Publications

Addressing food insecurity in rural primary care: a mixed-methods evaluation of barriers and facilitators.

Jordanova KE, Suresh A, Canavan CR, D'cruze T, Dev A, Boardman M, Kennedy MA

2024 May 11;25(1):163doi: 10.1186/s12875-024-02409-1

Food insecurity (FI) is associated with negative health outcomes and increased healthcare utilization. Rural populations face increased rates of FI and encounter additional barriers to achieving food security. We sought to identify barriers and facilitators to screening and interventions for FI in rural primary care practices.

BMC Prim Care | 2024 May 11

Impact of Implementing Serious Illness Conversations Across a Comprehensive Cancer Center Using an Interdisciplinary Approach.

Guo K, Wasp G, Vergo M, Wilson M, Holthoff MM, Buus-Frank ME, Perry JJ, Cullinan AM

2024 May 10;:10499091241252058doi: 10.1177/10499091241252058

Gaps in communication of end-of-life care preferences increase risk of patient harm. Adoption of oncology practice guidelines advocating serious illness communication for patients with advanced cancer is limited.

Am J Hosp Palliat Care | 2024 May 10

A Web-Based Peer Support Network to Help Care Partners of People With Serious Illness: Co-Design Study.

O'Donnell EA, Van Citters AD, Khayal IS, Wilson MM, Gustafson D, Barnato AE, Buccellato AC, Young C, Holthoff MM, Korsunskiy E, Tomlin SC, Cullinan AM, Steinbaugh AC, Hinson JJ, Johnson KR, Williams A, Thomson RM, Haines JM, Holmes AB, Bradley AD, Nelson EC, Kirkland KB

2024 May 8;11:e53194doi: 10.2196/53194

Care partners of people with serious illness experience significant challenges and unmet needs during the patient's treatment period and after their death. Learning from others with shared experiences can be valuable, but opportunities are not consistently available.

JMIR Hum Factors | 2024 May 8

Rethinking the Role of Biodosimetry to Assess Risks for Acute Radiation Syndrome in Very Large Radiation Events: Reconsidering Legacy Concepts.

Swartz HM, Flood AB

2024 May 1;201(5):440-448doi: 10.1667/RADE-23-00141.1

The development of effective uses of biodosimetry in large-scale events has been hampered by residual, i.e., "legacy" thinking based on strategies that scale up from biodosimetry in small accidents. Consequently, there remain vestiges of unrealistic assumptions about the likely magnitude of victims in "large" radiation events and incomplete analyses of the logistics for making biodosimetry measurements/assessments in the field for primary triage. Elements remain from an unrealistic focus on developing methods to use biodosimetry in the initial stage of triage for a million or more victims. Based on recent events and concomitant increased awareness of the potential for large-scale events as well as increased sophistication in planning and experience in the development of biodosimetry, a more realistic assessment of the most effective roles of biodosimetry in large-scale events is urgently needed. We argue this leads to a conclusion that the most effective utilization of biodosimetry in very large events would occur in a second stage of triage, after initially winnowing the population by identifying those most in need of acute medical attention, based on calculations of geographic sites where significant exposures could have occurred. Understanding the potential roles and limitations of biodosimetry in large-scale events involving significant radiation exposure should lead to development of the most effective and useful biodosimetric techniques for each stage of triage for acute radiation syndrome injuries, i.e., based on more realistic assumptions about the underlying event and the logistics for carrying out biodosimetry for large populations.

Radiat Res | 2024 May 1

ACcurate COnsensus Reporting Document (ACCORD) explanation and elaboration: Guidance and examples to support reporting consensus methods.

Logullo P, van Zuuren EJ, Winchester CC, Tovey D, Gattrell WT, Price A, Harrison N, Goldman K, Chisholm A, Walters K, Blazey P

2024 May 6;21(5):e1004390doi: 10.1371/journal.pmed.1004390

When research evidence is limited, inconsistent, or absent, healthcare decisions and policies need to be based on consensus among interested stakeholders. In these processes, the knowledge, experience, and expertise of health professionals, researchers, policymakers, and the public are systematically collected and synthesised to reach agreed clinical recommendations and/or priorities. However, despite the influence of consensus exercises, the methods used to achieve agreement are often poorly reported. The ACCORD (ACcurate COnsensus Reporting Document) guideline was developed to help report any consensus methods used in biomedical research, regardless of the health field, techniques used, or application. This explanatory document facilitates the use of the ACCORD checklist.

PLoS Med | 2024 May 6

Congenital Hernias in Adults: Bochdalek Hernias.

