Acute stroke care coordination in the United States: Variation in state laws for Emergency Medical Services and hospitals.

Background: Lack of care coordination between Emergency Medical Services (EMS) and hospitals contributes to delay of acute stroke (AS) treatment. In the United States, states have adopted laws to improve the quality of EMS and hospital care; the degree to which these laws create regulatory incentives to promote care coordination between them is less well known. We examined state variation in attributes of laws that may influence AS care coordination between EMS and hospitals.

Enhancing availability of services to control hypertension through a team-based care approach that includes pharmacists.

Background: Primary care physician (PCP) shortages are expected to increase. The Michigan Medicine Hypertension Pharmacists' Program uses a team-based care (TBC) approach to redistribute some patient care responsibilities from PCPs to pharmacists for patients with diagnosed hypertension.

Objective: This evaluation analyzed whether the Michigan Medicine Hypertension Pharmacists' Program increased the availability of hypertension management services and described facilitators that addressed barriers to program sustainability and replicability.

Policy implementation strategies to address rural disparities in access to care for stroke patients.

Context: Stroke systems of care (SSOC) promote access to stroke prevention, treatment, and rehabilitation and ensure patients receive evidence-based treatment. Stroke patients living in rural areas have disproportionately less access to emergency medical services (EMS). In the United States, rural counties have a 30% higher stroke mortality rate compared to urban counties.

Impact of State Stroke Systems of Care Laws on Stroke Outcomes.

Since 2003, 38 US states and Washington, DC have adopted legislation and/or regulations to strengthen stroke systems of care (SSOCs). This study estimated the impact of SSOC laws on stroke outcomes. We used a coded legal dataset of 50 states and DC SSOC laws (years 2003-2018), national stroke accreditation information (years 1997-2018), data from the Healthcare Cost and Utilization Project (years 2012-2018), and National Vital Statistics System (years 1979-2019).

Establishing a Protocol for Determining the Costs of an Integrated Set of Evidence-based Practices Aimed at Reducing Opioid Overdose Deaths.

Objectives: In the midst of the opioid overdose crisis, local jurisdictions face a choice of public health interventions. A significant barrier when considering evidence-based practices (EBPs) is the lack of information regarding their implementation cost. This protocol paper provides the methodological foundation for the economic cost evaluations of community-wide strategies on the scale of a national study.

Systematic Review of Self-Measured Blood Pressure Monitoring With Support: Intervention Effectiveness and Cost.

Introduction: Self-measured blood pressure monitoring with support is an evidence-based intervention that helps patients control their blood pressure. This systematic economic review describes how certain intervention aspects contribute to effectiveness, intervention cost, and intervention cost per unit of the effectiveness of self-measured blood pressure monitoring with support.

Methods: Papers published between data inception and March 2021 were identified from a database search and manual searches.

Evaluation of a Pharmacists' Patient Care Process Approach for Hypertension.

Introduction: An estimated 116 million American adults (47.3%) have hypertension. Most adults with hypertension do not have it controlled-3 in 4 (92.

"Nothing About Us Without Us": Insights from State-level Efforts to Implement Community Health Worker Certification.

As community health workers (CHWs) have increasingly become recognized as members of health care teams, several states have considered or implemented processes to certify them. Between April and September 2017, we interviewed 41 stakeholders (e.g.

Community Health Worker Initiatives: An Approach to Design and Measurement.

Context: The Centers for Disease Control and Prevention supports the engagement of community health workers (CHWs) to help vulnerable populations achieve optimum health through a variety of initiatives implemented in several organizational units.

Program: This article provides a unified and comprehensive logic model for these initiatives that also serves as a common framework for monitoring and evaluation.

Implementation: We developed a logic model to fully describe the levels of effort needed to effectively and sustainably engage CHWs.

A Replicable Approach to Promoting Best Practices: Translating Cardiovascular Disease Prevention Research.

Objective: Significant delays in translating health care-related research into public health programs and medical practice mean that people may not get the best care when they need it. Regarding cardiovascular disease, translation delays can mean lives may be unnecessarily lost each year. To facilitate the translation of knowledge to action, we created a Best Practices Guide for Cardiovascular Disease Prevention Programs.

