Fxr Activation By Obeticholic Acid Reduces Plasma Ldl-cholesterol In Mice By Upregulating Hepatic Ldl Receptor Via A Posttranscriptional Mechanism
Gastroenterology & Hepatology
Liu J W; Kraemer F B; Xu Y Y; Zhang Y Q; Singh A
Hepatology
2018
2018-10
Journal Article or Conference Abstract Publication
n/a
My Career Story: Description And Initial Validity Evidence
career; Career construction counseling; career construction theory; career intervention; career planning; decision-making; latent semantic analysis; life design; life design; my career; narrative career counseling; Psychology; story
My career story (MCS) comprises a self-guided autobiographical workbook designed to simulate career construction counseling. The MCS contains a series of questions from the Career Construction Interview to elicit a life-career story and reveal a life theme that are then related to a current career problem indicated by the workbook user. Reflecting on the answers to the questions aims to promote key life-design goals of adaptability, narratability, intentionality, and action. After describing its development and use, a case illustration and initial preliminary validity study of the MCS is presented. Latent semantic analysis, a method for determining meaning similarity of words and passages within bodies of text, indicated a mean agreement level of .81 between MCS life portraits constructed by participants (N =10) and those constructed for the participants by experts in career construction counseling. The MCS shows some initial promise for self-guided career intervention to increase self-reflection and ability to tell and enact one's career story. Future research is needed to support the validity of the MCS workbook.
Hartung P J; Santilli S
Journal of Career Assessment
2018
2018-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1177/1069072717692980" target="_blank" rel="noreferrer noopener">10.1177/1069072717692980</a>
Special Section: Career Development In The Digital Age Introduction To The Special Section
Psychology
Hartung P J
Career Development Quarterly
2018
2018-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1002/cdq.12141" target="_blank" rel="noreferrer noopener">10.1002/cdq.12141</a>
Seguro Popular Membership and Catastrophic Health Expenditure
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-12
Journal Article or Conference Abstract Publication
n/a
Religiosity and Prevention of Binge Drinking
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-09
Journal Article or Conference Abstract Publication
n/a
Promoting Resilience Among Pakistani Women
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-12
Journal Article or Conference Abstract Publication
n/a
Nutritional Intervention for Patients With HIV Receiving Antiretroviral Therapy
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-11
Journal Article or Conference Abstract Publication
n/a
Migrants to European Countries Report Higher Emergency Department Use Than Do Nonmigrants
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-09
Journal Article or Conference Abstract Publication
n/a
Metabolic Syndrome in School-Aged Children
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-11
Journal Article or Conference Abstract Publication
n/a
Maltreatment During Youth Is Associated With Poorer Educational and Cognitive Outcomes in Early Adulthood
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-11
Journal Article or Conference Abstract Publication
n/a
Knowledge of HIV/AIDS and Stigma in African Countries
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-09
Journal Article or Conference Abstract Publication
n/a
The Impact of Cultural Distance on Self-Rated Migrant Health
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-12
Journal Article or Conference Abstract Publication
n/a
E-Cigarette Use Not Increasing Cigarette Smoking Cessation Rates Among South Korean Adult Smokers
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-11
Journal Article or Conference Abstract Publication
n/a
Describing Changes in Food Intake in South Africa Through the PURE-NWP-SA Study
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2105/ajph.2018.304770" target="_blank" rel="noreferrer noopener">10.2105/ajph.2018.304770</a>
Characteristics of Parents With Inadequate Knowledge About and Negative Attitudes Toward Childhood Immunization
Environmental & Occupational Health; Public
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-09
Journal Article or Conference Abstract Publication
n/a
AJPH Global News (vol 108, 838, 2018)
New York; Environmental & Occupational Health; Public; Medical Sciences; Service introduction
Davila M G; Polanco V P; Segura L; Kingsbury D
American Journal of Public Health
2018
2018-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.2105/AJPH.2018.304457e" target="_blank" rel="noreferrer noopener">10.2105/AJPH.2018.304457e</a>
Atypical Alzheimer's Disease with Visual Agnosia
Geriatrics & Gerontology
Das A; Drost J
Journal of the American Geriatrics Society
2018
2018-04
Journal Article or Conference Abstract Publication
n/a
Developing Faculty Knowledge and Skills for Geriatric Interprofessional Education: A Pilot Project
Geriatrics & Gerontology
Brown D K; Drost J; Hazelett S; Kropp D
Journal of the American Geriatrics Society
2018
2018-04
Journal Article or Conference Abstract Publication
n/a
Borderland Biopolitics Public Health and Border Enforcement in Early Twentieth-Century Latinx Fiction
Literature; public-health; biopolitics; border; citizenship; control; medicalized nativism
This article situates early twentieth-century Latinx fiction within the intertwined histories of public health and border surveillance along the Rio Grande to reveal a "borderland biopolitics" unique to the US-Mexico border region. Drawing on three early twentieth-century novels-Daniel Venegas's Adventures of Don Chipote, Americo Paredes's George Washington Gomez, and Jovita Gonzalez and Eve Raleigh's Caballero- it adds another layer of historical nuance to studies of Latinx literature by demonstrating the profound, pervasive influence that epidemiological science and public health policy have had in shaping national identity politics in the borderlands. Because militarized border control evolves from public health efforts, reframing analyses of Latinx fiction to read for public health provides fresh insight into institutionalized forms of discrimination and social injustice that continue to condition Latinx lives in the US-Mexico borderlands.
