Evidence Review for the American College of Surgeons Quality Verification Part III: Standardization, Protocols, and Achieving Better Outcomes for Patient Care.

Background: After decades of experience supporting surgical quality and safety by the American College of Surgeons (ACS), the ACS Quality Verification Program (ACS QVP) was developed to help hospitals improve surgical quality and safety. This review is the final installment of a 3-part review aimed to synthesize evidence supporting the main principles of the ACS QVP.

Study Design: Evidence was systematically reviewed for 3 principles: standardized team-based care across 5 phases of surgical care, disease-based management, and external regulatory review.

A motivational interviewing-based counseling intervention to increase postabortion uptake of contraception: A pilot randomized controlled trial.

Objective: To determine if a counseling intervention using the principles of motivational interviewing (MI) would impact uptake of long-acting reversible contraception (LARC) after abortion.

Methods: We conducted a pilot randomized controlled trial comparing an MI-based contraception counseling intervention to only non-standardized counseling. Sixty women 15-29 years-old were randomized.

A systematic approach to improving intrauterine device services in family planning clinics.

Objectives: To improve the quality of intrauterine device (IUD) services at Title X clinics.

Study Design: Failure Modes Effects and Criticality Analysis (FMECA) is a step-by-step approach, adopted for healthcare, in which team members evaluate the systems and processes of a specific type of clinical care (e.g.

Impact of a revised appointment scheduling script on IUD service delivery in three Title X family planning clinics.

Objective: The objective was to study a redesigned call script for intrauterine device (IUD) appointment scheduling.

Study Design: The script for a Title X call center was redesigned. Pre- and postintervention data were collected.

Doula support during first-trimester surgical abortion: a randomized controlled trial.

Objective: The objective of the study was to evaluate the impact of doula support on first-trimester abortion care.

Study Design: Women were randomized to receive doula support or routine care during first-trimester surgical abortion. We examined the effect of doula support on pain during abortion using a 100 mm visual analog scale.

Development and testing of an iOS waiting room "app" for contraceptive counseling in a Title X family planning clinic.

Objective: Long-acting reversible contraceptive (LARC) methods, such as the intrauterine device and implant, are highly effective but used by less than 10% of US women. The objective of our study was to improve LARC interest by enhancing clinic counseling.

Study Design: A quality improvement methodology was used to evaluate intrauterine device service delivery in 3 Chicago Title X clinics.

Postplacental insertion of the levonorgestrel intrauterine device after cesarean delivery vs. delayed insertion: a randomized controlled trial.

Objective: This trial was designed to compare levonorgestrel intrauterine device (LNG-IUD) use at 1 year after delivery between women randomized to postplacental insertion at the time of cesarean delivery and delayed insertion 4-8 weeks after delivery.

Study Design: This randomized controlled trial was conducted at two urban medical centers. Eligible pregnant women with planned cesarean deliveries were randomized to immediate postplacental insertion during cesarean or delayed insertion after 4-8 weeks.

Pharmacokinetics of the etonogestrel contraceptive implant in obese women.

Objective: We sought to examine the pharmacokinetics and acceptability of the etonogestrel contraceptive implant in obese women.

Study Design: We developed and validated a plasma etonogestrel concentration assay and enrolled 13 obese (body mass index ≥30) women and 4 normal-weight (body mass index <25) women, who ensured comparability with historical controls. Etonogestrel concentrations were measured at 50-hour intervals through 300 hours postinsertion, then at 3 and 6 months to establish a pharmacokinetic curve.

Daily context matters: predictors of missed oral contraceptive pills among college and graduate students.

Objective: The purpose of this study was to understand the relationship between daily contextual factors and oral contraceptive (OC) adherence among students who attend college or graduate school.

Study Design: Data on OC adherence, demographics, contextual factors, and side-effects were collected as part of the acceptability of the NuvaRing (Merck & Co, Whitehouse Station, NJ) vs OC study, in which students were assigned randomly to the contraceptive vaginal ring or to a low-dose OC. We performed bivariate and multivariable analyses to create an explanatory model for nonperfect OC adherence (missed at least 1 pill during 3 months of use).

Adherence and acceptability of the contraceptive ring compared with the pill among students: a randomized controlled trial.

Objectives: To compare satisfaction with and adherence to the contraceptive vaginal ring and a daily low-dose oral contraceptive pill (OCP) among college and graduate students using a novel method of electronic data collection.

Methods: We randomly assigned 273 women to the contraceptive vaginal ring (n=136) or OCP (n=137) for three consecutive menstrual cycles. Participants completed daily Internet-based, online diaries regarding method adherence and satisfaction during cycles of use.

Novel measures of heart rate variability predict cardiovascular mortality in older adults independent of traditional cardiovascular risk factors: the Cardiovascular Health Study (CHS).

Unlabelled: Novel HRV Predicts CV Mortality in the Elderly.

Background: It is unknown whether abnormal heart rate turbulence (HRT) and abnormal fractal properties of heart rate variability identify older adults at increased risk of cardiovascular death (CVdth).

Methods: Data from 1,172 community-dwelling adults, ages 72 +/- 5 (65-93) years, who participated in the Cardiovascular Health Study (CHS), a study of risk factors for CV disease in people >or=65 years.