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Short M, Dobson J, Day G, Lefferts B, Singleton R, Keck J. "You can feel the fresh air … " Rural Alaska Native household perceptions of home air purifiers and health. Int J Circumpolar Health 2024; 83:2335702. [PMID: 38546171 PMCID: PMC10984226 DOI: 10.1080/22423982.2024.2335702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
Alaska Native and American Indian children experience frequent respiratory illness. Indoor air quality is associated with the severity and frequency of respiratory infections in children. High efficiency particulate air (HEPA) purifiers effectively improve indoor air quality and may protect respiratory health. In 2019, the Yukon-Kuskokwim Health Corporation implemented a pilot programme that provided education and HEPA purifiers to households of children with chronic lung conditions. The team evaluated HEPA purifier acceptability and use by interviewing representatives from 11 households that participated in the pilot programme. All interviewees reported improvement in their child's health, and some believed that the health of other household members was also improved because of the HEPA purifier. Interviewees reported that the HEPA purifiers were easy to use, quiet, and not expensive to run. Five of 11 households were still using the HEPA purifier at the time of the interview, which was about three years after receipt of the unit. The most common reasons for discontinuing use were equipment failure and lack of replacement filter, suggesting that programme support could increase sustainability. Our evaluation suggests that HEPA purifiers are acceptable and feasible for use in rural Alaska Native households.
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Affiliation(s)
- Madilyn Short
- WWAMI School of Medical Education, University of Alaska Anchorage, Anchorage, AK, USA
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Jennifer Dobson
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
- Office of Environmental Health and Engineering, Yukon-Kuskokwim Health Corporation, Bethel, AK, USA
| | - Gretchen Day
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Brian Lefferts
- Office of Environmental Health and Engineering, Yukon-Kuskokwim Health Corporation, Bethel, AK, USA
| | - Rosalyn Singleton
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - James Keck
- WWAMI School of Medical Education, University of Alaska Anchorage, Anchorage, AK, USA
- Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Vermunt L, Sutphen C, Dicks E, de Leeuw DM, Allegri R, Berman SB, Cash DM, Chhatwal JP, Cruchaga C, Day G, Ewers M, Farlow M, Fox NC, Ghetti B, Graff-Radford N, Hassenstab J, Jucker M, Karch CM, Kuhle J, Laske C, Levin J, Masters CL, McDade E, Mori H, Morris JC, Perrin RJ, Preische O, Schofield PR, Suárez-Calvet M, Xiong C, Scheltens P, Teunissen CE, Visser PJ, Bateman RJ, Benzinger TLS, Fagan AM, Gordon BA, Tijms BM. Axonal damage and astrocytosis are biological correlates of grey matter network integrity loss: a cohort study in autosomal dominant Alzheimer disease. medRxiv 2023:2023.03.21.23287468. [PMID: 37016671 PMCID: PMC10071836 DOI: 10.1101/2023.03.21.23287468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Brain development and maturation leads to grey matter networks that can be measured using magnetic resonance imaging. Network integrity is an indicator of information processing capacity which declines in neurodegenerative disorders such as Alzheimer disease (AD). The biological mechanisms causing this loss of network integrity remain unknown. Cerebrospinal fluid (CSF) protein biomarkers are available for studying diverse pathological mechanisms in humans and can provide insight into decline. We investigated the relationships between 10 CSF proteins and network integrity in mutation carriers (N=219) and noncarriers (N=136) of the Dominantly Inherited Alzheimer Network Observational study. Abnormalities in Aβ, Tau, synaptic (SNAP-25, neurogranin) and neuronal calcium-sensor protein (VILIP-1) preceded grey matter network disruptions by several years, while inflammation related (YKL-40) and axonal injury (NfL) abnormalities co-occurred and correlated with network integrity. This suggests that axonal loss and inflammation play a role in structural grey matter network changes. Key points Abnormal levels of fluid markers for neuronal damage and inflammatory processes in CSF are associated with grey matter network disruptions.The strongest association was with NfL, suggesting that axonal loss may contribute to disrupted network organization as observed in AD.Tracking biomarker trajectories over the disease course, changes in CSF biomarkers generally precede changes in brain networks by several years.
