23 results on '"Michele, Walsh"'
Search Results
2. Psychometric Properties of the Prenatal Opioid Use Perceived Stigma Scale and Its Use in Prenatal Care
- Author
-
Carla M. Bann, Jamie E. Newman, Katherine C. Okoniewski, Leslie Clarke, Deanne Wilson-Costello, Stephanie Merhar, Nicole Mack, Sara DeMauro, Scott Lorch, Namasivayam Ambalavanan, Catherine Limperopoulos, Brenda Poindexter, Michele Walsh, and Jonathan M. Davis
- Subjects
Maternity and Midwifery ,Critical Care Nursing ,Pediatrics - Published
- 2023
3. Health in All Policies: Working Across Sectors in Cooperative Extension to Promote Health for All
- Author
-
Michele Walsh, Deborah John, Nicole Peritore, Andrea Morris, Carolyn Bird, Marion Ceraso, Sarah Eichberger, Rachel Novotny, Laura Stephenson, Suzanne Stluka, and Roberta Riportella
- Subjects
cooperative extension ,extension ,health in all policies ,health equity ,cross-sector collaboration ,health and wellness framework ,ecop action teams ,Special aspects of education ,LC8-6691 - Abstract
A Health in All Policies approach engages cross-sector stakeholders to collaboratively improve systems that drive population health. We, the members of the Extension Committee on Organization and Policy (ECOP)’s Health in All Policies Action Team, propose that adopting a Health in All Policies approach within the national Cooperative Extension System will better prepare us to contribute meaningfully to improving the nation’s health. We first explain the Health in All Policies approach and argue for why and how it is relevant for Extension. We then present insights gathered from Extension Family and Consumer Sciences program leaders and state specialists to assess whether national and state leadership are poised to adopt a Health in All Policies approach within their affiliated programs. Although participant leaders saw the value of the approach in contributing to population health improvement, they generally saw the Extension system as having lower levels of readiness to adopt such an approach. Six themes emerged as ways to increase Extension’s engagement in Health in All Policies: a paradigm shift within Extension, professional development of competencies, transformational leaders and leadership support, continued and new partnerships, information access for all levels and disciplines of Extension.
- Published
- 2018
- Full Text
- View/download PDF
4. Outcomes of Babies with Opioid Exposure (OBOE): protocol of a prospective longitudinal cohort study
- Author
-
Carla M. Bann, Jamie E. Newman, Brenda Poindexter, Katherine Okoniewski, Sara DeMauro, Scott A. Lorch, Deanne Wilson-Costello, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Catherine Limperopoulos, Kushal Kapse, Jonathan M. Davis, Michele Walsh, and Stephanie Merhar
- Subjects
Pediatrics, Perinatology and Child Health - Abstract
Background While the health, social, and economic impacts of opioid addiction on adults and their communities are well known, the impact of maternal opioid use on the fetus exposed in utero is less well understood. Methods This paper presents the protocol of the ACT NOW Outcomes of Babies with Opioid Exposure (OBOE) Study, a multi-site prospective longitudinal cohort study of infants with antenatal opioid exposure and unexposed controls. Study objectives are to determine the impact of antenatal opioid exposure on brain development and neurodevelopmental outcomes over the first 2 years of life and explore whether family, home, and community factors modify developmental trajectories during this critical time period. Results Primary outcomes related to brain development include cortical volumes, deep cerebral gray matter volumes, resting-state functional connectivity measures, and structural connectivity measures using diffusion tensor imaging. Primary neurodevelopmental outcomes include visual abnormalities, cognitive, language, and motor skills measured using the Bayley Scales of Infant Development and social–emotional and behavioral problems and competence measured by the Brief Infant-Toddler Social and Emotional Assessment. Conclusions The OBOE study has been designed to overcome challenges of previous studies and will help further understanding of the effects of antenatal opioid exposure on early infant development. Impact This study will integrate MRI findings and comprehensive neurodevelopmental assessments to provide early insights into the functional topography of the brain in this high-risk population and assess MRI as a potential biomarker. Rather than conducting neuroimaging at a single time point, the study will include serial MRI assessments from birth to 2 years, allowing for the examination of trajectories throughout this period of rapid brain development. While previous studies often have had limited information on exposures, this study will use umbilical cord assays to accurately measure amounts of opioids and other substances from 20 weeks of gestation to birth.
