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Yale National Clinician Scholars Progra... Publications | LitMetric

52 results match your criteria: "Yale National Clinician Scholars Program[Affiliation]"

Impact of sex differences on patients with neuroendocrine neoplasms during hospital admission.

Ther Adv Med Oncol

December 2024

Department of Medicine, Section of Medical Oncology, Yale School of Medicine and Yale Cancer Center, 333 Cedar Street, PO Box 208028, New Haven, CT 06520, USA.

Background: Sex disparities are known modifiers of health and disease. In neuroendocrine neoplasms (NENs), sex-based differences have been observed in the epidemiology and treatment-related side effects.

Objectives: To examine sex differences in demographics, diagnoses present during hospital admission, comorbidities, and outcomes of hospital course among hospitalized patients with NENs.

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Background: Bubble continuous positive airway pressure (bCPAP) is a low-cost, non-invasive respiratory support therapy for children with respiratory distress, but its effectiveness is dependent on the context. We aimed to understand contextual factors influencing bCPAP implementation for children aged 1-59 months in low-income and middle-income countries (LMICs) and to develop a theory explaining how these factors influence implementation outcomes.

Methods: In this realist review, we generated an initial programme theory comprising candidate context-mechanism-outcome configurations (CMOCs) via review of key references and team discussion.

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Article Synopsis
  • There is growing interest in same-day discharge (SDD) after metabolic and bariatric surgery for older adults (65+), but their safety remains uncertain, leading to their common exclusion from these protocols.* -
  • A study analyzed 63,486 patients aged 65 and older, showing that while SDD rates increased from 1.15% to 4.33% between 2015-2022, most were still discharged on the first postoperative day (POD1).* -
  • Results indicated that those who had SDD had fewer obesity-related health issues and were not at greater risk for complications or hospital readmissions compared to those discharged on POD1, highlighting the importance of careful patient selection for SDD
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Background: Use of online crowdfunding to mitigate health-related cost burden is common in the US, but its usage among candidates for metabolic and bariatric surgery (MBS) is unknown. We aimed to identify GoFundMe campaigns fundraising for MBS and characterize sources of financial strain. We also aimed to determine factors associated with successful crowdfunding.

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Who, What, Where, and How? The State of Family Science in Pediatric Palliative Care.

J Pain Symptom Manage

October 2024

Department of Family and Community Health (K.M-D.), School of Nursing, University of Maryland, Baltimore, MD.

Context: Families are vital providers and recipients of pediatric palliative care (PPC) services. Understanding the scope and nature of evidence at the intersection of family science and PPC research is necessary to develop family-focused interventions that enhance child and family health.

Objectives: Explore and describe the family-level impact of pediatric serious illness.

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Background: Many women eligible for breast conservation therapy (BCT) elect unilateral mastectomy (UM) with or without contralateral prophylactic mastectomy (CPM) and cite a desire for "peace of mind." This study aimed to characterize how peace of mind is defined and measured and how it relates to surgical choice.

Methods: Nine databases were searched for relevant articles through 8 October 2023, and data were extracted from articles meeting the inclusion criteria.

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Importance: Black patients are more likely than White patients to be restrained during behavioral crises in emergency departments (EDs). Although the perils of policing mental health for Black individuals are recognized, it is unclear whether or to what extent police transport mediates the association between Black race and use of physical restraint in EDs.

Objective: To evaluate the degree to which police transport mediates the association between Black race and use of physical restraint in EDs.

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The Financialization of Health in the United States.

N Engl J Med

January 2024

From the Department of Public Health Sciences (J.D.B.) and the Crown Family School of Social Work, Policy, and Practice (C.M.G.), University of Chicago, Chicago; and the Yale National Clinician Scholars Program, Yale University, New Haven, CT (V.R.).

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Background: Patients face well documented problems accessing methadone from opioid treatment programs (OTPs) in the U.S., yet addressing these barriers has proven difficult due in part to the sheer number of actors governing treatment, including state authorities.

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Importance: The US Food and Drug Administration (FDA) and Centers for Medicare & Medicaid Services (CMS) have different statutory authorities; FDA evaluates safety and effectiveness for market authorization of medical devices while CMS determines whether coverage is "reasonable and necessary" for its beneficiaries. CMS has recently enacted policies automatically providing supplemental reimbursement for new, costly devices authorized after designation in FDA's Breakthrough Devices Program (BDP) and in June 2023 issued notice for a new Transitional Coverage for Emerging Technologies pathway, accelerating coverage for Breakthrough devices.

Observations: Aiming to incentivize innovation, FDA awards Breakthrough designations early in device development to expedite market authorization and can accept greater uncertainty in benefit and risk, contingent on postmarket evidence generation.

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Objectives: To describe relationships between parental incarceration and child health and flourishing-a measure of curiosity, resilience, and self-regulation-and to identify government programs that moderate this relationship.

Methods: Using the National Survey of Children's Health data from 2016 through 2019 for children 6-17 years old, we estimated associations with logistic regression between parental incarceration and overall health and flourishing, adjusting for child, caregiver, and household factors. We secondarily examined physical health (asthma, headaches), mental health (attention deficit disorder/attention deficit hyperactivity disorder, depression), developmental needs (learning disability, special educational plan use), and educational (missing ≥11 school days, repeated grade) outcomes.

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Existential Care in Daily Nursing Practice.

