The Balanced Opioid Initiative

The Balanced Opioid Initiative

Rates of opioid prescribing tripled in the USA between 1999 and 2015 and were associated with significant increases in opioid misuse and overdose death. Roughly half of all opioids are prescribed in primary care. The challenge remains in implementing guidelines in a way that balances safety and effectiveness when following clinical guidelines recommending opioid prescribing practices.

HIP Investigator, Dr. Andy Quanbeck et al. designed a study to discover the most cost-effective sequence and combination of strategies for improving opioid prescribing practices in diverse primary care clinics. The results of the study promise to help understand how to cost effectively improve the implementation of evidence-based practices.

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Emergency Department

Maggots, Mucous and Monkey Meat: Does Disgust Sensitivity Affect Case Mix Seen During Residency?

Maggots, Mucous and Monkey Meat: Does Disgust Sensitivity Affect Case Mix Seen During Residency?

Emergency physicians encounter scenarios daily that many would consider “disgusting.” While emergency physicians may have lower disgust sensitivity overall, it is not known whether individual differences in disgust sensitivity impact clinical performance during residency.

A group of authors including HIP Investigator, Dr. Brian Patterson, wrote this article that determines whether emergency physicians with higher disgust sensitivity see fewer “disgusting” cases during training.

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Doctor consulting woman

Stumbling Into Adulthood: Learning From Depression While Growing Up

Stumbling Into Adulthood: Learning From Depression While Growing Up

In the United States, approximately 16% of adults aged 18 to 24 years report having been diagnosed with depression at some point in their lives. Growing attention to the specific impact of depression on people in their late teens and twenties corresponds with efforts in the behavioral and social sciences to more carefully delineate “emerging adulthood” either as a distinctive developmental phase, or simply as a protracted period between adolescence and adulthood created by contemporary social and economic conditions.

In this article, HIP Investigator Dr. Rachel Grob et al. examine how depression impacted respondent's transition from adolescence to emerging adulthood, and built their capacity to form a coherent identity and find a purpose in life.

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Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition

The third edition of the Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy includes fundamental requirements to be followed when providing medical and other health care services using telecommunication technologies, and any other electronic communications between patients, practitioners, and other health care providers, as well as “best practice” recommendations. These guidelines were co-authored by HIP Investigator, Dr. Yao Liu and aim to assist providers in pursuing a sound course of action in providing safe and effective medical care using telehealth tools based on current scientific knowledge, technological requirements, and patient needs.

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Health System Research Priorities for Children and Youth With Special Health Care Needs

Health System Research Priorities for Children and Youth With Special Health Care Needs

Children and youth with special health care needs (CYSHCN) have, or are at an increased risk for, chronic physical, developmental, behavioral, or emotional conditions and also require health and related services of a type or amount beyond that required by children generally.

HIP Investigator, Dr. Ryan Coller et al. synthesized the opinions of a national multidisciplinary group of CYSHCN experts, including family caregivers, to prioritize research topics facing CYSHCN. Authors sought to take a foundational step toward developing a national research agenda for CYSHCN systems of care.

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Girl with Diabetes

Factors associated with health psychology use in pediatric type 1 diabetes

Factors associated with health psychology use in pediatric type 1 diabetes

For children with type 1 diabetes (T1D), self-management is complex and requires coordination between a child and his or her family multiple times every day to test blood sugars, determine and administer insulin doses, and adjust as needed. The consequences of suboptimal self-management are a combination of short- and long-term complications, some of which are life-threatening.

In this publication, HIP Investigator Dr. Elizabeth Cox et al. evaluated the prevalence of health psychology use in children with T1D and the association of this use with individual and contextual characteristics.

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Chemoprevention of Colorectal Cancer

Chemoprevention of Colorectal Cancer

Although colorectal cancer (CRC) screening has reduced the incidence of and mortality from CRC, chemoprevention strategies have the potential to further reduce CRC incidence and mortality. Chemoprevention agents might be used for average-risk as well as high-risk groups, and to prevent CRC recurrence after therapy. CRC chemoprevention agents that have been studied include aspirin, nonaspirin nonsteroidal anti-inflammatory drugs, statins, agents that target metabolic pathways, and vitamins and minerals.

In this article, HIP Investigator Dr. Jennifer Weiss along with Dr. Bryson Katona reviewed the prospect of chemoprevention of colorectal cancer, results from preclinical and human studies, challenges, and future directions.

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Doctors hospital corridor with nurses and female patient

Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy

Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy

Pelvic floor muscle exercises are a mainstay in the treatment of pelvic floor disorders such as urinary incontinence, overactive bladder, pelvic organ prolapse, and fecal incontinence. Women are more likely to report improvement in incontinence symptoms when they participate in directly supervised pelvic floor physical therapy (PFPT) as opposed to performing recommended exercises without supervision. However, < 50% of women referred for PFPT complete their prescribed program. HIP Investigator, Dr. Heidi Brown et al. sought to determine whether consultation with PFPT at the time of initial urogynecologic evaluation increases adherence to PFPT and to identify factors associated with PFPT attendance and completion.

The authors were also interested in exploring the relationship between the rate of surgical management of patients seen in multidisciplinary clinic versus those seen in a traditional clinic and those who attended PFPT versus those who did not. They hypothesized that rates of PFPT adherence would be higher when the patient met with a physical therapist at her initial urogynecology consultation as opposed to meeting with the urogynecologist alone.

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Worried older african american couple

Association of Cardiovascular and Alzheimer’s Disease Risk Factors with Intracranial Arterial Blood Flow in Whites and African Americans

Association of Cardiovascular and Alzheimer’s Disease Risk Factors with Intracranial Arterial Blood Flow in Whites and African Americans

Alzheimer’s disease (AD) is the most common cause of dementia among older adults (≥60 years old), affecting more than 5.3 million people in the United States. AD has a higher prevalence among African Americans. Targeting cardiovascular and metabolic risk factors may be potential mechanisms to modify AD risk and address racial/ethnic disparities in AD dementia. HIP Investigator, Dr. Heather Johnson et al. investigated relationships among cardiovascular and metabolic risk factors, APOE genotype, AD biomarkers, and intracranial arterial blood flow in Whites and African Americans enriched for AD risk.

Authors found that elevated fasting glucose and triglycerides were associated with lower intracranial arterial flow; these relationships were more prominent in African Americans. Targeting metabolic risk factors may impact intracranial arterial health. Additional research is needed to determine if this will impact disparities in dementia prevalence.

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A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers

A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers

Nearly 2 million Americans develop a diabetic foot ulcer each year; within 5 years of ulceration, 5% will undergo major amputation and 50% to 70% will die. Experts have recommended a multidisciplinary team approach to optimally address certain comorbidities in a coordinated manner and to reduce major amputations. Authors including HIP Investigators Dr. Meghan Brennan and Dr. Christie Bartels described multidisciplinary team composition and function using a systems engineering conceptual model and summarized the impact of multidisciplinary teams on major amputations. They hypothesized that multidisciplinary teams are associated with a reduced risk of major amputation.

The group found that multidisciplinary team composition was variable but reduced major amputations in 94% of studies.

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