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Patten CA, Hiratsuka VY, Nash SH, Day G, Redwood DG, Beans JA, Howard BV, Umans JG, Koller KR. Smoking Patterns Among Urban Alaska Native and American Indian Adults: The Alaska EARTH 10-Year Follow-up Study. Nicotine Tob Res 2022; 24:840-846. [PMID: 34850172 PMCID: PMC9048910 DOI: 10.1093/ntr/ntab245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Data on cigarette smoking prevalence among Alaska Native and American Indian (ANAI) people are limited to cross-sectional studies or specific subpopulations. Using data from the Alaska Education and Research toward Health (EARTH) Study 10-year follow-up, this study assessed patterns of smoking from baseline and factors associated with current use. AIMS AND METHODS EARTH Study urban south central ANAI participants (N = 376; 73% women) provided questionnaire data on smoking at baseline and 10-year follow-up. Multivariable-adjusted logistic regression assessed whether gender, cultural factors (Tribal identity, language spoken in the home), depressive symptoms (PHQ-9), baseline smoking status, and baseline cigarettes per day (CPD) were associated with current smoking at follow-up. RESULTS Current smoking was 27% and 23% at baseline and follow-up, respectively. Of baseline smokers, 60% reported smoking at follow-up (77% men, 52% women). From multivariable-adjusted analyses, the odds of current smoking at follow-up were lower among women than men, those who never or formerly smoked versus currently smoked at baseline, and smoking <10 CPD compared with ≥10 CPD at baseline. PHQ-9 score or cultural variables were not associated with smoking at follow-up. Smoking fewer baseline CPD was associated with former smoking status (ie, quitting) at follow-up among women, but not men. CONCLUSIONS Our project is among the first to longitudinally explore smoking within an ANAI cohort. While we observed persistent smoking during a 10-year period, there were important differences by gender and CPD in quitting. These differences may be important to enhance the reach and efficacy of cessation interventions for ANAI people. IMPLICATIONS This study contributes novel longitudinal information on cigarette smoking prevalence during a 10-year period among Alaska Native and American Indian (ANAI) people. Prior data on smoking prevalence among ANAI people are limited to cross-sectional studies or specific subpopulations. Our project is among the first to longitudinally explore smoking prevalence within an ANAI cohort. We observed persistent smoking during a 10-year period. The study also contributes information on differences by gender and cigarettes smoked per day in quitting. These findings have implications for enhancing the reach and efficacy of cessation interventions for ANAI people.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Vanessa Y Hiratsuka
- Center for Human Development, University of Alaska Anchorage, Anchorage, AK, USA
- Research Department, Southcentral Foundation, Anchorage, AK, USA
| | - Sarah H Nash
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Gretchen Day
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Diana G Redwood
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Julie A Beans
- Research Department, Southcentral Foundation, Anchorage, AK, USA
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Hadley ME, Day G, Beans JA, Groen RS. Postpartum hemorrhage: Moving from response to prevention for Alaska Native mothers. Int J Gynaecol Obstet 2021; 155:290-295. [PMID: 34403505 PMCID: PMC9438451 DOI: 10.1002/ijgo.13883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/29/2021] [Accepted: 08/16/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To identify risk factors for postpartum hemorrhage in a population of Alaska Native women. METHODS A case-control study of 384 women (128 cases, 256 controls) delivering between August 1, 2018, and July 31, 2019, was conducted at a Level III maternal referral center for Alaska Native women in Alaska. Risk factors were assessed via retrospective chart review, and bivariate and conditional regression analyses were conducted to determine odds ratios (ORs) between women with and without postpartum hemorrhage. RESULTS Body mass index ≥40 (OR 2.6, 95% confidence interval [CI] 1.4-4.5), antepartum bleeding (OR 6.3, 95% CI 1.2-31.6), previous postpartum hemorrhage (OR 5, 95% CI 2.6-9.8), suspected macrosomia (OR 2.7, 95% CI 1.4-5.3), macrosomia with birthweight ≥4000 g (OR 3.1, 95% CI 1.8-5.3), pre-eclampsia with magnesium sulfate (OR 4.0, 95% CI 2.0-8.0), length of third stage of labor >20 min (OR 2.2, 95% CI 1.1-4.4), oxytocin use >12 h (OR 5.4, 95% CI 2.0-14.6), residence in a rural community (OR 2.2, 95% CI 1.4-3.6), and vitamin D supplementation (OR 1.7, 95% CI 1.1-2.6) were associated with greater risk of postpartum hemorrhage. CONCLUSION Analysis of clinical and geographic risk factors for postpartum hemorrhage in Alaska Native women identified important targets for prevention.
