Comparison of In-Person and Virtual Implementations of an Obesity Prevention Culinary Nutrition Education Program for Family Care Providers.

Start Strong, a 4-week culinary nutrition education, obesity prevention program designed for rural family care providers in low-income areas of Minnesota, was initially an in-person training and recently adapted into a virtual version. Using a quasi-experimental design, this study examined within group and between group (in-person versus virtual) changes in culinary skill confidence and familiarity with food assistance programs after Start Strong participation. Additionally, we examined post-program participant experiences.

Implementing Cancer Registry Data With the PCORnet Common Data Model: The Greater Plains Collaborative Experience.

Purpose: Electronic health records (EHRs) comprise a rich source of real-world data for cancer studies, but they often lack critical structured data elements such as diagnosis date and disease stage. Fortunately, such concepts are available from hospital cancer registries. We describe experiences from integrating cancer registry data with EHR and billing data in an interoperable data model across a multisite clinical research network.

Effect of digital noise-reduction processing on subcortical speech encoding and relationship to behavioral outcomes.

Perceptual benefits from digital noise reduction (NR) vary among individuals with different noise tolerance and sensitivity to distortions introduced in NR-processed speech; however, the physiological bases of the variance are understudied. Here, we developed objective measures of speech encoding in the ascending pathway as candidate measures of individual noise tolerance and sensitivity to NR-processed speech using the brainstem responses to speech syllable /da/. The speech-evoked brainstem response was found to be sensitive to the addition of noise and NR processing.

Leveraging public health cancer surveillance capacity to develop and support a rural cancer network.

Introduction: As the rural-urban cancer mortality gap widens, centering care around the needs of rural patients presents an opportunity to advance equity. One barrier to delivering patient-centered care at rural hospitals stems from limited analytic capacity to leverage data and monitor patient outcomes. This case study describes the experience of a public health cancer surveillance system aiming to fill this gap within the context of a rural cancer network.

The Fragmentation of Specialty Care. The Role of Referral Location, Type of Referral, and Demographic Factors in Determining Completion Rates for Uninsured Patients in a Student-Run Free Clinic.

Little is known about how location of specialty care affects accessibility for uninsured patients at free clinics. To address this gap, the specialty referral completion rate by location and role of demographic and referral-specific factors were analyzed at an urban-based free clinic. A retrospective review was performed at a single site, student-run free clinic exclusively serving uninsured patients.

Geographic distance to Commission on Cancer-accredited and nonaccredited hospitals in the United States.

Purpose: The Commission on Cancer (CoC) establishes standards to support multidisciplinary, comprehensive cancer care. CoC-accredited cancer programs diagnose and/or treat 73% of patients in the United States. However, rural patients may experience diminished access to CoC-accredited cancer programs.

Analysis of social determinants of health on emergency department utilization by gunshot wound survivors after level 1 trauma center discharge.

Background: This project analyzed risk factors for emergency department (ED) utilization without readmission within 2 weeks post-discharge for survivors of gun violence.

Methods: A hundred gun violence survivors admitted to a Level 1 trauma center were surveyed. Descriptive analyses and group comparisons were conducted between patients who did and did not use the ED.

Rural comprehensive cancer care: Qualitative analysis of current challenges and opportunities.

Purpose: While limited resources can make high-quality, comprehensive, coordinated cancer care provision challenging in rural settings, rural cancer patients often rely on local hospitals for care. To develop resources and strategies to support high-quality local cancer care, it is critical to understand the current experiences of rural cancer care physicians, including perceived strengths and challenges of providing cancer care in rural areas.  METHODS: Semi-structured interviews were conducted with 13 cancer providers associated with all 12 non-metropolitan/rural Iowa hospitals that diagnose or treat >100 cancer patients annually.

A pilot project of a Post Discharge Care Team for firearm injury survivors decreases emergency department utilization, hospital readmission days, and cost.

Background: Persons of low socioeconomic status are overrepresented in the firearm injury patient population and may experience challenges in accessing complex outpatient health systems. Consequently, outpatient care for these patients is plagued by poor follow-up and increased emergency department (ED) utilization. We developed a Post Discharge Care Team (PDCT) consisting of a dedicated trauma nurse navigator and medical social worker to bridge the gap between hospital discharge and outpatient care to improve recovery.

Improved follow-up care for gun violence survivors in the Trauma Quality of Life Clinic.

Background: Outpatient follow-up represents a crucial opportunity to re-engage with gun violence survivors (GVS) and to facilitate positive health outcomes. Current outpatient models for firearm-related injuries and trauma care are inconsistent and unstandardized across trauma centers. This project describes the patient population served by the multidisciplinary Trauma Quality of Life (TQoL) Clinic for GVS.

Validation of an electronic self-administered version of the Dimensional Inventory of Stress and Trauma Across the Lifespan in a large sample of young adults.

Recent advances in the dimensional assessment of traumatic stress have initiated research examining correlates of exposure to specific features of stress. However, existing tools require intensive, in-person, clinician administration to generate the rich phenotypic data required for such analyses. These approaches are time consuming, costly, and substantially restrict the degree to which assessment tools can be disseminated in large-scale studies, constraining the refinement of existing dimensional models of early adversity.