Establishing a Baseline: Evidence-Supported State Laws to Advance Stroke Care.

Objective: Approximately 800 000 strokes occur annually in the United States. Stroke systems of care policies addressing prehospital and in-hospital care have been proposed to improve access to time-sensitive, lifesaving treatments for stroke. Policy surveillance of stroke systems of care laws supported by best available evidence could reveal potential strengths and weaknesses in how stroke care delivery is regulated across the nation.

Translating Workforce Development Policy Interventions for Community Health Workers: Application of a Policy Research Continuum.

Context: There is a need for knowledge translation to advance health equity in the prevention and control of cardiovascular disease and type 2 diabetes. One recommended strategy is engaging community health workers (CHWs) to have a central role in related interventions. Despite strong evidence of effectiveness for CHWs, there is limited information examining the impact of state CHW policy interventions.

Is Theory Guiding Our Work? A Scoping Review on the Use of Implementation Theories, Frameworks, and Models to Bring Community Health Workers into Health Care Settings.

Community health workers (CHWs) are becoming a well-recognized workforce to help reduce health disparities and improve health equity. Although evidence demonstrates the value of engaging CHWs in health care teams, there is a need to describe best practices for integrating CHWs into US health care settings. The use of existing health promotion and implementation theories could guide the research and implementation of health interventions conducted by CHWs.

The effects of sequential treatments on hippocampal volumes in malignant glioma patients.

Malignant gliomas (MG) are very aggressive tumors. In an effort to improve the outcome, the patients receive multi-modal therapies such as surgery, radiation and chemotherapy (temozolomide followed in many cases by bevacizumab). The survivors are affected by multiple learning and memory deficits.

DMAP: a connectivity map database to enable identification of novel drug repositioning candidates.

Background: Drug repositioning is a cost-efficient and time-saving process to drug development compared to traditional techniques. A systematic method to drug repositioning is to identify candidate drug's gene expression profiles on target disease models and determine how similar these profiles are to approved drugs. Databases such as the CMAP have been developed recently to help with systematic drug repositioning.

Single-incision technique for internal fixation of distal tibia and fibula fractures.

Open reduction and internal fixation of distal tibia and fibula fractures generally involves two separate incisions: an anteromedial incision to approach the tibia and a lateral incision to approach the fibula. Exposing the distal tibia from the medial side is associated with the risk of wound dehiscence, infection, and discomfort to the patient since the hardware is directly beneath the skin. By using a single incision from the anterolateral side, the fibular fracture can be fixed and the lateral aspect of the distal tibia can be safely approached for internal fixation, thus eliminating the need for two separate incisions.

Cloning of Protocatechuate 3,4-Dioxygenase Genes from Bradyrhizobium japonicum USDA110.

A heterologous gene probe encoding the alpha and beta subunits of the Pseudomonas cepacia protocatechuate 3,4-dioxygenase (PCD) was used to detect its homolog in the genome of Bradyrhizobium japonicum USDA110. Three cosmid clones carrying a 2.2-kb BamHI insert showed high levels of PCD activity.

Comparison of lateral pillar classification and Catterall classification of Legg-Calvé-Perthes' disease.

To compare the predictive value of the Herring lateral pillar and the Catterall classifications of Legg-Calvé-Perthes' disease, 71 hips with radiographic follow-up to maturity were reviewed. The Herring classification was a significantly better predictor of Stulberg outcome than the Catterall classification. Three independent observers classified early fragmentation stage films by both Herring and Catterall classifications.

Tips of the trade #41. Modified coaptation splint for humeral shaft fractures.

A technique for applying a modified coaptation splint for humeral shaft fractures is presented. Using this method, the splint extends from the base of the neck, passes over the shoulder and along the front and back of the arm, and returns toward the axillary fold. To prevent slippage, the proximal end of the splint is secured to the chest with a strap.

The ring butterfly fragment in diaphyseal fractures: its importance in flexible intramedullary nailing.

Ring butterfly fragment was described after it was noted to pose problems during insertion of flexible intramedullary nails. This fragment contains the entire circumference of the medullary canal or a substantial part of it. Once recognized preoperatively the fragment is reduced, providing a stable fracture configuration for fixation with flexible intramedullary nails.