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BackgroundLeukocytosis is a rise in white blood cell (WBC) count and clinical outcomes of moderate to severe leukocytosis in trauma patients have not been described. We hypothesized that trauma patients with severe leukocytosis (SL; ≥40.0 × 109 leukocytes/L) have higher rates of in-hospital complications and mortality than those with moderate leukocytosis (ML; 25.0-39 × 109 leukocytes/L).MethodsWe performed a retrospective analysis (2010-2017) on trauma patients developing ML or SL at a single Level-I trauma center. A multivariable logistic regression analysis for risk factors were performed.ResultsFrom 15,807 trauma admissions, 332 (2.1%) had ML or SL. Of these, 308 (92.8%) were ML and 24 (7.2%) were SL. Patients with ML and SL reached their peak WBC count in 1 and 10 days after admission respectively (p

Federally qualified health centers (FQHC) aim to improve cancer prevention by providing screening options and efforts to prevent harmful behavior. Patient portals are increasingly being used to deliver health promotion initiatives. However, little is known about patient portal activation rates in FQHC settings and the factors associated with activation. This study examined patient portal activation among FQHC patients and assessed correlations with demographic, clinical, and health service use variables. We analyzed electronic health record data from adults >18 years old with at least one appointment. Data were accessed from the electronic health records for patients seen between 1 September 2018 and 31 August 2022 (n = 40,852 patients). We used multivariate logistic regression models to examine the correlates of having an activated EPIC-supported MyChart patient portal account. One-third of patients had an activated MyChart portal account. Overall, 35% of patients with an activated account had read at least one portal message, 69% used the portal to schedule an appointment, and 90% viewed lab results. Demographic and clinical factors associated with activation included younger age, female sex, white race, English language, being partnered, privately insured, non-smoking, and diagnosed with a chronic disease. More frequent healthcare visits were also associated with an activated account. Whether or not a patient had an email address in the EHR yielded the strongest association with patient portal activation. Overall, 39% of patients did not have an email address; only 2% of those patients had activated their accounts, compared to 54% of those with an email address. Patient portal activation rates were modest and associated with demographic, clinical, and healthcare utilization factors. Patient portal usage to manage one's healthcare needs is increasing nationally. As such, FQHC clinics should enhance efforts to improve the uptake and usage of patient portals, including educational campaigns and eliminating email requirements for portal activation, to reinforce cancer prevention efforts. [ABSTRACT FROM AUTHOR]

Experiences of violence and behaviors that increase the risk of acquiring a sexually transmitted infection are high among women in the United States, and they often intersect (Meyer, Springer, & Altice, 2011; Montgomery et al., 2015; World Health Organization (WHO), 2010). However, there are few evidence-based HIV-prevention interventions that address the special needs and challenges faced by female survivors of violence (Centers for Disease Control and Prevention, (CDC), 2017a). To address this gap, we adapted and pilot-tested an existing evidence-based women-focused sexual risk-reduction intervention (The Future Is Ours) with 23 self-identified female survivors of violence. The intervention comprised eight-weekly, two-hour cognitive behavioral group sessions focusing on reducing sexual-risk and improving trauma-based coping skills. Using mixed-methods analyses, the adapted intervention was determined feasible and acceptable to participants, and preliminary results suggest that participation could reduce risk factors for sexually transmitted infections. Therefore, testing on a larger scale is warranted.

Community-engaged patient navigation safety net programs are established as an evidence-based approach to address cancer prevention and early detection efforts, but barriers to expand and sustain such programs persist. In addition, few studies describe how these programs impact buy-in among communities and policy change within health care systems and government. We describe how we used the Capacity for Sustainability Framework to guide efforts for program sustainability and community, institutional, and policy level change in a breast cancer screening and patient navigation safety net program. The nine domains of the Capacity for Sustainability Framework were used to develop program logic models, to inform program implementation and quality improvement agendas, and to guide multi-level partner and stakeholder engagement, outreach, and dissemination of outcomes. The program is currently in its seventh year and continues to be annually funded by a city public health department. In 2021, additional 5-year renewable funding from a state public health department was secured. In addition, institutional program support was expanded for patients diagnosed with breast cancer. Program leaders worked with policymakers to draft legislation to support training certification and third-payor reimbursement for patient navigators and community health workers. The program is well-known and trusted among community members, community-based organizations, and providers. Community, organizational, and policy-level outcomes demonstrate that community-engaged patient navigation safety net programs can influence more than individual and interpersonal outcomes and can be sustained over time. [ABSTRACT FROM AUTHOR]

The School Health Education Profiles monitor characteristics of health education in secondary schools nationwide, using school-based surveys conducted by state and local education agencies. This report summarizes results from 35 state surveys and 13 local surveys conducted among representative samples of school principals and lead health education teachers in 1996. Most states and cities required health education in grades 6-12, and most taught a separate health education course. The median percentage of schools that tried to increase student knowledge on certain topics was less than 72 percent for each topic. The median percentage of schools that tried to improve certain student skills was greater than 69 percent for each skill. The median percentage of schools that had health educators coordinate health education was 33 percent across states and 26.8 percent across cities. Most schools taught HIV education during required health education courses. Over half had written policies on HIV infection among students and staff. A median of 41.0 percent of schools across states and 25.8 percent across cities had a lead health educator with professional preparation in health and physical education. Across states, the median percentage of schools whose lead health educator had received inservice training on specific topics ranged from 15.6-51.4 percent. Of schools that received parental feedback, most reported receiving positive feedback. Thirteen tables comprise the bulk of this article. (Contains 11 references.) (SM)