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Affiliation(s)
- Megan E Hadley
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Obstetrics and Gynecology, Southcentral Foundation, Anchorage, Alaska, USA
| | - Gretchen Day
- Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA
| | - Julie A Beans
- Department of Research, Southcentral Foundation, Anchorage, Alaska, USA
| | - Reinou S Groen
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Obstetrics and Gynecology, Southcentral Foundation, Anchorage, Alaska, USA
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Nash SH, Day G, Hiratsuka VY, Beans J, Redwood D, Holck P, Howard BV, Umans J, Koller KR. Ten-year weight gain is not associated with multiple cardiometabolic measures in Alaska EARTH study participants. Nutr Metab Cardiovasc Dis 2021; 31:403-410. [PMID: 33127251 PMCID: PMC7887000 DOI: 10.1016/j.numecd.2020.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/01/2020] [Accepted: 09/17/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Alaska Native (AN) traditional lifestyle may be protective against chronic disease risk. Weight gain in adulthood has been linked to increases in chronic disease risk among other populations; yet, its impact among Alaska Native people has never been evaluated. We aimed to evaluate changes in obesity-related metrics over time, and determine associations of changes with cardiometabolic markers of chronic disease risk among AN people. METHODS AND RESULTS Study participants enrolled in the southcentral Alaska Education and Research Towards Health Study in 2004-2006 were invited to participate in a follow-up study conducted 2015-2017. Of the original 1320 participants, 388 completed follow-up health assessments consisting of multiple health surveys, anthropometric measurements, and cardiometabolic measures including blood sugars, blood lipids, and blood pressure. Differences in measurements between visits were determined and associations of weight change with cardiometabolic measures evaluated. Body mass index increased by 3.7 kg/m2 among men and 4.8 kg/m2 among women. Hip circumference (1.1 cm, p < 0.01) and waist circumference (0.7 cm, p < 0.01) increased among women; only waist circumference increased among men (1.6 cm, p < 0.01). Among men, there were no associations of weight change with cardiometabolic measures. Among women, there was an inverse association between weight gain and high-density lipoprotein cholesterol only (0.17 mg/dL (CI: -3.1, -0.03), p = 0.02). CONCLUSIONS While weight increase over a 10-year period was not associated with substantive changes in cardiometabolic measures among AN men, there was a decrease in high density lipid cholesterol associated with weight gain among AN women.
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Affiliation(s)
- Sarah H Nash
- Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
| | - Gretchen Day
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Julie Beans
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Diana Redwood
- Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Peter Holck
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Barbara V Howard
- Medstar Health Research Institute, Hyattsville, MD, USA; Georgetown/Howard Universities Center for Clinical and Translational Research, Washington, DC, USA
| | - Jason Umans
- Medstar Health Research Institute, Hyattsville, MD, USA; Georgetown/Howard Universities Center for Clinical and Translational Research, Washington, DC, USA
| | - Kathryn R Koller
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Nash SH, Day G, Hiratsuka VY, Zimpelman GL, Koller KR. Response to the letter. Int J Circumpolar Health 2020; 79:1763718. [PMID: 32449642 PMCID: PMC7755401 DOI: 10.1080/22423982.2020.1763718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sarah H. Nash
- Alaska Native Tumor Registry, Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Gretchen Day
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Garrett L. Zimpelman
- Alaska Native Tumor Registry, Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Kathryn R. Koller
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Sibanda D, Singleton R, Clark J, Desnoyers C, Hodges E, Day G, Redding G. Adult outcomes of childhood bronchiectasis. Int J Circumpolar Health 2020; 79:1731059. [PMID: 32090714 PMCID: PMC7048197 DOI: 10.1080/22423982.2020.1731059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 11/23/2022] Open
Abstract
Recent literature has highlighted the importance of transition from paediatric to adult care for children with chronic conditions. Non-cystic fibrosis bronchiectasis is an important cause of respiratory morbidity in low-income countries and in indigenous children from affluent countries; however, there is little information about adult outcomes of childhood bronchiectasis. We reviewed the clinical course of 31 Alaska Native adults 20-40 years of age from Alaska's Yukon Kuskokwim Delta with childhood bronchiectasis. In patients with chronic suppurative lung disease, a diagnosis of bronchiectasis was made at a median age of 4.5 years by computerised tomography (68%), bronchogram (26%), and radiographs (6%). The patients had a median of 75 lifetime respiratory ambulatory visits and 4.5 hospitalisations. As children, 6 (19%) experienced developmental delay; as adults 9 (29%) experienced mental illness or handicap. Four (13%) patients were deceased, four (13%) had severe pulmonary impairment in adulthood, 17 (54%) had persistent or intermittent respiratory symptoms, and seven (23%) were asymptomatic. In adulthood, only five were seen by adult pulmonologists and most had no documentation of a bronchiectasis diagnosis. Lack of provider continuity, remote location and co-morbidities can contribute to increased adult morbidity. Improving the transition to adult care starting in adolescence and educating adult providers may improve care of adults with childhood bronchiectasis.
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Affiliation(s)
- Dawn Sibanda
- Research Department, Yukon Kuskokwim Health Corporation, Bethel, AK, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Rosalyn Singleton
- Research Department, Yukon Kuskokwim Health Corporation, Bethel, AK, USA
| | - John Clark
- Clinical & Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Ellen Hodges
- Research Department, Yukon Kuskokwim Health Corporation, Bethel, AK, USA
| | - Gretchen Day
- Clinical & Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Gregory Redding
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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Nash SH, Day G, Hiratsuka VY, Zimpelman GL, Koller KR. Agreement between self-reported and central cancer registry-recorded prevalence of cancer in the Alaska EARTH study. Int J Circumpolar Health 2019; 78:1571383. [PMID: 30724720 PMCID: PMC6366410 DOI: 10.1080/22423982.2019.1571383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/14/2018] [Accepted: 01/10/2019] [Indexed: 10/27/2022] Open
Abstract
Reliance on self-reported health status information as a measure of population health can be challenging due to errors associated with participant recall. We sought to determine agreement between self-reported and registry-recorded site-specific cancer diagnoses in a cohort of Alaska Native people. We linked cancer history information from the Alaska Education and Research Towards Health (EARTH) cohort and the Alaska Native Tumor Registry (ANTR), and calculated validity measures (sensitivity, specificity, positive predictive value, negative predictive value, kappa). Multiple logistic regression models were used to assess independent associations of demographic variables with incorrect reporting. We found that among Alaska EARTH participants, 140 self-reported a history of cancer, and 99 matched the ANTR. Sensitivity ranged from 79% (colorectal cancer) to 100% (prostate cancer); specificity was over 98% for all-sites examined. Kappa was higher among prostate and female breast cancers (κ=0.86) than colorectal cancers (κ=0.63). Women (odds ratio [OR] (95% confidence interval [CI]): 2.8 (1.49-5.31)) and participants who were older than 50 years (OR (95% CI): 2.8 (1.53-4.12)) were more likely to report incorrectly. These data showed good agreement between self-reported and registry-recorded cancer history. This may be attributed to the high quality of care within the Alaska Tribal Health System, which strongly values patient-provider relationships and the provision of culturally appropriate care.