- Published
- 2022
5. Correction To: Outcomes of Babies with Opioid Exposure (OBOE): protocol of a prospective longitudinal cohort study
- Author
-
Carla M. Bann, Jamie E. Newman, Brenda Poindexter, Katherine Okoniewski, Sara DeMauro, Scott A. Lorch, Deanne Wilson-Costello, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Catherine Limperopoulos, Kushal Kapse, Jonathan M. Davis, Michele Walsh, and Stephanie Merhar
- Subjects
Pediatrics, Perinatology and Child Health - Published
- 2023
6. It Pays to be Accurate: Improving Critical Care Documentation in a Pediatric Emergency Department
- Author
-
S Barron, Frazier, Michele, Walsh, Glory, Beveridge, Clark, Thornton, Jaime Kaye, Otillio, Emily, Fain, and Barron, Patterson
- Subjects
Critical Care ,International Classification of Diseases ,Pediatrics, Perinatology and Child Health ,Humans ,Documentation ,General Medicine ,Child ,Emergency Service, Hospital ,Pediatrics ,Retrospective Studies - Abstract
BACKGROUND Clinician documentation is highly variable, and awareness of documentation requirements remains low despite post-training experience. At our hospital, critical care (CC) documentation was inconsistent. Our aim was to increase appropriate CC attestations from 51% to 90% for status asthmaticus, anaphylaxis, and diabetic ketoacidosis in the pediatric emergency department by December 2021. METHODS A physician team developed a key driver diagram. Retrospective baseline data using International Classification of Diseases, Ninth and Tenth Revision codes were obtained from January 2018 to September 2020, after which data were followed prospectively in consecutive groups of 20 encounters. Statistical process control charts were used to analyze data. Nelson rules were used to detect special cause variation. Primary outcome was the inclusion of appropriate CC attestations. Interventions included education, CC attestation templates, and provider feedback. We also tracked charges for the 3 diagnoses studied. Process measures included template use. Balancing measure was refusal of payment by insurers. RESULTS P-charts were used to analyze primary outcome and process measures. X-bar charts were used to analyze charges. Baseline data represented 706 encounters with 51% including CC documentation. Following clinician education and release of the CC template, special cause variation was detected, and centerline shifted to 88.1% (Fig 2). Average charges per encounter increased from $4527 to $5385. There was no reported refusal of payment. CONCLUSIONS We successfully achieved improvements in CC documentation in the 3 diagnoses of interest through education and process changes in documentation, leading over $1 million in new charges over the past 15 months.
- Published
- 2022
7. Online clinical tool to estimate risk of bronchopulmonary dysplasia in extremely preterm infants
- Author
-
Rachel G Greenberg, Scott A McDonald, Matthew M Laughon, David Tanaka, Erik Jensen, Krisa Van Meurs, Eric Eichenwald, Jane E Brumbaugh, Andrea Duncan, Michele Walsh, Abhik Das, and C Michael Cotten
- Subjects
Pediatrics, Perinatology and Child Health ,Obstetrics and Gynecology ,General Medicine - Abstract
ObjectiveDevelop an online estimator that accurately predicts bronchopulmonary dysplasia (BPD) severity or death using readily-available demographic and clinical data.DesignRetrospective analysis of data entered into a prospective registry.SettingInfants cared for at centres of the United States Neonatal Research Network between 2011 and 2017.PatientsInfants 501–1250 g birth weight and 23 0/7–28 6/7 weeks’ gestation.InterventionsNone.Main outcome measuresSeparate multinomial regression models for postnatal days 1, 3, 7, 14 and 28 were developed to estimate the individual probabilities of death or BPD severity (no BPD, grade 1 BPD, grade 2 BPD, grade 3 BPD) defined according to the mode of respiratory support administered at 36 weeks’ postmenstrual age.ResultsAmong 9181 included infants, birth weight was most predictive of death or BPD severity on postnatal day 1, while mode of respiratory support was the most predictive factor on days 3, 7, 14 and 28. The predictive accuracy of the models increased at each time period from postnatal day 1 (C-statistic: 0.674) to postnatal day 28 (C-statistic 0.741). We used these results to develop a web-based model that provides predicted estimates for BPD by postnatal day.ConclusionThe probability of BPD or death in extremely preterm infants can be estimated with reasonable accuracy using a limited amount of readily available clinical information. This tool may aid clinical prognostication, future research, and center-specific quality improvement surrounding BPD prevention.Trial registration numberNCT00063063