Bracken R C
English Language Notes
2018
2018-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1215/00138282-6960702" target="_blank" rel="noreferrer noopener">10.1215/00138282-6960702</a>
A description of inter-professional ethics education in a United States college of pharmacy
Education & Educational Research; Ethics Education; Ethics Training; Inter-Professional Education
Introduction: An inter-professional ethics curriculum should address core ethics concepts and principles, and challenge students to work in inter-professional teams to resolve dilemmas modelled after those encountered in the health professions. Description: An inter-professional ethics curriculum at a United States (U.S.) college of pharmacy has been developed and refined since 2005 and provides comprehensive ethics education to pharmacy students, while exposing medical and pharmacy students to the ethical issues and dilemmas that are both shared and unique to each health profession. Evaluation: Students have exceeded basic competencies in ethics education without failing performance measures at this U.S. college of pharmacy. The inter-professional ethics curriculum receives positive student evaluations; however, students see ethics education as secondary, rather than complementary, to basic science and clinical curricula. Future plans: A commitment to a longitudinal, inter-professional ethics curriculum is needed to enforce ethics content and values during students' practicum experiences in pharmacy and industry settings.
Aultman J M
Pharmacy Education
2018
2018
Journal Article or Conference Abstract Publication
n/a
Guidelines of care for the management of cutaneous squamous cell carcinoma
5-year follow-up; american joint committee; biopsy; carcinoma; curettage; Dermatology; fresh tissue technique; limited life expectancy; lymph-node biopsy; metastasis; mohs micrographic surgery; nonmelanoma skin-cancer; organ transplant; phototherapy; radiotherapy; randomized controlled-trial; recipients; squamous cell; staging; Surgery; surveillance; topical photodynamic therapy; topical therapy
Cutaneous squamous cell carcinoma (cSCC) is the second most common form of human cancer and has an increasing annual incidence. Although most cSCC is cured with office-based therapy, advanced cSCC poses a significant risk for morbidity, impact on quality of life, and death. This document provides evidence-based recommendations for the management of patients with cSCC. Topics addressed include biopsy techniques and histopathologic assessment, tumor staging, surgical and nonsurgical management, follow-up and prevention of recurrence, and management of advanced disease. The primary focus of these recommendations is on evaluation and management of primary cSCC and localized disease, but where relevant, applicability to recurrent cSCC is noted, as is general information on the management of patients with metastatic disease.
Alam M; Armstrong A; Baum C; Bordeaux J S; Brown M; Busam K J; Eisen D B; Iyengar V; Lober C; Margolis D J; Messina J; Miller A; Miller S; Mostow E; Mowad C; Nehal K; Schmitt-Burr K; Sekulic A; Storrs P; Teng J; Yu S; Huang C; Boyer K; Begolka W S; Bichakjian C; Kim J Y S; Kozlow J H; Mittal B; Moyer J; Olenecki T; Rodgers P
Journal of the American Academy of Dermatology
2018
2018-03
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.jaad.2017.10.007" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2017.10.007</a>
Interventions That Target Criminogenic Needs for Justice-Involved Persons With Serious Mental Illnesses: A Targeted Service Delivery Approach
assertive community treatment; behavioral programs; criminal thinking styles; criminogenic needs; Criminology & Penology; disordered; health treatment; mental illness; offenders; prevalence; prison-inmates; Psychology; recidivism; Rehabilitation; schizophrenia; violent recidivism
This research describes the development of a targeted service delivery approach that tailors the delivery of interventions that target criminogenic needs to the specific learning and treatment needs of justice-involved people with serious mental illnesses (SMI). This targeted service delivery approach includes five service delivery strategies: repetition and summarizing, amplification, coaching, low-demand practice, and maximizing participation. Examples of how to apply each strategy in session are provided, as well as recommendations on when to use each strategy during the delivery of interventions that target criminogenic needs. This targeted service delivery approach makes an important contribution to the development of interventions for justice-involved people with SMI by increasing the chances that people with SMI can participate fully in and benefit from these interventions that target criminogenic needs. These developments come at a critical time in the field as the next generation of services for justice-involved people with SMI are being developed.
