15 results on '"Jones NY"'
Search Results
2. The Design of the Electronic Health Record in Type 1 Diabetes Centers: Implications for Metrics and Data Availability for a Quality Collaborative.
- Author
-
Eng D, Ospelt E, Miyazaki B, McDonough R, Indyk JA, Wolf R, Lyons S, Neyman A, Fogel NR, Basina M, Gallagher MP, Ebekozien O, Alonso GT, Jones NY, and Lee JM
- Subjects
- Adult, Humans, Electronic Health Records, Quality Improvement, Benchmarking, Patient Care Team, Diabetes Mellitus, Type 1 therapy
- Abstract
Background: Systematic and comprehensive data acquisition from the electronic health record (EHR) is critical to the quality of data used to improve patient care. We described EHR tools, workflows, and data elements that contribute to core quality metrics in the Type 1 Diabetes Exchange Quality Improvement Collaborative (T1DX-QI)., Method: We conducted interviews with quality improvement (QI) representatives at 13 T1DX-QI centers about their EHR tools, clinic workflows, and data elements., Results: All centers had access to structured data tools, nine had access to patient questionnaires and two had integration with a device platform. There was significant variability in EHR tools, workflows, and data elements, thus the number of available metrics per center ranged from four to 17 at each site. Thirteen centers had information about glycemic outcomes and diabetes technology use. Seven centers had measurements of additional self-management behaviors. Centers captured patient-reported outcomes including social determinants of health (n = 9), depression (n = 11), transition to adult care (n = 7), and diabetes distress (n = 3). Various stakeholders captured data including health care professionals, educators, medical assistants, and QI coordinators. Centers that had a paired staffing model in clinic encounters distributed the burden of data capture across the health care team and was associated with a higher number of available data elements., Conclusions: The lack of standardization in EHR tools, workflows, and data elements captured resulted in variability in available metrics across centers. Further work is needed to support measurement and subsequent improvement in quality of care for individuals with type 1 diabetes., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JL is on the GoodRx medical advisory board, is a consultant for Tandem Diabetes Care and has participated on a Sanofi Digital Advisory Board. OE is an advisor for Medtronic Diabetes and Sanofi Diabetes. He has received research support through his institution (T1D Exchange) from Abbott, Vertex, Eli Lilly, Dexcom and Medtronic. RW receives research support through her institution (Johns Hopkins) from Novo Nordisk as the center PI of a trial.
- Published
- 2024
- Full Text
- View/download PDF
3. Associations of prenatal and postnatal exposure to perfluoroalkyl substances with pubertal development and reproductive hormones in females and males: The HOME study.
- Author
-
Liu Y, Calafat AM, Chen A, Lanphear BP, Jones NY, Cecil KM, Rose SR, Yolton K, Buckley JP, and Braun JM
- Subjects
- Male, Adolescent, Humans, Female, Pregnancy, Child, Estradiol, Alkanesulfonates, Environmental Pollutants, Fluorocarbons, Alkanesulfonic Acids
- Abstract
Background: Prenatal and childhood exposure to per- and polyfluoroalkyl substances (PFAS) may be associated with lower reproductive hormones and later puberty, but epidemiological studies evaluating these associations are scarce., Objectives: We examined associations of PFAS concentrations assessed from pregnancy to adolescence with pubertal development and reproductive hormones at age 12 years., Methods: We studied 200 mother-child pairs from the HOME Study in Cincinnati, OH (enrolled: 2003-2006). We quantified serum concentrations of perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoate (PFNA), and perfluorohexane sulfonate (PFHxS) in pregnant women and their children at age 3, 8 and 12 years. At age 12 years, children self-assessed pubertal development using Tanner staging of pubic hair growth (males and females) and breast growth (females), and age at menarche. We quantified serum concentrations of dehydroepiandrosterone sulfate, luteinizing hormone, and follicle-stimulating hormone in both sexes; estradiol in females; testosterone in males. We estimated associations of PFAS with pubertal outcomes and reproductive hormones using a combination of ordinal regression, Cox proportional-hazard regression, and linear regression. Quantile-based g-computation