Evaluating a Center for Interprofessional Education via Social Network Analysis.

Centers and institutes are created to support interdisciplinary collaboration. However, all centers and institutes face the challenge of how best to evaluate their impact since traditional counts of productivity may not fully capture the interdisciplinary nature of this work. The authors applied techniques from social network analysis (SNA) to evaluate the impact of a center for interprofessional education (IPE), a growing area for centers because of the global emphasis on IPE.

Congenital heart defects in West Virginia: Preliminary findings from an ecological study of effects of an industrial watershed on increased incidence.

Objective: Congenital anomalies are the leading cause of infant death, with congenital heart (CHD) defects the most common type. The study objective was to evaluate the incidence of fetal CHD in a tertiary care medical center's obstetric population in West Virginia and map areas of possible environmental exposure.

Methods: This was an observational study of patients with positive ultrasound screen for CHD from 1/1/2007-8/31/2016.

Evaluating the risk of tick-borne relapsing fever among occupational cavers-Austin, TX, 2017.

Tick-borne relapsing fever (TBRF) is a potentially serious spirochetal infection caused by certain species of Borrelia and acquired through the bite of Ornithodoros ticks. In 2017, Austin Public Health, Austin, TX, identified five cases of febrile illness among employees who worked in caves. A cross-sectional serosurvey and interview were conducted for 44 employees at eight organizations that conduct cave-related work.

Epidemiology of abusive head trauma in West Virginia children <24 months: 2000-2010.

Background: Few states have published statewide epidemiology of abusive head trauma (AHT).

Objective: To examine the statewide epidemiology of AHT in West Virginia (WV), with the primary objective of establishing AHT incidence for comparison to national data, and to use as a baseline for comparison to incidence post-implementation of a statewide AHT prevention program.

Participants And Setting: AHT cases in children less than 2 years old were identified from the 3 tertiary pediatric centers in WV.

Migration of Patients for Liver Transplantation and Waitlist Outcomes.

Background & Aims: Patients in need of liver transplantation may travel to improve their chance of receiving an organ. We evaluated factors to determine which transplant candidates travel to other regions to increase their chances of receiving a liver and effects of travel on waitlist outcomes.

Methods: We performed a retrospective cohort study of all adult patients registered for primary deceased donor liver transplantation in the United States from January 2004 to December 2016.

Determination of Optimal Weight-Based Enoxaparin Dosing and Associated Clinical Factors for Achieving Therapeutic Anti-Xa Assays for Deep Venous Thrombosis Prophylaxis.

Background: Previous studies have evaluated dose-to-weight ratios to define best practices for obtaining therapeutic anti-Xa assays for enoxaparin venous thromboembolism (VTE) prophylaxis. These studies have not examined relationships among dosing, patient characteristics, and therapeutic assays. This study examines factors associated with therapeutic assays and enoxaparin prophylaxis.

Despite high-risk exposures, no evidence of zoonotic transmission during a canine outbreak of leptospirosis.

Leptospirosis is a bacterial zoonosis that affects many mammals, including humans and dogs; dogs can transmit the bacteria to humans, but the frequency of transmission and highest risk exposures are poorly understood. During 2016-2017, the Maricopa County Department of Public Health, Arizona Department of Health Services and Centers for Disease Control and Prevention investigated the zoonotic potential of a canine leptospirosis outbreak in the Phoenix metro area. We identified symptomatic persons exposed to canine leptospirosis cases by conducting active and passive surveillance.

Results of Telehealth Electronic Monitoring for Post Discharge Complications and Surgical Site Infections following Arterial Revascularization with Groin Incision.

Background: Post-surgical discharge complications result in increased hospital readmissions, cost, and patient dissatisfaction. Telehealth technology to monitor patients, especially those in geographically isolated areas, may reduce post-operative complications and improve health and financial outcomes. The primary objective of this study was to compare outcomes between patients who received TeleHealth Electronic Monitoring (THEM) and those with routine discharge instructions and no monitoring, Standard Of Care (SOC).

Innovative approaches reaching underserved and rural communities to improve epilepsy care: A review of the methodology of the Connectors Project.

Objective: The Connectors Project, a collaboration between the Epilepsy Foundation and UCB Pharma, was a multiyear project designed to improve epilepsy care in underserved communities. A core objective of the Connectors Project was to pilot new and innovative approaches to epilepsy awareness and education in rural and underserved areas, including standardized curricula for healthcare providers and patients.

Methods: A series of consensus conferences explored opportunities and barriers to epilepsy care throughout the United States including access to local Epilepsy Foundations, neurologists, and epilepsy centers.

Value of Global Surgical Activities for US Academic Health Centers: A Position Paper by the Association for Academic Surgery Global Affairs Committee, Society of University Surgeons Committee on Global Academic Surgery, and American College of Surgeons' Operation Giving Back.

Background: Academic global surgery value to low- and middle-income countries (LMICs) is increasingly understood, yet value to academic health centers (AHCs) remains unclear.

Study Design: A task force from the Association for Academic Surgery Global Affairs Committee and the Society for University Surgeons Committee on Global Academic Surgery designed and disseminated a survey to active US academic global surgeons. Questions included participant characteristics, global surgeon qualifications, trainee interactions, academic output, productivity challenges, and career models.

County Context and Mental Health Service Utilization by Older Hispanics.

Background And Objectives: Although older Hispanics experience high rates of depression, they tend to underuse mental health services. The study examined the association between county characteristics and mental health service use among older Hispanics, controlling for individual characteristics.

Research Design And Methods: The study used the 2008-2012 Medical Expenditure Panel Study and linked county-level data from the 2013-2014 Area Health Resources Files and the 2008-2012 Chronic Conditions Data Warehouse, using the Federal Information Processing Standard county code.