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Affiliation(s)
- Sarah H. Nash
- Alaska Native Tumor Registry, Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Gretchen Day
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Garrett L. Zimpelman
- Alaska Native Tumor Registry, Alaska Native Epidemiology Center, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Kathryn R. Koller
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Nash SH, Day G, Zimpelman G, Hiratsuka VY, Koller KR. Cancer incidence and associations with known risk and protective factors: the Alaska EARTH study. Cancer Causes Control 2019; 30:1067-1074. [PMID: 31428891 DOI: 10.1007/s10552-019-01216-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Cancer is the leading cause of mortality among Alaska Native (AN) people. The Alaska Education and Research Towards Health (EARTH) cohort was established to examine risk and protective factors for chronic diseases, including cancer, among AN people. Here, we describe the cancer experience of the Alaska EARTH cohort in relation to statewide- and region-specific tumor registry data, and assess associations with key cancer risk factors. METHODS AN participants were recruited into the Alaska EARTH cohort during 2004-2006. Data collected included patient demographic, anthropometric, medical and family history, and lifestyle information. This study linked the Alaska EARTH data with cancer diagnoses recorded by the Alaska Native Tumor Registry (ANTR) through 12/31/15. We compared EARTH incidence to ANTR statewide incidence. We examined independent associations of smoking status, diet, BMI, and physical activity with incident all-site cancers using multivariable-adjusted Cox proportional hazards models. RESULTS Between study enrollment and 2015, 171 of 3,712 (4.7%) Alaska EARTH study participants were diagnosed with cancer. The leading cancers among Alaska EARTH participants were female breast, lung, and colorectal cancer, which reflected those observed among AN people statewide. Incidence (95% CI) of cancer (all sites) among Alaska EARTH participants was 629.7 (510.9-748.6) per 100,000 person-years; this was comparable to statewide rates [680.5 (660.0-701.5) per 100,000 population]. We observed lower risk of all-sites cancer incidence among never smokers. CONCLUSIONS Cancer incidence in the Alaska EARTH cohort was similar to incidence observed statewide. Risk and protective factors for leading cancers among AN people mirror those observed among other populations.
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Affiliation(s)
- Sarah H Nash
- Alaska Native Epidemiology Center, Alaska Native Tumor Registry, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
| | - Gretchen Day
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Garrett Zimpelman
- Alaska Native Epidemiology Center, Alaska Native Tumor Registry, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Kathryn R Koller
- Clinical and Research Services, Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Singleton R, Day G, Thomas T, Schroth R, Klejka J, Lenaker D, Berner J. Association of Maternal Vitamin D Deficiency with Early Childhood Caries. J Dent Res 2019; 98:549-555. [PMID: 30870599 DOI: 10.1177/0022034519834518] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Alaska Native (AN) children experience one of the highest reported rates of severe early childhood caries (S-ECC). Serum vitamin D concentrations in AN childbearing women in the Yukon Kuskokwim Delta (YKD) region have decreased since the 1960s to currently low levels, related to a decrease in traditional marine diet. Recent studies suggest an association between prenatal vitamin D (25(OH)D) concentrations in mothers and S-ECC in their infants. We used independent t tests to analyze the influence of prenatal 25(OH)D levels in YKD AN mothers on S-ECC in their children using data collected in the Maternal Organics Monitoring Study (MOMS). Maternal 25(OH)D levels were assessed at prenatal visits and in cord blood. We queried electronic dental records to assess early childhood caries (ECC) status using highest decayed, missing, filled, primary teeth (dmft) scores at 12 to 59 mo of age. We examined prenatal and cord blood for 76 and 57 mother/infant pairs, respectively. Children 12 to 35 mo of age with "deficient" cord blood (25(OH)D <30 nmol/L) had a mean dmft score twice as high as children who were "nondeficient" at birth (9.3 vs. 4.7; P = 0.002). There was no significant difference in mean dmft scores for children aged 36 to 59 mo with deficient versus nondeficient cord blood 25(OH)D (10.9 vs. 8.7 P = 0.14). There was no significant difference in mean dmft scores for children aged 12 to 35 mo whose mothers had "sufficient" versus "insufficient" 25(OH)D during prenatal visits (9.0 vs. 7.4; P = 0.48). In this small sample, children with deficient vitamin D levels in cord blood had a dmft score at 12 to 35 mo 2-fold higher than children with nondeficient cord blood. Maternal 25(OH)D may influence the primary dentition, and improving vitamin D status in pregnant women might affect ECC rates in their infants.
