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Is Your Graduate Nurse Suffering From Transition Shock?, Erin Wakefield 2018 Australian College of Perioperative Nurses (ACORN)

Is Your Graduate Nurse Suffering From Transition Shock?, Erin Wakefield

Journal of Perioperative Nursing

The term ‘transition shock’ is a relatively new concept used to describe the experience of moving from the comfortable and familiar role of the preregistration nursing student to the professional registered nurse (RN)1. The initial and most dramatic stage in this theory of role adaption occurs over the first four months of professional practice.

Transition shock has foundational basis in Kramer’s theory of ‘reality shock,’ which describes the phenomenon of studying for many years to practice a particular role, and then finding the professional reality is different than expected. Reality shock has four phases – the honeymoon phase, the ...


Task Transfer: A Survey Of Australian Surgeons On The Role Of The Non-Medical Surgical Assistant, Toni Hains, Catherine Turner, Haakan Strand 2018 Australian College of Perioperative Nurses (ACORN)

Task Transfer: A Survey Of Australian Surgeons On The Role Of The Non-Medical Surgical Assistant, Toni Hains, Catherine Turner, Haakan Strand

Journal of Perioperative Nursing

Background: A non-medical surgical assistant is a clinician who provides perioperative care in the role of surgical assistant but does not possess a medical degree. This role has been practiced in Australia for more than 20 years.

Aim: This survey investigates Australian surgeons’ attitudes and current practice regarding the role of the non-medical surgical assistant.

Design/method: Distribution of the survey was online in December 2015 by the Royal Australasian College of Surgeons (RACS). Data analysis was descriptive using online survey methodology and convenience sampling.

Results: In the private sector in Australia 105 respondents (35 per cent) use a non-medical ...


Identifying Windows Of Opportunity For Active Living And Healthy Eating Policies In Connecticut, 2016, Anna E. Greer, Ann-Uriel Knausenberger 2018 Sacred Heart University

Identifying Windows Of Opportunity For Active Living And Healthy Eating Policies In Connecticut, 2016, Anna E. Greer, Ann-Uriel Knausenberger

Public Health Faculty Publications

We examined the relative importance of 23 community issues among elected officials and health directors in Connecticut in 2016. For this cross-sectional study, 74 elected officials (40.7% response rate) and 47 health directors (62.7% response rate), who were purposively sampled, completed a questionnaire to rate their perceived importance of 23 community issues. Eight of these issues were related to active living, healthy eating, or obesity. We used χ2 tests to evaluate differences in responses. Compared with elected officials, health directors significantly more often perceived obesity, access to healthy groceries, poor nutrition, lack of pedestrian walkways, and pedestrian safety ...


Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso MPH, Zachariah Croll, Deborah Thayer MBA, Jean A. Talbot PhD, MPH, Andrew F. Coburn PhD 2018 University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center,

Residential Settings And Healthcare Use Of The Rural "Oldest-Old" Medicare Population, Nathan Paluso Mph, Zachariah Croll, Deborah Thayer Mba, Jean A. Talbot Phd, Mph, Andrew F. Coburn Phd

Long-term Care

The aging of the baby boom generation is projected to dramatically increase the population aged 65 and older in the coming decades. In particular, those aged 85 and older (the ‘oldest old’) are expanding at a faster rate than any other age group and by 2050 are expected to make up 4.5 percent of the population, compared to 1.9 percent in 2012. Faster growth in the percentage of older people (65+) in rural than in urban areas is likely to challenge the healthcare and long term services and supports (LTSS) capacity in many rural communities.

This study used ...


Ltss Clinical Guidelines Help Health Plans Navigate The Challenges Of Increased Demand, Jessica Carpenter 2018 University of Massachusetts Medical School

Ltss Clinical Guidelines Help Health Plans Navigate The Challenges Of Increased Demand, Jessica Carpenter

Commonwealth Medicine Publications

Long term services and supports (LTSS) clinical guidelines are the foundation of a successful LTSS utilization management program. Strong guidelines help health plans drive LTSS programs toward positive outcomes such as consistency in decision making, clinically appropriate services, contained costs and program integrity. The goal is ensuring individuals receive the right service, in the right setting, and at the right time.