Wilson A B; Farkas K; Bonfine N; Duda-Banwar J
International Journal of Offender Therapy and Comparative Criminology
2018
2018-10
Journal Article
<a href="http://doi.org/10.1177/0306624x18759242" target="_blank" rel="noreferrer noopener">10.1177/0306624x18759242</a>
The Student Career Construction Inventory
adaptability; adaptability; Adaptation; Adapting; Adaptivity; Career choice; Career construction; exploration; fit indexes; form; maturity; measurement invariance; Psychology; Self-concept; validation
To address counselors' need for a reliable measure of career adapting thoughts and behaviors as well as researchers' need for a specific measure of adapting as a dimension in the model of career adaptation, we developed the Student Career Construction Inventory (SCCI). In the study, 486 high school students (55% female), 290 college students (59% female), and 220 graduate students (82% female) responded to the SCCI. The SCCI contains 18 items across four scales assessing: (a) Crystallizing a vocational self-concept, (b) Exploring to gather information about occupations, (c) Deciding to commit to an occupational choice, and (d) Preparing to implement that choice. The four scales interrelate to constitute a continuum reflecting the general factor of adapting responses during the exploration stage of a career. Each scale assesses a specific group factor reflecting a particular career construction task involving crystallizing, exploring, deciding, and preparing. The results of a confirmatory factor analysis indicated that the SCCI displays configural and measurement invariance, meaning that its factor structure is replicable and generalizable across high school, college, and graduate students. The SCCI did not show scalar invariance because, as expected, the mean scores for the scales were elevated for older and more educated participants. The SCCI, as a measure of adapting responses, correlated as predicted with concurrent measures of three criteria: adaptive readiness, adaptability resources, and adaptation results. A provisional test of the career construction adaptation model indicated that, as hypothesized, adapting behaviors mediate the relationship between adaptability resources and adaptation outcomes.
Savickas M L; Porfeli E J; Hilton T L; Savickas S
Journal of Vocational Behavior
2018
2018-06
Journal Article
<a href="http://doi.org/10.1016/j.jvb.2018.01.009" target="_blank" rel="noreferrer noopener">10.1016/j.jvb.2018.01.009</a>
High risk for obstructive sleep apnea hypopnea syndrome predicts new onset atrial fibrillation after cardiac surgery: a retrospective analysis
arrhythmias; Atrial fibrillation; c-reactive protein; Coronary artery bypass graft surgery; cost; Length of; mortality; Neurosciences & Neurology; outcomes; recurrence; Respiratory System; Screening; Sleep apnea; stay
Purpose Obstructive sleep apnea hypopnea syndrome (OSAHS) is highly prevalent in patients undergoing coronary artery bypass surgery (CABG). OSAHS is a risk factor for the development of atrial fibrillation (AF), but the risk of AF in patients who are high risk for OSAHS is unclear. Methods A retrospective study was conducted on consecutive patients undergoing CABG from 2013 to 2015 without AF pre-operatively. Patients were categorized as low risk for OSAHS, high risk for OSAHS, or diagnosed OSAHS based on medical records review. All diagnosed OSAHS patients were on active treatment with positive airway pressure. Outcomes assessed were postoperative AF (POAF), postoperative length of stay, re-intubation, in-hospital mortality, and cost of hospitalization. Results Out of 209 eligible patients, 66.5% were low-risk for OSAHS, 18.7% high-risk for OSAHS, and 14.8% diagnosed/treated for OSAHS. POAF developed in 96 patients (45.9%) with greater frequency in high-risk OSAHS patients (69.2% high risk, 41.9% low risk, 40.3% diagnosed/treated, p = 0.01). In analyses adjusted for age, sex, ethnicity and comorbidities, high risk for OSAHS was associated with 2.9 greater odds (95% CI [1.2, 7.3], p = 0.02) for POAF while diagnosed/treated OSAHS was not associated with elevated risk (OR = 1.4, 95% CI [0.6, 3.6], p = 0.50) compared to patients at low risk for OSAHS. Conclusions High risk for OSAHS is an independent predictor for POAF in patients undergoing CABG. In contrast, patients diagnosed and treated for their OSAHS are not at elevated risk of POAF. These findings support evaluation of a standardized OSAHS screening and treatment program as part of the pre-operative evaluation for elective CABG.
Patel S V; Gill H; Shahi D; Rajabalan A; Patel P; Sonani R; Bhatt P; Rodriguez R D; Bautista M; Deshmukh A; Gonzalez J V; Patel S
Sleep and Breathing
2018
2018-12
Journal Article
<a href="http://doi.org/10.1007/s11325-018-1645-3" target="_blank" rel="noreferrer noopener">10.1007/s11325-018-1645-3</a>
Interventions That Target Criminogenic Needs for Justice-Involved Persons With Serious Mental Illnesses: A Targeted Service Delivery Approach.
Humans; criminogenic needs; mental illness; recidivism; Community Mental Health Services/*organization & administration; Mental Disorders/psychology/*therapy; Criminal Law; Criminals/*psychology/statistics & numerical data; Health Services Needs and Demand/*statistics & numerical data; Mentally Ill Persons/*psychology/statistics & numerical data
This research describes the development of a targeted service delivery approach that tailors the delivery of interventions that target criminogenic needs to the specific learning and treatment needs of justice-involved people with serious mental illnesses (SMI). This targeted service delivery approach includes five service delivery strategies: repetition and summarizing, amplification, coaching, low-demand practice, and maximizing participation. Examples of how to apply each strategy in session are provided, as well as recommendations on when to use each strategy during the delivery of interventions that target criminogenic needs. This targeted service delivery approach makes an important contribution to the development of interventions for justice-involved people with SMI by increasing the chances that people with SMI can participate fully in and benefit from these interventions that target criminogenic needs. These developments come at a critical time in the field as the next generation of services for justice-involved people with SMI are being developed.
