Letters will be published at the discretion of the Editor. The Editor may send the letter to the authors of the original paper so their comments may be published simultaneously. The Editor reserves the right to edit and shorten letters. Letters should be submitted using the Obstetrics & Gynecology online submission and review system, Editorial Manager (http://ong.edmgr.com). Financial Disclosure The authors did not report any potential conflicts of interest.

2022 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration With the American Academy of Pediatrics, American Association for Respiratory Care, the Society

2022 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration With the American Academy of Pediatrics, American Association for Respiratory Care, the Society

Creating Training for Embedded Librarians

ABSTRACT Embedded librarianship can give librarians direct impact on student success in a clinical setting, but there is not a prescribed method for training new librarians to work in this environment. The first of its kind Clinical Medical Librarian program at the University of Missouri Kansas City has embedded librarians into clinical instruction for decades, and has created a set of materials, protocol and templates that can be used to integrate a new hire into the position.

Social Media Disinformation Bots May Harm Psychiatry

Social Media Disinformation Bots May Harm Psychiatry

Altered Mental Status in a 5-year-old Girl

1. Tara M. Kopp, MD, MS* 2. Jacob M. Redel, MD†,‡ 3. Holly E. Depinet, MD, MPH§,¶ 1. *Department of Pediatrics, University of Louisville, Louisville, KY 2. †Division of Endocrinology, Children’s Mercy Hospital, Kansas City, MO 3. ‡Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO 4. §Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 5. ¶Department of Pediatric, College of Medicine, University of Cincinnati, Cincinnati, OH A 5-year-old fully immunized girl with a history of tuberous sclerosis, localization-related epilepsy with remote resection of a seizure focus, developmental delay, oral aversion with gastrostomy tube dependence, and necrotizing pancreatitis presents with reported episodes of gait instability and altered mental status described as her head falling down, sudden diffuse loss of muscle tone, and unresponsiveness lasting 15 to 45 seconds. During the past few hours, the mother has noticed that the child appears wobbly. She had 1 episode of wobbliness with subsequent fall but denies any head injury, loss of consciousness, or tonic-clonic movements. On presentation to the emergency department she had 2 additional episodes of hypotonia and unresponsiveness to verbal stimuli lasting less than 1 minute. She had not recently missed any of her antiepileptic medications, which included levetiracetam, perampanel, vigabatrin, and taurine. In addition, her medications had not been changed in the past 6 months. Due to her oral aversion, her mother assures us that she would not have accidentally ingested any medications or other household substances. Initial temporal temperature is 98.2°F (36.8°C), heart rate is 124 beats/min, blood pressure is 107/77 mm Hg, respiratory rate is 24 breaths/min, and oxygen saturation is 96% on room air. Physical examination reveals a wakeful crying girl fighting medical personnel and intermittently becoming hypotonic and unresponsive to verbal commands. Mucous membranes are moist, and extremities have brisk capillary refill. Respiratory effort is normal except for episodes of periodic shallow breathing. Pupils are midline and reactive but become dilated with minimal responsiveness during the episodes of hypotonia and unresponsiveness. Upper and lower extremity hypotonia is noted (with intermittent worsening during …

Guidance and Best Practices for Nuclear Cardiology Laboratories During the COVID-19 Pandemic: An Information Statement From ASNC and SNMMI.

Guidance and Best Practices for Nuclear Cardiology Laboratories During the COVID-19 Pandemic: An Information Statement From ASNC and SNMMI.