As the independent living movement continues to advance, more individuals with disabilities are seeking to live in their own homes or within a community setting. As such, there has been an increased demand for LTSS. Increased demand combined with ...


Objection! That’S A Leading Survey Question, Carla Hillerns 2018 University of Massachusetts Medical School

Objection! That’S A Leading Survey Question, Carla Hillerns

Commonwealth Medicine Publications

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness.


Clinical And Economic Burden Of Procedural Sedation-Related Adverse Events And Their Outcomes: Analysis From Five Countries, Rhodri Saunders, Jason A. Davis, Peter Kranke, Rachel Weissbrod, David K. Whitaker, Jenifer R. Lightdale 2018 Coreva Scientific GmbH & Co KG, Germany

Clinical And Economic Burden Of Procedural Sedation-Related Adverse Events And Their Outcomes: Analysis From Five Countries, Rhodri Saunders, Jason A. Davis, Peter Kranke, Rachel Weissbrod, David K. Whitaker, Jenifer R. Lightdale

Pediatric Publications and Presentations

Background: Studies have reported on the incidence of sedation-related adverse events (AEs), but little is known about their impact on health care costs and resource use.

Methods: Health care providers and payers in five countries were recruited for an online survey by independent administrators to ensure that investigators and respondents were blinded to each other. Surveys were conducted in the local language and began with a "screener" to ensure that respondents had relevant expertise and experience. Responses were analyzed using Excel and R, with the Dixon's Q statistic used to identify and remove outliers. Global and country-specific average treatment ...


Rural Family Physicians In Patient Centered Medical Homes Have A Broader Scope Of Practice, Lars E. Peterson, Bo Fang 2018 The American Board of Family Medicine

Rural Family Physicians In Patient Centered Medical Homes Have A Broader Scope Of Practice, Lars E. Peterson, Bo Fang

Rural & Underserved Health Research Center Publications

Overview

  • Rural family physicians often have a broader scope of practice, defined as the range of clinical and procedural services that they provide, than urban family physicians. The Patient Centered Medical Home (PCMH) model of care is intended to provide accessible and comprehensive care, but little is known about how practicing in a PCMH is associated with rural family physicians’ scope of practice.
  • Using data from 18,846 family physicians nationally, we found that rural family physicians working in PCMH practices generally provide a wider scope of clinical and procedural services than those not working in PCMH practices.


Patient-Provider Race And Sex Concordance: New Insights Into Antibiotic Prescribing For Acute Bronchitis, Jake R. Morgan, Mari-Lynn Drainoni, Cindy Christiansen, Tamar F. Barlam 2018 Boston University

Patient-Provider Race And Sex Concordance: New Insights Into Antibiotic Prescribing For Acute Bronchitis, Jake R. Morgan, Mari-Lynn Drainoni, Cindy Christiansen, Tamar F. Barlam

Journal of Health Disparities Research and Practice

Objective: To examine whether patient and provider concordance by sex or race predicts antibiotic prescribing for acute bronchitis.

Study setting: General Internal Medicine and Family Medicine adult clinics at a large safety-net hospital.

Study design: We used a logistic model of prescribing as a function of race and sex concordance.

Data extraction: Data were extracted from de-identified patient records for those with an acute bronchitis visit between 2008 and 2010.

Principal findings: 71% (95% CI 68%-73%) of visits resulted in an antibiotic prescription. Patients in race-concordant visits were 17% (95% CI 8%-25%) less likely to receive a prescription ...


Rural Family Physicians Have A Broader Scope Of Practice Than Urban Family Physicians, Lars E. Peterson, Bo Fang 2018 The American Board of Family Medicine

Rural Family Physicians Have A Broader Scope Of Practice Than Urban Family Physicians, Lars E. Peterson, Bo Fang

Rural & Underserved Health Research Center Publications

Overview of Key Findings

  • Little is known about whether rural family physicians provide a broader scope of practice, defined as the range of clinical and procedural services that they provide, than metropolitan family physicians.
  • Using data from 18,846 family physicians, we examined variations in the provision of 21 clinical services (e.g., inpatient care, home visits, and obstetrics) and 18 procedural services (e.g., prenatal ultrasound, endoscopy, and office skin procedures) across metropolitan, large rural, small rural, and frontier areas.
  • We found that the percentage of family physicians providing each type of clinical and procedural service rises with increasing ...


