Performance of Optic Disc Optical Coherence Tomography Normative Database in a Large, Diverse, Real-World Cohort.

Precis: Current optical coherence tomography normative sample data may not represent diverse human optic nerve anatomy to accurately classify all individuals with true glaucomatous optic neuropathy.

Purpose: To compare optic nerve head (ONH) measurements between published values from an optical coherence tomography (OCT) normative database and a more diverse cohort of healthy individuals.

Patients And Methods: ONH parameters from healthy participants of the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program and the Topcon Maestro-1 normative cohort were compared.

Identifying Core Functions and Forms of "Discharge by Noon" Interventions.

Background: Many hospitals have implemented Discharge by Noon (DBN) programs to improve hospital throughput but have had mixed results.

Objective: Use a complex health intervention framework to define core functions and forms of DBN interventions.

Design: Qualitative study combined with scoping review.

Travel Time as an Indicator of Poor Access to Care in Surgical Emergencies.

Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.

Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.

Sleep disturbances and progression of mobility disability: Longitudinal findings from the Nurses' Health Study.

Objective: To examine longitudinal associations between self-reported sleep disturbances and mobility disability progression among women, including subgroups with multiple sclerosis (MS), diabetes, and osteoarthritis (OA).

Methods: Prospective cohort study using data from Nurses' Health Study long-form questionnaires (2008, 2012, 2014, 2016). Logistic regression was used to quantify associations between sleep-related variables at baseline and subsequent increase in mobility disability.

Outcome Measures to Evaluate Functional Recovery in Survivors of Respiratory Failure: A Scoping Review.

Background: Respiratory failure is a life-threatening condition affecting millions of individuals in the United States annually. Survivors experience persistent functional impairments, decreased quality of life, and cognitive impairments. However, no established standard exists for measuring functional recovery among survivors of respiratory failure.

Older US adults' experiences with and views about cognitive screening and blood biomarker testing for Alzheimer's disease.

Introduction: Dementia is underdiagnosed in the United States. Understanding of older adults' experiences with screening is needed to optimize diagnosis.

Methods: US adults ages 65 to 80 ( = 1298) were surveyed on experiences with cognitive screening and blood biomarker (BBM) testing.

Health Care Utilization and Costs for Older Adults Aging Into Medicare After the Affordable Care Act.

Importance: The Affordable Care Act (ACA) expanded Medicaid and Marketplace insurance to nonelderly adults in 2014, but whether these policies improved outcomes later in life is unknown.

Objective: To examine whether exposure to ACA expansions during middle age (50-64 years) was associated with changes in health, utilization, and spending after these adults entered Medicare at 65 years of age.

Design, Setting, And Participants: This serial analysis of the Health and Retirement Study cohort linked to Medicare enrollment and claims data from January 1, 2010, to December 31, 2018.

Self-Collected Testing for Sexually Transmitted Infections: A National Text Message Survey of Adolescents and Young Adults.

Purpose: We aimed to analyze adolescent and young adults' (AYAs) perspectives on using sexually transmitted infection (STI) self-collection kits to help guide the provision and implementation of accessible and confidential reproductive health-care services for those who experience the burden of STIs and STI-related morbidity.

Methods: We utilized MyVoice, a nationwide text message survey of AYAs, to pose 6 open-ended questions on their perceptions and use of STI self-collection kits. Two independent reviewers used inductive content analysis to develop a codebook and analyze responses, and a third settled any coding discrepancies through discussion to reach consensus.

Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing.

Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.

Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.

Black/White disparities in low birth weight across maternal trajectories of social mobility in South Carolina.

Persistent racial disparities in low birth weight (LBW) in the United States may be better understood through the adoption of a life course perspective that considers differential exposure and vulnerability of Black and White women to socioeconomic position across generations. Using a multigenerational dataset of singleton birth certificates from South Carolina from 1989 to 2020 linked along the maternal line, we constructed intergenerational social mobility trajectories of grandmaternal and maternal education and compared unadjusted and adjusted associations between trajectories and LBW among Black and White women. We found that White women were more likely to be upwardly mobile, and Black women to be downwardly mobile.

Representation of Hispanic Patients in Clinical Trials for Respiratory Failure: A Systematic Review.

Objectives: Hispanic individuals comprise one-fifth of the U.S. population and Hispanic patients with acute hypoxemic respiratory failure (AHRF) experience higher odds of death compared with non-Hispanic White patients.

