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Calihan JB, Recto M, Wheeler N, Tomaszewski K, Trent M. Using Reproductive Health as a Strategy to Engage Youth in Preventive Care. J Adolesc Health 2021; 69:523-526. [PMID: 33824072 PMCID: PMC8403621 DOI: 10.1016/j.jadohealth.2021.02.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This research examined differences in receipt of recommended preventive services by contraceptive use in adolescent and young adult (AYA) women. METHODS Data are from a retrospective chart review of 408 AYA women who received sexual health risk reduction counseling in an urban academic AYA clinic. Descriptive, bivariate, and logistic regression analyses were used to examine relationships between contraception use and receipt of care. RESULTS AYA women aged 12-24 years using hormonal contraception were more likely to receive recommended preventive care, including an annual preventive visit and sexually transmitted infection screening, compared with those using condoms or no contraception. Women using medium-acting reversible contraception were more likely to have an annual visit compared with those not using hormonal contraception. CONCLUSIONS AYA women using contraception are more likely to receive recommended preventive health services, suggesting reproductive health visits may be used to promote engagement around preventive care.
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Affiliation(s)
- Jessica B Calihan
- Departments of Internal Medicine and Pediatrics, Johns Hopkins School of Medicine, Bloomberg Center, Baltimore, Maryland.
| | - Michelle Recto
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Noah Wheeler
- Analytics, Reporting, and Insights, APSI, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kathy Tomaszewski
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Maria Trent
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
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Onyewuchi UF, Tomaszewski K, Upadhya KK, Gupta PS, Whaley N, Burke AE, Trent ME. Improving LARC Access for Urban Adolescents and Young Adults in the Pediatric Primary Care Setting. Clin Pediatr (Phila) 2019; 58:24-33. [PMID: 30318927 PMCID: PMC6261697 DOI: 10.1177/0009922818805234] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this quality improvement study was to assess the feasibility, acceptability, and impact of integrating long-acting reversible contraceptive (LARC) delivery services into an academic pediatric primary care practice. Adolescent medicine providers in Baltimore, Maryland, were trained in LARC placement with gynecology providers integrated to offer onsite LARC placement and procedural support. Referrals, appointments, and contraceptive method choice/receipt were tabulated. Of 212 individuals referred for LARC consultations, 104 attended appointments. LARC placement at the initial referral increased from year 1 (N = 1) to year 2 (N = 42; P < .01). Adolescent medicine providers placed more LARCs in year 2 (N = 34) than year 1 (N = 0; P < .01). Patients aged 18 to 24 years were less likely to have a LARC placed than those aged 13 to 17 years (unadjusted odds ratio = 0.47 [0.26-0.86]). In conclusion, provider training and service integration of LARC services within a pediatric practice is feasible, acceptable, and increases LARC access and placement.
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Affiliation(s)
| | | | | | - Priya S. Gupta
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Anne E. Burke
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maria E. Trent
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Arrington-Sanders R, Wheeler NJ, Matson P, Kim JM, Tawe MS, Tomaszewski K, Campbell N, Rogers J, Upadhya KK, Marcell AV. A System-Level Approach to Improve HIV Screening in an Urban Pediatric Primary Care Setting. Pediatrics 2018; 142:peds.2018-0506. [PMID: 30327377 DOI: 10.1542/peds.2018-0506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Less than 50% of youth living with HIV know their status. The Centers for Disease Control and Prevention and the United States Preventive Services Task Force recommend universal HIV screening in adolescence. Pediatric primary care settings are still lacking in testing youth who are at risk for HIV. Our objective was to determine whether implementing rapid HIV screening improved HIV screening rates and result receipt in 13- to 25-year-old pediatric primary patients. METHODS From March 2014 to June 2015, a 4-cycle plan-do-study-act quality improvement model was used. A total of 4433 patients aged 13 to 25 years were eligible for HIV screening on the basis of Centers for Disease Control and Prevention criteria. Logistic regression with random effects was used to estimate the odds of HIV screening and screening with a rapid test compared with each previous cycle. Statistical process control charts using standard interpretation rules assessed the effect of patients receiving rapid HIV screening. RESULTS Baseline HIV screening rate was 29.6%; it increased to 82.7% in cycle 4. The odds of HIV screening increased 31% between cycle 1 and baseline (odds ratio 1.31 [95% confidence interval: 1.01-1.69]) to a 1272% increase between cycle 4 and baseline (odds ratio 12.72 [95% confidence interval: 10.45-15.48]), with most (90.4%) via rapid screening. Rapid screening yielded higher same-day result receipt . Five patients were identified with HIV and immediately linked to on-site care. CONCLUSIONS Rapid HIV screening and system-level modifications significantly increased screening rates and result receipt, revealing this to be an effective method to deliver HIV services to youth.