was used for PFAS mixture., Results: In females, adolescent PFAS concentrations and their mixture were associated with later pubic hair growth, breast maturation, and age at menarche, but there was no pattern for prenatal or other postnatal concentrations. For instance, in females, each doubling in adolescent PFAS concentrations was associated with 79 % (PFOA), 63 % (PFOS), 56 % (PFNA), and 47 % (PFHxS) lower odds of attaining a higher stage for breast growth. In addition, adolescent PFAS concentrations were consistently associated with lower estradiol concentrations in females. No pattern was observed for associations of PFAS concentrations with pubic hair growth or reproductive hormones in males., Conclusions: We observed associations between PFAS concentrations in adolescence and later pubertal development in females, but this could be due to reverse causation induced by excretion of PFAS through menstrual fluid., Competing Interests: Declaration of competing interest Joseph M. Braun's was financially compensated for his services as an expert witness for plaintiffs in litigation related to PFAS-contaminated drinking water. The other authors declare they have no actual or potential competing financial interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
4. Factors Associated With Achieving Target A1C in Children and Adolescents With Type 1 Diabetes: Findings From the T1D Exchange Quality Improvement Collaborative.
- Author
-
Demeterco-Berggren C, Ebekozien O, Noor N, Rompicherla S, Majidi S, Jones NY, McDonough R, Odugbesan O, Kim A, Izquierdo R, Kamboj MK, and Jacobsen LM
- Abstract
The optimal care of type 1 diabetes involves consistent glycemic management to avoid short- and long-term complications. However, despite advancements in diabetes technology and standards, achieving adequate glycemic levels in children and adolescents remains a challenge. This study aimed to identify factors associated with achieving the recommended A1C target of <7% from the United States-based multicenter T1D Exchange Quality Improvement Collaborative cohort, including 25,383 children and adolescents living with type 1 diabetes., (© 2022 by the American Diabetes Association.)
- Published
- 2022
- Full Text
- View/download PDF
5. Implicit Racial-Ethnic and Insurance-Mediated Bias to Recommending Diabetes Technology: Insights from T1D Exchange Multicenter Pediatric and Adult Diabetes Provider Cohort.
- Author
-
Odugbesan O, Addala A, Nelson G, Hopkins R, Cossen K, Schmitt J, Indyk J, Jones NY, Agarwal S, Rompicherla S, and Ebekozien O
- Subjects
- Adult, Attitude of Health Personnel, Child, Ethnicity, Healthcare Disparities, Humans, Diabetes Mellitus, Type 1, Insurance
- Abstract
Background: Despite documented benefits of diabetes technology in managing type 1 diabetes, inequities persist in the use of these devices. Provider bias may be a driver of inequities, but the evidence is limited. Therefore, we aimed to examine the role of race/ethnicity and insurance-mediated provider implicit bias in recommending diabetes technology. Method: We recruited 109 adult and pediatric diabetes providers across 7 U.S. endocrinology centers to complete an implicit bias assessment composed of a clinical vignette and ranking exercise. Providers were randomized to receive clinical vignettes with differing insurance and patient names as proxy for Racial-Ethnic identity. Bias was identified if providers: (1) recommended more technology for patients with an English name (Racial-Ethnic bias) or private insurance (insurance bias), or (2) Race/Ethnicity or insurance was ranked high (Racial-Ethnic and insurance bias, respectively) in recommending diabetes technology. Provider characteristics were analyzed using descriptive statistics and multivariate logistic regression. Result: Insurance-mediated implicit bias was common in our cohort ( n = 66, 61%). Providers who were identified to have insurance-mediated bias had greater years in practice (5.3 ± 5.3 years vs. 9.3 ± 9 years, P = 0.006). Racial-Ethnic-mediated implicit bias was also observed in our study ( n = 37, 34%). Compared with those without Racial-Ethnic bias, providers with Racial-Ethnic bias were more likely to state that they could recognize their own implicit bias (89% vs. 61%, P = 0.001). Conclusion: Provider implicit bias to recommend diabetes technology was observed based on insurance and Race/Ethnicity in our pediatric and adult diabetes provider cohort. These data raise the need to address provider implicit bias in diabetes care.
