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Clinical & Translational Research In Pneumonia: Defining A Research Agenda For Today And Tomorrow, Julio A. Ramirez 2017 University of Louisville

Clinical & Translational Research In Pneumonia: Defining A Research Agenda For Today And Tomorrow, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

From the Editor in Chief

The reason for this special supplement of the Journal is to inform readers of a scientific research conference supported by the National Institutes of Health (NHI). The NIH Research Conference Grant (R13) supports high quality scientific conferences in areas that are important to the NIH's mission and to the public health. We just received notification that the National Heart, Lung, and Blood Institute (NHLBI) has approved the application for an international research conference entitled: DzClinical & Translational Research in Pneumonia: Defining a Research Agenda for Today and Tomorrowdz. The conference will be held on Wednesday ...


Mobile Health Interventions For Adult Obesity In The United States: Analysis Of Effectiveness And Efficacy, David P. Paul III, Keerthi Gochipathala, Alberto Coustasse, Bezawit Wodajo, Niharika Bhardwaj 2017 Marshall University

Mobile Health Interventions For Adult Obesity In The United States: Analysis Of Effectiveness And Efficacy, David P. Paul Iii, Keerthi Gochipathala, Alberto Coustasse, Bezawit Wodajo, Niharika Bhardwaj

Alberto Coustasse

The Unites States continues to struggle with the negative health effects associated with increasing population obesity, a problem which has been historically difficult, if not impossible, to solve. Mobile health applications represent a potential partial solution to this problem. We examine the existing literature on the effects of mobile health applications on body weight, waist circumference, BMI, and lifestyle, examining both physical findings as well as adherence, satisfaction and cost effectiveness. The use of mobile for weight reduction looks promising, but evidence is mixed, which is not surprising given the rapidly evolving nature of the mobile application field.


Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor 2017 University of Massachusetts Medical School

Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor

Lawrence D. Garber

BACKGROUND: Clinical decision support (CDS), including computerized reminders for providers and patients, can improve health outcomes. CDS promoting influenza vaccination, delivered directly to patients via an electronic health record (EHR) patient portal and interactive voice recognition (IVR) calls, offers an innovative approach to improving patient care. OBJECTIVE: To test the effectiveness of an EHR patient portal and IVR outreach to improve rates of influenza vaccination in a large multispecialty group practice in central Massachusetts. METHODS: We describe a nonblinded, randomized controlled trial of EHR patient portal messages and IVR calls designed to promote influenza vaccination. In our preparatory phase, we ...


Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor 2017 University of Massachusetts Medical School

Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor

Kathleen M. Mazor

BACKGROUND: Clinical decision support (CDS), including computerized reminders for providers and patients, can improve health outcomes. CDS promoting influenza vaccination, delivered directly to patients via an electronic health record (EHR) patient portal and interactive voice recognition (IVR) calls, offers an innovative approach to improving patient care.

OBJECTIVE: To test the effectiveness of an EHR patient portal and IVR outreach to improve rates of influenza vaccination in a large multispecialty group practice in central Massachusetts.

METHODS: We describe a nonblinded, randomized controlled trial of EHR patient portal messages and IVR calls designed to promote influenza vaccination. In our preparatory phase, we ...


Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor 2017 University of Massachusetts Medical School

Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor

Sarah L. Cutrona

BACKGROUND: Clinical decision support (CDS), including computerized reminders for providers and patients, can improve health outcomes. CDS promoting influenza vaccination, delivered directly to patients via an electronic health record (EHR) patient portal and interactive voice recognition (IVR) calls, offers an innovative approach to improving patient care.

OBJECTIVE: To test the effectiveness of an EHR patient portal and IVR outreach to improve rates of influenza vaccination in a large multispecialty group practice in central Massachusetts.

METHODS: We describe a nonblinded, randomized controlled trial of EHR patient portal messages and IVR calls designed to promote influenza vaccination. In our preparatory phase, we ...


Improving The Use Of Electronic Medical Records In Primary Health Care: A Systematic Review And Meta-Analysis, Noura Hamade 2017 The University of Western Ontario

Improving The Use Of Electronic Medical Records In Primary Health Care: A Systematic Review And Meta-Analysis, Noura Hamade

Electronic Thesis and Dissertation Repository

Electronic Medical Records were first introduced in the 1970s to organize patient information, improve coordination of care, and improve communication. The purpose of this systematic review was to identify interventions aimed at improving EMR use in primary health care settings. Of 2,098 identified studies twelve were included in the review. Results showed that interventions focused on the use of EMR functions were five times more likely to show improvements in EMR use compared to controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared to controls. Individuals in ...


