Impact of Local Tailoring on Acute Stroke Care in 21 Disparate Emergency Departments: A Prospective Stepped Wedge Type III Hybrid Effectiveness-Implementation Study.

Background: Faster delivery of tPA (tissue-type plasminogen activator) results in better health outcomes for eligible patients with stroke. Standardization of stroke protocols in emergency departments (EDs) has been difficult, especially in nonstroke centers. We measured the effectiveness of a centrally led implementation strategy with local site tailoring to sustain adherence to an acute stroke protocol to improve door-to-needle (DTN) times across disparate EDs in a multihospital health system.

Alerting Wisely: Reducing Inappropriate Blood Chemistry Panel Orders Using a Clinical Decision Support Tool.

The Choosing Wisely (CW) initiative provides recommendations for healthcare providers, aimed at reducing unnecessary or inappropriate tests and procedures. A clinical decision support (CDS) alert in the electronic health record was developed to reflect organizational CW guidelines regarding blood chemistry panel ordering in the primary care setting. An interrupted time series design was used to analyze the weekly proportion of inappropriate blood chemistry panel orders prior to and after implementation of the CDS alert in treatment and control groups.

"Pharming out" support: a promising approach to integrating clinical pharmacists into established primary care medical home practices.

Objective Embedding clinical pharmacists into ambulatory care settings needs to be assessed in the context of established medical home models. Methods A retrospective, observational study examined the effectiveness of the Intermountain Healthcare Collaborative Pharmacist Support Services (CPSS) program from 2012-2015 among adult patients diagnosed with diabetes mellitus (DM) and/or high blood pressure (HBP). Patients who attended this program were considered the intervention (CPSS) cohort.

The stability of time estimation in older adults.

The ability to correctly estimate time is important for many daily activities, such as cooking and driving. This study investigated the stability time estimation in healthy older adults and compared them to healthy younger adults. Participants were tested and retested across the duration of 1 year.

State-level strategies for reducing prescription drug overdose deaths: Utah's prescription safety program.

Introduction: The Utah Department of Health created a program to decrease deaths and other harm from prescription pain medication. Program goals included educating the public, providers, and patients on prescription safety and creating guidelines for providers on prescribing opioids.

Program Interventions: The department's Prescription Pain Medication Program was organized in collaboration with many state agencies as well as public and private organizations.

Recovery of time estimation following moderate to severe traumatic brain injury.

Objective: Accurate time estimation abilities are thought to play an important role in efficient performance of many daily activities. This study investigated the role of episodic memory in the recovery of time estimation abilities following moderate to severe traumatic brain injury (TBI).

Method: Using a prospective verbal time estimation paradigm, TBI participants were tested in the early phase of recovery from TBI and then again approximately one year later.

Assessment of memory self-awareness following traumatic brain injury.

Objective: To examine memory self-awareness abilities in individuals with moderate-to-severe traumatic brain injury (TBI) using both 'online assessment' and 'offline assessment' methodologies.

Design And Methods: Participants were 23 individuals with TBI and 23 controls matched on age, education and sex. Online assessment of memory was assessed by comparing the predicted amount of information participants expected that they would remember following trial 1, trial 5 and a 20-minute delay with actual memory performance on list-learning and visuospatial memory tests.

Mild cognitive impairment and feeling-of-knowing in episodic memory.

This study examined both retrospective and prospective memory self-monitoring abilities in 33 individuals with amnestic mild cognitive impairment (MCI) and 33 healthy older adult controls. Participants learned 36 critical cue-target word pairs. Following a distractor task, participants were asked to recall each target word that corresponded to a given cue word.

A policy and environmental response to overweight in childhood: the impact of Gold Medal Schools.

Background: The prevalence of overweight among US children and adolescents has increased substantially since 1980. As a result, overweight in childhood and adolescence has become a substantial health problem that requires effective health promotion programs and interventions.

Context: Coinciding with the 2002 Winter Olympic Games in Salt Lake City, the Utah Department of Health (UDOH) developed a pilot program called Gold Medal Schools (GMS) to promote healthy lifestyles among school-aged children.

Predictions of episodic memory following moderate to severe traumatic brain injury during inpatient rehabilitation.

We examined memory self-awareness and memory self-monitoring abilities during inpatient rehabilitation in participants with moderate to severe traumatic brain injury (TBI). A total of 29 participants with moderate to severe TBI and 29 controls matched on age, gender, and education completed a performance prediction paradigm. To assess memory self-awareness, participants predicted the amount of information they would remember before completing list-learning tasks and visual-spatial memory tasks.

Feeling of knowing in episodic memory following moderate to severe closed-head injury.

The ability to accurately monitor one's memory is a metacognitive process that is important in everyday life. The authors examined episodic memory feeling-of-knowing (FOK) ratings in 21 moderate to severe closed-head injury (CHI) participants (more than 1 year postinjury) and 21 controls. Participants studied 36 critical cue-target word pairs.

Attention dysfunction and parent reporting in children with brain tumors.

Background: The IQ declines observed in children treated for brain tumor emerge as "late effects" and are conceptualized as secondary to changes in underlying mental processes, such as attention. Early identification of the underlying changes might help minimize the long-term adverse outcomes. We evaluated the validity of a time-efficient, standardized parent-report measure in identifying attention dysfunction in childhood brain tumor survivors.