A Menu to Evaluate Factors Influencing Implementation of Obesity Prevention Early Care and Education Regulations.

Context: In recent years, several states have adopted new regulations concerning nutrition, physical activity, and screen time in early care and education (ECE) settings to help prevent childhood obesity.

Objective: To disseminate a menu of factors that facilitate and/or impede implementation of obesity prevention regulations in ECE settings.

Design: To create the menu, we condensed and categorized factors identified in the literature and through field work by placing them within domains.

Triple Aim Is Triply Tough: Can You Focus on Three Things at Once?

Background And Objectives: The I3 POP Collaborative sought to improve health of patients attending North Carolina, South Carolina, and Virginia primary care teaching practices using the triple aim framework of better quality, appropriate utilization, and enhanced patient experience. We examined change in triple aim measures over 3 years, and identified correlates of improvement.

Methods: Twenty-nine teaching practices representing 23 residency programs participated.

Appropriate Use of Venous Imaging and Analysis of the D-Dimer/Clinical Probability Testing Paradigm in the Diagnosis and Location of Deep Venous Thrombosis.

Background: The D-dimer (DD) level combined with the pretest Wells criteria probability (WCP) score can safely exclude deep venous thrombosis (DVT). The objective of this study was to examine the correlation between DD results alongside WCP score with findings on venous duplex ultrasound (VDU). The hypothesis is that VDU remains overutilized in low-risk patients with negative DD and that higher DD levels may correlate with thrombus burden and location.

Development of a Diabetes Mellitus Knowledge Resource for Clinical Decision Support Assisting Primary Care Physicians With Work-Related Issues.

Objective: The aim of this study was to describe the process by which a group of subject matter experts (SMEs) in the area of occupational health and primary care developed a clinical decision support (CDS) tool addressing work-related issues, which are important in the care of patients with diabetes mellitus (DM). The CDS is intended for primary care clinicians caring for employed adults with DM.

Methods: The SME's selected guidelines for the management of DM in working adults, reviewed pertinent literature, and developed specific recommendations for action in the clinical setting.

Issues related to renal artery angioplasty and stenting.

Renal artery stenosis may play a significant role in the pathogenesis of secondary hypertension, renal dysfunction, and flash pulmonary edema. Currently correction of renal arterial inflow stenosis is reserved for resistant hypertension patients who have failed maximal medical therapy, have worsening renal function and/or unexplained proximal congestive failure. With the recent advances in minimally invasive percutaneous stent placement techniques, open surgical revascularization has been largely replaced by renal artery stenting.

Burden of palliative care issues encountered by radiation oncologists caring for patients with advanced cancer.

Purpose: Radiation oncologists frequently provide care for patients with advanced cancer who are in their last months or weeks of life. This study examined the previously not well-characterized types and frequencies of palliative care issues encountered in consultations for palliative radiation therapy (PRT).

Methods And Materials: This prospective, survey-based study assessed consecutive consults for PRT from May 19, 2014, to September 26, 2014 at 3 Boston-area community and academic, hospital-based centers.

Hybrid Treatment of Extracranial Carotid Artery Disease.

Objective: High-degree stenosis of both innominate (IA) or left common carotid artery (CCA) and carotid bifurcation is uncommon but still represents a significant challenge to interventionists in many aspects including techniques, timing, and priority. There are several strategies for intervention that have been reported in the literature. A well-described, less-invasive strategy for extracranial tandem carotid lesions is concomitant carotid endarterectomy (CEA) with retrograde carotid angioplasty and stenting (CAS).

Implementation and Outcomes of a Community-Based Pulmonary Rehabilitation Program in Rural Appalachia.

Purpose: To report on the implementation and clinical outcomes of a community-based pulmonary rehabilitation program in rural Appalachia.

Methods: Three rural health centers and a large referral hospital worked together to establish pulmonary rehabilitation services based on AACVPR guidelines. Each site hired at least 1 respiratory therapist.

Assisted Reproductive Technology Surveillance - United States, 2013.

Problem/condition: Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States.

Improving the Care of Dual Eligible Patients in Rural Federally Qualified Health Centers: The Impact of Care Coordinators and Clinical Pharmacists.

Background: Dual eligible persons are those covered by both Medicare and Medicaid. There were 9.6 million dual eligible persons in the United States and 82 000 in West Virginia in 2010.

Debriefing in Simulation and Beyond.

Debriefing, with its roots in military and aviation, is critically important to effective application of simulation education. With its widespread implementation and strong underpinnings in a variety of educational theories, debriefing is a central pillar of essentially all health care simulation centers. Even anesthesiologists who have completed training and practice outside of teaching centers will encounter debriefing when they participate in Part IV of Maintenance of Certification in Anesthesiology in endorsed simulation centers.

Safety Culture in Cardiac Surgical Teams: Data From Five Programs and National Surgical Comparison.

Background: Little is known about safety culture in the area of cardiac surgery as compared with other types of surgery. The unique features of cardiac surgical teams may result in different perceptions of patient safety and patient safety culture.

Methods: We measured and described safety culture in five cardiovascular surgical centers using the Hospital Survey on Patient Safety Culture, and compared the data with the Agency for Healthcare Research and Quality (AHRQ) 2010 comparative database in surgery and anesthesiology (all types).

Assisted Reproductive Technology Surveillance — United States, 2012.

Problem/condition: Since the first U.S. infant conceived with Assisted Reproductive Technology (ART) was born in 1981, both the use of advanced technologies to overcome infertility and the number of fertility clinics providing ART services have increased steadily in the United States.