A Budget Impact Model For Two Investigational Agents For The Treatment Of Nonalcoholic Steatohepatitis, Nicole M. Trask, Pavel Lavitas, Vincent Palumbo 2018 University of Massachusetts Medical School

A Budget Impact Model For Two Investigational Agents For The Treatment Of Nonalcoholic Steatohepatitis, Nicole M. Trask, Pavel Lavitas, Vincent Palumbo

Commonwealth Medicine Publications

Statistics show approximately 15 million Americans suffer from NASH, a nonalcoholic fatty liver disease that is projected to become the most common reason for liver transplantation. There are no FDA approved therapies for NASH, so doctors are forced to treat patients with off-label medications while keeping an eye out for breakthroughs in medication development.

Two novel therapies, obeticholic acid and elafibranor, are currently in Phase III trials. If they receive FDA approval, interest will be high as they will be the first treatments specifically labeled for NASH. We detail a budget impact model for a sample state Medicaid plan in ...


Rural/Urban Disparities In Pneumococcal Vaccine Service Delivery Among The Fee-For-Service Medicare Population, Jeffery C. Talbert, Aric Schadler, Patricia R. Freeman 2018 University of Kentucky

Rural/Urban Disparities In Pneumococcal Vaccine Service Delivery Among The Fee-For-Service Medicare Population, Jeffery C. Talbert, Aric Schadler, Patricia R. Freeman

Rural & Underserved Health Research Center Publications

Overview of Key Findings

  • In 2014, the overall mean vaccination rate in urban areas was 4.66 compared to a mean vaccination rate of 2.81 in rural areas, indicating a 40% lower mean vaccination rate in rural communities.
  • The majority of pneumococcal vaccine services delivered to fee-for-service Medicare beneficiaries were provided by primary care providers, although pharmacy providers delivered close to one-fourth (22.2%) of these services.
  • The proportion of pneumococcal vaccine services delivered by pharmacy providers was significantly greater in rural versus urban counties (29.4% vs. 21.1%).
  • Consistent with previous literature, county characteristics positively associated with ...


Impact Of A Pilot Outreach Program Upon Provider Awareness And Prescribing Of A Concerning Opioid Combination Regimen, Briana Santaniello, Thomas C. Pomfret, Mark A. Tesell, Nicole M. Trask, Caroline J. Alper, Karen M. Clements, Vincent Palumbo, Kimberly Lenz, Paul L. Jeffrey 2018 Magellan Rx Management

Impact Of A Pilot Outreach Program Upon Provider Awareness And Prescribing Of A Concerning Opioid Combination Regimen, Briana Santaniello, Thomas C. Pomfret, Mark A. Tesell, Nicole M. Trask, Caroline J. Alper, Karen M. Clements, Vincent Palumbo, Kimberly Lenz, Paul L. Jeffrey

Commonwealth Medicine Publications

This pilot program was developed in response to a drug utilization review within a large Medicaid population that revealed some hazardous practices. Co-prescribing of opioids with benzodiazepines, gabapentin, and other stimulants occurred in more than 500 members, putting them at risk for additive central nervous system depression, misuse, abuse, and death from overdose.

The poster presentation outlines the objectives, methods, and results of a telephonic outreach program that addressed these safety concerns. It captures prescriber awareness of the presence and risks of potentially deadly medication combinations among members in their care, with some intriguing results.

Our experts provide health plans ...


Wdph 2017 Summer Internship Report, Lauren Meininger 2018 Clark University

Wdph 2017 Summer Internship Report, Lauren Meininger

Mosakowski Institute for Public Enterprise

In the spring of 2014, the Worcester Division of Public Health, UMass Memorial Health Care, and Clark University’s Mosakowski Institute for Public Enterprise joined forces to begin developing a partnership that would combine academic resources, student input, and public health needs in the City of Worcester. Founders of this program were motivated to seek and implement innovative interventions for public health issues while simultaneously inspiring a new generation of public health professionals.