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Affiliation(s)
- R Singleton
- 1 Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - G Day
- 1 Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - T Thomas
- 1 Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - R Schroth
- 2 University of Manitoba, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, Winnipeg, Canada
| | - J Klejka
- 3 Yukon Kuskokwim Health Corporation, Bethel, AK, USA
| | - D Lenaker
- 4 Southeast Alaska Regional Health Consortium, Sitka, AK, USA
| | - J Berner
- 1 Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Day G, Holck P, Strayer H, Koller K, Thomas T. Disproportionately higher unintentional injury mortality among Alaska Native people, 2006-2015. Int J Circumpolar Health 2018; 77:1422671. [PMID: 29347890 PMCID: PMC5774398 DOI: 10.1080/22423982.2017.1422671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022] Open
Abstract
We compared rates of unintentional injury (UI) deaths (total and by injury category) among Alaska Native (AN) people to rates of U.S. White (USW) and Alaska White (AKW) populations during 2006-2015. The mortality data for AN and AKW populations were obtained from Alaska Bureau of Vital Statistics and USW mortality data were obtained from WISQARS, the Center for Disease Control and Prevention online injury data program. AN and AKW rates were age-adjusted to the U.S. 2000 Standard Population and rate ratios (RR) were calculated. AN people had higher age-adjusted total UI mortality than the USW (RR = 2.6) and AKW (RR = 2.3) populations. Poisoning was the leading cause of UI death among AN people (35.9 per 100,000), more than twice that of USW (RR = 2.9) and AKW (RR = 2.5). Even greater disparities were found between AN people and USW for: natural environment (RR = 20.7), transport-other land (RR = 12.4), and drowning/submersion (RR = 9.1). Rates of AN UI were markedly higher than rates for either USW or AKW. Identifying all the ways in which alcohol/drugs contribute to UI deaths would aid in prevention efforts. All transportation deaths should be integrated into one fatality rate to provide more consistent comparisons between groups.
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Affiliation(s)
- Gretchen Day
- Clinical & Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Peter Holck
- Clinical & Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Hillary Strayer
- Wellness & Prevention, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Kathryn Koller
- Clinical & Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Timothy Thomas
- Clinical & Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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O'Keefe S, Wilson A, Koller K, Flanagan C, Sapp F, Day G, Holck P, Methe B, Morris A, Li J, Kinross J, Thomas T. Abstract IA06: Changes in the composition and activity of the colonic microbiome that may explain the extreme risk of colon cancer in Alaskan Native People. Cancer Epidemiol Biomarkers Prev 2018. [DOI: 10.1158/1538-7755.disp17-ia06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Alaska Native People (AN) suffer the highest recorded incidence of CRC globally (100:100,000) and thus have the greatest risk of dying from this disease. Diet drives genetic susceptibility risk factors, and there is convincing evidence that high consumption rates of red and processed meats and fat increase risk, while a diet rich in fiber suppresses risk. We have shown that the high risk of colon cancer in African Americans (~65:100,000) is suppressed by increasing the consumption of high-fiber foods, in part driven by the health-promoting and antineoplastic influence of colonic microbiome cometabolites (e.g., short chain fatty acids [SCFA] and butyrate) and the suppression of inflammatory and procarcinogenic cometabolites (e.g., conjugated bile acids, nitrogenous end products). This study aimed to determine if dietary-microbiome metabolism explains the extreme risk of colon cancer in AN. 20 adults living in Anchorage and 9 in Barrow (age range 40-65 years) were prospectively recruited and dietary data were recorded. This cohort was compared to 25 native Africans who consume a high-fiber diet (>50g/day) and have an extremely low risk of colon cancer (<5:100,000). Meta-taxonomic analysis of stool was performed by 16s rRNA sequencing and by 1H NMR (nuclear magnetic spectroscopy) for analysis of the metabolome. Results confirmed the AN diet was rich in protein and fat, but low in fiber-rich foods. Measurements of the microbiome composition showed clear separation between AN and Africans on PCA and MDS plots (p=0.0001). The microbiotas were dominated at the genus level by Blautia, Bacteroides, and Lachnospiraceae, which characterize Western populations (enterotype I) while the Africans overexpressed Prevotella, Ruminococcus, and Succinovibria, organisms that play a key role in fiber breakdown and butyrogenesis (enterotype II). The fecal metabolome showed clear separation on OPLS-DA cross-validated scores plot (p=4x10-11) driven in part by higher levels of SCFA and butyrate in Africans. Subgroup analysis showed that these differences were exaggerated in the Barrow cohort. In conclusion, these findings are consistent with our hypothesis that the extreme risk of colon cancer in AN is related to insufficient intake of fiber-rich foods and that fiber supplementation of their current diet may reduce the development of cancer.
