Barriers to Interconception Care Delivery in Primary Care: Clinician, Staff, and Patient Perspectives.

Purpose: Many reproductive age women, cared for routinely by primary care providers (PCPs), would benefit from interconception care, yet a minority of primary care visits include interconception care. This study assessed barriers to providing interconception care from the perspective of primary care clinicians, staff, and patients.

Materials And Methods: Clinicians ( = 11), staff ( = 14), and patients eligible for interconception care ( = 6) from three primary care clinics in Chicago, Illinois participated in focus groups or interviews.

The Impact of Clear and Loud Speech Cues on Acoustic and Perceptual Features of Speech Production in Adolescents With Down Syndrome.

Purpose: There are few evidence-based speech interventions designed to alter speech production in a way that ultimately results in increased speech intelligibility in adolescents with Down syndrome (DS). The primary purpose of this study was to examine the impact of clear and loud speech cues on acoustic and perceptual features of speech production in adolescents with DS.

Method: Eight adolescents diagnosed with DS repeated sentences of varying lengths in three conditions: habitual, big mouth (i.

The Relationship Between Social Media Use, Nurse Characteristics, and Job Decision-Making.

Objective: To describe nurses' use of social media and examine the relationship between social media use, nurse characteristics, and job decision-making.

Background: Social media shares information, connects, and influences thought. A gap remains in understanding how nurses use social media for professional purposes.

Return on Investment: Explanation and a Case Study.

Nurses are uniquely positioned to significantly impact organizational and system improvement through improving quality and reducing costs. Using an evidenced based tool to identify costs and the financial benefit involved in any quality improvement project is invaluable in developing and evaluating proposals and allocation of resources to support the organization's financial health and viability. The return on investment analysis is an essential accounting tool that will provide nurse leaders with critical information quantifying costs and benefits of both financial and nonfinancial metrics to identify the feasibility, efficacy, risk or efficiency of a proposed project.

Maslow's Hierarchy of Needs: Achieving Outcomes, Improving Value, and Work Environment - Lessons Learned from the Pandemic.

Health care delivery science, according to Faerber, "focuses on ways to improve health and services to individuals and populations." The triple aim, described as improving population health, enhancing the care experience, and reducing costs; is a model for health care improvement. In 2014, the triple aim expanded to the quadruple aim to include the health and satisfaction of health care professionals.

Demand for abortion training and technical assistance in primary care: Unmet need and programmatic interventions.

Objective: Quantify primary care provider requests for abortion training and technical assistance (TA) and availability of programs to support abortion provision.

Study Design: We reviewed requests for training and TA from four programs focused on capacity building for abortion care. Collectively, these programs serve every region of the United States.

Primary care-based screening and recruitment for an adolescent depression prevention trial: Contextual considerations during a youth mental health crisis.

Background: Rising rates of adolescent depression in the wake of COVID-19 and a youth mental health crisis highlight the urgent need for accessible mental healthcare and prevention within primary care. Digital mental health interventions (DMHIs) may increase access for underserved populations. However, these interventions are not well studied in adolescents, nor healthcare settings.

Mediterranean-style dietary interventions in adults with cancer: a systematic review of the methodological approaches, feasibility, and preliminary efficacy.

Background: Cancer and its treatments can lead to excess body fat, decreases in lean mass, cardiotoxicity, and other side effects. The Mediterranean diet (MED-diet) has the potential to improve clinical and supportive care outcomes. The aim of this systematic review was to evaluate the feasibility, safety, and efficacy of the MED-diet on health outcomes in adults with cancer.

Racial and ethnic disparities in short interval pregnancy following delivery in Catholic vs non-Catholic hospitals among California Medicaid enrollees.

Objectives: We examined the impact of Catholic hospital delivery on short interval pregnancy in the California 2010-2014 Medicaid population.

Study Design: We used Cox regression to estimate the association between hospital affiliation and short interval pregnancy, adjusting for patient factors.

Results: Catholic hospital delivery had increased the risk of pregnancy within 6 months for Black (hazard ratio [HR] 1.

Reproductive care in community health centers: Multi-method evaluation of the Illinois Contraceptive Access Now (ICAN!) demonstration program.

Objectives: Nearly one-third of low-income women of reproductive age in the U.S. receive care in federally qualified community health centers, but comprehensive reproductive care is not consistently provided.

Mifepristone implementation in primary care: Clinician and staff insights from a pilot learning collaborative.

Objectives: The ExPAND Mifepristone (ExPAND) learning collaborative aims to support primary care providers in overcoming logistical barriers to mifepristone provision. This qualitative study describes clinician and staff perspectives on the impact of ExPAND in two federally qualified health center networks (FQHCs).

Study Design: Researchers conducted semi-structured qualitative interview with a purposive sample of clinicians, staff, and leadership from two Illinois FQHCs.

Ocular lymphoma: overcoming a diagnostic challenge with an endoscopic sinus approach.

