Improving Decannulation and Swallowing Function: A Comprehensive, Multidisciplinary Approach to Post-Tracheostomy Care.

Background: Multidisciplinary tracheostomy teams have been successful in improving operative outcomes; however, limited data exist on their effect on postoperative care. We aimed to determine the effectiveness of a multidisciplinary tracheostomy service alone and following implementation of a post-tracheostomy care bundle on rates of decannulation and tolerance of oral diet before discharge.

Methods: Prospective data on all subjects requiring tracheostomy by any trauma/critical care surgeon were collected from January 2011 to December 2013 following development of a tracheostomy service and continued following implementation of the post-tracheostomy care bundle.

Addressing Childhood Obesity Through Multisector Collaborations: Evaluation of a National Quality Improvement Effort.

The Healthy Weight Collaborative (HWC) represents a national quality improvement effort to increase uptake of evidence-based community-based interventions to address obesity among children. Implemented from 2011 to 2013, the HWC built the capacity of 49 community-based multisector teams (10 teams in the Phase 1 pilot, 39 teams in Phase 2), delivered services to support health behavior changes in children and families, and implemented sustainable social and environmental policy change at the organizational and community levels. Phase 2 teams participated in three virtual collaborative learning sessions interspersed with three "action periods" during which teams implemented the HWC "change package" while receiving tailored coaching and peer-support.

The Healthy Weight Collaborative: using learning collaboratives to enhance community-based prevention initiatives addressing childhood obesity.

This report from the field describes the design, implementation, and early evaluation results of the Healthy Weight Collaborative, a federally-supported learning collaborative to develop, test, and disseminate an integrated change package of six promising, evidence-based clinical and community-based strategies to prevent and treat obesity for children and families.

The Building Bridges Initiative: residential and community-based providers, families, and youth coming together to improve outcomes.

The Building Bridges Initiative (BBI) provides a framework for achieving positive outcomes for youth and families served in residential and community programs. Founded on core principles, an emerging evidence base, and acknowledged best practices, the BBI emphasizes collaboration and coordination between providers, families, youth, advocates, and policymakers to achieve its aims. Examples are presented of successful state, community, and provider practice changes, and available tools and resources to support all constituencies in achieving positive outcomes.

Mental health disparities.

Mental health disparities have received increased attention in the literature in recent years. After considering 165 different health disparity conditions, the Federal Collaborative for Health Disparities Research chose mental health disparity as one of four topics warranting its immediate national research attention. In this essay, we describe the challenges and opportunities encountered in developing a research agenda to address mental health disparities in the United States.

Characteristics, service experiences, and outcomes of transition-aged youth in systems of care: programmatic and policy implications.

This article examines data for 8,484 transition-aged youth (TAY) in different age groups who received services in 45 federally funded systems of care between 1997 and 2006. Data from the national evaluation of these systems of care were used to compare descriptive and clinical characteristics at intake of TAY aged 14-15, 16-17, and 18 years, and service use and outcomes of TAY aged 14-15 and 16-17 at 6 and 12 months after system of care intake. Few studies have examined outcomes of TAY.

Evidence-based practice knowledge, use, and factors that influence decisions: results from an Evidence-based Practice Survey of providers in American Indian/Alaska Native communities.

Data from the Evidence-based Treatment Survey were used to compare providers serving families in American Indian and Alaska Native communities to their counterparts in non-American Indian/Alaska Native communities on provider characteristics and factors that influence their decision to use evidence-based practices (N = 467). The findings suggest that providers affiliated with American Indian/Alaska Native communities are similar to their non-AI/AN community-affiliated counterparts in terms of familiarity, knowledge and use of evidence-based practices, and only differ slightly on the factors considered when deciding to use an evidence-based practice with a child and family.

Workshop report on the extraction of foetal DNA from maternal plasma.

Objective: Cell free foetal DNA (cff DNA) extracted from maternal plasma is now recognized as a potential source for prenatal diagnosis but the methodology is currently not well standardized. To evaluate different manual and automated DNA extraction methods with a view to developing standards, an International Workshop was performed.

Methods: Three plasma pools from RhD-negative pregnant women, a DNA standard, real-time-PCR protocol, primers and probes for RHD were sent to 12 laboratories and also to one company (Qiagen, Hilden, Germany).