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Affiliation(s)
- Renata Arrington-Sanders
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Noah J Wheeler
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Pamela Matson
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Julia M Kim
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Marie-Sophie Tawe
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Kathy Tomaszewski
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Nancy Campbell
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Jamie Rogers
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Krishna K Upadhya
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Arik V Marcell
- Division of Pediatrics and Adolescent Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Wheeler NJ, Upadhya KK, Tawe MS, Tomaszewski K, Arrington-Sanders R, Marcell AV. Integrating Pregnancy Prevention Into an HIV Counseling and Testing Program in Pediatric Primary Care. J Adolesc Health 2018; 63:50-56. [PMID: 29655517 DOI: 10.1016/j.jadohealth.2018.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/06/2018] [Accepted: 01/15/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE Certified health educator (CHE)-based HIV counseling and testing typically focus on HIV and sexually transmitted infection (STI) prevention only. A quality improvement initiative examined integrating assessment of reproductive life plans, counseling about pregnancy prevention, and contraception referral into a CHE-based HIV testing program. METHODS Between February 2014 and January 2017, in one urban pediatric primary care clinic serving patients aged 0-25, CHEs assessed sexual history, HIV risk, short-term (i.e., the next 6-12 months) pregnancy desire, and current contraception method and satisfaction among patients aged 13-25 who had ever had vaginal sex, using a standardized questionnaire. Data were analyzed using a de-identified administrative dataset that also tracked referrals to initiate contraception and actual method initiation. RESULTS Of 1,211 patients, most (96%) reported no short-term pregnancy or partner pregnancy desire. Use of less effective or no contraception, as well as method dissatisfaction, was common. A high proportion of female patients referred to new methods opted for more effective methods (62%) and initiated these methods (76%); a high proportion of male patients opted for receipt of condoms (67%). Patients reporting short-term pregnancy desire reported higher rates of previous pregnancy and STIs. CONCLUSIONS Program findings highlight the potential benefit of integrating assessment for and counseling about pregnancy prevention in a CHE-based HIV testing program. This can more effectively address the needs of patients with concomitant risks of STI/HIV and unintended pregnancy, and link patients who do not desire pregnancy to more effective methods.
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Affiliation(s)
- Noah J Wheeler
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Krishna K Upadhya
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Marie-Sophie Tawe
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kathy Tomaszewski
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Renata Arrington-Sanders
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Arik V Marcell
- Department of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
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Koch M, Jensen Hjermstad M, Tomaszewski K, Tomaszewska I, Hornslien K, Harle A, Arraras J, Morag O, Pompili C, Ioannidis G, Georgu M, Navarra C, Chie W, Johnson C, Himpel A, Schulz C, Bohrer T, Janssens A, Kulis D, Bottomley A, Koller M. Gender Aspekte in der Lebensqualität von Lungenkarzinom Patienten. Pneumologie 2018. [DOI: 10.1055/s-0037-1619214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Koch
- Med. Klinik und Poliklinik II, Klinikum der Universität Regensburg
| | - M Jensen Hjermstad
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, European Palliative Care Research Centre,
| | | | - I Tomaszewska
- Department of Medical Education, Uniwersytet Jagiellonski Collegium Medicum Wydzial, Lekarski
| | | | - A Harle
- Oncology, Poole Hospital NHS Foundation Trust
| | - J Arraras
- Oncology Departments, Complejo Hospitalario de Navarra
| | - O Morag
- Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - C Pompili
- Thoracic Surgery, Ospedali Riuniti Di Acona, Italien
| | - G Ioannidis
- Oncology Department, Nicosia General Hospital, Zypern
| | - M Georgu
- Oncology, Lincoln County Hospital
| | - C Navarra
- Psychology, Università Degli Studi Di Roma 'La Sapienza'
| | - W Chie
- Graduate Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - C Johnson
- Surgical Unit, University of Southampton
| | - A Himpel
- Center for Clinical Studies, University Hospital Regensburg,
| | - C Schulz
- Med. Klinik und Poliklinik II, Klinikum der Universität Regensburg,
| | - T Bohrer
- Thoraxchirurgie, Klinikum Bamberg
| | - A Janssens
- Thoracic Oncology, Universitair Ziekenhuis Antwerpen
| | - D Kulis
- European Organisation for Research and Treatment of Cancer, Quality of Life Department
| | - A Bottomley
- Quality of Life Department, Eortc Data Center Brussels
| | - M Koller
- Center for Clinical Studies, University Hospital Regensburg,
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Abstract
OBJECTIVE To evaluate the longitudinal impact of a 9-month text message intervention on participant adherence beyond the intervention to highly effective contraceptive methods among urban adolescent and young adult women enrolled in the DepoText randomized control trial (RCT). STUDY DESIGN Retrospective longitudinal cohort study of long-term follow-up data from the DepoText RCT. Sixty-seven female participants (aged 13-21 years) using depot medroxyprogesterone acetate (DMPA) were recruited from an urban academic adolescent practice in Baltimore, Maryland. The principal outcome measured was a comparison of contraceptive method choice between the control and intervention groups during the 20 months postintervention. RESULTS Intervention participants were 3.65 times more likely to continue using DMPA or a more efficacious method at the 20-month postintervention evaluation (odds ratio 3.65, 95% CI 1.26-10.08; P = .015). CONCLUSION Participation in the DepoText trial was associated with continued use of DMPA or a more effective contraceptive method almost 20 months after the intervention exposure ended.