Adherence to Annual Lung Cancer Screening in a Centralized Academic Program.

Background: Adherence to lung cancer screening (LCS) protocols is critical for achieving mortality reductions. However, adherence rates, particularly for recommended annual screening among patients with low-risk findings, are often sub-optimal. We evaluated annual LCS adherence for patients with low-risk findings participating in a centralized screening program at a tertiary academic center.

Differential response to neoadjuvant endocrine therapy for Black/African American and White women in NCDB.

Purpose: Compared to White women, there are higher mortality rates in Black/African American (BAA) women with hormone receptor-positive breast cancer (HR + BC) which may be partially due to differences in treatment resistance. We assessed factors associated with response to neoadjuvant endocrine therapy (NET).

Methods: The National Cancer Database (NCDB) was queried for women with clinical stage I-III HR + BC diagnosed 2006-2017 and treated with NET.

Psychiatric comorbidity in emergency general surgery patients: a prospective observational study.

Objectives: Annually, approximately 27 million individuals in the United States are admitted to hospitals for emergency general surgery (EGS). Approximately 50% develop postoperative complications and 22% require unplanned readmission within 90 days, highlighting a need to understand factors impacting well-being and recovery. Psychiatric comorbidity can impact medical treatment adherence, cost, and premature mortality risk.

An implementation science approach to the systematic study of access to gynecologic cancer care.

Introduction: Barriers to access to cancer care are profoundly threatening to patients with gynecologic malignancies. Implementation science focuses on empirical investigation of factors influencing delivery of clinical best practices, as well as interventions designed to improve delivery of evidence-based care. We outline one prominent framework for conducting implementation research and discuss its application to improving access to gynecologic cancer care.

Comprehensive Framework of Firearm Violence Survivor Care: A Review.

Importance: Firearm violence is a public health crisis placing significant burden on individuals, communities, and health care systems. After firearm injury, there is increased risk of poor health, disability, and psychopathology. The newest 2022 guidelines from the American College of Surgeons Committee on Trauma require that all trauma centers screen for risk of psychopathology and provide referral to intervention.

The Impact of Surgical Boot Camp on Medical Student Confidence and Imposter Syndrome.

Introduction: Transitioning from medical student to surgical intern is accompanied by increased responsibility, stress, and clinical burden. This environment lends itself to imposter syndrome (IS), a psychological condition grounded in self-doubt causing fear of being discovered as fraud despite adequate abilities. We hypothesized a 2-week surgical boot camp for fourth year medical students would improve confidence in technical skills/knowledge and IS.

Generating Practice-Based Evidence in the Use of Guideline-Recommended Combination Therapy for Secondary Prevention of Acute Myocardial Infarction.

: Clinical guidelines recommend beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers, and statins for the secondary prevention of acute myocardial infarction (AMI). It is not clear whether variation in real-world practice reflects poor quality-of-care or a balance of outcome tradeoffs across patients. : The study cohort included Medicare fee-for-service beneficiaries hospitalized 2007-2008 for AMI.

Optimizing discharge opioid prescribing in trauma patients: A quasi-experimental study.

Background: Patients prescribed higher opioid dosages are at increased risk of overdose and death without added pain reduction. Increases in opioid prescribing continue to fuel the epidemic. We hypothesized a comprehensive guideline to standardize opioid prescribing would decrease postdischarge dosages for patients experiencing trauma without requiring additional refills.

Addressing the educational gap in the role of law enforcement personnel in the resuscitation bay.

Background: Health care workers are often uncertain of the role of law enforcement personnel in the resuscitation bay. A cross-sectional, quality improvement project was designed with an educational intervention to address the knowledge gaps.

Methods: There were 2 sessions for trauma surgery and emergency medicine faculty, residents, and staff.

Identifying Core Functions of an Evidence-Based Intervention to Improve Cancer Care Quality in Rural Hospitals.

Background: Rural patients experience worse cancer survival outcomes than urban patients despite similar incidence rates, due in part to significant barriers to accessing quality cancer care. Community hospitals in non-metropolitan/rural areas play a crucial role in providing care to patients who desire and are able to receive care locally. However, rural community hospitals typically face challenges to providing comprehensive care due to lack of resources.

Trauma video review outperforms prospective real-time data collection for study of resuscitative thoracotomy.

Background: A major challenge in the study of high-impact, low-frequency procedures in trauma is the lack of accurate data for time-sensitive processes of care. Trauma video review offers a possible solution, allowing investigators to collect extremely granular time-stamped data. Using resuscitative thoracotomy as a model, we compared data collected using review of audiovisual recordings to data prospectively collected in real time with the hypothesis that data collected using video review would be subject to less missingness and bias.

Outcomes From Healthy Eating and Physical Activity Recognition Programs in Early Child Care and Education: A Scoping Review.

Objective: Recognition programs are designed to incentivize early care and education (ECE) settings to implement childhood obesity prevention standards, yet little is known regarding their efficacy. This scoping review details characteristics, methodologies, and criteria used to evaluate recognition programs, identifies gaps in evaluation, and synthesizes existing evidence.

Data Source: A public health librarian created the search strategies for six databases: Ovid MEDLINE, AGRICOLA, CAB Abstracts, PAIS Index, ERIC, and Scopus.