Knowledge Skill and Attitude among fresh dental graduates about orthodontics

Introduction: The field of orthodontics is an essential component of the bachelor in dental surgery program. As stated by the American Association of Orthodontics, it is defined as an area of dentistry that deals with diagnostics, prevention, interceptions, and correcting the relationships between mature or developing orofacial structures. The goals of orthodontic therapy are to improve the aesthetics of a person of which a very important component is the smile, obtain the normal or close to normal occlusion, and establish normal oral function. Due to a growing esthetic awareness among the general population orthodontics is gaining popularity as a profession. Hence dentists need to be trained well in this field to cater to the growing needs of the general population.Objective: The objective of the survey was to find out whether the graduates that are being produced by the dental colleges of Pakistan are knowledgeable and skillful in the field of orthodontics or not.Methods: It was a quantitative descriptive survey carried out in 2018. The questionnaire was developed with the help of an orthodontic expert following the American, European, Canadian, and Australian competencies and piloted before being used for the actual research process. Students who had recently graduated were the target population. Informed consent was obtained from each student before handing them the questionnaire. 33 students in total participated in the study.Results:33 surveys were returned. The questionnaire was divided into knowledge, skills, and attitude portion. For the knowledge part, the majority of graduates felt underconfident and were felt they were not well versed theoretically. In the skills portion, the most common answers were either not confident or fairly confident revealing that students again did not have again enough confidence in their skills and the majority had done either very little or no patients in their final year. For the attitude section, the majority of students were not interested in taking orthodontic as their subject of post-graduation since they did not feel very confident about it.Conclusion: The results of the survey identified the lags in the final year BDS curriculum especially when it came to orthodontics. Serious consideration needs to be given to training students in the particular field so the dental graduates are confident and skilled in all fields of dentistry when they pass out.
 Keywords:
 Fresh dental graduate, Knowledge, Skill, Attitude

Survival After In-Hospital Cardiac Arrest in Critically Ill Patients: Implications for COVID-19 Outbreak?

The coronavirus disease 2019 (COVID-19) outbreak is placing a considerable strain on U.S. healthcare systems by requiring both significant acute resources and endangering healthcare team members th...

Media Review: The Owlet Smart Sock—a “must have” for the baby registry?

Citation:Malik A, Ehsan Z. Media Review: The Owlet Smart Sock—a “must have” for the baby registry? J Clin Sleep Med. 2020;16(5):839–840.

The 'Kansas City' Approach to Modern Money Theory

Modern money theory (MMT) synthesizes several traditions from heterodox economics. Its focus is on describing monetary and fiscal operations in nations that issue a sovereign currency. As such, it applies Georg Friedrich Knapp’s state money approach (chartalism), also adopted by John Maynard Keynes in his Treatise on Money. MMT emphasizes the difference between a sovereign currency issuer and a sovereign currency user with respect to issues such as fiscal and monetary policy space, ability to make all payments as they come due, credit worthiness, and insolvency. Following A. Mitchell Innes, however, MMT acknowledges some similarities between sovereign and non-sovereign issues of liabilities, and hence integrates a credit theory of money (or, “endogenous money theory,” as it is usually termed by post-Keynesians) with state money theory. MMT uses this integration in policy analysis to address issues such as exchange rate regimes, full employment policy, financial and economic stability, and the current challenges facing modern economies: rising inequality, climate change, aging of the population, tendency toward secular stagnation, and uneven development. This paper will focus on the development of the “Kansas City” approach to MMT at the University of Missouri–Kansas City (UMKC) and the Levy Economics Institute of Bard College.

Medical Leaders Identify Personal Characteristics and Experiences that Contribute to Leadership Success in Medicine.

This article was migrated. The article was marked as recommended. Introduction: The approach of medical educators to preparing learners for leadership reflects the emphasis leadership theories once placed on experiential learning. But, contemporary theories now also show a renewed interest in the role of personal characteristics in effective leadership. This shift raises questions explored here: What characteristics mark top medical leaders? What experiences nurture those characteristics? Method: In a 2015 qualitative study, 48 University of Missouri-Kansas City (UMKC) medical graduates who met criteria for outstanding leadership participated in semi-structured interviews. Investigators applied directed content-analysis to their responses. Then, using iterative open-coding, investigators identified personal characteristics leaders said contributed to their leadership, clustered them into types, and counted the number of leaders who spoke to each type. Next, they coded and categorized experiences leaders discussed and counted the number of leaders who mentioned each type of experience. Finally, they identified leaders' comments about which types of experiences helped develop which types of characteristics. Results: Most leadersmentioned four types of characteristics: openness to new ideas/opportunities/astute risk-taking; intense motivation/active involvement/commitment; people-orientation; and capability/competence/ intelligence. Many discussed two additional types: self-awareness and service-orientation. Leaders said these types of experiences nurtured their characteristics: family traditions, high-school co-curricular activities, participation in medical school learning communities plus interaction with role models/mentors and authentic opportunities to practice leadership, innovation, and excellence throughout their education and in the workplace. Conclusions: Medical leaders' views of the role of personal characteristics in outstanding leadership and the power of educational and workplace experiences, especially informal ones, to mold those characteristics have enriched understanding how to prepare tomorrow's leaders.