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Ramsey A, Lanzo E, Huston-Paterson H, Tomaszewski K, Trent M. Increasing Patient Portal Usage: Preliminary Outcomes From the MyChart Genius Project. J Adolesc Health 2018; 62:29-35. [PMID: 29169768 PMCID: PMC5963535 DOI: 10.1016/j.jadohealth.2017.08.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 04/20/2017] [Revised: 08/13/2017] [Accepted: 08/14/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine the feasibility, acceptability, and preliminary effectiveness of dedicating staff ("MyChart Geniuses") to assist adolescents with patient portal sign-up; to examine patient satisfaction with MyChart Genius services; and to determine patient preferences for future communications related to health issues. METHODS Adolescent patients (13-25 years old) in an urban, academic, primary care clinic were approached by MyChart Genius staff to assist with enrolling in MyChart and downloading the MyChart mobile App. Patients were also invited to partake in a brief, online survey assessing their technology use and access, as well as their preferences surrounding communication with their health-care providers. Survey responses were analyzed using SPSS Statistics (SPSS Inc., Chicago, IL). RESULTS Ninety-six patients were approached, 84 (87.5%) of whom enrolled in MyChart. Sixty-four adolescents agreed to answer survey questions. Respondents were primarily African-American patients (87%), with a mean age of 18.7 years. The majority (79%) of participants were either satisfied or very satisfied with the Genius program. The respondents reported high access to and use of basic technology, and a high perceived need for an electronic health record App. Preferences for future communications with health-care providers revealed population subsets, indicating an area to further individualize interventions. CONCLUSIONS This is one of the first studies to examine a strategy to increase patient portal uptake and usage among minority, urban adolescents (a group with demonstrated preferences on communications with health-care providers). The presence of specially trained MyChart Genius staff is a feasible, effective, and patient-satisfactory method of engaging with this group of adolescents.
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Affiliation(s)
- Alexandra Ramsey
- Section on Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Erin Lanzo
- Section on Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Hattie Huston-Paterson
- Section on Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kathy Tomaszewski
- Section on Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Maria Trent
- Section on Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
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Trent M, Thompson C, Tomaszewski K. Text Messaging Support for Urban Adolescents and Young Adults Using Injectable Contraception: Outcomes of the DepoText Pilot Trial. J Adolesc Health 2015; 57:100-6. [PMID: 26002432 PMCID: PMC4478161 DOI: 10.1016/j.jadohealth.2015.03.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/06/2015] [Accepted: 03/07/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the feasibility, acceptability, and preliminary effectiveness of DepoText, a text messaging reminder system designed to improve moderately long-acting reversible contraception appointment attendance among young urban adolescent girls and young adult women using Depo-Provera. METHODS Female patients aged 13-21 years willing to be randomized, using Depo-Provera, and owning a cell phone with text messaging were recruited from an urban academic practice in a community with high rates of unplanned pregnancy for this institutional review board-approved randomized controlled pilot trial. Participants completed a baseline Web-based survey and were followed for three injection cycles. Intervention participants received welcome, appointment, and healthy self-management messages using the Compliance for Life short messaging system platform over each injection cycle. Compliance for Life recorded outgoing and incoming communications, and patients were tracked for clinical behaviors. The log-transformed number of days between scheduled appointment and injection was analyzed using linear regression. RESULTS Recruitment data show 95% eligibility and 91% enrollment rates with maximum enrollment completion in 3 months. Most were African-American and resided in low-income, single-parent, and mother-headed households. Most participants had cell phone plans that included unlimited text messaging and Internet access and completed all three Depo-Provera cycles. Intervention participants returned closer to their scheduled appointments than their control peers for the first visit (Β = -.75; 95% confidence interval, -1.4 to .06; p = .03) but not for the second and third visits. CONCLUSIONS The DepoText intervention is acceptable, feasible, and shows short-term preliminary efficacy for improving clinic attendance for moderately long-acting reversible contraception appointments. Additional research exploring the cost and longitudinal prevention effectiveness is warranted.