Wilson Amy Blank; Farkas Kathleen; Bonfine Natalie; Duda-Banwar Janelle
International journal of offender therapy and comparative criminology
2018
2018-10
<a href="http://doi.org/10.1177/0306624X18759242" target="_blank" rel="noreferrer noopener">10.1177/0306624X18759242</a>
DERM: A Four-Step Dermatology Education Digital Tool Kit for Nondermatologists.
Background and Objectives: Dermatology is often an overlooked and underemphasized area of training in postgraduate primary care medical education, with an abundance of dermatological educational resources available, but no clear guidelines on how to best take advantage of them. The objective of this study was to develop a dermatology digital tool kit designed to describe, evaluate, recognize, and manage (DERM) common dermatological conditions in primary care residency education and to evaluate potential improvement in clinical confidence.Methods: A total of 14 family medicine (FM) and 33 internal medicine (IM) residents were given the DERM tool kit to complete over 7 weeks. Effects on residents' self-reported comfort with dermatology and resources used were measured by voluntary anonymous surveys distributed before and after DERM completion.Results: A response rate of 100% (14/14) for FM residents and 52% (17/33) for IM residents was achieved. The majority of residents (61%) recalled minimal dermatology education-less than 2 weeks-in medical school and 71% agreed that there is not enough dermatology in their residency curriculum. A statistically significant increase in resident comfort with describing (P=0.002), recognizing and diagnosing (P\textless0.001), and managing (P=0.001) dermatologic conditions was observed postcompletion. Residents reported they would recommend this tool to other primary care residents.Conclusions: Implementing the DERM digital tool kit is feasible with primary care residents and appears to improve comfort with describing, recognizing and diagnosing, and managing dermatologic conditions.
Giesey Rachel; Narively Doria; Mostow Eliot; Davidson Elliot; Mullen Chanda
Family medicine
2018
2018-08-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.22454/FamMed.2018.504756" target="_blank" rel="noreferrer noopener">10.22454/FamMed.2018.504756</a>
Getting the hypertension Dx right: Patient positioning matters.
AMERICAN Heart Association; BLOOD pressure; HYPERTENSION; LOGISTIC regression analysis; PATIENT positioning; SPHYGMOMANOMETERS
Taking blood pressure with the patient seated on the edge of an exam table led to misclassification of prehypertension or hypertension in 13.2% of patients.
Morcos Roy N; Carter Kimbroe J; Castro Frank; Yu Nathan; Jordan Cary; Macabobby Thomas D; Rodriguez Angelina
The Journal of Family Practice
2018
2018-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Biochemistry, Hemoglobin Synthesis
Hemoglobin is an oxygen-binding protein found in erythrocytes which transports oxygen from the lungs to tissues. Each hemoglobin molecule is a tetramer made of four polypeptide globin chains. Each globin subunit contains a heme moiety formed of an organic protoporphyrin ring and a central iron ion in the ferrous state (Fe2+). The iron molecule in each heme moiety can bind and unbind oxygen, allowing for oxygen transport in the body. The most common type of hemoglobin in the adult is HbA, which comprises two alpha-globin and two beta-globin subunits. Different globin genes encode each type of globin subunit.[1] The two main components of hemoglobin synthesis are globin production and heme synthesis. Globin chain production occurs in the cytosol of erythrocytes and occurs by genetic transcription and translation. Many studies have shown that the presence of heme induces globin gene transcription. Genes for the alpha chain are on chromosome 16 and genes for the beta chain are on chromosome 11. Heme synthesis occurs in both the cytosol and the mitochondria of erythrocytes. It begins with glycine and succinyl coenzyme A and ends with the production of a protoporphyrin IX ring. Binding of the protoporphyrin to an Fe2+ ion forms the final heme molecule.[2]
Farid Yostina; Lecat Paul
StatPearls
2018
2018-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Retrospective Comparison of Cardiac Testing and Results on Inpatients with Low Pretest Probability Compared with Moderate/High Pretest Probability for Coronary Artery Disease.