Differences in US Adult Dietary Patterns by Cardiovascular Health and Socioeconomic Vulnerability.

Background: Naturally occurring dietary patterns, a major contributor to health, are not well described among those with cardiovascular disease (CVD) - particularly in light of socioeconomic vulnerability. We sought to identify major dietary patterns in the US and their distribution by CVD, social risk factors, and Supplemental Nutrition Assistance Program (SNAP) participation.

Methods: This was a cross-sectional study among 32,498 noninstitutionalized adults from the National Health and Nutrition Examination Survey (2009-2020).

National Telehealth Contingency Staffing Program and Primary Care Quality in the VHA.

Importance: The Veterans Health Administration (VHA) launched the Clinical Resource Hub (CRH), a national telehealth contingency staffing program, to address primary care staffing shortages and improve veteran access to primary care. How this large-scale telehealth intervention affects quality of care is unknown.

Objective: To assess the quality of care for chronic disease management among US veterans receiving high vs low levels of CRH-delivered primary care services and whether racial and ethnic minority veterans experience outcomes similar to those of White veterans when receiving CRH-delivered care.

The potential impact of optimal blood pressure treatment intensity to reduce disparities in dementia between Black and White individuals.

Background: Black adults have higher dementia risk than White adults. Whether tighter population-level blood pressure (BP) control reduces this disparity is unknown.

Objective: Estimate the impact of optimal BP treatment intensity on racial disparities in dementia.

Exploring diagnostic stewardship in the emergency department evaluation of pediatric abdominal pain in a statewide quality collaborative.

Background: Diagnostic stewardship is the effort to optimize diagnostic testing to reduce errors while avoiding overtesting and overtreatment. Abdominal pain and appendicitis in children are essential use cases. Delayed diagnosis of appendicitis can be dangerous and even life-threatening, but overtesting is harmful.

Development of an implementation intervention to promote adoption of the COMFORT clinical practice guideline for peripartum pain management: a qualitative study.

Background: Pain management after childbirth is widely variable, increasing risk of untreated pain, opioid harms, and inequitable experiences of care. The Creating Optimal Pain Management FOR Tailoring Care (COMFORT) clinical practice guideline (CPG) seeks to promote evidence-based, equitable acute peripartum pain management in the United States. We aimed to identify contextual conditions (i.

Effects of Nursing Home Changes in Antipsychotic Use on Outcomes among Residents with Dementia.

Objectives: Little information exists on whether nationwide efforts to reduce antipsychotic use among nursing home (NH) residents with Alzheimer's disease and related dementias improved mortality and hospitalization outcomes for residents. Our objective was to examine the effect of NH decreases in antipsychotic use on outcomes for residents with Alzheimer's disease and related dementias.

Design: Observational nationwide study that emulated a series of cluster randomized trials.

Associations between rural hospital closures and acute and post-acute care access and outcomes.

Objective: To determine whether rural hospital closures affected hospital and post-acute care (PAC) use and outcomes.

Study Setting And Design: Using a staggered difference-in-differences design, we evaluated associations between 32 rural hospital closures and changes in county-level: (1) travel distances to and lengths of stay at hospitals; (2) functional limitations at and time from hospital discharge to start of PAC episode; (3) 30-day readmissions and mortality and hospitalizations for a fall-related injury; and (4) population-level hospitalization and death rates.

Data Sources And Analytic Sample: 100% Medicare claims and home health and skilled nursing facility clinical data to identify approximately 3 million discharges for older fee-for-service Medicare beneficiaries.

Considerations for the Treatment of Sexual and Gender Minority Individuals in Colon and Rectal Surgery.

Sexual and gender minorities (SGMs) experience critical barriers to health care access and have unique health care needs that are often overlooked. Given the rise in individuals identifying as lesbian, gay, bisexual, transgender, and queer, colorectal surgeons are likely to care for increasing numbers of such individuals. Here, we discuss key barriers to health care access and research among SGM populations and outline approaches to address these barriers in clinical practice.

Closing the Gap: Approaches to Improving Colorectal Surgery Care for the Uninsured and Underinsured.

Health insurance plays a critical role in access to and delivery of health care in the United States. As the only industrialized nation without universal health coverage, Americans without adequate insurance (i.e.