Citation Format: Stephen O'Keefe, Annette Wilson, Kathryn Koller, Christie Flanagan, Flora Sapp, Gretchen Day, Peter Holck, Barbara Methe, Alison Morris, Jia Li, James Kinross, Timothy Thomas. Changes in the composition and activity of the colonic microbiome that may explain the extreme risk of colon cancer in Alaskan Native People [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr IA06.
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Affiliation(s)
- Stephen O'Keefe
- 1Division of Gastroenterology, University of Pittsburgh, Pittsburgh, PA,
| | - Annette Wilson
- 1Division of Gastroenterology, University of Pittsburgh, Pittsburgh, PA,
| | | | | | - Flora Sapp
- 2Alaska Native Tribal Health Consortium, Anchorage, AK,
| | - Gretchen Day
- 2Alaska Native Tribal Health Consortium, Anchorage, AK,
| | - Peter Holck
- 2Alaska Native Tribal Health Consortium, Anchorage, AK,
| | - Barbara Methe
- 3Microbiome Center, University of Pittsburgh, Pittsburgh, PA,
| | - Alison Morris
- 3Microbiome Center, University of Pittsburgh, Pittsburgh, PA,
| | - Jia Li
- 4Cancer Research, Imperial College, London, United Kingdom
| | - James Kinross
- 4Cancer Research, Imperial College, London, United Kingdom
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Flanagan CA, Koller KR, Wolfe AW, Thomas TK, Benowitz NL, Renner CC, Hughes C, Hatsukami DK, Bronars C, Murphy NJ, Day G, Decker PA, Patten CA. Fetal Exposure to Carcinogens With Tobacco Use in Pregnancy: Phase 1 MAW Study Findings. Nicotine Tob Res 2016; 18:2162-2168. [PMID: 27190400 DOI: 10.1093/ntr/ntw134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 05/02/2016] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The high prevalence of smoking and smokeless tobacco (ST) use during pregnancy in Alaska Native (AN) women is concerning due to the detrimental effects of these products to the mother and the developing fetus. We sought to correlate maternal cotinine levels with fetal exposure to a tobacco-specific carcinogen to incorporate in a biomarker feedback intervention to motivate tobacco cessation during pregnancy. METHODS Demographic and tobacco use data were collected from a convenience sample of pregnant AN smokers, ST users, and non-users. Maternal and neonatal urine were collected at delivery. Maternal urine cotinine and neonatal urine total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a tobacco-specific carcinogen) levels in smokers and ST users were analyzed and their correlations determined by Spearman correlation coefficients. RESULTS During 2012-2014, we enrolled 64 non-users, 54 smokers, and 30 ST (20 homemade iqmik; 10 commercial ST) users (n = 148). Analyses of paired maternal-infant urine samples obtained for 36 smokers demonstrated a moderate to strong correlation (r = 0.73, P < .001) between maternal cotinine and infant NNAL levels. The correlation was not significant for 25 iqmik users (r = 0.36, P = .17) or 9 commercial ST users (r = 0.60, P = .09). No analysis was conducted for 55 non-users with cotinine and NNAL levels < limits of quantification. CONCLUSIONS There is a moderate to strong correlation between maternal smoking and fetal exposure to the tobacco-specific carcinogen NNAL. IMPLICATIONS The correlation between maternal smoking and fetal carcinogen exposure may provide an education tool to help motivate smoking cessation among pregnant AN women. Further investigation is warranted to determine correlations between maternal commercial ST and iqmik use and neonatal NNAL.
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Affiliation(s)
- Christie A Flanagan
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK;
| | - Kathryn R Koller
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK
| | - Abbie W Wolfe
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK
| | - Timothy K Thomas
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK
| | - Neal L Benowitz
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA.,Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, Departments of Medicine, and Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA
| | - Caroline C Renner
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK
| | - Christine Hughes
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Carrie Bronars
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Neil J Murphy
- Southcentral Foundation, Department of Obstetrics and Gynecology, Alaska Native Medical Center, Anchorage, AK
| | - Gretchen Day
- Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK
| | - Paul A Decker
- Divison of Biomedical Statistics and Informatics, Mayo Clinic, Rochester MN
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Provost E, Craig JA, Strayer HD, Asay E, Day G, Holck P. Unintentional Injury Mortality among Alaska Native People. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rowland JC, Dietrich WE, Day G, Parker G. Formation and maintenance of single‐thread tie channels entering floodplain lakes: Observations from three diverse river systems. ACTA ACUST UNITED AC 2009. [DOI: 10.1029/2008jf001073] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Dehn M, Day G. Managementansätze in einer zunehmend komplexeren Gesundheitsumgebung im australischen Krankenhaussektor. Gesundheitswesen 2006. [DOI: 10.1055/s-2006-948583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Day G. Water pricing in England and Wales--institutions and objectives. Water Sci Technol 2003; 47:33-41. [PMID: 12731769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Water pricing in England and Wales reflects a range of influences. Cost recovery is generallythe primary influence over prices. The privatised public water supply sector dominates water usage. Water abstractions are licensed and allocated mainly on an administrative basis. Charges are levied to recover the water management costs of the licensing authority (the Environment Agency), and are not closely related to the scarcity of water resources, or the environmental impact of abstractions. Public water supplies are subject to price cap regulation. This provides incentives to reduce costs. Public water suppliers are expected to choose an optimal combination of water resource interventions in planning water supplies. The system of regulation has exposed choices. Tariffs for customers reflect company and regulatory concerns to share the burden of cost recovery equitably. Tariff innovation to influence behaviour has been limited by the low extent of metering of household customers. The cost recovery and institutional framework has led to discipline in investment decision-making.