Am J Nurs

October 2023

Elise C. Tarbi is an assistant professor in the Department of Nursing at the University of Vermont in Burlington. Elizabeth G. Broden is a fellow in the Yale National Clinician Scholars Program in New Haven, CT, and has received funding from a National Institutes of Health training grant (5T32HS017589) to the Yale School of Public Health. William E. Rosa is assistant attending behavioral scientist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City. Adam Hayden is an independent scholar and unaffiliated patient advocate. Brianna E. Morgan is a postdoctoral fellow in the Division of Geriatric Medicine and Palliative Care, Department of Medicine, NYU Langone Health in New York City. Contact author: Elise C. Tarbi, . The authors have disclosed no potential conflicts of interest, financial or otherwise.

Relationship-centered palliative nursing during serious illness requires existential care. Yet, multilevel systemic barriers hinder nurses' ability to provide this care. The authors suggest ways to navigate these barriers, highlighting existential care priorities that nurses can attend to in their daily practice.

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Introduction: Police involvement in patient transport to emergency medical care has increased over time, yet studies assessing racial inequities in transport are limited. This study evaluated the relationship between race and police transport to the emergency department for adult patients.

Methods: This cross-sectional study evaluated adult (aged ≥18 years) visits at 13 different emergency departments across two regional hospital systems in the Southeastern and Northeastern U.

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Introduction: The decision to discharge a patient from the hospital with confirmed or suspected coronavirus 2019 (COVID-19) is fraught with challenges. Patients who are discharged home must be both medically stable and able to safely isolate to prevent disease spread. Socioeconomically disadvantaged patient populations in particular may lack resources to safely quarantine and are at high risk for COVID-19 morbidity.

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Importance: Black students remain underrepresented in medicine despite national efforts to increase diversity in the physician workforce. Historically Black College and University (HBCU) students play a vital role in increasing representation in the workforce. Currently, there is a paucity of literature understanding the impact of COVID-19 on premedical students from HBCUs.

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Centering Health Equity Within COVID-19 Contact Tracing: Connecticut's Community Outreach Specialist Program.

J Public Health Manag Pract

October 2022

Connecticut Department of Public Health, Hartford, Connecticut (Dr Johnson and Mss Diallo and Soto); Global Health Justice Partnership, Yale Law School, New Haven, Connecticut (Dr Johnson); Department of Epidemiology of Microbial Diseases (Mss Hennein and Gupta, Mr Shelby, and Dr Davis), Department of Biostatistics (Dr Zhou), Pulmonary, Critical Care and Sleep Medicine Section (Drs Davis, Zhou), and Center for Methods in Implementation and Prevention Science (Dr Davis), Yale School of Public Health, New Haven, Connecticut; Yale National Clinician Scholars Program (Drs Ludomirsky and Nunez-Smith), Equity, Research, and Innovation Center (Ms Weiss and Dr Nunez-Smith), and Center for Research Engagement (Dr Nunez-Smith), Yale School of Medicine, New Haven, Connecticut; Section of Pediatric Hospitalist Medicine, Department of Pediatrics, Yale New Haven Children's Hospital, New Haven, Connecticut (Dr Ludomirsky); and Section of General Medicine, Department of Internal Medicine, Yale New Haven Health System, New Haven, Connecticut (Ms Weiss and Dr Nunez-Smith).

Context: The COVID-19 pandemic has disproportionately impacted vulnerable populations, including those who are non-English-speaking and those with lower socioeconomic status; yet, participation of these groups in contact tracing was initially low. Distrust of government agencies, anticipated COVID-19-related stigma, and language and cultural barriers between contact tracers and communities are common challenges.

Program: The Community Outreach Specialist (COS) program was established within the Connecticut Department of Public Health (DPH) COVID-19 contact tracing program to encourage participation in contact tracing and address a need for culturally competent care and social and material support among socially vulnerable and non-English-speaking populations in 11 high-burden jurisdictions in Connecticut.

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Background: Youth are arrested at high rates in the United States; however, long-term health effects of arrest remain unmeasured. We sought to describe the sociodemographic characteristics and health of adults who were arrested at various ages among a nationally representative sample.

Methods: Using the National Longitudinal Study of Adolescent to Adult Health, we describe sociodemographics and health status in adolescence (Wave I, ages 12-21) and adulthood (Wave V, ages 32-42) for people first arrested at age younger than 14 years, 14 to 17 years, and 18 to 24 years, compared to never arrested adults.

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Objectives: To assess the association between racial discrimination, race and ethnicity, and social class with child health and unmet health care needs among children in the United States (US).

Methods: We used a nationally representative sample of children aged 0 to 17 from the 2018-2019 National Survey of Children's Health. Bivariate and multivariable logistic regression were used to test associations between measures of discrimination, social class (income, employment, and education), and race and ethnicity with overall child health and unmet health care needs controlling for covariates identified a priori.

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COVID-19 Vaccination in Children: Lessons Learned From Human Papillomavirus Vaccination.

J Adolesc Health

April 2022

Department of Medicine, Division of General Medicine & Health Services Research, University of California, Los Angeles, Los Angeles, California; Olive View-UCLA Medical Center, Sylmar, California.

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Children are the poorest age group in our country, with 1 in 6, or 12 million, living in poverty. This sobering statistic became even more appalling in spring 2020 when COVID-19 magnified existing inequities. These inequities are particularly important to pediatricians, because poverty, along with racism and other interrelated social factors, significantly impact overall child health and well-being.

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