Medical Student And Hospital Team Fight Cervical Cancer In Rural China, Haley Newman 2017 University of Massachusetts Medical School

Medical Student And Hospital Team Fight Cervical Cancer In Rural China, Haley Newman

Senior Scholars Program

Blog post for the Gynius company website describing Newman's Senior Scholars project. She is evaluating portable colposcopy for cervical cancer screening in rural China.


Sustained Use Of Patient Portal Features And Improvements In Diabetes Physiological Measures, Stephanie L. Shimada, Jeroan J. Allison, Amy K. Rosen, Hua Feng, Thomas K. Houston 2017 University of Massachusetts Medical School

Sustained Use Of Patient Portal Features And Improvements In Diabetes Physiological Measures, Stephanie L. Shimada, Jeroan J. Allison, Amy K. Rosen, Hua Feng, Thomas K. Houston

Jeroan J. Allison

BACKGROUND: Personal health records (PHRs) have the potential to improve patient self-management for chronic conditions such as diabetes. However, evidence is mixed as to whether there is an association between PHR use and improved health outcomes.

OBJECTIVE: The aim of this study was to evaluate the association between sustained use of specific patient portal features (Web-based prescription refill and secure messaging-SM) and physiological measures important for the management of type 2 diabetes.

METHODS: Using a retrospective cohort design, including Veterans with diabetes registered for the My Health e Vet patient portal who had not yet used the Web-based refill or ...


Why A New Journal?, Julio A. Ramirez 2017 University of Louisville Division of Infectious Diseases, Louisville, KY

Why A New Journal?, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

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Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez 2017 University of Louisville, Louisville, KY

Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Time to clinical stability is a well-defined early clinical outcome in hospitalized patients with community-acquired pneumonia, but it has not been evaluated in patients with ventilator-associated pneumonia (VAP). The objective of this study was to compare time to clinical stability in patients with MRSA VAP treated with linezolid versus vancomycin.

Methods: This was a secondary analysis of the IMPACT-HAP study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. A patient was considered to reach clinical stability the day that the following four criteria were ...


Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon 2017 Providence Hospital, Washington, DC

Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes included ...


A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin 2017 University of Louisville, Louisville, KY

A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin

The University of Louisville Journal of Respiratory Infections

Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority ...


Patient Portal As A Tool For Enhancing Patient Experience And Improving Quality Of Care In Primary Care Practices, Barbara Sorondo MD MBA, Amy Allen DPT, Samreen Fathima BDS MPH, Janet Bayleran, PhD, Iyad Sabbagh MD MBA 2017 Eastern Maine Medical Center

Patient Portal As A Tool For Enhancing Patient Experience And Improving Quality Of Care In Primary Care Practices, Barbara Sorondo Md Mba, Amy Allen Dpt, Samreen Fathima Bds Mph, Janet Bayleran, Phd, Iyad Sabbagh Md Mba

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: This study assessed whether patient portals influence patients’ ability for self-management, improve their perception of health state, improve their experience with primary care practices, and reduce healthcare utilization.

Methods: Patients participating in a nurse-led care coordination program received personalized training to use the portal to communicate with the care team. Data analysis included pre-post comparison of self-efficacy (CDSES), health state (EQVAS), functional status (PROMIS®), experience with the provider/practice (CG-CAHPS), and healthcare utilization (admissions and ED visits).

Results: A total of 94 patients were enrolled, and 92 (Intent to Treat) were followed up for 7 months to assess their ...


High Burden Of Unrecognized Atrial Fibrillation In Rural India: An Innovative Community-Based Cross-Sectional Screening Program, Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael S. Chin, John Stephen Sullivan, Shyamsundar Raithatha, Robert J. Goldberg, Somashekhar Nimbalkar, Jeroan J. Allison, Sunil Thanvi, David D. McManus 2017 University of Massachusetts Medical School

High Burden Of Unrecognized Atrial Fibrillation In Rural India: An Innovative Community-Based Cross-Sectional Screening Program, Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael S. Chin, John Stephen Sullivan, Shyamsundar Raithatha, Robert J. Goldberg, Somashekhar Nimbalkar, Jeroan J. Allison, Sunil Thanvi, David D. Mcmanus

David D. McManus

BACKGROUND: Atrial fibrillation, the world's most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly. OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor. METHODS: Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent ...