Coronary Artery Disease; Pretest Probability; Stress Test
OBJECTIVE: To determine whether admission, and provocative stress testing of patients who have ruled out for acute coronary syndrome put patients with low-risk category for coronary artery disease (CAD) at risk for false-positive provocative stress testing and unnecessary coronary angiogram/imaging. METHODS: A retrospective chart review was performed on patients between 30 and 70 years old, with no pre-existing diagnosis of CAD, admitted to observation or inpatient status chest pain or related complaints. Included patients were categorized based on Duke Clinical Score for pretest probability for CAD into either low-risk group, or moderate/high-risk group. The inpatient course was compared including whether provocative stress testing was performed; results of stress testing; whether patients underwent further coronary imaging; and what the results of the further imaging showed. RESULTS: 543 patients were eligible: 305 low pretest probability, and 238 moderate/high pretest probability. No difference was found in rate of stress testing relative risk (RR) = 1.01 (95% CI, 0.852 to 1.192; P = 0); rate of positive or equivocal stress tests between the 2 groups: RR = 0.653 (95% CI, 0.415 to 1.028; P = .07,). Low-pretest-probability patients had a lower likelihood of positive coronary imaging after stress test, RR = 0.061 (95% CI, 0.004 to 0.957; P = .001). CONCLUSION: Follow-up provocative testing of all patients admitted/observed after emergency department presentation with chest pain is unlikely to find CAD in patients with low pretest probability. Testing all low-probability patients puts them at increased risk for unnecessary invasive confirmatory testing. Further prospective testing is needed to confirm these retrospective results.
Lear Aaron; Huber Merritt; Canada Amy; Robertson Jessica; Bosman Evan; Zyzanski Stephen
Journal of the American Board of Family Medicine : JABFM
2018
2018-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3122/jabfm.2018.02.170295" target="_blank" rel="noreferrer noopener">10.3122/jabfm.2018.02.170295</a>
On the Importance of Accurate Inputs and Assumptions for Screening Mammography Modeling.
Carter Kimbroe J; Castro Frank; Morcos Roy N
AJR. American journal of roentgenology
2018
2018-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2214/AJR.18.19749" target="_blank" rel="noreferrer noopener">10.2214/AJR.18.19749</a>
Insights Into Breast Cancer Screening: A Computer Simulation of Two Contemporary Screening Strategies.
Female; Humans; *Computer Simulation; *Practice Guidelines as Topic; American Cancer Society; Biopsy/economics/statistics & numerical data; breast cancer; Breast Neoplasms/*diagnostic imaging; Cost-Benefit Analysis; cost-effectiveness acceptability curves; Early Detection of Cancer/economics/methods; False Positive Reactions; mammography screening; Mammography/economics/*statistics & numerical data; Mass Screening/*methods; Medical Overuse/economics; mixed interval screening; Monte Carlo method; Monte Carlo Method; Unnecessary Procedures/economics
OBJECTIVE: The debate over the value of screening mammography is rekindled with each new published study or guideline. Central to the discussion are the uncertainties about screening benefits and harms and the criteria used to assess them. Today, the magnitude of benefits for a population is less certain, and the evolving concept of harm has come to encompass false-positives (FPs), unnecessary biopsies, overdiagnosis, and overtreatment. This study uses a Monte Carlo computer simulation to study the balance of benefits and harms of mammographic breast cancer screening for average-risk women. MATERIALS AND METHODS: This investigation compares the American Cancer Society's 2015 mixed annual-biennial guideline with the U.S. Preventive Services Task Force's 2016 fixed biennial guideline. Screening strategies are compared using cost-effectiveness acceptability curves, an economic analysis describing uncertainty in evaluating costs and health outcomes. Strategy preference is examined under changing assumptions of willingness to pay for a quality-adjusted life-year. Additionally, comparative effectiveness analysis is performed using FP screens and unnecessary biopsies per life-year gained. Alternative scenarios are compared assuming a reduced mortality benefit of screening. RESULTS: In general, results using both cost-effectiveness and clinical measures indicate that American Cancer Society's 2015 mixed annual-biennial guideline is preferred. Assuming decreases in the mortality benefit of mammography, no screening may be reasonable. CONCLUSION: The use of a mixed annual-biennial strategy for population screening takes advantage of the nonuniformity of occurrence of mammography benefits and harms over the duration of screening. This approach represents a step toward improving guidelines by exploiting age dependencies at which benefits and harms accrue.
Carter Kimbroe J; Castro Frank; Morcos Roy N
AJR. American journal of roentgenology
2018
2018-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2214/AJR.17.18484" target="_blank" rel="noreferrer noopener">10.2214/AJR.17.18484</a>
Public Program Enrollment Following US State Medicaid Expansion and Outreach.
OBJECTIVES: To examine the joint impact of states' Medicaid expansion and participation in Medicaid enrollment outreach at the take-up of other means-tested public programs (Women, Infants, and Children [WIC], Supplemental Nutrition Assistance Program [SNAP]). METHODS: Data were used from the American Community Survey, WIC, and SNAP. We used difference-in-differences analyses to compare the combined impact of Medicaid expansion and enrollment outreach on program enrollment. RESULTS: Enrollment in means-tested programs decreased after 2014, regardless of Medicaid expansion and outreach status. However, gaps in enrollment among states that both expanded Medicaid and conducted outreach, compared with states that did neither, increased after expansion of SNAP and WIC enrollment (10.15% and 4.57%, respectively) and favored those states that did both. CONCLUSIONS: States that both expanded Medicaid and conducted Medicaid enrollment outreach experienced smaller decreases in SNAP and WIC enrollment in comparison with other states. Moreover, enrollment in SNAP has shown to reduce health care expenditures. Greater collaboration among public programs, such as streamlining eligibility data and concerted outreach efforts, is one of the achievements of the Affordable Care Act that should be continued.