Background: Ocular lymphomas are rare, indolent tumours that pose a diagnostic challenge. Patients may be asymptomatic or present with symptoms of increased orbital mass. An index of suspicion is required alongside an understanding of the diagnostics and staging required to facilitate expedited multi-disciplinary work-up and management.

Pattern of nodal metastasis of cutaneous squamous cell carcinoma involving the temporal bone.

Objective: The objective of this study was to explore the pattern of lymph-node spread of SCCs involving the temporal bone.

Methods: We retrospectively reviewed all cutaneous SCCs involving the temporal bone over a 20-year time-period. Forty-one patients were eligible.

Safe surgical training: evaluation of a national functional endoscopic sinus surgery model simulation course using the Kirkpatrick evaluation model.

Background: Simulation is a rapidly developing field in modern undergraduate skills education and postgraduate surgical training.

Aim: We aim to evaluate simulation training as a tool for higher surgical training in functional endoscopic sinus surgery (FESS) using the Kirkpatrick evaluation model.

Methods: This was a prospective cohort study in which a qualitative survey and multiple-choice questionnaire were distributed to otolaryngology trainees pre- and post-FESS training course using simulation models.

Randomized controlled trial of prepregnancy lifestyle intervention to reduce recurrence of gestational diabetes mellitus.

Background: Preconception lifestyle intervention holds potential for reducing gestational diabetes mellitus, but clinical trial data are lacking.

Objective: This study aimed to determine the effects of a prepregnancy weight loss intervention on gestational diabetes mellitus recurrence in women with overweight/obesity and previous gestational diabetes mellitus.

Study Design: A 2-site, randomized controlled trial comparing a prepregnancy lifestyle intervention with educational control was conducted between December 2017 and February 2022.

Preconception, Interconception, and reproductive health screening tools: A systematic review.

Objective: To identify and describe the standardized interconception and preconception screening tools for reproductive health needs that are applicable in general outpatient clinical practice.

Data Sources And Study Setting: This systematic review identifies research on pregnancy intention screening and counseling tools, and standardized approaches to preconception and interconception care. We focus on tools designed for clinical settings, but also include research tools with potential for clinical implementation.

Direct comparison of runoff of residual and knockdown herbicides in sugarcane using a rainfall simulator finds large difference in runoff losses and toxicity relative to diuron.

Runoff losses of herbicides have rarely been compared simultaneously under the same conditions. Our aim was to directly compare herbicide runoff losses, normalised for the amount present (relative runoff loads) and in absolute terms. Toxicity and runoff concentrations were combined to provide a risk ranking relative to diuron.

Telehealth for contraceptive care: Lessons from staff and clinicians for improving implementation and sustainability in Illinois.

Objective: To solicit Illinois staff and clinician perspectives on rapid implementation of telehealth for contraceptive counseling and recommendations to improve and sustain it in the long term.

Study Design: Researchers recruited and interviewed clinicians ( = 20) in primary care and obstetrics/gynecology clinics across 13 health care systems in Illinois, as well as clinicians ( = 11), leadership ( = 6) and staff ( = 7) from Planned Parenthood of Illinois clinics. Guided by the Consolidated Framework for Implementation Research, we coded and analyzed interview transcripts in Dedoose with a focus on themes regarding steps to improve quality and sustainability of telehealth.

Detection rates of a national fetal anomaly screening programme: A national cohort study.

Objective: To measure condition-specific detection rates for 14 physical conditions screened for by the NHS fetal anomaly screening programme (FASP) fetal anomaly (FA) ultrasound scan.

Design: Retrospective audit of 12 694 diagnoses across a 3-year national cohort.

Setting: All English NHS and crown-dependency hospital trusts providing maternity services.

Beyond : Employer's responsibilities and opportunities to improve network access to reproductive healthcare for employees.

The majority of United States (US) women age 15-49 have employer-sponsored health insurance, but these insurance plans fall short if employees cannot find providers who meet reproductive health needs. Employers could and should do more to facilitate and advocate for their employees through the insurance plans they sponsor. We conducted interviews with 14 key informants to understand how large United States employers see their role in health insurance benefits, especially when it comes to reproductive health care access and restrictions in religious health systems.

Use of the Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity ('P-POSSUM') to predict morbidity in patients undergoing surgery with reconstruction for temporal bone malignancy.

Objective: The Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity ('P-POSSUM') is a two-part scoring system that includes a physiological assessment and a measure of operative severity. This study sought to determine whether risk estimates for this scoring system could be used in major head and neck reconstructive surgery.

Method: A retrospective review was performed of patients undergoing resection for a temporal bone malignancy in a single head and neck centre in Dublin, Ireland, from 2002 to 2021.

Determining Losses in Jet Injection Subcutaneous Insulin Delivery: A Model-Based Approach.

Objective: Accurate, safe glycemic management requires reliable delivery of insulin doses. Insulin can be delivered subcutaneously for action over a longer period of time. Needle-free jet injectors provide subcutaneous (SC) delivery without requiring needle use, but the volume of insulin absorbed varies due to losses associated with the delivery method.