Physician Service Attribution Methods For Examining Provision Of Low-Value Care, Eva Chang PhD, MPH, Diana SM Buist PhD, MPH, Matthew Handley MD, Roy Pardee JD, MA, Gabrielle Gundersen MPH, Robert J. Reid MD, PhD 2017 echang@rti.org

Physician Service Attribution Methods For Examining Provision Of Low-Value Care, Eva Chang Phd, Mph, Diana Sm Buist Phd, Mph, Matthew Handley Md, Roy Pardee Jd, Ma, Gabrielle Gundersen Mph, Robert J. Reid Md, Phd

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Objectives: There has been significant research on provider attribution for quality and cost. Low-value care is an area of heightened focus, with little of the focus being on measurement; a key methodological decision is how to attribute delivered services and procedures. We illustrate the difference in relative and absolute physician- and panel-attributed services and procedures using overuse in cervical cancer screening.

Study Design: A retrospective, cross-sectional study in an integrated health care system.

Methods: We used 2013 physician-level data from Group Health Cooperative to calculate two utilization attributions: (1) panel attribution with the procedure assigned to the physician’s predetermined ...


Digital Pills To Measure Opioid Ingestion Patterns In Emergency Department Patients With Acute Fracture Pain: A Pilot Study, Peter R. Chai, Stephanie Carreiro, Brendan J. Innes, Rochelle K. Rosen, Conall O'Cleirigh, Kenneth Mayer, Edward W. Boyer 2017 Brigham and Women's Hospital

Digital Pills To Measure Opioid Ingestion Patterns In Emergency Department Patients With Acute Fracture Pain: A Pilot Study, Peter R. Chai, Stephanie Carreiro, Brendan J. Innes, Rochelle K. Rosen, Conall O'Cleirigh, Kenneth Mayer, Edward W. Boyer

UMass Center for Clinical and Translational Science Supported Publications

BACKGROUND: Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy.

OBJECTIVE: The purpose of this study was to determine the feasibility of a ...


The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im 2016 Duke University

The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im

Asian/Pacific Island Nursing Journal

The benefits of physical activities on depressive symptoms have increasingly been reported in the literature, but the effect through which a Web-based physical activity promotion program alleviates depressive symptoms is not clearly known, especially among ethnic minority midlife women. The purpose of this pilot randomized control study is to examine the preliminary efficacy of the Web-based physical activity promotion program in enhancing the depressive symptoms of Asian American midlife women through increasing physical activity. This study adopted a randomized repeated measures pretest/posttest control group design. This study consisted of two groups of research participants: 18 in an intervention group ...


Technology Highlights Healthcare Informatics Capstone Event, Christina B. Gunther 2016 Selected Works

Technology Highlights Healthcare Informatics Capstone Event, Christina B. Gunther

Christina B. Gunther

Health-care technology was in the spotlight recently at Sacred Heart University when eight graduate students in the College of Health Professions presented their health-care informatics capstone poster projects. The projects were assessed by These were assessed by Professor Christina Gunther, who leads the healthcare informatics capstone course; Stephen Burrows, chair of the Health Science & Leadership Program; and Patricia Walker, dean of the College of Health Professions.


Implementation Of A Computerized Screening Inventory: Improved Usability Through Iterative Testing And Modification, Edwin D. Boudreaux, Andrew Christopher Fischer, Brianna Haskins, Zubair Saeed Zafar, Guanling Chen, Sneha A. Chinai 2016 University of Massachusetts Medical School

Implementation Of A Computerized Screening Inventory: Improved Usability Through Iterative Testing And Modification, Edwin D. Boudreaux, Andrew Christopher Fischer, Brianna Haskins, Zubair Saeed Zafar, Guanling Chen, Sneha A. Chinai

Edwin D. Boudreaux

BACKGROUND: The administration of health screeners in a hospital setting has traditionally required (1) clinicians to ask questions and log answers, which can be time consuming and susceptible to error, or (2) patients to complete paper-and-pencil surveys, which require third-party entry of information into the electronic health record and can be vulnerable to error and misinterpretation. A highly promising method that avoids these limitations and bypasses third-party interpretation is direct entry via a computerized inventory.

OBJECTIVE: To (1) computerize medical and behavioral health screening for use in general medical settings, (2) optimize patient acceptability and feasibility through iterative usability testing ...


Health Communication, It And The Public’S Attitude Toward Periodic Ghe, Quan-Hoang Vuong 2016 Universite Libre de Bruxelles

Health Communication, It And The Public’S Attitude Toward Periodic Ghe, Quan-Hoang Vuong

Quan-Hoang Vuong

Periodic general health examinations (GHEs) are gradually becoming more popular as they employ
subclinical screenings as a means of early detection. This study considers the effect of information
technology (IT), health communications and the public’s attitude towards GHEs in Vietnam. A total of
2,068 valid observations were obtained from a survey in Hanoi and its surrounding areas, out of which
42.12% said they were willing to use IT applications to recognise illness symptoms, nearly 2/3 of them
rated the healthcare quality at average level or below. The data, which is processed by the BCL model,
has ...


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