Integration of Community Health Workers into Palliative Care Teams: A Scoping Review.

Background: Rural communities, like other places in the United States, face a growing need for palliative care. Community health workers (CHWs) are one potential way to expand the ability to provide palliative care. This scoping review explores what is known about CHWs involved in palliative care teams in the United States.

Phase II study of dichloroacetate, an inhibitor of pyruvate dehydrogenase, in combination with chemoradiotherapy for unresected, locally advanced head and neck squamous cell carcinoma.

Chemoradiotherapy (CRT) for locally-advanced head and neck squamous cell carcinoma (LA-HSNCC) yields 5-year survival rates near 50% despite causing significant toxicity. Dichloroacetate (DCA), a pyruvate dehydrogenase kinase metabolic inhibitor, reduces tumor lactate production and has been used in cancer therapy previously. The safety of adding this agent to CRT is unknown.

Effects of a Decentralized Nursing Model on Patient Outcomes in Two Rural Community Hospitals.

Aim: To assess hypothesized effects of decentralized nursing models on adult inpatient outcomes, patient medical records and satisfaction surveys were analyzed from two rural community hospitals that transitioned from centralized to decentralized nursing unit designs in 2015.

Background: The objective to place nurses closer to patients precipitates broad use of decentralized nursing unit designs over models with centralized nurse stations. Decentralized models have been hypothesized to improve patient outcomes, but few studies have empirically measured effects.

Knowledge, Attitudes, and Needs: Assessing the COVID-19 Impact in Rural America.

Objective: There is a lack of information concerning the impact of COVID-19 on rural populations. This report shares key results from a cross-sectional survey of South Dakota residents' perceptions on the impact and knowledge of COVID-19 during the early phases of the pandemic.

Methods: From March 24 to April 14, 2020, South Dakota residents (n = 4,761) reported on their psychological symptoms, pandemic-related stressful experiences, top concerns regarding the pandemic, attitudes towards COVID-19, and social distancing behaviors, and where residents were getting COVID information and who they trust to provide accurate information.

From Fable to Reality at Parkland Hospital: The Impact of Evidence-Based Design Strategies on Patient Safety, Healing, and Satisfaction in an Adult Inpatient Environment.

Objective: This research aimed to evaluate the quantitative effects of new hospital design on adult inpatient outcomes.

Background: Tenets of evidence-based healthcare design, notably single-patient acuity-adaptable and same-handed rooms, decentralized nursing stations, onstage offstage layout, and access to nature were expected to promote patient healing and increase patient satisfaction, while decreasing adverse events.

Methods: Patient healing was operationalized through length of stay (LOS) and patient safety through three adverse events: falls, hospital-acquired infections (HAI), and medication-related events.

Geographical analysis of the distribution of certified genetic counselors in the United States.

The number of certified genetic counselors (CGCs) in the genetic counseling workforce has increased over the past few decades as the number of training programs increases and CGCs expand into new patient-facing and non-patient-facing roles. Few studies have explored the distribution of CGCs across the United States. We sought to identify the U.

Single-family room neonatal intensive care unit design: do patient outcomes actually change?

Objective: This study examined outcomes in a single-family room neonatal intensive care unit (NICU) compared to an open bay within a public safety net hospital.

Study Design: We included 9995 NICU encounters over 5 years pre and post move for a predominantly low SES population. Outcomes were length of stay (LOS), growth, time to first oral feeding, and incidence of sepsis.

The Impact of Health Equity Coaching on Patient's Perceptions of Cultural Competency and Communication in a Pediatric Emergency Department: An Intervention Design.

Purpose: American Indian (AI) children experience significant disparities in health-care access. As a result, they are more likely to use the emergency department (ED) for nonemergent visits than white children. In a recent study, pediatric ED providers have shown an implicit bias for white children over AI children.

A County-Level Health Index to Capture Geographic Variation in Health Conditions in North Dakota, South Dakota, and Minnesota.

Introduction: Individual health is influenced by multiple, potentially correlated factors including healthcare availability, community context, and socioeconomic factors. To measure the health changes at county-levels across North Dakota, South Dakota, and Minnesota, a measure of relative health, health index, was developed incorporating multiple indicators from domains of health conditions, health behaviors, and social determinants.

Methods: We combined data from all 206 counties in the aforementioned three states for the years 2008-2012 from multiple data sources.

Using Social Network Analysis to Visualize Networks in American Indian Health Research.

The Collaborative Research Center for American Indian Health (CRCAIH) is a transdisciplinary, collaborative center focused on building American Indian tribal research infrastructure. Funded by the National Institute of Minority Health and Health Disparities in 2012, it was created as a platform to join tribal communities and researchers in South Dakota, North Dakota, and Minnesota to develop research infrastructure and stimulate research in American Indian health. The CRCAIH infrastructure has created a large network of transdisciplinary research partnerships.

Associations of Patient and Staff Outcomes With Inpatient Unit Designs Incorporating Decentralized Caregiver Workstations: A Systematic Review of Empirical Evidence.

Objectives:: This systematic literature review synthesizes and assesses quality of research addressing associations of patient and staff outcomes with inpatient unit designs incorporating decentralized caregiver workstations.

Background:: A current hospital design trend is to include decentralized caregiver workstations on inpatient units. A review of literature addressing decentralized unit design is needed.

The Role of Socioeconomic Status in Individuals that Leave Against Medical Advice.

