scholarly journals Establishing a protocol for the compatibilities of closed-system transfer devices with multiple chemotherapy drugs under simulated clinical conditions

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257873
Author(s):  
Shao-Chin Chiang ◽  
Mandy Shen ◽  
Chen-Chia Lin ◽  
Hui-Ping Chang
Keyword(s):  
Health Care Providers ◽  
Closed System ◽  
Care Providers ◽  
Chemotherapy Drugs ◽  
Drug Potency ◽  
The Us ◽  
Plasticizer Migration ◽  
Small Cracks ◽  
Us Fda ◽  
Clinical Conditions

Closed-system drug transfer devices (CSTDs) are used to prevent occupational exposure to hazardous drugs in health care providers. They are considered Class II medical devices by the US FDA and are cleared but not approved before marketing. While compatibility tests are conducted by CSTD manufacturers, the procuring institution needs to consider performing its own studies before buying these devices. Herein we tested the compatibility of the components of the Needleless® DualGuard CSTD system (vial access clips, vial access spikes, and administration adaptors) with 10 antineoplastic drugs, under simulated clinical conditions, including compounding and administration, and examined drug potency maintenance, plasticizer migration, and device functionality. All drugs maintained potency within 5%. Diisononyl phthalate leakage was observed from the administration adaptors for paclitaxel and concentrated etoposide solution. In addition, white particles were discovered in CSTDs storing busulfan solution and small cracks were observed on devices which stored melphalan. Thus, it was concluded that even in simulated clinical conditions, instead of extreme conditions, there are still concerns regarding the efficacy and safety of CSTD components. The methodology may be used to implement and detect possible interactions between antineoplastic agents and CSTD components before procurement.

Digital Health Engagement in the US Population: Insights From the 2018 Health Information National Trends Survey

2021 ◽  
pp. e1-e4
Author(s):  
Chelsea L. Ratcliff ◽  
Melinda Krakow ◽  
Alexandra Greenberg-Worisek ◽  
Bradford W. Hesse
Keyword(s):  
Public Health ◽  
Health Information ◽  
Health Care Providers ◽  
Digital Health ◽  
Smart Device ◽  
P Value ◽  
Care Providers ◽  
Cross Sectional ◽  
The Us ◽  
National Trends

Objectives. To examine prevalence and predictors of digital health engagement among the US population. Methods. We analyzed nationally representative cross-sectional data on 7 digital health engagement behaviors, as well as demographic and socioeconomic predictors, from the Health Information National Trends Survey (HINTS 5, cycle 2, collected in 2018; n = 2698–3504). We fitted multivariable logistic regression models using weighted survey responses to generate population estimates. Results. Digitally seeking health information (70.14%) was relatively common, whereas using health apps (39.53%) and using a digital device to track health metrics (35.37%) or health goal progress (38.99%) were less common. Digitally communicating with one’s health care providers (35.58%) was moderate, whereas sharing health data with providers (17.20%) and sharing health information on social media (14.02%) were uncommon. Being female, younger than 65 years, a college graduate, and a smart device owner positively predicted several digital health engagement behaviors (odds ratio range = 0.09–4.21; P value range < .001–.03). Conclusions. Many public health goals depend on a digitally engaged populace. These data highlight potential barriers to 7 key digital engagement behaviors that could be targeted for intervention. (Am J Public Health. Published online ahead of print May 20, 2021: e1–e4. https://doi.org/10.2105/AJPH.2021.306282 )

scholarly journals Health Care Providers’ Advice on Lifestyle Modification in the US Population: Results from the NHANES 2011-2016

2019 ◽  
Vol 132 (4) ◽  
pp. 489-497.e1 ◽  
Author(s):  
Igor Grabovac ◽  
Lee Smith ◽  
Sinisa Stefanac ◽  
Sandra Haider ◽  
Chao Cao ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Lifestyle Modification ◽  
Care Providers ◽  
The Us

Enhancing the Value Chain to Increase Customer Satisfaction and Build Successful Breast Imaging Practices

2019 ◽  
Vol 1 (1) ◽  
pp. 56-59
Author(s):  
Vilert A Loving
Keyword(s):  
Health Care ◽  
Customer Satisfaction ◽  
Health Care Providers ◽  
Value Creation ◽  
Value Chain ◽  
Breast Imaging ◽  
Care Providers ◽  
Operational Effectiveness ◽  
A Value ◽  
The Us