Lanese Bethany G; Fischbein Rebecca; Furda Chelsea
American Journal of Public Health
2018
2018-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2105/AJPH.2018.304592" target="_blank" rel="noreferrer noopener">10.2105/AJPH.2018.304592</a>
Twin-twin transfusion syndrome screening and diagnosis in the United States: A triangulation design of patient experiences.
Adult; Female; Humans; Retrospective Studies; Ultrasonography; Cross-Sectional Studies; Fetofetal Transfusion/*diagnosis/*diagnostic imaging/*epidemiology; Gestational Age; Patient Reported Outcome Measures; Pregnancy; Prenatal Care/methods; Ultrasonography/methods; United States; Prenatal/methods
OBJECTIVE: Using patient-reported experiences, this study: 1) quantitatively evaluated TTTS screening trends, 2) examined screening and diagnostic experiences using a mixed methods approach, and 3) determined gaps in clinical care experiences. DESIGN: This was a cross-sectional study. Data was collected using a self-report, retrospective survey. A triangulation design was used to validate quantitative survey data with thematically analyzed qualitative data. SETTING: Participants were recruited through social media and national foundations and completed the survey online. PARTICIPANTS: Participants were 312 women who completed a TTTS pregnancy in the United States, representing the largest survey of participants who have experienced TTTS. METHODS: Descriptive statistics and bivariate analyses were conducted. Multivariate logistic regression examined predictors of ultrasound frequency. Qualitative data were initially coded by hand and checked using qualitative software. RESULTS: The percentages of participants reporting guideline recommended screening, including identification of pregnancy type by gestational week 13 and timely receipt of ultrasounds, increased over time. However, 44.6% of participants diagnosed in recent years (2014 and later), reported that prior to TTTS diagnosis, they did not receive biweekly or more frequent ultrasounds. Three patient-reported provider practices were related to receiving ultrasounds at the recommended frequency: (1) determining MCDA status prior to gestational week 14, (2) providing participants with early warnings about the risk of TTTS to their pregnancies after MCDA status had been determined, and (3) referring participants to a Maternal-Fetal Medicine Specialist after MCDA identification, as validated by qualitative data. Our qualitative data revealed gaps in effective clinical care experiences among OB/GYN and specialist providers. CONCLUSION: These findings indicate screening and diagnosis for TTTS, as reported by patients, is improving in the United States; however, further efforts are required to ensure all patients receive appropriate screening, education and a team-based approach to comprehensive and supportive clinical care.
Fischbein Rebecca; Nicholas Lauren; Aultman Julie; Baughman Kristin; Falletta Lynn
PloS one
2018
1905-7
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1371/journal.pone.0200087" target="_blank" rel="noreferrer noopener">10.1371/journal.pone.0200087</a>
Pregnant or recently pregnant opioid users: contraception decisions, perceptions and preferences.
Contraception; Opioid Drug Use; Pregnancy
Background: Multiple factors are linked to extremely high unintended pregnancy rates among women who use opioids, including various barriers to contraception adherence. These include patient level barriers such as lack of knowledge and education about highly effective contraception, and potential provider barriers. Using a mixed-methods framework to examine the contraception-related perceptions and preferences of opioid using women is a necessary next step to understanding this phenomenon. Methods: A mixed-method study was conducted which included both self-report questionnaires along with a semi-structured qualitative interview of opioid-using pregnant or recently pregnant women in two drug treatment facilities in Ohio. Results: Forty-two women completed the study. The majority of recent (75%) and total pregnancies were unintended. Male condoms were reported as the highest form of lifetime contraception used within the present sample (69%). Participants reported low lifetime use of long acting reversible contraception (LARC) (ranging from 5 to 12%). Participants preferred hormonal injections first (40%), followed by IUDs (17%). Reasons for preferences of injections and LARC were similar: not needing to remember, side effects, and long-term effectiveness. Conclusions: Most of the study population participants stated they would utilize contraception, particularly Tier 1 LARC methods, if freely available; however, high rates of unintended pregnancy were observed in this sample. This indicates the need for contraception education, and addressing the procedural, logistical and economic barriers that may be preventing the use of LARC among this population.