- Published
- 2022
8. Utilization of Transport Data to Decrease Unnecessarily Repeated Laboratory Tests
- Author
-
Austin Brett Adair, Bryan Dejanovich, and Michele Walsh
- Subjects
Pediatrics, Perinatology and Child Health ,Emergency Medicine ,General Medicine - Published
- 2023
9. Lessons Learned in Remote Establishment of a Consortium and Virtual Launch During the COVID-19 Pandemic - Outcomes of Babies with Opioid Exposure (OBOE) Study
- Author
-
Jamie Elizabeth Newman, Megan Dhawan, Leslie Clarke, Sharon Owen, Traci Beirsdorfer, Lindsay Parlberg, Stephanie Merhar, Sara B. Demauro, Scott A. Lorch, Deanne Wilson-Costello, Namasivayam Ambalavanan, Myriam Peralta-Carcelen, Michele Walsh, Brenda Poindexter, Jonathan M. Davis, Catherine Limperopoulos, Nicole Mack, and Carla M. Bann
- Published
- 2023
10. Exposure to umbilical cord management approaches and death or neurodevelopmental impairment at 22-26 months' corrected age after extremely preterm birth
- Author
-
Sara C Handley, Neha Kumbhat, Barry Eggleston, Elizabeth E Foglia, Alexis S Davis, Krisa Van Meurs, Satyan Lakshminrusimha, Michele Walsh, Kristi L Watterberg, Myra H Wyckoff, Abhik Das, and Sara B DeMauro
- Subjects
Pediatrics, Perinatology and Child Health ,Obstetrics and Gynecology ,General Medicine - Abstract
ObjectiveTo compare death or severe neurodevelopmental impairment (NDI) at 22–26 months’ corrected age (CA) among extremely preterm infants following exposure to different forms of umbilical cord management.DesignRetrospective study.SettingEunice Kennedy ShriverNational Institute of Child Health and Human Development Neonatal Research Network registry.PatientsInfants born ExposuresImmediate cord clamping (ICC), delayed cord clamping (DCC) or umbilical cord milking (UCM).Main outcomes and measurePrimary composite outcome of death or severe NDI at 22–26 months’ CA, defined as severe cerebral palsy, Bayley-III cognitive/motor composite score ResultsAmong 1900 infants, 64.1% were exposed to ICC, 27.8% to DCC and 8.1% to UCM. Compared with ICC-exposed infants, DCC-exposed infants had lower odds of death or severe NDI (adjusted OR 0.64, 95% CI 0.50 to 0.83). No statistically significant differences were observed when comparing UCM with either ICC or DCC, or between secondary outcomes across groups. Association between cord management and the primary outcome was not mediated by severe IVH.ConclusionCompared with ICC, DCC exposure was associated with lower death or severe NDI at 22–26 months’ CA among extremely preterm infants, which was not mediated by severe IVH.
- Published
- 2022
11. Contributors
- Author
-
Kabir Abubakar, Namasivayam Ambalavanan, Robert Mason Arensman, Nicolas Bamat, Eduardo H. Bancalari, Keith J. Barrington, Monika Bhola, David M. Biko, Laura D. Brown, Waldemar A. Carlo, Robert L. Chatburn, Nelson Claure, Clarice Clemmens, Christopher E. Colby, Sherry E. Courtney, Peter G. Davis, Eugene M. Dempsey, Robert M. DiBlasi, Matthew Drago, Eric C. Eichenwald, Jonathan M. Fanaroff, Maria V. Fraga, Debbie Fraser, K. Suresh Gautham, Jay P. Goldsmith, Peter H. Grubb, Malinda N. Harris, Helmut Hummler, Erik B. Hysinger, Robert M. Insoft, Erik Allen Jensen, Jegen Kandasamy, Lakshmi I. Katakam, Martin Keszler, Haresh Kirpalani, Nathaniel Koo, Satyan Lakshminrusimha, Krithika Lingappan, Akhil Maheshwari, Mark Crawford Mammel, Brett J. Manley, Camilia R. Martin, Richard John Martin, Bobby Mathew, Mark R. Mercurio, Andrew Mudreac, Leif D. Nelin, Louise S. Owen, Allison Hope Payne, Jeffrey M. Perlman, Joseph Piccione, J. Jane Pillow, Richard Alan Polin, Francesco Raimondi, Tonse N.K. Raju, Lawrence Rhein, Guilherme Sant’Anna, Georg Schmölzer, Andreas Schulze, Grant Shafer, Wissam Shalish, Edward G. Shepherd, Billie Lou Short, Thomas L. Sims, Nalini Singhal, Roger F. Soll, Amuchou Singh Soraisham, Nishant Srinivasan, Raymond C. Stetson, Sarah N. Taylor, Colm P. Travers, Payam Vali, Anton H. van Kaam, Maximo Vento, Michele Walsh, Gary Weiner, Gulgun Yalcinkaya, Vivien Yap, Bradley A. Yoder, and Huayan Zhang
- Published
- 2022
12. Stratified management of hemiplegic shoulder pain using an integrated care pathway:an 18-year clinical cohort analysis
- Author
-
Aideen Steed, Hilary Rose, Stephen Ashford, Michele Walsh, Ejessie Alfonso, and Lynne Turner-Stokes
