Implementing a Quality Improvement Initiative to Screen for Dementia in a Down Syndrome Specialty Clinic.

Using quality improvement methods, we aimed to implement a protocol to assess for dementia among adults with Down syndrome (DS). To track implementation, interval retrospective chart review of patients with DS with visits to the Massachusetts General Hospital DS Program (MGH DSP) was conducted quarterly. The impact of a newly implemented protocol created and informed by clinical experts in the MGH DSP including laboratory tests, imaging, referrals, and screening tools for dementia and mental health concerns, was analyzed using statistical process control charts.

Adults with Down syndrome and obstructive sleep apnea treated with hypoglossal nerve stimulation.

Study Objectives: To examine the feasibility, adherence to therapy, and efficacy of hypoglossal nerve stimulation (HGNS) in adults with Down syndrome (DS) with obstructive sleep apnea.

Methods: Adults patients with DS who met criteria for hypoglossal nerve stimulation were prospectively enrolled. Objective adherence was extracted from a cloud-based compliance database.

Forensic Obstetrics and Clinical Risk Factors.

Forensic obstetrics attracts much attention from forensic experts and the public owing to the professional, legal, public health, and not inconsiderable social-emotional aspects and directly correlates with maternal, fetoneonatal, and iatrogenic risk factors. Modern obstetrics and fetomaternal medicine must not be quantified and qualified based only on perinatal disease but also according to current obstetric problems that burden forensic obstetrics. Therefore, high-risk obstetrics as a significant medico-legal problem should be viewed from the point of view of the entire perinatal period with possible long-term consequences, hence the monitoring of complete perinatal and infant morbidity is of immediate importance for quality control and risk control in the profession.

Tailored vs. General COVID-19 prevention for adults with mental disabilities residing in group homes: a randomized controlled effectiveness-implementation trial.

Background: People with serious mental illness (SMI) and people with intellectual disabilities/developmental disabilities (ID/DD) are at higher risk for COVID-19 and more severe outcomes. We compare a tailored versus general best practice COVID-19 prevention program in group homes (GHs) for people with SMI or ID/DD in Massachusetts (MA).

Methods: A hybrid effectiveness-implementation cluster randomized control trial compared a four-component implementation strategy (Tailored Best Practices: TBP) to dissemination of standard prevention guidelines (General Best-Practices: GBP) in GHs across six MA behavioral health agencies.