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Changing The Standard Of Blood Management In Australia: An Overview, Alana Delaforce, Jed Duff, Nicholas Ralph 2018 Australian College of Perioperative Nurses (ACORN)

Changing The Standard Of Blood Management In Australia: An Overview, Alana Delaforce, Jed Duff, Nicholas Ralph

Journal of Perioperative Nursing

No abstract provided.


Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. McClure, Sarah Saleem 2018 Columbia University, New York, NY, USA.

Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem

Community Health Sciences

This paper reviews the very large discrepancies in pregnancy outcomes between high, low and middle-income countries and then presents the medical causes of maternal mortality, stillbirth and neonatal mortality in low-and middle-income countries. Next, we explore the medical interventions that were associated with the very rapid and very large declines in maternal, fetal and neonatal mortality rates in the last eight decades in high-income countries. The medical interventions likely to achieve similar declines in pregnancy-related mortality in low-income countries are considered. Finally, the quality of providers and the data to be collected necessary to achieve these reductions are discussed. It ...


Dynamical Properties Of Postural Control In Obese Community-Dwelling Older Adults, Christopher W. Frames, Rahul Soangra, Thurmon Lockhart, John Lach, Dong Sam Ha, Karen A. Roberto, Abraham Lieberman 2018 Arizona State University

Dynamical Properties Of Postural Control In Obese Community-Dwelling Older Adults, Christopher W. Frames, Rahul Soangra, Thurmon Lockhart, John Lach, Dong Sam Ha, Karen A. Roberto, Abraham Lieberman

Physical Therapy Faculty Articles and Research

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at ...


Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. McManus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg 2018 University of Massachusetts Medical School

Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. Mcmanus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg

Quantitative Health Sciences Publications and Presentations

BACKGROUND: Direct oral anticoagulants (DOACs) have emerged as promising alternatives to vitamin K antagonists (VKAs) for patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE). Few meta-analyses have included all DOACs that have received FDA approval for these cardiovascular indications, and their overall comparisons against VKAs have shortcomings in data and methods. We provide an updated overall assessment of the efficacy and safety of those DOACs at dosages currently approved for NVAF or VTE, in comparison with VKAs.

METHODS: We used data from Phase 3 randomized trials that compared an FDA-approved DOAC with VKA for primary prevention of stroke ...


The Aging Initiative Experience: A Call For Sustained Support For Team Science Networks, Tullika Garg, Kathryn Anzuoni, Valentina Landyn, Alexandra Hajduk, Stephen Waring, Leah R. Hanson, Heather E. Whitson 2018 Geisinger Health System, Danville, PA

The Aging Initiative Experience: A Call For Sustained Support For Team Science Networks, Tullika Garg, Kathryn Anzuoni, Valentina Landyn, Alexandra Hajduk, Stephen Waring, Leah R. Hanson, Heather E. Whitson

Open Access Articles

Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the ...


Insurance Coverage Policies For Pharmacogenomic And Multi-Gene Testing For Cancer, Christine Y. Lu, Stephanie Loomer, Rachel Ceccarelli, Kathleen M. Mazor, James Sabin, Ellen Wright Clayton, Geoffrey S. Ginsburg, Ann Chen Wu 2018 Harvard Medical School

Insurance Coverage Policies For Pharmacogenomic And Multi-Gene Testing For Cancer, Christine Y. Lu, Stephanie Loomer, Rachel Ceccarelli, Kathleen M. Mazor, James Sabin, Ellen Wright Clayton, Geoffrey S. Ginsburg, Ann Chen Wu

Open Access Articles

Insurance coverage policies are a major determinant of patient access to genomic tests. The objective of this study was to examine differences in coverage policies for guideline-recommended pharmacogenomic tests that inform cancer treatment. We analyzed coverage policies from eight Medicare contractors and 10 private payers for 23 biomarkers (e.g., HER2 and EGFR) and multi-gene tests. We extracted policy coverage and criteria, prior authorization requirements, and an evidence basis for coverage. We reviewed professional society guidelines and their recommendations for use of pharmacogenomic tests. Coverage for KRAS, EGFR, and BRAF tests were common across Medicare contractors and private payers, but ...