- Subjects
medicine.medical_specialty ,Clinical cohort ,business.industry ,Delivery of Health Care, Integrated ,shoulder pain ,Rehabilitation ,hemiplegia ,Hemiplegia ,Integrated approach ,medicine.disease ,Integrated care ,Cohort Studies ,Stroke ,acquired brain injury ,Shoulder Pain ,Cohort ,Physical therapy ,medicine ,Humans ,Presentation (obstetrics) ,business ,Complication ,Cohort study ,Acquired brain injury - Abstract
PURPOSE: Hemiplegic shoulder pain (HSP) is a common but heterogeneous complication of acquired brain injury. Integrated care pathways (ICPs) can support clinical decision-making, prompting timely intervention to improve quality of care. This 18-year cohort analysis of clinical data presents outcomes from an ICP for management of HSP in an inpatient rehabilitation unit.MATERIALS & METHODS: Consecutive data were extracted for all eligible patients admitted between 2000-2018 (n = 333). Patients were categorised according to presentation pattern ("Floppy-subluxed" (59%), "Painful-stiff" (21%) or Mixed/not categorised(20%)) to help guide early management. Pain was assessed using the Shoulder-Q with pain ratings/10 in three domains: rest, night-time and movement. Patients with pain reduction ≥3 points in any domain were designated 'responders'.RESULTS: Mean baseline pain scores were 4.7 (95%CI 4.5,5.0). They were higher on movement (6.1(5.8,6.3)) than at rest (4.7(4.3, 5.0)) or at night (5.7(5.2,5.9)). Pain reduced significantly in all three domains (p CONCLUSION: These high pain-response rates compare favourably to the literature (14-27%), suggesting that this stratified and integrated approach to HSP guides more effective management in this heterogeneous clinical presentation.Implications for RehabilitationTwo-thirds of the patients demonstrated a clinically-significant reduction in pain when managed using the integrated care pathway. These results compare favourably with pain resolution rates of well under one-third cited in the literature and suggest that the integrated care pathway leads to reduced pain and improved patient outcomes.Hemiplegic shoulder pain can result from a range of different clinical problems. The diversity of presentation and the range of required treatments are confirmed in this 18-year cohort analysis.Heterogeneity in presentation of HSP poses a challenge for both management and the evaluation of outcome. The results of this study suggest that a stratified approach helps to guide more effective management.
- Published
- 2021
13. Pediatric emergency department to primary care transfer protocol: Transforming access for patients' needs
- Author
-
S. Barron Frazier, James C. Gay, Shari Barkin, Michelle Graham, Michele Walsh, and Kathryn Carlson
- Subjects
Primary Health Care ,Cost Savings ,Health Policy ,Humans ,Length of Stay ,Child ,Emergency Service, Hospital ,Retrospective Studies - Abstract
Previous interventions to reduce emergency department (ED) overutilization from non-urgent visits have shown little success. At our hospital, we created an ED to primary care clinic (PCC) transfer protocol for non-urgent ED visits of established patients. Our study analyzed the impact of this protocol on patient encounters.Chart reviews were conducted for a retrospective cohort of transfers from the ED to PCC from 9/01/17-8/31/18. Primary outcomes included length of stay (LOS), cost, and need for return to the ED. Cost savings were calculated by comparing encounters with identical primary diagnoses in the ED with internal technical and professional financial data. Secondary outcomes were final diagnoses and primary care services provided.374 patient encounters were transferred from ED to PCC. The five most common diagnoses were viral upper respiratory infection (n=80, 21.4%), dermatologic diagnoses (n=37, 9.9%), acute otitis media (n=35, 9.4%), pharyngitis (n=34, 9.1%), and influenza (n=34, 9.1%). Overall, total cost savings equaled approximately $100,000. For the top 10 diagnoses, costs were reduced from $29-$46 per $100 of ED costs and LOS was reduced by a mean of 49 min/encounter. For 9 of these 10 conditions, costs exceeded reimbursement in both settings; however, evaluation in PCC versus ED reduced the loss of revenue by 10-68%. Sixty-four encounters (17.1%) received additional primary care services. There were no safety events or inappropriate transfers.This protocol provided a safe, efficient method for patients to be evaluated in their medical home while reducing non-urgent emergency visits in the ED.VI.