- Published
- 2022
- Full Text
- View/download PDF
6. Socioeconomic and Racial Disparities in Diabetic Ketoacidosis Admissions in Youth With Type 1 Diabetes.
- Author
-
Maxwell AR, Jones NY, Taylor S, Corathers SD, Rasnick E, Brokamp C, Riley CL, Parsons A, Kichler JC, and Beck AF
- Abstract
Objective: We sought to determine whether census tract poverty, race, and insurance status were associated with the likelihood and severity of diabetic ketoacidosis (DKA) hospitalization among youth with type 1 diabetes (T1D)., Methods: We conducted a retrospective population-based cohort study using Cincinnati Children's Hospital electronic medical record (EMR) data from January 1, 2011, to December 31, 2017, for T1D patients ≤18 years old. The primary outcome was admission for DKA. Secondary outcomes included DKA severity, defined by initial pH and bicarbonate, and length of stay. Exposures were the poverty rate for the youth's home census tract, parent-reported race, and insurance status. We used multivariable logistic regression to analyze effects on odds of admission., Results: We identified 439 patients with T1D; 152 were hospitalized. The cohort was 48% female, 25% Black, and 36% publicly insured; the median age was 14 years. For every 10% increase in a youth's census tract poverty rate, the adjusted odds of admission increased by 22% (95% CI, 1.03-1.47). Public insurance status was associated with DKA admission (adjusted odds ratio [AOR], 2.71, 95% CI, 1.62-4.55) while race was not. There were no clinically meaningful differences in pH or bicarbonate by census tract poverty, race, or insurance status; however, Black patients experienced differences in care (eg, longer length of stay)., Conclusion: Youth with T1D living in high poverty areas and on public insurance were significantly more likely to be admitted for DKA. Severity upon presentation was similar across exposures. Understanding contextual mechanisms by which disparities emerge will inform changes aimed at equitably improving care.
- Published
- 2021
- Full Text
- View/download PDF
7. Inequities in Health Outcomes in Children and Adults With Type 1 Diabetes: Data From the T1D Exchange Quality Improvement Collaborative.
- Author
-
Majidi S, Ebekozien O, Noor N, Lyons SK, McDonough R, Gandhi K, Izquierdo R, Demeterco-Berggren C, Polsky S, Basina M, Desimone M, Thomas I, Rioles N, Jimenez-Vega J, Malik FS, Miyazaki B, Albanese-O'Neill A, and Jones NY
- Abstract
Health care inequities among racial and ethnic groups remain prevalent. For people with type 1 diabetes who require increased medical access and care, disparities are seen in access to care and health outcomes. This article reports on a study by the T1D Exchange Quality Improvement Collaborative evaluating differences in A1C, diabetic ketoacidosis (DKA), severe hypoglycemia, and technology use among racial and ethnic groups. In a diverse cohort of nearly 20,000 children and adults with type 1 diabetes, A1C was found to differ significantly among racial and ethnic groups. Non-Hispanic Blacks had higher rates of DKA and severe hypoglycemia and the lowest rate of technology use. These results underscore the crucial need to study and overcome the barriers that lead to inequities in the care and outcomes of people with type 1 diabetes., Competing Interests: O.E. is a compensated Health Equity Advisory Board member for Medtronic Diabetes and serves as the principal investigator for investigator-led projects sponsored by Abbott, Dexcom, Eli Lilly, Insulet, and Medtronic. No other potential conflicts of interest relevant to this article were reported., (© 2021 by the American Diabetes Association.)