A Cohort Study Of Public Health Insurance Coverage Loss Among Oregon Adolescents, Heather Angier MPH, Carrie Tillotson MPH, Lorraine Wallace PhD, Miguel Marino PhD, Jean O'Malley MPH, Aleksandra Sumic MPH, Lynn Baker BSEE, Christine Nelson PhD, RN, Nathalie Huguet PhD, Andrew Suchocki MD, MPH, Heather Holderness MPH, Jennifer E. DeVoe MD, DPhil 2018 Oregon Health & Science University

A Cohort Study Of Public Health Insurance Coverage Loss Among Oregon Adolescents, Heather Angier Mph, Carrie Tillotson Mph, Lorraine Wallace Phd, Miguel Marino Phd, Jean O'Malley Mph, Aleksandra Sumic Mph, Lynn Baker Bsee, Christine Nelson Phd, Rn, Nathalie Huguet Phd, Andrew Suchocki Md, Mph, Heather Holderness Mph, Jennifer E. Devoe Md, Dphil

Journal of Health Disparities Research and Practice

ABSTRACT

Introduction: Churning on and off and/or experiencing coverage gaps is common among public health insurance recipients. Although the Affordable Care Act (ACA) provisions to extend parental coverage for adolescents transitioning to young adulthood on private insurance plans were implemented in 2010, no such protection was mandated for adolescents with public health insurance.

Methods: Oregon public health insurance enrollment and electronic health record data from community health centers were used to conduct a retrospective, observational cohort study of Oregon adolescents (17-19 years of age) with public coverage [January 1, 2011-December 31, 2013 (n=51,988)] to assess loss. Time-to-event ...


Optimism And Compliance: An Examination Of Disempowering Processes Within Online Patient Communities, Wendi F. Coleman 2018 Minnesota State University, Mankato

Optimism And Compliance: An Examination Of Disempowering Processes Within Online Patient Communities, Wendi F. Coleman

Technical Communication Capstone Course

Patients diagnosed with long-term conditions (LTCs) are now being asked of medical practitioners to take an active role in their own health care as “expert patients.” This trend has accelerated the increase in people with LTCs who are using the internet for both information and social support. A valuable resource to these patients, and of interest to researchers, is a new type of online space: online patient communities (OPCs) created for patients suffering from specific illnesses. In order to better understand potential disempowering processes within OLPs, I follow the research and examine the illness narratives, focusing on their various external ...


Code Help: Can This Unique State Regulatory Intervention Improve Emergency Department Crowding?, Sean S. Michael, John Broach, Kevin A. Kotkowski, David Eric Brush, Gregory A. Volturo, Martin A. Reznek 2018 University of Massachusettts Medical School

Code Help: Can This Unique State Regulatory Intervention Improve Emergency Department Crowding?, Sean S. Michael, John Broach, Kevin A. Kotkowski, David Eric Brush, Gregory A. Volturo, Martin A. Reznek

Open Access Articles

Introduction: Emergency department (ED) crowding adversely affects multiple facets of high-quality care. The Commonwealth of Massachusetts mandates specific, hospital action plans to reduce ED boarding via a mechanism termed "Code Help." Because implementation appears inconsistent even when hospital conditions should have triggered its activation, we hypothesized that compliance with the Code Help policy would be associated with reduction in ED boarding time and total ED length of stay (LOS) for admitted patients, compared to patients seen when the Code Help policy was not followed.

Methods: This was a retrospective analysis of data collected from electronic, patient-care, timestamp events and from ...


Sex Education Among Latino Adolescents, Roxana Tapia 2018 California State University, Monterey Bay

Sex Education Among Latino Adolescents, Roxana Tapia

Capstone Projects and Master's Theses

Adolescents often have little knowledge of the risks of sexual activity or lack sufficient sexual education to understand the consequences of engaging in these activity. As a result, . To aid with the lack of sexual education, I have developed a cultural component to the established sexual education curriculum for the students in health education at Everett Alvarez High School. 22 students took part in this research study. Overall, this research showed to have taught freshman students how much of their knowledge is based around other influences and this presentation improved their knowledge about sex education.


Efficacy Of Technology-Based And In-Person Health Education For Behavior Change In College-Aged Women, Madeline Bremel 2018 College of Saint Benedict/Saint John's University

Efficacy Of Technology-Based And In-Person Health Education For Behavior Change In College-Aged Women, Madeline Bremel

All College Thesis Program, 2016-present

Purpose: The purpose of this study was to determine whether an in-person or technology based bone health intervention improved bone health knowledge and behaviors in college-aged women. Methods: 30 college-aged women were randomly divided into three groups: personal intervention (n = 10), technological intervention (n = 10), and control (n = 10). Both intervention groups received identical information regarding the importance of bone health and the appropriate behaviors for maintaining strong bones including weight-bearing exercise, calcium consumption, and vitamin D consumption. The technology group received the information via an online video, and the personal group via a one-on-one health intervention. Changes in bone ...


