Equity, Listening, and the Transference of Power in Design-Driven Healthcare Innovation

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Matthew MANOS
Keyword(s):  
Graduate Students ◽  
Rural Communities ◽  
Los Angeles ◽  
Design Research ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Community Needs ◽  
Healthcare Innovation ◽  
Residential Experience

The American Heart Association has almost 100 years of experience uncovering barriers to better health across the United States. Looking to transition towards a more equitable approach to health, the AHA partnered with verynice, a design strategy consultancy, in 2017, to develop a design research toolkit that could understand the needs of rural communities, align scientific understanding with human-centered design, and build capacity for qualitative design research. In 2018, Professor Matthew Manos of the USC Iovine and Young Academy led a group of 19 graduate students on a Professional Practices Residential in Dallas, Texas. Along the way, students developed a series of strategic recommendations for the organization moving forward. In a second application of the toolkit, Professor Manos led 20 additional graduate students in a residential experience with the Children’s Hospital of Los Angeles in 2019. By introducing the framework in the offerings of the Academy, we saw first-hand the power of the methodology in an educational environment as a tool for teaching students how to listen to community needs, and suspend their bias.

Cardiopulmonary Resuscitation of the Newborn

1990 ◽  
Vol 12 (5) ◽  
pp. 136-141
Author(s):  
Robert A. Sinkin ◽  
Jonathan M. Davis
Keyword(s):  
United States ◽  
American Academy ◽  
American Heart Association ◽  
Life Support ◽  
American Heart ◽  
Neonatal Resuscitation ◽  
Heart Association ◽  
The United States ◽  
Delivery Room ◽  
American Academy Of Pediatrics

Approximately 3.5 million babies are born each year in approximately 5000 hospitals in the United States. Only 15% of these hospitals have neonatal intensive care facilities. Six percent of all newborns require life support in the delivery room or nursery, and this need for resuscitation rises to 80% in neonates weighing less than 1500 g at birth. Personnel who are skilled in neonatal resuscitation and capable of functioning as a team and an appropriately equipped delivery room must always be readily available. At least one person skilled in neonatal resuscitation should be in attendance at every delivery. Currently, a joint effort by the American Academy of Pediatrics and the American Heart Association has resulted in the development of a comprehensive course to train appropriate personnel in neonatal resuscitation throughout the United States. Neonatal resuscitation is also taught as part of a Pediatric Advanced Life Support course offered by the American Heart Association. In concert with the goals of the American Academy of Pediatrics and the American Heart Association, we strongly urge all personnel responsible for care of the newborn in the delivery room to become certified in neonatal resuscitation. The practical approach to neonatal resuscitation is the focus of this article.

Abstract P003: Distribution of Ideal Cardiovascular Health Metrics in US and Non-US populations: A Meta-Analysis of Proportions

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Adnan Younus ◽  
Ehimen Aneni ◽  
Oluseye Ogunmoroti ◽  
Omar Jamal ◽  
Shozab Ali ◽  
...  
Keyword(s):  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Meta Analysis ◽  
Heart Association ◽  
The United States ◽  
Free Text ◽  
Significant Heterogeneity ◽  
Ideal Cardiovascular Health ◽  
Us Studies

Introduction: With the development of new health metrics to define ideal cardiovascular health (CVH), several studies have examined the distribution of the American Heart Association (AHA) 2020 ideal CVH metrics both within and outside the United States (US). In this meta-analysis of proportions, we synthesized available data on ideal CVH metrics distribution in US cohorts and compared them with non-US populations. Methods: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “ideal cardiovascular health” between January 2000 and October 2014. Studies were included in the meta-analysis if the proportions achieving ideal for 0, 1, 2, 3, 4, 5 or ≥6 ideal CVH metrics were known or could be estimated. A meta-analysis of proportions was conducted for US and non-US studies using a random effect model (REM). REM models were chosen because of the significant heterogeneity among studies. Results: Overall the pooled data consisted of 10 US cohorts with a total population of 94,761 participants and 6 non-US cohorts with a total of 130,242 participants. The table shows the pooled prevalence of ideal CVH factors in this population. Overall the pooled estimates of US cohorts showed 15% had 0-1 ideal CVH metrics (inter-study range: 7-22%), while 3% (inter-study range: 1-10%) had 6-7 ideal CVH metrics. This is comparable to 12% (inter-study range 1-17%) and 2% (inter-study range: 1-12%) for 0-1 and 6-7 ideal CVH metrics in the non-US studies. Conclusion: The proportion of persons achieving 6 or more ideal CVH metrics in both US and non-US cohorts is very low and the distribution of CVH metrics is similar in both US and non-US populations. Considering the strong association with worse outcomes, a coordinated global effort at improving CVH should be considered a priority.