Introduction: Individuals leaving against medical advice (AMA) are at risk for adverse health outcomes including a 40 percent increased mortality rate a year after self-discharge. Additionally, leaving AMA may dramatically increase medical costs due to failure to complete treatment resulting in higher risk of readmission with additional co-morbidities.

Methods: Retrospective study of inpatients utilizing the Healthcare Cost and Utilization Project (HCUP) 2012 National Inpatient Sample (NIS) database.

Leaving the emergency department without complete care: disparities in American Indian children.

Background: Children who leave the emergency department (ED) without complete evaluation or care (LWCET) have poorer outcomes in general. Previous studies have found that American Indian (AI) children have higher rates of LWCET than other racial or ethnic groups. Therefore, this study aims to examine LWCET in AI children by exploring differences by ED location and utilization patterns.

Abnormal lipoprotein oxylipins in metabolic syndrome and partial correction by omega-3 fatty acids.

Metabolic syndrome (MetSyn) is characterized by chronic inflammation which mediates the associated high risk for cardiovascular and other diseases. Oxylipins are a superclass of lipid mediators with potent bioactivities in inflammation, vascular biology, and more. While their role as locally produced agents is appreciated, most oxylipins in plasma are found in lipoproteins suggesting defective regulation of inflammation could be mediated by the elevated VLDL and low HDL levels characteristic of MetSyn.

Vaccine-preventable, hospitalizations among American Indian/Alaska Native children using the 2012 Kid's Inpatient Database.

Our aim was to assess the odds of hospitalization for a vaccine-preventable, infectious disease (VP-ID) in American Indian/Alaska Native (AI/AN) children compared to other racial and ethnic groups using the 2012 Kid's Inpatient Database (KID) The KID is a nationally representative sample, which allows for evaluation of VP-ID in a non-federal, non-Indian Health Service setting. In a cross-sectional analysis, we evaluated the association of race/ethnicity and a composite outcome of hospitalization due to vaccine-preventable infection using multivariate logistic regression. AI/AN children were more likely (OR=1.

Genesurance Counseling: Genetic Counselors' Roles and Responsibilities in Regards to Genetic Insurance and Financial Topics.

While traditional components of genetic counseling sessions are well recognized, less is known about insurance and financial discussions. This study sought to examine "genesurance counseling" which we defined as: that portion of a genetic counseling session, whether intentional or non-intentional, that is devoted to the topic of costs and insurance/third party coverage (particularly for genetic testing). Our objective was to assess genetic counselors' practices and perspective related to genesurance counseling.

Community Perspectives on Emergency Department Use and Care for American Indian Children.

Emergency department (ED) utilization by American Indian (AI) children is among the highest in the nation. Numerous health disparities have been well documented in AI children, but limited information is available on parental experiences of care for AI children in the ED. Our objective was to understand parental attitudes towards ED care for AI children.

Emergency Department Utilization by Native American Children.

Objectives: The aims of this study were to determine differences in emergency department (ED) use by Native American (NA) children in rural and urban settings and identify factors associated with frequent ED visits.

Methods: This cross-sectional, cohort study examined visits to 6 EDs: 2 rural, 2 midsize urban, and 2 large urban EDs from June 2011 to May 2012. Univariate and multiple regression analyses were conducted.

Racial/Ethnic Variation in Emergency Department Care for Children With Asthma.

Objective: To assess the variation between racial/ethnic groups in emergency department (ED) treatment of asthma for pediatric patients.

Methods: This study was a cross-sectional analysis of pediatric (2-18 years) asthma visits among 6 EDs in the Upper Midwest between June 2011 and May 2012. We used mixed-effects logistic regression to assess the odds of receiving steroids, radiology tests, and returning to the ED within 30 days.

Patient and Physician Perceptions of Genetic Testing in Primary Care.

Introduction: The convergence of biomedical informatics and translational genomics is changing the way we practice. Primary care will play a pivotal role in this transformation. We therefore sought to assess general knowledge about genetic testing among outpatient internal medicine providers, and the patients that they serve across a five state region in the Midwest.

Epidemiology of substance-exposed pregnancies at one Great Lakes hospital that serves a large number of American Indians.

Objective: The purpose of this research was to determine the prevalence of substance-exposed pregnancies at a hospital in the Great Lakes region of the U.S.

Method: Data were collected via retrospective chart abstractions of patients who were seen for delivery at one Great Lakes region hospital during a 1-year period who were given at least one of the International Classification of Diseases codes related to substance use.

Emergency Department Utilization for Mental Health in American Indian Children.

Objectives: To examine emergency department (ED) visits for mental health concerns by American Indian children in a multicenter cohort. To analyze demographic and clinical factors, the types of mental health concerns, and repeat mental health visits.

Study Design: Cross-sectional study of children 5-18 years old who visited 1 of 6 EDs in the Upper Midwest from June 2011 to May 2012 and self-identified as white or American Indian.

The Role of Bias by Emergency Department Providers in Care for American Indian Children.

Background: American Indian children have high rates of emergency department (ED) use and face potential discrimination in health care settings.

Objective: Our goal was to assess both implicit and explicit racial bias and examine their relationship with clinical care.

Research Design: We performed a cross-sectional survey of care providers at 5 hospitals in the Upper Midwest.

Racial Differences in Pediatric Emergency Department Triage Scores.

Background: Racial disparities are frequently reported in emergency department (ED) care.

Objectives: To examine racial differences in triage scores of pediatric ED patients. We hypothesized that racial differences existed but could be explained after adjusting for sociodemographic and clinical factors.