- Published
- 2021
- Full Text
- View/download PDF
8. Multi-Clinic Quality Improvement Initiative Increases Continuous Glucose Monitoring Use Among Adolescents and Young Adults With Type 1 Diabetes.
- Author
-
Prahalad P, Ebekozien O, Alonso GT, Clements M, Corathers S, DeSalvo D, Desimone M, Lee JM, Lorincz I, McDonough R, Majidi S, Odugbesan O, Obrynba K, Rioles N, Kamboj M, Jones NY, and Maahs DM
- Abstract
Continuous glucose monitoring (CGM) use is associated with improved A1C outcomes and quality of life in adolescents and young adults with diabetes; however, CGM uptake is low. This article reports on a quality improvement (QI) initiative of the T1D Exchange Quality Improvement Collaborative to increase CGM use among patients in this age-group. Ten centers participated in developing a key driver diagram and center-specific interventions that resulted in an increase in CGM use from 34 to 55% in adolescents and young adults over 19-22 months. Sites that performed QI tests of change and documented their interventions had the highest increases in CGM uptake, demonstrating that QI methodology and sharing of learnings can increase CGM uptake., Competing Interests: O.E. is a compensated Health Equity Advisory Board member for Medtronic Diabetes and serves as principal investigator for investigator-led projects sponsored by Abbott, Eli Lilly, Insulet, and Medtronic. M.C. has consulting arrangements with Eli Lilly and Medtronic, is an employee (chief medical officer) of Glooko, and has received research support from Abbott Diabetes Care and Dexcom and travel support from Intrexon and Provention Bio. J.M.L. is on a medical advisory board for GoodRx. D.M.M. has received research support from the Helmsley Charitable Trust, JDRF, the National Institutes of Health, and the National Science Foundation; his institution has received research support from Bigfoot Biomedical, Dexcom, Insulet, Medtronic, Roche, and Tandem; and he has been a consultant for Abbott, Aditxt, Dompe, Eli Lilly, the Helmsley Charitable Trust, Insulet, Medtronic, Novo Nordisk, and Sanofi. No other potential conflicts of interest relevant to this article were reported., (© 2021 by the American Diabetes Association.)
- Published
- 2021
- Full Text
- View/download PDF
9. Seven practices for pursuing equity through learning health systems: Notes from the field.
- Author
-
Parsons A, Unaka NI, Stewart C, Foster J, Perez V, Jones NY, Kahn R, Beck AF, and Riley C
- Abstract
Introduction: Despite learning health systems' focus on improvement in health outcomes, inequities in outcomes remain deep and persistent. To achieve and sustain health equity, it is critical that learning health systems (LHS) adapt and function in ways that directly prioritize equity., Methods: We present guidance, including seven core practices, borne from theory, evidence, and experience, for actors within LHS pursuing equity., Results: We provide a foundational definition of equity. We then offer seven core practices for how LHS may effectively pursue equity in health: establish principle, measure for equity, lead from lived experience, co-produce, redistribute power, practice a growth mindset, and engage beyond the healthcare system. We include three use cases that illustrate ways in which we have begun to center equity in the work of our own LHS., Conclusion: The achievement of equity requires real transformation at individual, institutional, and structural levels and requires sustained and persistent effort., Competing Interests: Dr. Riley has received funding from the Institute for Healthcare Improvement and Heluna Health to support her effort in developing and implementing the measurement framework for the 100 Million Healthier Lives initiative and Wellbeing in the Nation. None of the other authors have a conflict of interest., (© 2021 The Authors. Learning Health Systems published by Wiley Periodicals LLC on behalf of University of Michigan.)
- Published
- 2021
- Full Text
- View/download PDF
10. Inequities in Diabetic Ketoacidosis Among Patients With Type 1 Diabetes and COVID-19: Data From 52 US Clinical Centers.