Abstract The US health care industry is increasingly shifting to a value seeking mindset. The breast imaging value chain elucidates how breast imaging radiologists generate and deliver value to their customers, who include both patients and referring health care providers. The breast imaging value chain can be used by radiologists to improve operational effectiveness and to plan new value creation strategically. The overarching goals are increased customer satisfaction and successful practices.

scholarly journals Airmen and health-care providers’ attitudes toward the use of genomic sequencing in the US Air Force: findings from the MilSeq Project

2020 ◽  
Vol 22 (12) ◽  
pp. 2003-2010
Author(s):  
Stacey Pereira ◽  
◽  
Rebecca L. Hsu ◽  
Rubaiya Islam ◽  
Jill Oliver Robinson ◽  
...  
Keyword(s):  
Health Care ◽  
Air Force ◽  
Health Care Providers ◽  
Genomic Sequencing ◽  
Care Providers ◽  
Us Air Force ◽  
The Us

Patient use of online medical records: an application of technology acceptance framework

2019 ◽  
Vol 28 (1) ◽  
pp. 97-115
Author(s):  
Surma Mukhopadhyay ◽  
Ramsankar Basak ◽  
Darrell Carpenter ◽  
Brian J. Reithel
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Perceived Usefulness ◽  
Security And Privacy ◽  
Care Providers ◽  
Content Type ◽  
The Us ◽  
Continued Use ◽  
Patient Use

Purpose Little is known about factors that affect patient use of online medical records (OMR). Specifically, with rising vulnerability concerns associated with security and privacy breaches, patient use of OMR requires further attention. This paper aims to investigate patient use of OMR. Using the Unified Theory of Acceptance and Use of Technology (UTAUT), factors affecting continued use of OMR were examined. Design/methodology/approach The Health Information National Trends Survey 5 (HINTS 5), Cycle 1 data were used. This is an ongoing nation-wide survey sponsored by the National Cancer Institute (NCI) of the USA. The subjects were 31-74 years old with access to the Internet. Descriptive information was projected to the US population. Findings In total, 765 respondents representing 48.7 million members of the US population were analyzed. Weighted regression results showed significant effects of perceived usefulness, visit frequency and provider encouragement on continued use of OMR while vulnerability perception was not significant. Moderating effects of these variables were also noted. Perceived usefulness and provider encouragement emerged as important predictors. Practical implications Insights may help design interventions by health-care providers and policymakers. Social implications Insights should help patient empowerment and developers with designing systems. Originality/value This is the first study to examine health-care consumers’ continued use of OMR using nationally representative data and real-world patients, many of who have one or more chronic diseases (e.g. diabetes, hypertension, asthma) or are cancer survivors. Results highlight factors helping or hindering continuing OMR use. As such, insights should help identify opportunities to increase the extent of use, project future OMR usage patterns and spread the benefits of OMR, including bringing forth positive health outcomes.

Preparing Emergency Physicians for Acute Disaster Response: A Review of Current Training Opportunities in the US

2016 ◽  
Vol 31 (6) ◽  
pp. 643-647 ◽  
Author(s):  
Bhakti Hansoti ◽  
Dylan S. Kellogg ◽  
Sara J. Aberle ◽  
Morgan C. Broccoli ◽  
Jeffrey Feden ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Grey Literature ◽  
Care Providers ◽  
Emergency Physicians ◽  
The Us ◽  
Disaster Training ◽  
Training Opportunities

AbstractStudy ObjectiveThis study aimed to review available disaster training options for health care providers, and to provide specific recommendations for developing and delivering a disaster-response-training program for non-disaster-trained emergency physicians, residents, and trainees prior to acute deployment.MethodsA comprehensive review of the peer-reviewed and grey literature of the existing training options for health care providers was conducted to provide specific recommendations.ResultsA comprehensive search of the Pubmed, Embase, Web of Science, Scopus, and Cochrane databases was performed to identify publications related to courses for disaster preparedness and response training for health care professionals. This search revealed 7,681 unique titles, of which 53 articles were included in the full review. A total of 384 courses were found through the grey literature search, and many of these were available online for no charge and could be completed in less than six hours. The majority of courses focused on management and disaster planning; few focused on clinical care and acute response.ConclusionThere is need for a course that is targeted toward emergency physicians and trainees without formal disaster training. This course should be available online and should utilize a mix of educational modalities, including lectures, scenarios, and virtual simulations. An ideal course should focus on disaster preparedness, and the clinical and non-clinical aspects of response, with a focus on an all-hazards approach, including both terrorism-related and environmental disasters.HansotiB, KelloggDS, AberleSJ, BroccoliMC, FedenJ, FrenchA, LittleCM, MooreB, SabatoJJr., SheetsT, WeinbergR, ElmesP, KangC. Preparing emergency physicians for acute disaster response: a review of current training opportunities in the US. Prehosp Disaster Med. 2016;31(6):643–647.