Bridges CJ, Hasson RM

2024 May;34(2):155-162doi: 10.1016/j.thorsurg.2024.01.007

Bochdalek hernias are a rare occurrence in adults and usually asymptomatic, resulting in incidental discovery. However, surgical intervention is recommended for both symptomatic and asymptomatic Bochdalek hernias due to the risk of acute morbidity and mortality. There are various possible surgical approaches that may be appropriate depending on the circumstance, with robotic repair becoming increasingly popular. To date, the rarity of the condition has limited the available data on postoperative outcomes.

Thorac Surg Clin | 2024 May

Collaborative Modeling to Compare Different Breast Cancer Screening Strategies: A Decision Analysis for the US Preventive Services Task Force.

Trentham-Dietz A, Chapman CH, Jayasekera J, Lowry KP, Heckman-Stoddard BM, Hampton JM, Caswell-Jin JL, Gangnon RE, Lu Y, Huang H, Stein S, Sun L, Gil Quessep EJ, Yang Y, Lu Y, Song J, Muñoz DF, Li Y, Kurian AW, Kerlikowske K, O'Meara ES, Sprague BL, Tosteson ANA, Feuer EJ, Berry D, Plevritis SK, Hu...

2024 Apr 30;doi: 10.1001/jama.2023.24766

The effects of breast cancer incidence changes and advances in screening and treatment on outcomes of different screening strategies are not well known.

JAMA | 2024 Apr 30

Breast density knowledge and willingness to delay treatment for pre-operative breast cancer imaging among women with a personal history of breast cancer.

Smith RE, Sprague BL, Henderson LM, Kerlikowske K, Miglioretti DL, Wernli KJ, Onega T, diFlorio-Alexander RM, Tosteson ANA

2024 Apr 29;26(1):73doi: 10.1186/s13058-024-01820-x

Following a breast cancer diagnosis, it is uncertain whether women's breast density knowledge influences their willingness to undergo pre-operative imaging to detect additional cancer in their breasts. We evaluated women's breast density knowledge and their willingness to delay treatment for pre-operative testing.

Breast Cancer Res | 2024 Apr 29

Gender and Autism Program: A novel clinical service model for gender-diverse/transgender autistic youth and young adults.

Strang JF, Fischbach AL, Rao S, Clawson A, Knauss M, Bernstein SN, van der Miesen AIR, Inge AP, Alonzo K, Zeroth J, Kenworthy L, Morgan CI, Brandt A, Moore CC, Ahlers K, Jankowski MK, McClellan LS, Henise SB, Cap CJ, Exley SL, Youmatz A, Song M, McLaren JL, Parchem B

2024 Apr 25;:1-37doi: 10.1080/13854046.2024.2318155

Situated in Children's National Hospital (CNH)'s Neuropsychology Division, the Gender and Autism Program (GAP) is the first clinical service dedicated to the needs of autistic gender-diverse/transgender youth. This study describes GAP clinical assessment profiles and presents a multi-perspective programmatic review of GAP evaluation services. Seventy-five consecutive gender- and neuropsychologically-informed GAP evaluations were analyzed, including demographics, gender and autism characterization, and primary domains evaluated. Three program-based Delphi studies were conducted and identify: clinician priorities and challenges in providing care, program administrator lessons learned and ongoing barriers, and considerations adapting this model for a rural academic medical center. Nearly two-thirds of referrals were transfeminine. Most youth had existing autism diagnoses; of those undiagnosed, three-quarters were found to be autistic. Five goals of evaluations were identified: Mental health was always assessed, and most evaluations also assessed gender-related needs in the context of autism neurodiversity. Neuropsychological characterization of strengths and challenges informed personalized accommodations to support youth gender-related self-advocacy. Clinicians emphasized frequent youth safety concerns. Administrators emphasized the need for specialized training for working with families. Components for adaptation of the GAP in a rural academic medical center were identified. Since its founding, the GAP has proven a sustainable neuropsychology-based service with consistent referral flow and insurance authorizations. Capturing staff perspectives through rigorous Delphi methods, and addressing the GAP's feasibility and replicability, this study provides a road map for replicating this service. We also highlight GAP training of specialist clinicians, fundamental to addressing the desperate shortage of providers in this field.

Clin Neuropsychol | 2024 Apr 25

Measuring Local-Area Racial Segregation for Medicare Hospital Admissions.

Akré EL, Chyn D, Carlos HA, Barnato AE, Skinner J

2024 Apr 1;7(4):e247473doi: 10.1001/jamanetworkopen.2024.7473

Considerable racial segregation exists in US hospitals that cannot be explained by where patients live. Approaches to measuring such segregation are limited.

JAMA Netw Open | 2024 Apr 1