Care Transitions From Patient And Caregiver Perspectives, Suzanne E. Mitchell, Vivian Laurens, Gabriela M. Weigel, Karen B. Hirschman, Allison M. Scott, Huong Q. Nguyen, Jessica Martin Howard, Lance Laird, Carol Levine, Terry C. Davis, Brianna Gass, Elizabeth Shaid, Jing Li, Mark V. Williams, Brian W. Jack 2018 Boston Medical Center

Care Transitions From Patient And Caregiver Perspectives, Suzanne E. Mitchell, Vivian Laurens, Gabriela M. Weigel, Karen B. Hirschman, Allison M. Scott, Huong Q. Nguyen, Jessica Martin Howard, Lance Laird, Carol Levine, Terry C. Davis, Brianna Gass, Elizabeth Shaid, Jing Li, Mark V. Williams, Brian W. Jack

Communication Faculty Publications

PURPOSE: Despite concerted actions to streamline care transitions, the journey from hospital to home remains hazardous for patients and caregivers. Remarkably little is known about the patient and caregiver experience during care transitions, the services they need, or the outcomes they value. The aims of this study were to (1) describe patient and caregiver experiences during care transitions and (2) characterize patient and caregiver desired outcomes of care transitions and the health services associated with them.

METHODS: We interviewed 138 patients and 110 family caregivers recruited from 6 health networks across the United States. We conducted 34 homogenous focus groups ...


An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia Jessup 2018 Abilene Christian University

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative ...


Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach 2018 University of Tennessee, Knoxville

Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach

University of Tennessee Honors Thesis Projects

No abstract provided.


Concussion Protocols For Youth Sport In Tennessee, Corinne C. Oliphant 2018 University of Tennessee Knoxville

Concussion Protocols For Youth Sport In Tennessee, Corinne C. Oliphant

University of Tennessee Honors Thesis Projects

No abstract provided.


Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff 2018 University of Nebraska Medical Center

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Service Learning/Capstone Experience

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year ...


The Influence Of Social Determinants Of Health On High School Students’ Health Literacy, Rebecca Welch 2018 University of Arkansas, Fayetteville

The Influence Of Social Determinants Of Health On High School Students’ Health Literacy, Rebecca Welch

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The broad topic of health literacy has been assessed in a variety of studies. The most extensive research has been completed on how a lack of health literacy contributes to specific disease progressions. However, there is a deficit of research on how general health literacy contributes to overall individual health in high school students. The purpose of this study was to evaluate the health literacy scores of Northwest Arkansas high school students and examine the impact that age, gender, and ethnicity have on their health literacy. Health literacy was assessed using the Health Literacy Questionnaire (HLQ). A cross-sectional research design ...


Addressing Culturally Specific Mental Health Care Needs In The Us: The Asian American Population, Moira Lewerk 2018 University of Connecticut

Addressing Culturally Specific Mental Health Care Needs In The Us: The Asian American Population, Moira Lewerk

Honors Scholar Theses

As the fastest growing minority group in the US, Asian American health needs and disparities are becoming critical areas to address, particularly in the mental health domain (Leong, Park, & Kalibatseva, 2013). Currently, the culturally specific needs of this group are not being adequately met. This includes appropriately serving low English proficiency (LEP) patients who experience different healthcare quality and outcomes than other individuals. Additionally, recognizing culturally unique perspectives, emotional burdens, and immigrant experiences is crucial in developing culturally tailored mental health interventions and shifting mental health toward individualized care. This work aims to examine current policies surrounding culturally competent care ...


Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner 2018 Aurora UW Medical Group, Aurora Health Care

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.


'No Pink Ribbons': How Women's Lived Experiences With Breast Atypia Inform Decisions Involving Risk-Reducing Medications, Sarah L. Goff, Reva Kleppel, Grace Makari-Judson 2018 University of Massachusetts Medical School - Baystate

'No Pink Ribbons': How Women's Lived Experiences With Breast Atypia Inform Decisions Involving Risk-Reducing Medications, Sarah L. Goff, Reva Kleppel, Grace Makari-Judson

Journal of Patient-Centered Research and Reviews

Purpose: Atypical hyperplasia (AH) is associated with a nearly 4-fold elevation of lifetime risk for breast cancer, and lobular carcinoma in situ (LCIS) is associated with a 7- to 8-fold risk. Women with AH/LCIS make numerous decisions in the course of treatment, including whether to take a risk-reducing medication, an option relatively few women pursue. We explored women’s decision-making processes through patient narratives in an effort to inform decision supports for AH/LCIS.

Methods: We conducted in-depth interviews with 20 English-speaking women with AH/LCIS and no subsequent diagnosis of invasive breast cancer who had enrolled in the ...


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