- Published
- 2020
14. Assessing 3 Bronchopulmonary Dysplasia Definitions: Associations between Room Air Challenge Results and Respiratory Outcomes
- Author
-
Samia Aleem, Barbara T. Do, Marie Gantz, Anna M. Hibbs, Erik A. Jensen, Charles M. Cotten, William Malcolm, Michele Walsh, and Rachel G. Greenberg
- Subjects
Pediatrics, Perinatology and Child Health - Published
- 2021
15. Admission Temperature and Associated Mortality and Morbidity among Moderately and Extremely Preterm Infants
- Author
-
Abbot R. Laptook, Edward F. Bell, Seetha Shankaran, Nansi S. Boghossian, Myra H. Wyckoff, Sarah Kandefer, Michele Walsh, Shampa Saha, Rosemary Higgins, Richard A. Polin, Martin Keszler, Betty R. Vohr, Angelita M. Hensman, Elisa Vieira, Emilee Little, Avroy A. Fanaroff, Anna Marie Hibbs, Nancy S. Newman, Bonnie S. Siner, William E. Truog, Eugenia K. Pallotto, Howard W. Kilbride, Cheri Gauldin, Anne Holmes, Kathy Johnson, Kurt Schibler, Suhas G. Kallapur, Cathy Grisby, Barbara Alexander, Estelle E. Fischer, Lenora Jackson, Kristin Kirker, Jennifer Jennings, Sandra Wuertz, Greg Muthig, Edward F. Donovan, Jody Hessling, Marcia Worley Mersmann, Holly L. Mincey, C. Michael Cotten, Ronald N. Goldberg, Joanne Finkle, Kimberley A. Fisher, Kathy J. Auten, Matthew M. Laughon, Carl L. Bose, Janice Bernhardt, Cindy Clark, Barbara J. Stoll, David P. Carlton, Ellen C. Hale, Yvonne Loggins, Diane I. Bottcher, Stephanie Wilson Archer, Linda L. Wright, Elizabeth M. McClure, Brenda B. Poindexter, Gregory M. Sokol, Dianne E. Herron, James A. Lemons, Diana D. Appel, Lucy C. Miller, Pablo J. Sanchez, Leif D. Nelin, Sudarshan R. Jadcherla, Patricia Luzader, Nehal A. Parikh, Marliese Dion Nist, Jennifer Fuller, Julie Gutentag, Marissa E. Jones, Sarah McGregor, Elizabeth Rodgers, Jodi A. Ulloa, Tara Wolfe, Abhik Das, Dennis Wallace, W. Kenneth Poole, Kristin M. Zaterka-Baxter, Margaret Crawford, Jenna Gabrio, Jeanette O'Donnell Auman, Carolyn Petrie Huitema, Betty K. Hastings, Krisa P. Van Meurs, David K. Stevenson, M. Bethany Ball, Melinda S. Proud, Waldemar A. Carlo, Namasivayam Ambalavanan, Monica V. Collins, Shirley S. Cosby, Uday Devaskar, Meena Garg, Teresa Chanlaw, Rachel Geller, Tarah T. Colaizy, Dan L. Ellsbury, Jane E. Brumbaugh, Karen J. Johnson, Donia B. Campbell, Jacky R. Walker, Kristi L. Watterberg, Robin K. Ohls, Conra Backstrom Lacy, Sandra Sundquist Beauman, Carol Hartenberger, Barbara Schmidt, Haresh Kirpalani, Noah Cook, Sara B. DeMauro, Aasma S. Chaudhary, Soraya Abbasi, Toni Mancini, Dara Cucinotta, Carl T. D'Angio, Ronnie Guillet, Satyan Lakshminrusimha, Dale L. Phelps, Ann Marie Reynolds, Julianne Hunn, Rosemary Jensen, Holly I.M. Wadkins, Stephanie Guilford, Ashley Williams, Michael Sacilowski, Linda Reubens, Erica Burnell, Mary Rowan, Karen Wynn, Deanna Maffett, Luc P. Brion, Diana M. Vasil, Lijun Chen, Lizette E. Torres, Walid A. Salhab, Susie Madison, Gay Hensley, Nancy A. Miller, Alicia Guzman, Kathleen A. Kennedy, Jon E. Tyson, Julie Arldt-McAlister, Carmen Garcia, Karen Martin, Georgia E. McDavid, Sharon L. Wright, Esther G. Akpa, Patty A. Cluff, Anna E. Lis, Claudia I. Franco, Athina Pappas, John Barks, Rebecca Bara, Shelley Handel, Geraldine Muran, Diane F. White, Mary Christensen, and Stephanie A. Wiggins
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Fever ,Hospital mortality ,Hypothermia ,Infant, Premature, Diseases ,Logistic regression ,Child health ,Article ,Body Temperature ,03 medical and health sciences ,0302 clinical medicine ,Patient Admission ,Risk Factors ,030225 pediatrics ,Intensive Care Units, Neonatal ,Medicine ,Humans ,030212 general & internal medicine ,Hospital Mortality ,business.industry ,Extremely preterm ,Infant, Newborn ,Infant newborn ,United States ,Logistic Models ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
