Contralateral Prophylactic Mastectomy Decision-Making: The Partners' Perspective.

Background: The rate of contralateral prophylactic mastectomy (CPM) continues to rise despite no improvement in survival, an increased risk of surgical complications, and negative effects on quality of life. This study explored the experiences of the partners of women who undergo CPM.

Methods: This study was part of an investigation into the factors motivating women with early-stage unilateral breast cancer and low genetic risk to opt for contralateral prophylactic mastectomy (CPM).

Strategies to Address COVID-19 Vaccine and Pregnancy Myths.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses risks to pregnant women and their infants. The spread of misinformation about COVID-19 vaccination is a barrier to optimizing vaccination rates among women of childbearing age. We conducted an environmental scan to identify misinformation about COVID-19 vaccination, pregnancy, and fertility, and a review to identify evidence to refute misinformation and strategies to correct and prevent the spread of misinformation.

Reframing the conversation about contralateral prophylactic mastectomy: Preparing women for postsurgical realities.

Objective: Women with unilateral, early-stage breast cancer and low genetic risk are increasingly opting for contralateral prophylactic mastectomy (CPM), a concerning trend because CPM offers few clinical benefits while increasing risks of surgical complications. Few qualitative studies have analyzed factors motivating this irreversible decision. Using qualitative methods, this study sought to understand women's decision making and the impact of CPM on self-confidence, sense of femininity, sexual intimacy, and peace of mind.

Patient reminder and recall interventions to improve immunization rates.

Background: Immunization rates for children and adults are rising, but coverage levels have not reached optimal goals. As a result, vaccine-preventable diseases still occur. In an era of increasing complexity of immunization schedules, rising expectations about the performance of primary care, and large demands on primary care providers, it is important to understand and promote interventions that work in primary care settings to increase immunization coverage.

ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

Background: In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity.

Objectives: Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines.

Nursing Intervention Aimed at Improving Self-Managementfor Persons with Chronic Kidney Disease in North Carolina Medicaid: A Pilot Project.

This pilot project aimed to improve knowledge and self-management among Medicaid beneficiaries with Stage 3b and 4 chronic kidney disease who were identified using a population-based approach. Participants received up to six in-person educational sessions delivered by a nurse practitioner. Increases in knowledge and self-reported behavior changes were generally observed among participants.

Conflicting Readmission Rate Trends in a High-Risk Population: Implications for Performance Measurement.

The 30-day readmission rate is a common performance indicator for hospitals and accountable care entities. There is reason to question whether measuring readmissions as a function of hospital discharges is an appropriate measure of performance for initiatives that aim to improve overall cost and quality outcomes in a population. The objectives of this study were to compare trends in 30-day readmission rates per discharge to population-based measures of hospital admission and readmission frequency in a high-risk statewide Medicaid population over a 5-year period of quality improvement and care management intervention.

Reducing children's exposure to school bus diesel exhaust in one school district in North Carolina.

Children who are exposed to diesel exhaust from idling school buses are at increased risk of asthma exacerbation, decreased lung function, immunologic reactions, leukemia, and increased susceptibility to infections. Policies and initiatives that aim to protect school children from the harmful effects of exposure to diesel exhaust range from general environmental air quality standards to more specific legislation that targets diesel exhaust near school children. School nurse standards of practice specify that school nurses should attain current knowledge of environmental health concepts, implement environmental health strategies, and advocate for environmental health principles.

How baccalaureate nursing programs teach writing.

Background: Written communication skills are critical for nursing practice. However, nursing faculty often find students unprepared to communicate clearly and effectively in writing. This integrative review identifies and discusses specific approaches used in baccalaureate programs to teach writing skills to prelicensure nursing students.

Use of a tool to determine perceived barriers to children's healthy eating and physical activity and relationships to health behaviors.

This pilot investigation assesses whether barriers to children's healthy eating and physical activity reported by parents on a newly developed brief pediatric obesity screening and counseling tool are related to healthy eating and physical activity behaviors. The sample included parents of 115 Medicaid-enrolled children in a general pediatric clinic. Of 10 barriers, 7 were statistically associated with parent-reported behaviors with odds ratios (ORs) ranging from 0.

Use of a pediatrician toolkit to address parental perception of children's weight status, nutrition, and activity behaviors.

Background: Communication of children's weight status and targeted counseling by pediatricians may change parental perceptions or child dietary and physical activity behaviors. The aim of this study was to determine whether accuracy of parental perception of children's weight status and reports of related behaviors changed following a brief pediatrics resident intervention.

Methods: Parents (N = 115) of children aged 4 to 12 years enrolled in Medicaid completed baseline questionnaires with providers about prior communication of weight status and/or body mass index (BMI), perceptions of their children's weight, and children's dietary and physical activity behaviors, and children were weighed and measured.

Pharmacist and physician satisfaction and rates of switching to preferred medications associated with an instant prior authorization program for proton pump inhibitors in the North Carolina Medicaid program.

Background: Proton pump inhibitors (PPIs) are among the highest expenditure drugs covered by health care plans. During fiscal year 2001-2002, Medicaid programs nationwide spent nearly $2 billion on PPIs. Although the costs of individual PPIs vary widely, there is little variation in therapeutic effectiveness.

Prevalence of overweight and mothers' perception of weight status of their children with intellectual disabilities in South Korea.

The purpose of this study was to estimate the prevalence of overweight and examine relationships between weight status of children with intellectual disabilities (IDs), mothers' perceived weight status of children, and socioeconomic status (SES). A cross-sectional study of 206 mothers of children with IDs in six special schools in Seoul, South Korea, was conducted. Data were collected through school health record abstraction and parent survey during December 2004.

Bolstering confidence in obesity prevention and treatment counseling for resident and community pediatricians.

Objective: To assess whether equipping resident pediatricians and community pediatricians with both training and practical tools improves their perceived confidence, ease, and frequency of obesity-related counseling to patients.

Methods: In 2005-2006, resident pediatricians (n = 49) and community pediatricians (n = 18) received training regarding three evidence-based obesity prevention/treatment tools and responded to pre- and post-intervention questionnaires. We analyzed changes in reported mean confidence, ease, and frequency of dietary, physical activity, and weight status counseling.

Measuring community-based case management performance: strategies for evaluation.

Case management services are not implemented uniformly or with the same levels of intensity. Case managers serve in diverse settings, have varied training and experiences, and individualize care at the patient level. The flexible characteristics of case management services pose challenges to, and accentuate the need for, successful ongoing evaluation.

Patient reminder and patient recall systems to improve immunization rates.

Background: Immunization rates for children and adults are rising, but coverage levels have not reached optimal goals. As a result of low immunization rates, vaccine-preventable diseases still occur. In an era of increasing complexity of immunization schedules, rising expectations about the performance of primary care and large demands on primary care physicians, it is important to understand and promote interventions that work in primary care settings to increase immunization coverage.