scholarly journals Small molecules in targeted cancer therapy: advances, challenges, and future perspectives

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Lei Zhong ◽  
Yueshan Li ◽  
Liang Xiong ◽  
Wenjing Wang ◽  
Ming Wu ◽  
...  
Keyword(s):  
Small Molecule ◽  
Kinase Inhibitor ◽  
Cancer Drugs ◽  
Drug Candidates ◽  
Chemotherapy Drugs ◽  
National Medical ◽  
Anti Cancer ◽  
The Us ◽  
Us Fda ◽  
Approved Drugs

AbstractDue to the advantages in efficacy and safety compared with traditional chemotherapy drugs, targeted therapeutic drugs have become mainstream cancer treatments. Since the first tyrosine kinase inhibitor imatinib was approved to enter the market by the US Food and Drug Administration (FDA) in 2001, an increasing number of small-molecule targeted drugs have been developed for the treatment of malignancies. By December 2020, 89 small-molecule targeted antitumor drugs have been approved by the US FDA and the National Medical Products Administration (NMPA) of China. Despite great progress, small-molecule targeted anti-cancer drugs still face many challenges, such as a low response rate and drug resistance. To better promote the development of targeted anti-cancer drugs, we conducted a comprehensive review of small-molecule targeted anti-cancer drugs according to the target classification. We present all the approved drugs as well as important drug candidates in clinical trials for each target, discuss the current challenges, and provide insights and perspectives for the research and development of anti-cancer drugs.

scholarly journals Extracorporeal Membrane Oxygenation for Adults and Children With Severe Respiratory Failure

2021 ◽  
Vol 1 (6) ◽  
Author(s):  
Andrea Smith ◽  
Hannah Loshak
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Health Care Providers ◽  
Life Support ◽  
Family Members ◽  
Care Providers ◽  
Framework Analysis ◽  
Team Members ◽  
Membrane Oxygenation ◽  
Medical Histories ◽  
Clinical Conditions

This review used a framework analysis to synthesize 9 included studies on the perspectives and experiences of patients, family members, and providers on extracorporeal membrane oxygenation (ECMO). Patients’ perspectives on their experiences are limited due to their sedated status when treated with ECMO. Supporting a relative treated with ECMO is stressful for family members. They feel anxious and worried about their relative because of the patient’s critical condition, and they struggle to juggle multiple roles at work and home while supporting their relative receiving ECMO. Family members often have to travel to see their critically ill relative. Financial and logistical support for temporary relocation near the ECMO centre may ease the burden of travel. Family members benefit from clear and frequent communication from health care providers as a source of support and reassurance while their loved ones are being treated with ECMO. There may be a role for informal or formal peer support for family members of patients receiving ECMO. Clinicians’ decisions to offer, continue, and withdraw ECMO are based on their assessments of prognostic factors from patients’ medical histories and clinical conditions. Additional clinical research and/or refinements of prognostic guidance for ECMO may further support evidence-informed decision-making around ECMO. Patients, family members, and clinical team members may differ in their assessment of the limits of ECMO treatment and the decision to transition from active treatment to the withdrawal of life support. These findings point to the role of ethical considerations and processes when engaging in transitioning to end-of-life support in the provision of ECMO. After discharge, patients who had received ECMO and their family members continued to have feelings of anxiety, intrusive thoughts, and a need to process the event. ECMO programs that can offer continued or ongoing support or referral for patients and their family members’ mental health may help address these needs.

scholarly journals A qualitative study to assess perceptions, barriers, and motivators supporting smokeless tobacco cessation in the US fire service

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251128
Author(s):  
Nattinee Jitnarin ◽  
Walker S. C. Poston ◽  
Sara A. Jahnke ◽  
Christopher K. Haddock ◽  
Hannah N. Kelley ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Smokeless Tobacco ◽  
Fire Service ◽  
Service Organizations ◽  
Care Providers ◽  
Occupational Groups ◽  
Tobacco Policies ◽  
The Us ◽  
Social Environmental ◽  
Barriers And Motivators