- Author
-
Ebekozien O, Agarwal S, Noor N, Albanese-O'Neill A, Wong JC, Seeherunvong T, Sanchez J, DeSalvo D, Lyons SK, Majidi S, Wood JR, Acharya R, Aleppo G, Sumpter KM, Cymbaluk A, Shah NA, Van Name M, Cruz-Aviles L, Alonso GT, Gallagher MP, Sanda S, Feuer AJ, Cossen K, Rioles N, Jones NY, Kamboj MK, and Hirsch IB
- Subjects
- Adolescent, Adult, Black or African American statistics & numerical data, COVID-19 complications, COVID-19 diagnosis, COVID-19 epidemiology, Child, Child, Preschool, Cross-Sectional Studies, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 diagnosis, Diabetic Ketoacidosis complications, Diabetic Ketoacidosis diagnosis, Female, Hispanic or Latino statistics & numerical data, Humans, Male, Prevalence, Prognosis, SARS-CoV-2 physiology, Socioeconomic Factors, United States epidemiology, White People statistics & numerical data, Young Adult, COVID-19 ethnology, Diabetes Mellitus, Type 1 ethnology, Diabetic Ketoacidosis ethnology, Health Status Disparities
- Abstract
Objective: We examined whether diabetic ketoacidosis (DKA), a serious complication of type 1 diabetes (T1D) was more prevalent among Non-Hispanic (NH) Black and Hispanic patients with T1D and laboratory-confirmed coronavirus disease 2019 (COVID-19) compared with NH Whites., Method: This is a cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 52 clinical sites in the United States, data were collected from April to August 2020. We examined the distribution of patient factors and DKA events across NH White, NH Black, and Hispanic race/ethnicity groups. Multivariable logistic regression analysis was performed to examine the odds of DKA among NH Black and Hispanic patients with T1D as compared with NH White patients, adjusting for potential confounders, such as age, sex, insurance, and last glycated hemoglobin A1c (HbA1c) level., Results: We included 180 patients with T1D and laboratory-confirmed COVID-19 in the analysis. Forty-four percent (n = 79) were NH White, 31% (n = 55) NH Black, 26% (n = 46) Hispanic. NH Blacks and Hispanics had higher median HbA1c than Whites (%-points [IQR]: 11.7 [4.7], P < 0.001, and 9.7 [3.1] vs 8.3 [2.4], P = 0.01, respectively). We found that more NH Black and Hispanic presented with DKA compared to Whites (55% and 33% vs 13%, P < 0.001 and P = 0.008, respectively). After adjusting for potential confounders, NH Black patients continued to have greater odds of presenting with DKA compared with NH Whites (OR [95% CI]: 3.7 [1.4, 10.6])., Conclusion: We found that among T1D patients with COVID-19 infection, NH Black patients were more likely to present in DKA compared with NH White patients. Our findings demonstrate additional risk among NH Black patients with T1D and COVID-19., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