Fischbein Rebecca L; Lanese Bethany G; Falletta Lynn; Hamilton Kelsey; King Jennifer A; Kenne Deric R
Contraception and reproductive medicine
2018
2018
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s40834-018-0056-y" target="_blank" rel="noreferrer noopener">10.1186/s40834-018-0056-y</a>
Twin-Twin Transfusion Syndrome and Maternal Symptomatology-An Exploratory Analysis of Patient Experiences When Reporting Complaints.
maternal symptomatology; MCDA; monochorionic-diamniotic; patient experience; reporting; TTTS; twin-twin transfusion syndrome
Objective: The aim of this study was to assess patient experiences when reporting symptoms of twin-twin transfusion syndrome (TTTS) to their health-care providers. Methodology: The study utilized an online, retrospective survey of women, over the age of 18, who were living in the United States at the time of their pregnancy and had completed a TTTS pregnancy. Results: Three hundred sixty-seven cases were included for analysis. Nearly half of the respondents (45.2%) reported experiencing maternal symptoms prior to TTTS diagnosis. The average number of symptoms experienced was 2.85. The average gestational week of symptom onset was 18.2. A total of 76.2% of respondents experiencing symptoms shared these concerns with their health-care provider; however, slightly more than half (51.2%) believed that the provider dismissed their complaints. Conclusions: Results suggest a disconnect between patients' reporting TTTS symptoms and health-care providers responding attentively, as perceived by the patient. It would be advantageous for health-care providers to inform women pregnant with a monochorionic-diamniotic pregnancy to immediately report the presence of any symptom described in the present research, which may be associated with any number of twin pregnancy-related complications.
Nicholas Lauren; Fischbein Rebecca; Falletta Lynn; Baughman Kristin
Journal of patient experience
2018
2018-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/2374373517736760" target="_blank" rel="noreferrer noopener">10.1177/2374373517736760</a>
Interventions That Target Criminogenic Needs for Justice-Involved Persons With Serious Mental Illnesses: A Targeted Service Delivery Approach.
*Criminals; *Health Services Needs and Demand; Adult; criminogenic needs; Health Services Needs and Demand; Humans; Mental Disorders – Therapy; Mental Disorders/*therapy; Mental Health Services – Administration; Mental Health Services/*organization & administration; mental illness; Middle Age; Middle Aged; Public Offenders; recidivism; Young Adult
This research describes the development of a targeted service delivery approach that tailors the delivery of interventions that target criminogenic needs to the specific learning and treatment needs of justice-involved people with serious mental illnesses (SMIs). This targeted service delivery approach includes five service delivery strategies: repetition and summarizing, amplification, active coaching, low-demand practice, and maximizing participation. Examples of how to apply each strategy in session are provided, as well as recommendations on when to use each strategy during the delivery of interventions that target criminogenic needs. This targeted service delivery approach makes an important contribution to the development of interventions for justice-involved people with SMI by increasing the chances that people with SMI can participate fully in and benefit from these interventions that target criminogenic needs. These developments come at a critical time in the field as the next generation of services for justice-involved people with SMI are being developed.
Wilson Amy Blank; Farkas Kathleen; Bonfine Natalie; Duda-Banwar Janelle
International journal of offender therapy and comparative criminology
2018
2018-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0306624X17695588" target="_blank" rel="noreferrer noopener">10.1177/0306624X17695588</a>
Sequential Intercept Mapping: Developing Systems-Level Solutions for the Opioid Epidemic.
Cross-systems issues; Opioids; Sequential intercept mapping; Sequential intercept model
Sequential intercept mapping, a community-based application of the sequential intercept model, was recently adapted in Ohio to address the complex challenge of the opioid crisis. Sequential intercept mapping for opioids provides a framework for criminal justice, mental health and addictions treatment providers, family members and opioid-involved individuals, and other stakeholders to develop community-based responses that emphasize prevention, regulation, and treatment for opioid dependency, with a goal of reducing unintended deaths and overdoses. The authors describe a promising approach to using sequential intercept mapping to address the opioid crisis.
Bonfine Natalie; Munetz Mark R; Simera Ruth H
Psychiatric services (Washington, D.C.)
2018
2018-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/appi.ps.201800192" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.201800192</a>
A Comparison of Participants in Two Community-Based Programs: Assisted Outpatient Treatment and a Mental Health Court.
Assisted Outpatient Treatment; mental health courts; Outpatient commitment
OBJECTIVE: Mental health courts and assisted outpatient treatment (AOT) are tools to help people with serious mental illness engage in treatment and avoid or reduce institutionalization. As both programs become increasingly prevalent, questions remain about whether people with severe mental illness who receive AOT have the same characteristics, histories, and service needs as those who participate in mental health courts. If there are differences, each program may require assessments and interventions tailored to the specific characteristics and needs of participants. METHODS: This study examined administrative criminal justice and mental health services data for 261 people with serious mental illness who participated in AOT, a mental health court, or both over seven years. RESULTS: Three percent of the sample participated in both programs. Compared with participants in mental health court, participants in AOT were older, less likely to have an alcohol use disorder, and more likely to have a schizophrenia spectrum disorder than a bipolar disorder. The participants' histories of crisis mental health service utilization, hospitalization, and incarceration prior to program entry varied significantly by program. CONCLUSIONS: The findings suggest that there are differences among individuals with serious mental illness who are served by AOT and mental health court programs. AOT participants had greater engagement with mental health services, and a significant portion of AOT participants also had a prior criminal history that placed them at risk of future justice involvement. Program administrators need to recognize and address the clinical and criminogenic needs that place individuals at risk of becoming hospitalized and incarcerated.