While firefighters currently have low smoking rates, rates of smokeless tobacco (SLT) use among this population are remarkably high and substantially greater than similar occupational groups, and the general population. This study explored determinants associated with SLT use, barriers to cessation, and motivators for SLT cessation in the fire service. Key informant interviews were conducted in 23 career firefighters who were current (n = 14) and former (n = 9) SLT users from across the U.S. Discussions were recorded and independently coded according to questions and themes. Major themes that developed among firefighters regarding SLT use determinants included positive perceptions of SLT products, social influences from their peers and family members, acceptability of SLT use in the fire service, and a coping resource for job stress. Firefighters discussed several barriers to SLT cessation, including intrapersonal barriers such as SLT use habits and its dependency, concerns about withdrawal symptoms; and social-environmental barriers including lack of support from health and other services providers, and lack of enforcement of existing tobacco policies regarding SLT use. Firefighters also mentioned both internal and external motivators for cessation. Internal motivators included self-motivation and their health concerns while external motivators included friends and family support, incentives or rewards, and price of SLT products. Findings provide unique perspectives from firefighters on factors that influence SLT use and barriers and motivators to SLT cessation. These are insufficiently assessed and considered by the fire service organizations and their health care providers. Thus, the organizations must understand these issues in order to mitigate barriers and motivate the personnel to quit using SLT. Information gained from firefighters who were current and former SLT users can be used to develop an effective, culturally-tailored intervention that is acceptable to fire service personnel.

609 Comparing parental sleep goals for younger versus older toddlers

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A239-A240
Author(s):  
Jodi Mindell ◽  
Meghan Collins ◽  
Erin Leichman ◽  
Katie Rotella
Keyword(s):  
Health Care Providers ◽  
Online Survey ◽  
Sleep Problem ◽  
Developmental Differences ◽  
Care Providers ◽  
Falling Asleep ◽  
The Us ◽  
One Year ◽  
Bedtime Routine ◽  
Pacifier Use

Abstract Introduction This study aimed to assess parental sleep goals, comparing younger (12-23.9-month-olds) and older toddlers (24-35.9-month-olds) in consideration of developmental differences. Methods Parents (98.0% mothers) of 401 toddlers (12–35 mos; M=22.49 mos; 49% male) in the US completed an online survey, including an abbreviated Brief Infant Sleep Questionnaire and a list of 58 desired areas of change (DACs). There were 230 one-year-olds (1yos; M=17.42mos) and 171 two-year-olds (2yos; M=29.30mos), with no difference in parent age between groups (M=34.41 years). Results 25.7% reported a perceived sleep-problem, whereas 94.8% indicated at least one sleep-related DAC. Parents of one- and two-year-olds reported similar rates of DAC for overnight sleep (58% vs. 49%), morning sleep (55% vs. 52%), and naps (70% vs. 64%), p&gt;.05. Parents of 2yos, however, reported bedtime as a DAC at a higher rate (59% vs. 79%), p&lt;.001. Twenty-five percent of specific bedtime DACs (n=8) were endorsed by ≥10% of parents. Parents endorsed falling asleep without an adult (17% of 1yos vs. 22% of 2yos) and falling asleep without nursing (10% vs. 9%) at similar rates, p&gt;.05. Parents of two-year-olds were more likely to endorse: getting through bedtime routine quickly/easily without stalling (10% vs. 30%,), earlier bedtime (10% vs. 24%), falling asleep faster at bedtime (24% vs. 10%), falling asleep without a pacifier (11% vs. 19%), falling asleep faster while alone (8% vs. 16%), and falling asleep without stalling/making requests (3% vs. 18%), p&lt;.05. Conclusion The majority of parents of toddlers endorsed a sleep-related desired area of change, with two-thirds wanting to change something about bedtime and naps, and over half wanting to change something about overnight and morning sleep. Parents of older toddlers (2yos) were more likely to desire changes at bedtime than parents of younger toddlers (1yos), especially related to stalling and discontinuing pacifier use. As toddlers age, bedtime problems are more likely. Health care providers should be aware of developmental changes, such as increased language and assertions of independence, that seem to mostly affect bedtime when addressing sleep issues in toddlers. Support (if any) Johnson & Johnson Consumer Inc., Skillman, NJ, USA.

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