The Utilization of Screening Tests for Plasma Cell Dyscrasias By Internal Medicine Physicians at a Teaching Hospital

Background. Plasma cell Dyscrasias (PCD) are a spectrum of monoclonal gammopathies which result from proliferation of plasma cells that produce an immunologically homogeneous protein known as M-protein. PCDs include monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), multiple myeloma (MM), Waldenstrom's macroglobulinemia (WM), primary amyloidosis (AL), plasmacytoma, light chain deposition disease (LCDD) and POEMS syndrome. Screening for gammopathy is usually done by serum protein electrophoresis (SPEP) with immunofixation (IFE), serum free light chains (FLC) and urine protein electrophoresis (UPEP) with immunofixation. Except for low risk MGUS, early diagnosis can have a significant impact on the clinical outcome of PCD. Thus, accurate and timely screening for early diagnosis is crucial. In this study, we aim to evaluate the screening process for plasma cell dyscrasias in a teaching hospital by targeting internal medicine physicians including primary care physicians. Methods: We retrospectively reviewed charts of 2532 patients who had undergone PCD screening tests at Truman Medical Center (TMC), the primary teaching hospital for University of Missouri-Kansas City (UMKC). The studied data was from two blocks of time: 2011-2012 and 2017-2018. Only patients who were >18 years of age and who had any of these screening tests done for the very first time during the study period were included. Patients who had tests done outside of the study period or had prior similar testing or known diagnosis of PCD were excluded. Data was collected to assess if screening tests had been ordered appropriately by internal medicine physicians. Appropriate screening was defined as a screening that had SPEP along with IFE and FLC. We compared internal medicine physicians' utilization of these tests between two different time frames 1/1/2011-12/31/2012 versus 1/1/2017-12/31/2018. Results: A total of 2532 patients were reviewed. 1076 were included with a mean age of 57.4 years. Population demographic is detailed in Table 1. Most of the PCD screening tests were ordered in the outpatient setting (67%). The three most common indications for testing were workup of chronic kidney disease, abnormal serum protein levels and neuropathy (Figure 1). Outcomes of screening tests are shown in Figure 2. Majority of these tests were ordered by internal medicine physicians (42%) followed by nephrology (19%) and hematology-oncology services (10%). Internal medicine ordered 448 tests overall. During 2011-2012 they screened 211 patients. Out of these, 199 had SPEP, 19 had IFE, 68 had UPEP and 23 patients had FLC ordered on initial screening. Only 18 patients (8.5%) were screened appropriately. Between 2017-2018, a total of 237 patients were screened by internal medicine physicians. Among them 231 had SPEP, IFE was checked by automatic reflex (a new feature added by our lab in 2013) in 138 patients, UPEP was ordered 67 times and 48 patients had FLC checked with 45 patients (19%) screened appropriately. Conclusion : Screening for plasma cell dyscrasias is frequently done by physicians from specialties other than hematology-oncology. Ordering an appropriate set of tests including FLC in addition to SPEP with IFE is imperative at time of initial screening. Our study showed that internal medicine physicians order most of the intial testing for PCD, however they often miss incorporating FLC as part of their screening for PCD. This could potentially lead to missing some cases and delay in timely diagnosis. Although there has been improvement in ordering appropriate screening, but proper measures should be undertaken to increase the efficacy of screening for PCD. Disclosures No relevant conflicts of interest to declare.

Volunteering in Two Border Communities.

: Editor&s note: Patricia J. Kelly is a retired professor of nursing at the University of Missouri-Kansas City. In this report, she writes about her work and observations while volunteering at and visiting migrant shelters in Tucson, Arizona, where she lives, and San Diego, where she often travels to visit family.