Bonfine Natalie; Ritter Christian; Teller Jennifer L S; Munetz Mark R
Psychiatric services (Washington, D.C.)
2018
2018-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1176/appi.ps.201700341" target="_blank" rel="noreferrer noopener">10.1176/appi.ps.201700341</a>
Interprofessional education model for geriatric falls risk assessment and prevention.
Background: One in three people over the age of 65 fall every year, with 1/3 sustaining at least moderate injury. Falls risk reduction requires an interprofessional health team approach. The literature is lacking in effective models to teach students how to work collaboratively in interprofessional teams for geriatric falls prevention. The purpose of this paper is to describe the development, administration and outcome measures of an education programme to teach principles of interprofessional care for older adults in the context of falls prevention. Methods: Students from three academic institutions representing 12 health disciplines took part in the education programme over 18 months (n=237). A mixed method one-group pretest and post-test experimental design was implemented to measure the impact of a multistep education model on progression in interprofessional collaboration competencies and satisfaction. Results: Paired t-tests of pre-education to posteducation measures of Interprofessional Socialization and Valuing Scale scores (n=136) demonstrated statistically significant increase in subscales and total scores (p\textless0.001). Qualitative satisfaction results were strongly positive. Discussion: Results of this study indicate that active interprofessional education can result in positive student attitude regarding interprofessional team-based care, and satisfaction with learning. Lessons learnt in a rapid cycle plan-do-study-act approach are shared to guide replication efforts for other educators. Conclusion: Effective models to teach falls prevention interventions and interprofessional practice are not yet established. This education model is easily replicable and can be used to teach interprofessional teamwork competency skills in falls and other geriatric syndromes.
Brown Diane K; Fosnight Sue; Whitford Maureen; Hazelett Susan; McQuown Colleen; Drost Jenifer C; Kropp Denise J; Hovland Cynthia A; Niederriter Joan E; Patton Rikki; Morgan Abigail; Fleming Eileen; Steiner Richard P; Scott Edward Demond; Ortiz Figueroa Fabiana
BMJ open quality
2018
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1136/bmjoq-2018-000417" target="_blank" rel="noreferrer noopener">10.1136/bmjoq-2018-000417</a>
A broader understanding of care managers' attitudes of advance care planning: A concurrent nested design.
*Attitude of Health Personnel; *Health Knowledge; Adult; Advance Care Planning; Advance Care Planning/*standards; Attitudes; Case Managers; Chi Square Test; community health; Concurrent Prospective Studies; Convenience Sample; decision-making; Discussion; end of life; Female; Focus Groups; Funding Source; Health Services Accessibility/standards; Human; Humans; Male; Middle Age; Middle Aged; Midwestern United States; Multicenter Studies; Multimethod Studies; Nurse Attitudes; nurses; Practice; qualitative; Qualitative Research; quantitative; Questionnaires; Surveys; Surveys and Questionnaires; Thematic Analysis
AIMS AND OBJECTIVES: To examine barriers of advance care planning (ACP) experienced by care managers (CMs) through a mixed methods approach. A concurrent nested design was used to acquire a deeper understanding of ACP and to identify nuances between quantitative and qualitative data. BACKGROUND: Past quantitative studies on providers have identified barriers related to time, culture, knowledge, responsibility and availability of legal documents. These barriers, and accompanying attitudes and feelings, have been taken at face value without rich qualitative data to identify under what conditions and to what extent a barrier impacts care. DESIGN: A two-part multisite, mixed methods study was conducted using surveys and focus groups. METHODS: Surveys were completed by 458 CMs at 10 Area Agencies on Aging and 62 participated in one of eight focus groups. Data were analysed using a concurrent nested design with individual data analysis and a merged data approach. RESULTS: There were three main distinctions between the quantitative and qualitative data. First, while CMs reported on the survey that ACP was not too time consuming, focus group data revealed that time was an issue especially related to competing priorities. Second on the survey 60% of the CMS reported they had enough knowledge, but qualitative data revealed about more nuances. Last, the reported comfort levels in the quantitative data were less overt in the qualitative date where additional feelings and attitudes were revealed, for example, frustration with families, preferences for more physician involvement. CONCLUSIONS: Care managers reported their attitudes about ACP, clarified through a rigorous mixed methods analysis. Care managers can successfully lead ACP discussions, but require further education, resources and team-based guidance. RELEVANCE TO CLINICAL PRACTICE: Advance care planning is essential for reducing emotional, social and financial burdens associated with healthcare decision-making, and CMs can positively impact ACP discussions when appropriately supported by the clinical community. The many nuances in the ACP process that we found illustrate the need for ongoing discussions, education and research on this important topic.
Aultman Julie; Baughman Kristin R; Ludwick Ruth
Journal of clinical nursing
2018
2018-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/jocn.14531" target="_blank" rel="noreferrer noopener">10.1111/jocn.14531</a>