To evaluate the temperature distribution among moderately preterm (MPT, 29-33 weeks) and extremely preterm (EPT,29 weeks) infants upon neonatal intensive care unit (NICU) admission in 2012-2013, the change in admission temperature distribution for EPT infants between 2002-2003 and 2012-2013, and associations between admission temperature and mortality and morbidity for both MPT and EPT infants.Prospectively collected data from 18 centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were used to examine NICU admission temperature of inborn MPT and EPT infants. Associations between admission temperature and mortality and morbidity were determined by multivariable logistic regression. EPT infants from 2002-2003 and 2012-2013 were compared.MPT and EPT cohorts consisted of 5818 and 3213 infants, respectively. The distribution of admission temperatures differed between the MPT vs EPT (P .01), including the percentage36.5°C (38.6% vs 40.9%), 36.5°C-37.5°C (57.3% vs 52.9%), and37.5°C (4.2% vs 6.2%). For EPT infants in 2012-2013 compared with 2002-2003, the percentage of temperatures between 36.5°C and 37.5°C more than doubled and the percentage of temperatures37.5°C more than tripled. Admission temperature was inversely associated with in-hospital mortality.Low and high admission temperatures are more frequent among EPT than MPT infants. Compared with a decade earlier, fewer EPT infants experience low admission temperatures but more have elevated temperatures. In spite of a change in distribution of NICU admission temperature, an inverse association between temperature and mortality risk persists.
- Published
- 2017
16. Desired Elements and Timing of Cancer Survivorship Care: One Approach May Not Fit All
- Author
-
Ann H. Partridge, Richard Boyajian, Anna C. Snavely, Amy Grose, Susan Neary, Larissa Nekhlyudov, Michele Walsh, Karen Sommer, Kristin Roper, and Nina N. Grenon
- Subjects
Adult ,Male ,Cancer survivorship ,Gerontology ,Lymphoma ,Cross-sectional study ,Treatment outcome ,MEDLINE ,Medical Oncology ,Patient Care Planning ,Young Adult ,Neoplasms ,Surveys and Questionnaires ,Humans ,Medicine ,Survivors ,Young adult ,Aged ,Gastrointestinal Neoplasms ,Internet ,Oncology (nursing) ,business.industry ,Health Policy ,Follow up studies ,Neoplasms therapy ,Patient Preference ,Continuity of Patient Care ,Middle Aged ,Patient preference ,humanities ,Health Care Delivery ,Cross-Sectional Studies ,Treatment Outcome ,Attitude ,Oncology ,Head and Neck Neoplasms ,Female ,business ,Follow-Up Studies - Abstract
INTRODUCTION: Although survivorship care recommendations exist, there is limited evidence about current practices and patient preferences. METHODS: A cross-sectional survey was completed by survivors of lymphoma, head and neck, and gastrointestinal cancers at an academic cancer center. The survey was designed to capture patients' reports of receipt of survivorship care planning and their attitudes, preferences, and perceived needs regarding content and timing of cancer survivorship care information. Elements of survivorship care were based on the Institute of Medicine recommendations, literature review, and clinical experience. RESULTS: Eighty-five survivors completed the survey (response rate, 81%). More than 75% reported receiving a follow-up plan or appointment schedule, a monitoring plan for scans and blood tests, information about short- and long-term adverse effects, and a detailed treatment summary. These elements were reported as desired by more than 90% of responders. Approximately 40% of these elements were only verbally provided. Although more than 70% described not receiving information about employment, smoking cessation, sexual health, genetic counseling, fertility, or financial resources, these elements were not reported as desired. However, “strategies to cope with the fear of recurrence” was most often omitted, yet desired by most respondents. Survivors' preferences regarding optimal timing for information varied depending on the element. CONCLUSIONS: Our study suggests that cancer survivorship care planning is heterogeneous and may not need to be comprehensive, but rather tailored to individual survivors' needs. Providers must assess patient needs early and continue to revisit them during the cancer care continuum.
