Effect of Monoclonal Antibody Treatment on Clinical Outcomes in Ambulatory Patients With Coronavirus Disease 2019.

We compared rates of emergency department visits or hospitalizations among ambulatory coronavirus disease 2019 (COVID-19) patients treated with monoclonal antibody (mAb) therapy (n = 305) vs untreated patients (n = 6354). Treatment was associated with decreased encounters within 30 days (adjusted odds ratio, 0.23 [95% confidence interval, .

Evolution and Evaluation of a Quality and Patient Safety Fellowship for Practicing Health Professionals.

Developing clinical quality champions is an important strategy for improving health care quality. The NorthShore Quality and Patient Safety Fellowship was a yearlong program for practicing physicians devoting 4 hours/wk to a didactic curriculum and quality practicum. Thirty-seven clinicians completed the Fellowship from 2011 to 2018.

Using the RE-AIM framework to evaluate internal and external validity of mobile phone-based interventions in diabetes self-management education and support.

Objective: We evaluated the extent to which studies that tested short message service (SMS)- and application (app)-based interventions for diabetes self-management education and support (DSMES) report on factors that inform both internal and external validity as measured by the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework.

Materials And Methods: We systematically searched PubMed, Embase, Web of Science, CINAHL (Cumulative Index of Nursing and Allied Health Literature), and IEEE Xplore Digital Library for articles from January 1, 2009, to February 28, 2019. We carried out a multistage screening process followed by email communications with study authors for missing or discrepant information.

Development and validation of an asthma exacerbation prediction model using electronic health record (EHR) data.

Asthma exacerbations are associated with significant morbidity, mortality, and cost. Accurately identifying asthma patients at risk for exacerbation is essential. We sought to develop a risk prediction tool based on routinely collected data from electronic health records (EHRs).

Text Messaging to Improve Disease Management in Patients With Painful Diabetic Peripheral Neuropathy.

Purpose The purpose of the study was to determine the impact of educational text messages on diabetes self-management activities and outcomes in patients with painful diabetic peripheral neuropathy (pDPN). Methods Patients with pDPN identified from a large integrated health system who agreed to participate were randomized to 6 months of usual care (UC) or UC plus twice-daily diabetes self-management text messages (UC+TxtM). Outcomes included the Pain Numerical Rating Scale, Summary of Diabetes Self-Care Activities (SDSCA), questions on diabetes health beliefs, and glycated hemoglobin (A1C).

Methodological Standards for Meta-Analyses and Qualitative Systematic Reviews of Cardiac Prevention and Treatment Studies: A Scientific Statement From the American Heart Association.

Meta-analyses are becoming increasingly popular, especially in the fields of cardiovascular disease prevention and treatment. They are often considered to be a reliable source of evidence for making healthcare decisions. Unfortunately, problems among meta-analyses such as the misapplication and misinterpretation of statistical methods and tests are long-standing and widespread.

The Role Of NOACs in Atrial Fibrillation Management: A Qualitative Study.

Patients with atrial fibrillation (AF) benefit from anticoagulation to reduce stroke risk. However, 30-60% of patients with AF are not anticoagulated. This study explored physicians' reasons for under-treatment of AF, focusing on the role of the novel oral anticoagulants (NOACs).

Physician perspectives on de-intensifying diabetes medications.

Guidelines for diabetes care recommend that physicians select individualized glycemic goals based on life expectancy, diabetes duration, comorbidity, and resources/support. When patients have stable hemoglobin A1C (HbA1C) levels, guidelines lack recommendations on when diabetes medications should be de-intensified.To understand physicians' perspectives on de-intensifying diabetes medications in patients with type 2 diabetes.

Perceptions of racism in healthcare among patients with systemic lupus erythematosus: a cross-sectional study.

Background: Racial disparities in the clinical outcomes of systemic lupus erythematosus (SLE) exist. Perceived racial discrimination may contribute to disparities in health.

Objectives: To determine if perceived racism in healthcare differs by race among patients with SLE and to evaluate its contribution to racial disparities in SLE-related outcomes.

Evaluating Primary Care Physician Performance in Diabetes Glucose Control.

This study demonstrates that it is possible to identify primary care physicians (PCPs) who perform better or worse than expected in managing diabetes. Study subjects were 14 033 adult diabetics and their 133 PCPs. Logistic regression was used to predict the odds that a patient would have uncontrolled diabetes (defined as HbA1c ≥8%) based on patient-level characteristics alone.

Racial differences in treatment preferences among lupus patients: a two-site study.

Objectives: To identify the demographic, clinical and psychosocial characteristics associated with racial differences in willingness to receive cyclophosphamide (CYC) or participate in a research clinical trial (RCT) among patients with systemic lupus erythematosus (SLE).

Methods: Data from 163 African-American (AA) and 180 white (WH) SLE patients were evaluated. Structured interviews and chart reviews were conducted to determine treatment preferences in hypothetical situations and identify variables that may affect preferences.

A technology-based quality innovation to identify undiagnosed hypertension among active primary care patients.

Purpose: The goal of this study was to develop a technology-based strategy to identify patients with undiagnosed hypertension in 23 primary care practices and integrate this innovation into a continuous quality improvement initiative in a large, integrated health system.

Methods: In phase 1, we reviewed electronic health records (EHRs) using algorithms designed to identify patients at risk for undiagnosed hypertension. We then invited each at-risk patient to complete an automated office blood pressure (AOBP) protocol.

Evaluating the role of key learning theories in ECHO: a telehealth educational program for primary care providers.

