Evaluation of the Delaware Contraceptive Access Now (DelCAN) initiative: A qualitative analysis of site leaders' implementation recommendations.

Objectives: In 2014, Delaware launched a statewide initiative to reduce the rate of unintended pregnancies and increase access to contraception services. Our study objective was to understand the implementation experiences, barriers, and successes across health care practice settings and to provide recommendations for future, similar initiatives.

Study Design: As part of a larger multicomponent process evaluation, we conducted semistructured interviews with 32 leaders from 26 practice settings implementing the initiative across the state.

Reversal of ε-Aminocaproic Acid-Induced Massive Thromboemboli Using Tissue Plasminogen Activator During Cardiac Surgery: A Case Report.

ε-Aminocaproic acid is routinely used in cardiac surgery to prevent excess bleeding. It is rarely associated with thrombotic events. This case report illustrates the formation of intracardiac thrombi leading to massive pulmonary embolism during a coronary artery bypass graft surgery, secondary to the administration of ε-aminocaproic acid as confirmed by intraoperative transesophageal echocardiogram.

Accuracy of the Safer Dx Instrument to Identify Diagnostic Errors in Primary Care.

Importance: Diagnostic errors are common and harmful, but difficult to define and measure. Measurement of diagnostic errors often depends on retrospective medical record reviews, frequently resulting in reviewer disagreement.

Objectives: We aimed to test the accuracy of an instrument to help detect presence or absence of diagnostic error through record reviews.

Implementation of a Standard Verbal Sign-Out Template Improves Sign-Out Process in a Pediatric Intensive Care Unit.

Sign-out of patient data at change of shifts is vulnerable to errors that impact patient safety. Although sign-outs are complex in intensive care units (ICU), a paucity of studies exists evaluating optimal ICU sign-out. Our prospective interventional study investigated the use of a standard verbal template in a Pediatric ICU to improve the sign-out process.

Toward a new understanding of risk perception among young female BRCA1/2 "previvors".

The quantitative risk of cancer among BRCA1/2 gene mutation carriers is generally well-understood, and can be communicated clearly to potential and known mutation carriers during the genetic risk assessment, education, and testing process. The extent to which individual mutation carriers feel vulnerable to cancer is a more complex dynamic with a powerful effect on risk-management decision-making; however, these decisions are not the products of straightforward personal assessment of one's quantitative probability of being diagnosed with cancer. We undertook this National Cancer Institute study to broaden understanding of the lived experiences of women who learn early in the life course that they carry a BRCA1/2 mutation.

Use of an expert concept map as an advance organizer to improve understanding of respiratory failure.

Background: Helping novices transition toward expertise requires "meaningful" learning. Advance organizers are educational tools which help connect prior knowledge with new information, a critical step in making learning meaningful. Concept maps visually represent knowledge organization and can serve as advance organizers enabling deeper and more meaningful learning while enhancing knowledge integration.

Pediatric residents experience a significant decline in their response capabilities to simulated life-threatening events as their training frequency in cardiopulmonary resuscitation decreases.

Objective: To determine the frequency of cardiopulmonary resuscitation education using high-fidelity patient simulators during pediatric residency training.

Design: Randomized controlled trial.

Setting: Suburban tertiary care children's hospital residency training program.

Making daddies into fathers: community-based fatherhood programs and the construction of masculinities for low-income African American men.

In this analysis, we explore how low-income African American fathers build understandings of successful manhood in the context of community-based responsible fatherhood programs. Drawing on life history interviews with 75 men in Illinois and Indiana, we explore men's attempts to fulfill normative expectations of fatherhood while living in communities with limited resources. We examine the efforts of community-based fatherhood programs to shape alternative African American masculinities through facilitation of personal turning points and "breaks with the past," use of social support and institutional interventions, and the reframing of provision as a priority of successful fatherhood.

Family ties: constructing family time in low-income families.

"Family time" is reflected in the process of building and fortifying family relationships. Whereas such time, free of obligatory work, school, and family maintenance activities, is purchased by many families using discretionary income, we explore how low-income mothers make time for and give meaning to focused engagement and relationship development with their children within time constraints idiosyncratic to being poor and relying on welfare. Longitudinal ethnographic data from 61 low-income African American, European American, and Latina American mothers were analyzed to understand how mothers construct family time during daily activities such as talking, play, and meals.