- Published
- 2014
17. Trauma Arrest and Spinal Injury in a 3-Year-Old Girl
- Author
-
Michele Walsh, Kevin High, and Rebecca Kidd
- Subjects
medicine.medical_specialty ,Emergency Medical Services ,medicine.medical_treatment ,Psychological intervention ,Poison control ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Fatal Outcome ,Injury prevention ,Medicine ,Humans ,Intensive care medicine ,Spinal Cord Injuries ,business.industry ,Accidents, Traffic ,Human factors and ergonomics ,Cervical Cord ,030208 emergency & critical care medicine ,General Medicine ,medicine.disease ,Blunt trauma ,Spinal Injuries ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Emergency Medicine ,Wounds and Injuries ,Airway management ,Female ,Medical emergency ,business ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery - Abstract
Management of an acutely injured pediatric patient with multiple traumas is a common challenge facing clinicians in pediatric emergency care. Blunt trauma is more common in the pediatric population with motor vehicle accidents being the most common cause of injury. Spinal injury, especially in young children, is only seen in 1% to 2% of cases and can be lethal. It is incumbent upon clinicians to be able to meet the challenges of patient management including airway management, providing hemodynamic support, and addressing potentially reversible causes of arrest while recognizing presenting symptoms of spinal injury. This case presents a child in trauma arrest after a motor vehicle crash requiring advanced interventions, diagnostics, and support. Her clinical course is described and reveals a complete distraction of the cervical and thoracic spine. This case illustrates pathology and management along with the importance of proper management and interventions by pediatric emergency clinicians to manage the patient and attempt to maximize the patient's outcome.
- Published
- 2016
18. Difficult Airways, Difficult Physiology and Difficult Technology: Respiratory Treatment of the Special Needs Child
- Author
-
Kimberly MacKeil-White, John Fischer, Ian Kane, Valerie Whatley, Donald H. Arnold, Michele Walsh, and Brian S. Bassham
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,Population ,Children with special health care needs ,Physiology ,Special needs ,Medical care ,Acute illness ,Pediatrics, Perinatology and Child Health ,Emergency Medicine ,medicine ,Intensive care medicine ,business ,Airway ,education - Abstract
Continued advances in medical care and technology have led to an ever-increasing population of children with specialized respiratory needs. These children often have complex anatomy and altered physiology that may lead to a compromised airway or decreased pulmonary reserve in an acute illness. It is essential for emergency care providers to be familiar with the management of these children, including airway equipment, medications, and technology. This management must be necessarily tailored to each child's unique needs and physiology. This article will discuss both the general management and disease-specific details of the child with complex respiratory pathology.