Each year, the Academic Health Collaborative of Worcester (AHCW) brings in student interns to work on the pressing public health issues of the moment. Interns work alongside ...


Systems And Psychosocial Advances Research Center 2017 Annual Report To The Massachusetts Department Of Mental Health, Systems and Psychosocial Advances Research Center 2018 University of Massachusetts Medical School

Systems And Psychosocial Advances Research Center 2017 Annual Report To The Massachusetts Department Of Mental Health, Systems And Psychosocial Advances Research Center

Systems and Psychosocial Advances Research Center Publications and Presentations

Annual report for fiscal year 2017 from the Systems and Psychosocial Advances Research Center (SPARC).

We are grateful to the Massachusetts Department of Mental Health (DMH) for its continued support of the University of Massachusetts Medical School’s (UMMS) DMH Research Center of Excellence, the Systems and Psychosocial Advances Research Center (SPARC). We continue to leverage the DMH investment to support innovative, recovery-oriented, state-of-the-art psychosocial and systems research.

The Systems and Psychosocial Advances Research Center conducts research to enhance services, improve the quality of life, and promote recovery for people with behavioral health conditions. Our research involves, informs, and advises ...


Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons 2018 Seton Hall University

Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons

Seton Hall University Dissertations and Theses (ETDs)

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive ...


A Medicaid Compromise Expanded Coverage For Hoosiers, But Important Questions Linger, Robert W. Seifert 2018 University of Massachusett Medical School

A Medicaid Compromise Expanded Coverage For Hoosiers, But Important Questions Linger, Robert W. Seifert

Commonwealth Medicine Publications

In today’s polarized political environment, it is easy to forget that most policy decisions are not black or white, but rather some indeterminate shade of gray. A case in point is Indiana’s Medicaid waiver, which the federal government just approved for a three-year extension.


Racial/Ethnic Representation In Lifestyle Weight Loss Intervention Studies In The United States: A Systematic Review, Christina Haughton, Valerie J. Silfee, Monica L. Wang, Andrea Lopez-Cepero, David P. Estabrook, Christine F. Frisard, Milagros C. Rosal, Sherry L. Pagoto, Stephenie C. Lemon 2018 University of Massachusetts Medical School

Racial/Ethnic Representation In Lifestyle Weight Loss Intervention Studies In The United States: A Systematic Review, Christina Haughton, Valerie J. Silfee, Monica L. Wang, Andrea Lopez-Cepero, David P. Estabrook, Christine F. Frisard, Milagros C. Rosal, Sherry L. Pagoto, Stephenie C. Lemon

UMass Worcester PRC Publications

Obesity remains a persistent public health and health disparity concern in the United States. Eliminating health disparities, particularly among racial/ethnic minority groups, is a major health priority in the US. The primary aim of this review was to evaluate representation of racial/ethnic sub-group members in behavioral weight loss interventions conducted among adults in the United States. The secondary aims were to assess recruitment and study design approaches to include racial/ethnic groups and the extent of racial/ethnic sub-group analyses conducted in these studies. PubMed, PsycInfo, Medline, and CINAHL were searched for behavioral weight loss intervention trials conducted ...


Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo 2018 Aurora Health Care; University of Wisconsin School of Medicine and Public Health

Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo

Journal of Patient-Centered Research and Reviews

Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin.

Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board ...


Imagine A World …, David A. Nelson 2018 Medical College of Wisconsin

Imagine A World …, David A. Nelson

Journal of Patient-Centered Research and Reviews

The author and issue editor introduces the second half of Journal of Patient-Centered Research and Reviews’ two-part series on health disparities and inequities in the United States. The chasm between an ideal health care system and the current reality may appear vast, and closing it insurmountable at times, but acknowledging and working to address the many health conditions that disproportionately affect specific patient populations is one step health providers and researchers can take toward closing the gap.


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