Prudent Life-style for Children: Dietary Fat and Cholesterol

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 521-525 ◽  
Author(s):  
Keyword(s):  
American Heart ◽  
Eating Habits ◽  
Saturated Fat ◽  
Heart Association ◽  
The United States ◽  
Dietary Factors ◽  
Atherosclerotic Cardiovascular Disease ◽  
Food Groups ◽  
Monounsaturated Fat ◽  
Total Fat

In the 1983 AAP Committee on Nutrition statement, "Toward a Prudent Diet for Children," the evidence linking dietary factors with the risk of atherosclerosis was reviewed.1 Based on the analysis of the available information, the Committee made seven recommendations concerning steps to be taken during childhood that would reduce the risk of atherosclerotic cardiovascular disease in adults. With respect to childhood eating habits, it was noted that, after 1 year of age, a varied diet that includes items from each of the major food groups is the best assurance of nutritional adequacy. The dietary trends in the United States during the last few decades, with emphasis on decreased consumption of saturated fats, cholesterol, and salt and increased intake of polyunsaturated fats, were recommended as sensible when followed with moderation.1 OTHER FINDINGS Since publication of that Committee statement, recommendations for alteration of childhood diets have also been made by the American Heart Association, 2 by the American Health Foundation, 3 and by a Consensus Development panel sponsored by the National Institutes of Health (NIH).4 All three of these groups have recommended more restrictive childhood diets than had been recommended by the Committee on Nutrition. The American Heart Association2 recommends a total fat intake that would be approximately 30% of total calories; this 30% would include 10% or less from saturated fat, 10% from monounsaturated fat, and less than 10% from polyunsaturated fat. The recommendation for daily cholesterol intake was 100 mg/1,000 calories and not to exceed 300 mg/d, total. Similar recommendations have been made by the American Health Foundation3 to achieve a target goal of serum total cholesterol values averaging 140 mg/dL for children and young adults.

scholarly journals The Use of Sex-Specific Factors in the Assessment of Women’s Cardiovascular Risk

Circulation ◽  
2020 ◽  
Vol 141 (7) ◽  
pp. 592-599 ◽  
Author(s):  
Anandita Agarwala ◽  
Erin D. Michos ◽  
Zainab Samad ◽  
Christie M. Ballantyne ◽  
Salim S. Virani
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Increased Risk

Cardiovascular disease (CVD) is the leading cause of death among women in the United States. As compared with men, women are less likely to be diagnosed appropriately, receive preventive care, or be treated aggressively for CVD. Sex differences between men and women have allowed for the identification of CVD risk factors and risk markers that are unique to women. The 2018 American Heart Association/American College of Cardiology Multi-Society cholesterol guideline and 2019 American College of Cardiology/American Heart Association guideline on the primary prevention of CVD introduced the concept of risk-enhancing factors that are specific to women and are associated with an increased risk of incident atherosclerotic CVD in women. These factors, if present, would favor more intensified lifestyle interventions and consideration of initiation or intensification of statin therapy for primary prevention to mitigate the increased risk. In this primer, we highlight sex-specific CVD risk factors in women, stress the importance of eliciting a thorough obstetrical and gynecological history during cardiovascular risk assessment, and provide a framework for how to initiate appropriate preventive measures when sex-specific risk factors are present.

scholarly journals One Grip a Little Stronger

2003 ◽  
Vol 83 (11) ◽  
pp. 1014-1021 ◽  
Author(s):  
Pamela W Duncan
Keyword(s):  
United States ◽  
Health Care ◽  
Physical Therapy ◽  
Stroke Rehabilitation ◽  
American Heart Association ◽  
American Heart ◽  
Physical Therapist ◽  
Heart Association ◽  
The United States ◽  
Rehabilitation Research