- View/download PDF
11. Hypothyroidism and Iodine Deficiency in Children on Chronic Parenteral Nutrition.
- Author
-
Ikomi C, Cole CR, Vale E, Golekoh M, Khoury JC, and Jones NY
- Subjects
- Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Hypothyroidism etiology, Male, Parenteral Nutrition adverse effects, Thyroid Function Tests trends, Hypothyroidism diagnosis, Hypothyroidism urine, Iodine deficiency, Iodine urine, Parenteral Nutrition trends
- Abstract
Background and Objectives: Iodine is an essential trace element for maintenance of normal thyroid function. Normal thyroid function is a prerequisite for neurocognitive development and growth in children. In the United States, iodine is not routinely added as a trace element in parenteral nutrition (PN). Our objective was to determine the prevalence of iodine deficiency and hypothyroidism in children on chronic PN., Methods: This was a cross-sectional study of children <17 years of age and using PN for >6 months at a tertiary children's hospital. Primary outcomes were spot urine iodine concentration (UIC), serum thyrotropin, and free thyroxine levels., Results: Twenty-seven patients were identified (74% male). The median age at screening was 48 months (range: 7-213 months). The median duration on PN was 27 months (range: 11-77 months). Seventeen out of 20 patients (85%) were iodine deficient (spot UIC <100 μg/L), whereas 11 out of 20 patients (55%) were severely iodine deficient (spot UIC <20 μg/L). The prevalence of acquired hypothyroidism (elevated thyrotropin, low free thyroxine, and UIC <100 μg/L) was 33% ( n = 8). None of the children with hypothyroidism screened for autoimmune thyroiditis had positive test results. There was no statistically significant association between duration of PN use and development of iodine deficiency ( P = .08) or hypothyroidism ( P = .96)., Conclusions: Children on chronic PN are at risk for developing iodine deficiency and resultant hypothyroidism; hence, these children should be screened for these outcomes. Further studies are needed to define the temporal onset of iodine deficiency and timing to thyroid dysfunction related to PN., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)
- Published
- 2018
- Full Text
- View/download PDF
12. Severe Hypothyroidism From Iodine Deficiency Associated With Parenteral Nutrition.
- Author
-
Golekoh MC, Cole CR, and Jones NY
- Subjects
- Child, Preschool, Dietary Supplements, Humans, Hypothyroidism blood, Hypothyroidism etiology, Iodine administration & dosage, Iodine blood, Male, Nutritional Status, Risk Factors, Treatment Outcome, Hypothyroidism diagnosis, Iodine deficiency, Parenteral Nutrition adverse effects
- Abstract
Parenteral nutrition is crucial for supply of nutrients in children who cannot tolerate a full enteral diet. In the United States, it is not standard of care to give iodine to children dependent on parenteral nutrition, hence iodine is not routinely included in the micronutrient package. Herein, we present a case of a boy with hypothyroidism secondary to iodine deficiency after prolonged exclusive use of parenteral nutrition. Our case highlights the importance of screening for iodine deficiency and administering timely iodine supplementation in these at-risk children to prevent iatrogenic hypothyroidism., (© 2015 American Society for Parenteral and Enteral Nutrition.)
- Published
- 2016
- Full Text
- View/download PDF
13. Fibrous dysplasia in the accessory carpal bone of a horse.
- Author
-
Jones NY and Patterson-Kane JC
- Subjects
- Animals, Biopsy, Needle veterinary, Diagnosis, Differential, Euthanasia, Animal, Fibrous Dysplasia of Bone diagnostic imaging, Fibrous Dysplasia of Bone pathology, Horses, Lameness, Animal etiology, Male, Prognosis, Radiography, Carpal Bones diagnostic imaging, Carpal Bones pathology, Fibrous Dysplasia of Bone veterinary, Horse Diseases diagnostic imaging, Horse Diseases pathology
- Published
- 2004
- Full Text
- View/download PDF
14. Desflurane in equine anaesthesia: a preliminary trial.
- Author
-
Jones NY, Clarke KW, and Clegg PD
- Subjects
- Anesthetics, Intravenous administration & dosage, Animals, Desflurane, Drug Evaluation, Hemodynamics drug effects, Horses physiology, Isoflurane administration & dosage, Male, Anesthesia, Inhalation veterinary, Anesthetics, Inhalation administration & dosage, Horses surgery, Isoflurane analogs & derivatives, Orchiectomy veterinary
- Published
- 1995
15. The use of uniform labeling with zinc-65 to measure stable zinc turnover in the mosquito fish, Gambusia affinis--I. Retention.
- Author
-
Willis JN and Jones NY
- Subjects
- Animals, Female, Isotope Labeling, Male, Zinc Radioisotopes, Cyprinodontiformes metabolism, Fishes metabolism, Zinc metabolism
- Published
- 1977
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.