Impact of Remote Blood Pressure Monitoring Device Connectivity on Engagement Among Pregnant Individuals Enrolled in the Delfina Care Platform: Observational Study.

User engagement with remote blood pressure monitoring during pregnancy is critical to optimize the associated benefits of blood pressure control and early detection of hypertensive disorders of pregnancy. In our study population of pregnant individuals, we found that connected blood pressure cuffs, which automatically sync measures to a monitoring platform or health record, increase engagement (2.13 [95% CI 1.

Prescriptive Authority for Direct Entry Midwives in Washington State: Increasing Client Access to Contraception.

Improving health and achieving health equity includes access to sexual and reproductive health care for all populations, especially those most in need. However, access to life-saving and life-affirming contraception with an individual's chosen perinatal provider can be impeded by restrictive regulations that limit scope and practice authority. This is especially true for the majority of community and direct entry midwives in the United States who have historically been unable to legally provide effective contraceptive methods.

Increasing Access to Medications and Devices for the Care of Low-Risk Childbearing Families: An Analysis of Existing Law and Strategies for Advocacy.

Limited access to medications and devices relevant to the care of low-risk childbearing families acts as a barrier to the successful integration of high-quality midwifery care into health care systems. Families who live in clinically underserved areas, whether urban or rural, are particularly in need of perinatal professionals who can provide comprehensive care. This article reviews existing US laws that impact whether families who choose community-based care with direct entry midwives have access, through their chosen provider, to the medications and devices relevant to their normal perinatal and postpartum care.

Oncolytic virotherapy induced CSDE1 neo-antigenesis restricts VSV replication but can be targeted by immunotherapy.

In our clinical trials of oncolytic vesicular stomatitis virus expressing interferon beta (VSV-IFNβ), several patients achieved initial responses followed by aggressive relapse. We show here that VSV-IFNβ-escape tumors predictably express a point-mutated CSDE1 form of the RNA-binding Cold Shock Domain-containing E1 protein, which promotes escape as an inhibitor of VSV replication by disrupting viral transcription. Given time, VSV-IFNβ evolves a compensatory mutation in the P/M Inter-Genic Region which rescues replication in CSDE1 cells.

Moving toward implementation: the potential for accountable care organizations and private-public partnerships to advance active neighborhood design.

The 2010 Affordable Care Act's (ACA) aims of lowering costs and improving quality of care will renew focus on preventive health strategies. This coincides with a trend in medicine to reconsider population health approaches as part of the standard curriculum. This intersection of new policy and educational climates presents a unique opportunity to reconsider traditional healthcare structures.

Evaluation of organizational culture among different levels of healthcare staff participating in the Institute for Healthcare Improvement's 100,000 Lives Campaign.

Background: Little is known about how hospital organizational and cultural factors associated with implementation of quality initiatives such as the Institute for Healthcare Improvement's (IHI) 100,000 Lives Campaign differ among levels of healthcare staff.

Design: Evaluation of a mixed qualitative and quantitative methodology ("trilogic evaluation model").

Setting: Six hospitals that joined the campaign before June 2006.

A healthy bottom line: healthy life expectancy as an outcome measure for health improvement efforts.

Context: Good health is the most important outcome of health care, and healthy life expectancy (HLE), an intuitive and meaningful summary measure combining the length and quality of life, has become a standard in the world for measuring population health.

Methods: This article critically reviews the literature and practices around the world for measuring and improving HLE and synthesizes that information as a basis for recommendations for the adoption and adaptation of HLE as an outcome measure in the United States.

Findings: This article makes the case for adoption of HLE as an outcome measure at the national, state, community, and health care system levels in the United States to compare the effectiveness of alternative practices, evaluate disparities, and guide resource allocation.

Diagnosis of symptomatic postmenopausal women by traditional Chinese medicine practitioners.

Objective: To learn more about the way that practitioners of traditional Chinese medicine (TCM) diagnose women who have menopausal symptoms.

Design: We assembled a cohort of 23 postmenopausal women who had hot flushes and were otherwise healthy. Each woman was examined independently by nine practitioners of TCM on the same day.

Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial.

Objective: To evaluate possible estrogenic effects of dong quai on vaginal cells and on endometrial thickness in postmenopausal women.

Design: Double-blind, randomized, placebo-controlled clinical trial.

Setting: Department of Obstetrics and Gynecology in a large health maintenance organization (HMO).

Diagnostic and operative arthroscopy of the knee under local anesthesia with parenteral medication.

Arthroscopy of the knee under local anesthesia was performed on 102 patients for operative and diagnostic purposes between January and December of 1985. The procedures were performed on a same day basis without a pneumatic tourniquet. The operative record of each patient was reviewed to determine postoperative diagnosis and treatment.

Compression pain in a diver with intraosseous pneumatocysts.

A 30-yr-old diver experienced pain in the area of the sacroiliac joint during the descent phase of air diving to less than 10 ATA. Computed tomography of the pelvis demonstrated two gas-filled cysts within the ilium. The mechanism by which this lesion causes pain is discussed and reports of gas within bone are reviewed.

Combined ankle and subtalar instability.

Ipsilateral ankle and subtalar instability has been alluded to in the orthopaedic literature. A case demonstrating this combined instability pattern is presented and a technique for documenting this disorder is described.