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Affiliation(s)
- G Day
- Office of Water Services, Centre City Tower, 7 Hill Street, Birmingham, B5 4UA, United Kingdom.
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Sarna RJ, Simon GP, Day G, Kim HJ, Jackson WR. Effects of Annealing Siloxane Side-Chain Liquid Crystalline Polymers in the Biphasic Region. Macromolecules 2002. [DOI: 10.1021/ma00084a050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Day G. Polymerat—Life after Two Years. Aust J Chem 2002. [DOI: 10.1071/ch02055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Day G, Glaser R, Shimomura N, Takamuku A, Ichikawa K. Electronic excitations in homopolyatomic bismuth cations: spectroscopic measurements in molten salts and an ab initio CI-singles study. Chemistry 2000; 6:1078-86. [PMID: 10785828 DOI: 10.1002/(sici)1521-3765(20000317)6:6<1078::aid-chem1078>3.0.co;2-r] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The electronic excitations of the low-valence bismuth cluster cations Bi5(3+), Bi8(2+), and Bi9(5+) have been studied with experimental and theoretical techniques. The UV-visible spectra of the bismuth ions were measured in acidic chloroaluminate melts (mixture of 1-methyl-3-benzyl imidazolium chloride and AlCl3). The spectra of the Bi5(3+) and Bi8(2+) ions agree fairly well with previous reports, but also revealed additional low-energy absorptions. Ab initio methods were employed to assign the experimentally observed electronic transitions of these homopolyatomic bismuth cations. Structures were optimized at the RHF, MP2, and B3LYP levels of theory by using split-valence LANL2DZ basis sets that were augmented with one and two sets of pure d functions. The computed structures agree well with the results of neutron diffraction analyses of melts. Electronically excited states of the three clusters were treated by using the CI-Singles theory. The results of these calculations were used to explain the observed UV-visible spectra. The observed electronic excitations in the UV-visible range are all found to result from transitions involving the molecular orbitals formed by 6p-atomic-orbital overlap. This leads to the necessity of using basis sets that include d-type functions, which allow for an adequate description of the bonding that results from such p-orbital overlap. Spin-orbit coupling becomes increasingly important with increasing atomic number and its consideration is necessary when describing the electronic transitions in clusters of heavy atoms. The calculations show that singlet-triplet transitions, which are made accessible by strong spin-orbit coupling, are responsible for some of the observed absorptions.
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Affiliation(s)
- G Day
- Department of Chemistry, University of Missouri-Columbia 65211, USA
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Mosher C, Rademacher K, Day G, Fanelli D. Documenting for patient-focused care. Nurs Econ 1996; 14:218-23. [PMID: 8826309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Hospitals across the country are rethinking the way health care is delivered. With a shift from inpatient to outpatient care, there is an effort to deliver quality, "patient-focused care" in the hospital setting. Multidisciplines have embarked in cross-training to provide immediate services at the bedside. The premise of "nursing" documentation is no longer feasible in multicaregiver environments. One hospital's adaptation to documentation methods to meet the needs of a patient-focused system is described.
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Abstract
Like many other healthcare organizations today, the authors' facility, a 306-bed acute care community hospital in Michigan, strives to visualize and make a transition from traditional quality assurance to continuous quality improvement. The Juran Trilogy provided the insight that strategic planning, measurement, and continuous improvement must exist side by side. At the authors' facility, this realization resulted in the hospital quality plan, which treats each of these components as part of the foundation for quality. The authors explain this model and the reporting and communication mechanisms that support it.
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Affiliation(s)
- G Day
- Bon Secours Hospital, Grosse Pointe, MI, USA
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Abstract
Accurate data about medication errors are essential to prevention efforts. A multidisciplinary team at Bon Secours Hospital trialed an innovative method of reporting medication errors. It increased the number of reported medication errors six times compared with the same time period for the previous year on the pilot unit. It also saved time for the person reporting the error. The continuous quality improvement methodology was used to implement the new process.