Background: ECHO (Extension for Community Healthcare Outcomes) is a telehealth educational program that uses videoconference technology to train community-based primary care providers (PCP's) on the management of complex, chronic diseases. The main components of ECHO are didactics, case presentations, and case-based learning. ECHO was developed using the key principles of Social Cognitive Theory, Situated Learning Theory, and Community of Practice Theory.

A study of racial/ethnic differences in treatment preferences among lupus patients.

Objectives: To determine whether there are racial/ethnic differences in the willingness of SLE patients to receive CYC or participate in clinical trials, and whether demographic, psychosocial and clinical characteristics contribute to these differences.

Methods: Data from 120 African-American and 62 white lupus patients were evaluated. Structured telephone interviews were conducted to determine treatment preferences, as well as to study characteristics and beliefs that may affect these preferences.

Using an established telehealth model to train urban primary care providers on hypertension management.

The objective of this study was to determine whether a videoconference-based telehealth network can increase hypertension management knowledge and self-assessed competency among primary care providers (PCPs) working in urban Federally Qualified Health Centers (FQHCs). We created a telehealth network among 6 urban FQHCs and our institution to support a 12-session educational program designed to teach state-of-the-art hypertension management. Each 1-hour session included a brief lecture by a university-based hypertension specialist, case presentations by PCPs, and interactive discussions among the specialist and PCPs.

The health promise of Promise Neighborhoods.

The Promise Neighborhoods initiative from the U.S. Department of Education offers grant funding to develop innovative educational and community support programs in distressed communities.

Serum 2-methoxyestradiol, an estrogen metabolite, is positively associated with serum HDL-C in a population-based sample.

Serum HDL cholesterol (HDL-C) is inversely associated with coronary artery disease, ischemic stroke, and atherosclerosis in men and women. Among postmenopausal women, oral conjugated equine estrogen (CEE) increases serum HDL-C. This is due to activation of hepatic nuclear estrogen receptors, resulting in increased HDL-C expression, as well as modulation of proteins which metabolize HDL-C.

Dietary fiber and serum 16α-hydroxyestrone, an estrogen metabolite associated with lower systolic blood pressure.

Objective: We recently identified an inverse relation between systolic blood pressure (SBP) and serum 16α-hydroxyestrone, a metabolite of 17β-estradiol, in postmenopausal women. Formation of 16α-hydroxyestrone is catalyzed primarily by CYP1A2, a cytochrome P450 enzyme. The objective of this study was to evaluate the relations between known modifiers of CYP1A2 activity and serum 16α-hydroxyestrone in postmenopausal women.

A meta-analysis of interventions to reduce loneliness.

Social and demographic trends are placing an increasing number of adults at risk for loneliness, an established risk factor for physical and mental illness. The growing costs of loneliness have led to a number of loneliness reduction interventions. Qualitative reviews have identified four primary intervention strategies: (a) improving social skills, (b) enhancing social support, (c) increasing opportunities for social contact, and (d) addressing maladaptive social cognition.

Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults.

Loneliness is a prevalent social problem with serious physiological and health implications. However, much of the research to date is based on cross-sectional data, including our own earlier finding that loneliness was associated with elevated blood pressure (Hawkley, Masi, Berry & Cacioppo, 2006). In this study, we tested the hypothesis that the effect of loneliness accumulates to produce greater increases in systolic blood pressure (SBP) over a 4-year period than are observed in less lonely individuals.

Serum estrogen metabolites and systolic blood pressure among middle-aged and older women and men.

Background: Hypertension is more common among men at younger ages and among women after age 60, suggesting a possible link between endogenous estrogens and systolic blood pressure (SBP). We tested whether serum 17beta-estradiol (E(2)) or any of its metabolites were associated with SBP among middle-aged and older adults.

Methods: Using a cross-sectional study design, we examined data from a population-based sample of 98 adults living in Cook County, Illinois.

Autonomic tone and C-reactive protein: a prospective population-based study.

Objectives: To examine the cross-sectional and longitudinal relationships between cardiac autonomic tone and serum CRP and to investigate potential causal links between these measures.

Methods: A population-based sample of 188 home-dwelling, middle-aged and older adults (104 women, mean age 59 years) from Cook County, IL, participated in this prospective cohort study. High-frequency heart rate variability (HF) and pre-ejection period (PEP) served as markers of cardiac parasympathetic and sympathetic tone, respectively.

Perceptions of breast cancer treatment among African-American women and men: implications for interventions.

Background: While breast cancer mortality has declined in recent years, the mortality gap between African-American and white women continues to grow. Current strategies to reduce this disparity focus on logistical and information needs, but contextual factors, such as concerns about racism and treatment side effects, may also represent significant barriers to improved outcomes.

Objective: To characterize perceptions of breast cancer treatment among African-American women and men.

From social structural factors to perceptions of relationship quality and loneliness: the Chicago health, aging, and social relations study.

Objective: The objective of this study was to test a conceptual model of loneliness in which social structural factors are posited to operate through proximal factors to influence perceptions of relationship quality and loneliness.

Methods: We used a population-based sample of 225 White, Black, and Hispanic men and women aged 50 through 68 from the Chicago Health, Aging, and Social Relations Study to examine the extent to which associations between sociodemographic factors and loneliness were explained by socioeconomic status, physical health, social roles, stress exposure, and, ultimately, by network size and subjective relationship quality.

Result: Education and income were negatively associated with loneliness and explained racial/ethnic differences in loneliness.

Biomarkers of Psychological Stress in Health Disparities Research.

Psychological stress can contribute to health disparities in populations that are confronted with the recurring stress of everyday life. A number of biomarkers have been shown to be affected by psychological stress. These biomarkers include allostatic load, which is a summary measure of the cumulative biological burden of the repeated attempts to adapt to daily stress.