- Published
- 2012
19. Intercenter Differences in Bronchopulmonary Dysplasia or Death Among Very Low Birth Weight Infants
- Author
-
Namasivayam, Ambalavanan, Michele, Walsh, Georgiy, Bobashev, Abhik, Das, Burton, Levine, Waldemar A, Carlo, Rosemary D, Higgins, and JoAnn, Poulsen
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,Birth weight ,Prenatal care ,law.invention ,Randomized controlled trial ,law ,medicine ,Cluster Analysis ,Humans ,Infant, Very Low Birth Weight ,Bronchopulmonary Dysplasia ,business.industry ,Obstetrics ,Mortality rate ,Infant, Newborn ,Articles ,Odds ratio ,Models, Theoretical ,medicine.disease ,Low birth weight ,Bronchopulmonary dysplasia ,Predictive value of tests ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business - Abstract
OBJECTIVES: To determine (1) the magnitude of clustering of bronchopulmonary dysplasia (36 weeks) or death (the outcome) across centers of the Eunice Kennedy Shriver National Institute of Child and Human Development National Research Network, (2) the infant-level variables associated with the outcome and estimate their clustering, and (3) the center-specific practices associated with the differences and build predictive models. METHODS: Data on neonates with a birth weight of RESULTS: In 2001–2004, clustering of bronchopulmonary dysplasia/death was significant (pairwise odds ratio: 1.3; P < .001) and increased in 2006 (pairwise odds ratio: 1.6; overall incidence: 52%; range across centers: 32%–74%); center rates were relatively stable over time. Variables that varied according to center and were associated with increased risk of outcome included lower body temperature at NICU admission, use of prophylactic indomethacin, specific drug therapy on day 1, and lack of endotracheal intubation. Center differences remained significant even after correction for clustered variables. CONCLUSION: Bronchopulmonary dysplasia/death rates demonstrated moderate clustering according to center. Clinical variables associated with the outcome were also clustered. Center differences after correction of clustered variables indicate presence of as-yet unmeasured center variables.
- Published
- 2011
20. Unpacking 'Rurality' What the Heterogeneity of Rural Areas Can Teach Us About Health
- Author
-
Michele | Walsh, Tanoue, Kara Haberstock, and Daws, John
- Published
- 2015
- Full Text
- View/download PDF
21. Neonatal intraventricular hemorrhage. Author reply
- Author
-
Shenandoah, Robinson, Alan R, Cohen, Nancy, Bass, Nima, Alan, Sunil, Manjila, Nori, Minich, and Michele, Walsh
- Subjects
Humans ,Infant, Premature, Diseases ,Ventriculoperitoneal Shunt ,Cerebral Hemorrhage ,Cerebral Ventricles ,Hydrocephalus - Published
- 2013
22. Low oxygen saturation target range is associated with increased incidence of intermittent hypoxemia
- Author
-
Juliann M, Di Fiore, Michele, Walsh, Lisa, Wrage, Wade, Rich, Neil, Finer, Waldemar A, Carlo, Richard J, Martin, and Clarence, Demetrio
- Subjects
Male ,Positive pressure ,Infant, Premature, Diseases ,Severity of Illness Index ,Article ,Hypoxemia ,medicine ,Humans ,Single-Blind Method ,Oximetry ,Prospective Studies ,Hypoxia ,Monitoring, Physiologic ,Models, Statistical ,medicine.diagnostic_test ,business.industry ,Incidence ,Postmenstrual Age ,Age Factors ,Infant, Newborn ,Gestational age ,Retinopathy of prematurity ,Oxygenation ,medicine.disease ,Respiration, Artificial ,Oxygen ,Pulse oximetry ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Regression Analysis ,Female ,medicine.symptom ,Saturation (chemistry) ,business ,Infant, Premature - Abstract
To test the hypothesis that preterm infants randomized to a low vs high O(2) saturation target range have a higher incidence of intermittent hypoxemia.A subcohort of 115 preterm infants with high resolution pulse oximetry enrolled in the Surfactant, Positive Pressure, and Oxygenation Randomized Trial were randomized to low (85%-89%) or high (91%-95%) O(2) saturation target ranges. Oxygen saturation was monitored until 36 weeks postmenstrual age or until the infant was breathing room air without respiratory support for ≥72 hours.The low target O(2) saturation group had a higher rate of intermittent hypoxemia (≤80% for ≥10 seconds and ≤3 minutes) prior to 12 days and beyond 57 days of life (P.05). The duration shortened (P.0001) and the severity increased (P.0001) with increasing postnatal age with no differences between target saturation groups. The higher rate of intermittent hypoxemia events in the low target group was associated with a time interval between events of1 minute.A low O(2) saturation target was associated with an increased rate of intermittent hypoxemia events that was dependent on postnatal age. The duration and severity of events was comparable between target groups. Further investigation is needed to assess the role of intermittent hypoxemia and their timing on neonatal morbidity.
- Published
- 2011
23. An audit of total colonic imaging by colonoscopy and barium enema
- Author
-
Scott Levison, Roger C. Prudham, Neil Haslam, Ann Turner, Michele Walsh, and Sheila Augustine
- Subjects
medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,General surgery ,Gastroenterology ,medicine ,Colonoscopy ,Audit ,Radiology ,business ,Barium enema - Published
- 2003
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.