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Affiliation(s)
- G Day
- Department of Nursing Administration, Bon Secours Hospital, Grosse Pointe, MI
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Beauregard K, Day G, Kramer JA, O'Donnell M, Sowards B. Detroit area coordinators conduct study of most important aspects (functions) of nursing care. Nurs Qual Connect 1994; 4:10. [PMID: 7767268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Day G, Powell ME. A unit-based approach to outcome centered nursing quality assurance in critical care. AACN Clin Issues Crit Care Nurs 1991; 2:44-8. [PMID: 1995017 DOI: 10.4037/15597768-1991-1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This chapter describes a unit-based nursing quality assurance program in critical care. It outlines a unit-based structure, implementation of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) ten steps and joint nurse/physician outcome indicators.
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Affiliation(s)
- G Day
- Bon Secours Hospital, Grosse Pointe, MI
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Day G. Education, sharing, and visibility promote nursing QA. J Nurs Qual Assur 1989; 3:78-9. [PMID: 2913020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Day G. Streamline your repair soldering operations. NADL J 1983; 30:25-6. [PMID: 6136914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Prasad A, Day G, Best D. Brazing nonprecious alloys properly, professionally and perfectly. Dent Lab Rev 1983; 58:21, 24, 40. [PMID: 6130008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
Forty-two spinal injury patients underwent single or sequential urodynamic studies to assess the value of dynamic urethral pressure using transducer tipped catheters. Three groups of patients were identified: those with poor detrusor function, those with unsustained dyssynergia and those with sustained dyssynergia. All patients demonstrated some dyssynergia. Urethral needle EMG mirrored urethral pressure changes accurately. The addition of dynamic profilometry to fluoroscopy, detrusor pressure and urethral EMG has clarified our understanding of lower urinary tract behaviour after cord lesions.
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von Preyss B, Day G. Points: Rectal examination and acid phosphatase. West J Med 1981. [DOI: 10.1136/bmj.283.6292.677-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Day G. Samaritans versus suicide. Br Med J 1979; 2:935. [PMID: 519244 PMCID: PMC1596706 DOI: 10.1136/bmj.2.6195.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
Onset of QRS was compared between simultaneously recorded conventional ECG leads in 84 subjects with clinically normal hearts from a defined population sample. Mean onset of QRS was 6.4 msec earlier in lead V1 and 7.4 msec earlier in V2 than in lead II. These differences were statistically significant. The measuring system was adapted from drafting techniques and took into account variations in paper speed which occurred during recording. Interobserver differences equivalent to greater than 1 msec occurred in 3.9% of timeline measurements, but in in 38% of QRS onset measurements. The lower precision in measuring QRS onset may be attributed to baseline oscillations and to the relatively slow rate of voltage change at the onset of ventricular depolarization.
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Abstract
Bronchial lability was studied in 52 children with cystic fibrosis (CF) and assessed by changes in the peak expiratory flow measured before, during, and after running. The findings are discussed in relation to the severity of pulmonary involvement assessed clinically and radiologically, and with those found in asthmatic children and those with a history of wheezy bronchitis in early childhood. In patients with CF, bronchial lability was found even in those with minimal pulmonary involvement. The lability was due not only to bronchoconstriction but to a dilatation which was greater than occurs in normal and asthmatic children; this dilatation increased with the severity of the disease. Only 14 of 52 children with CF had results within the normal range for all indices; 50% had abnormal bronchodilatation during exercise and 46% had abnormal bronchoconstriction after exercise.
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Abstract
The effect of intravenous tolbutamide on plasma levels of glucose, cortisol, growth hormone, and insulin, and the effect of oral Bovril on plasma growth hormone have been studied in 10 children with coeliac disease and 6 children who, though small, had normal jejunal morphology (`controls'). The growth hormone and insulin responses to tolbutamide in the children with coeliac disease were significantly smaller than in the controls. Growth hormone response to Bovril was normal in most of the children but 3 of them with coeliac disease failed to achieve a satisfactory response in growth hormone levels after both tolbutamide and Bovril. These results cannot be explained by malnutrition or by inadequate hypoglycaemia during tolbutamide stimulation, and a convincing hypothesis to explain them has not been formulated. Clinically, though tests of other conventional stimuli of growth hormone and insulin production require study, the diagnosis of coeliac disease should actively be considered in any child with low levels of insulin and growth hormone. These observations may partly explain the association of coeliac disease and diabetes mellitus.
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Day G. Absence from Work Attributed to Sickness. West J Med 1969. [DOI: 10.1136/bmj.2.5648.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Day G. The power of emotions in inducing and curing physical disease. J Rehabil 1967; 33:15. [PMID: 6038926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Nelson AF, Watson J, Blair W, Paterson W, Day G. A symposium on clinical problems of practice. "The sair back". J Coll Gen Pract 1967; 13 Suppl 1::1-30. [PMID: 4381184 PMCID: PMC2237416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Day G. Periodical Medical Examinations. West J Med 1961. [DOI: 10.1136/bmj.1.5219.132-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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