Abstract Pamela W Duncan, PT, PhD, FAPTA Dr Duncan has actively participated in and contributed to physical therapist practice, physical therapist professional education, professional preparation of other health care providers, national policy development related to rehabilitation after stroke and aging, and scientific investigation. She has served several government appointments and provides leadership within several organizations. She served as co-chair of the Consensus Panel on Establishing Guidelines for Stroke Rehabilitation for the Agency for Health Care Policy, Research, and Education. She was a panel member on the National Institutes of Health's Total Hip Replacement Consensus Conference and served on the Strategic Planning Group for Stroke Research for the National Institute of Neurological Disorders and Stroke. She recently was appointed to serve on the Steering Committee of the Department of Education's National Institute on Disability and Rehabilitation Research and is currently on the Executive Leadership Council of the American Stroke Foundation and the Advisory Committee of the Canadian Stroke Network. She has served on committees and panels for the American Heart Association and was president of APTA's Neurology section. Dr Duncan's research activities focus on geriatric rehabilitation, stroke rehabilitation, and health outcomes measurement. She developed the Functional Reach Test, used to assess balance in older adults. In the past 20 years, she has received $13 million in research awards as principal investigator or co-investigator from agencies such as the National Institutes of Health, National Institute on Aging, American Heart Association, Department of Veteran's Affairs, and National Center for Medical Rehabilitation Research and from multiple private funding sources. Dr Duncan has disseminated her research findings in more than 80 peer-reviewed articles in 20 different journals, and she has written a book and 12 book chapters. Dr Duncan's work has influenced the care and rehabilitation of patients in the United States and worldwide. Physical therapy education programs across the country incorporate her findings and professional vision into the preparation of the next generation of physical therapists. APTA has awarded Dr Duncan the Marian Williams Award for Research in Physical Therapy, the Catherine Worthingham Fellowship Award, and the Mary McMillan Scholarship Award. She has also received research awards from the APTA Neurology Section, Sports Physical Therapy Section, and Section on Geriatrics, as well as a service award from the Neurology Section. She is an elected fellow of the Stroke Council of the American Heart Association and has given 8 invited lectureships at universities across the United States.

scholarly journals Industry Payment to Vascular Neurologists

Stroke ◽  
2020 ◽  
Vol 51 (4) ◽  
pp. 1339-1343 ◽  
Author(s):  
Krishna Nalleballe ◽  
Sen Sheng ◽  
Chenghui Li ◽  
Ruchira Mahashabde ◽  
Amarnath R. Annapureddy ◽  
...  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
American Heart Association ◽  
American Heart ◽  
Conflicts Of Interest ◽  
Heart Association ◽  
The United States ◽  
Regional Trends ◽  
Impact Patient Care ◽  
And Behavior

Background and Purpose— Industry payments to physicians raise concerns regarding conflicts of interest that could impact patient care. We explored nonresearch and nonownership payments from industry to vascular neurologists to identify trends in compensation. Methods— Using Centers for Medicare and Medicaid Services and American Board of Psychiatry and Neurology data, we explored financial relationships between industry and US vascular neurologists from 2013 to 2018. We analyzed payment characteristics, including payment categories, payment distribution among physicians, regional trends, and biomedical manufacturers. Furthermore, we analyzed the top 1% (by compensation) of vascular neurologists with detailed payment categories, their position, and their contribution to stroke guidelines. Results— The number of board certified vascular neurologist increased from 1169 in 2013 to 1746 in 2018. The total payments to vascular neurologist increased from $99 749 in 2013 to $1 032 302 in 2018. During the study period, 16% to 17% of vascular neurologists received industry payments. Total payments from industry and mean physician payments increased yearly over this period, with consulting fee (31.1%) and compensation for services other than consulting (30.7%) being the highest paid categories. The top 10 manufacturers made the majority of the payments, and the top 10 products changed from drug or biological products to devices. Physicians from south region of the United States received the highest total payment (38.72%), which steadily increased. Payments to top 1% vascular neurologists increased from 64% to 79% over the period as payments became less evenly distributed. Among the top 1%, 42% specialized in neuro intervention, 11% contributed to American Heart Association/American Stroke Association guidelines, and around 75% were key leaders in the field. Conclusions— A small proportion of US vascular neurologists consistently received the majority of industry payments, the value of which grew over the study period. Only 11% of the top 1% receiving industry payments have authored American Heart Association/American Stroke Association guidelines, but ≈75% seem to be key leaders in the field. Whether this influences clinical practice and behavior requires further investigation.

Identifying Properties for an Aortic Stent-Graft That Counteracts Hypertension

2018 ◽  
Author(s):  
Shannen B. Kizilski ◽  
Omid Amili ◽  
Filippo Coletti ◽  
Rumi Faizer ◽  
Victor H. Barocas
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Stent Graft ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Aortic Stent Graft

In 2017, the American Heart Association reported that one third of deaths in the United States, and 31% of deaths worldwide, are attributed to cardiovascular disease (CVD) [1]. A risk factor pervasive across most types of CVD is chronic high blood pressure, or hypertension [2].

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