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Affiliation(s)
- Maria Trent
- Section on Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Population, Family, and Reproductive Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Carol Thompson
- Department of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland, USA
| | - Kathy Tomaszewski
- Section on Adolescent Medicine, Department of Pediatrics Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
Urban adolescents face economic, social, and behavioral challenges in adhering to long-term contraceptive use. Use of text messaging reminders has the potential to increase adherence to family planning appointments and to educate patients about safe sexual health practices; however, nonresponsiveness to messages is difficult to interpret and may jeopardize programmatic success. We aimed to understand why adolescent girls enrolled in a randomized, controlled pilot trial (DepoText) designed to increase attendance at family planning visits were periodically nonresponsive to text messages through conducting structured interviews with participants whose text reply rates were less than 100 % during the trial period. Qualitative and quantitative data were collected and classified using descriptive data analysis. Reasons for nonresponsiveness, barriers to continuous cell phone coverage, cell phone plan characteristics, and attitudes toward the DepoText program were the primary endpoints of interest. Most participants (78%) attributed instances of nonresponsiveness to being away from the phone or due to a personal conflict such as school or work. Service interruption due to bill nonpayment (44%), phone loss (28%), and cell phone number change (28%) were significant barriers to continuous coverage during the trial period, and many respondents indicated that the downturn in the economy made it more difficult to maintain their cell phone plan. Almost a third reported having to choose between cell phone and other payments, but the vast majority (88%) considered their cell phone a "need" rather than a "want." Participants universally expressed satisfaction with the text messaging program and reported feeling more connected to the clinic (96%) through the messages serving as reminders (64%), encouragement to assume personal responsibility for their health care (12%), and enhanced personal connection with the clinic staff (4%). Our study suggests that a text messaging program can be used in an urban clinical setting to communicate with adolescent girls about family planning services. While economic barriers to continuous cell phone coverage do exist, adolescents indicate that the text message reminder system can be a valuable tool for enhancing clinic connectedness and promoting autonomy in care-seeking behavior.
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Affiliation(s)
- Mallory Irons
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Pranke I, Tomaszewski K, Bitam S, Faure G, Chevet E, Sermet-Gaudelus I, Edelman A. The role of cytokeratin 8 in alpha-1-antitrypsin secretion and/or degradation. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2015.02.040] [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: 11/26/2022]
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Menegatou E, Claeys C, Wasserman D, Tomaszewski K. Assessment of Health States and Erectile Dysfunction-Associated Quality of Life Among Adult Males and Females With Male Partners in Germany, the United Kingdom and the United States. Value Health 2014; 17:A516. [PMID: 27201602 DOI: 10.1016/j.jval.2014.08.1599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - C Claeys
- KJT Group, Inc., Honeoye Falls, NY, USA
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Klir D, Kravarik J, Kubes P, Rezac K, Litseva E, Tomaszewski K, Karpinski L, Paduch M, Scholz M. Fusion neutron detector for time-of-flight measurements in z-pinch and plasma focus experiments. Rev Sci Instrum 2011; 82:033505. [PMID: 21456735 DOI: 10.1063/1.3559548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We have developed and tested sensitive neutron detectors for neutron time-of-flight measurements in z-pinch and plasma focus experiments with neutron emission times in tens of nanoseconds and with neutron yields between 10(6) and 10(12) per one shot. The neutron detectors are composed of a BC-408 fast plastic scintillator and Hamamatsu H1949-51 photomultiplier tube (PMT). During the calibration procedure, a PMT delay was determined for various operating voltages. The temporal resolution of the neutron detector was measured for the most commonly used PMT voltage of 1.4 kV. At the PF-1000 plasma focus, a novel method of the acquisition of a pulse height distribution has been used. This pulse height analysis enabled to determine the single neutron sensitivity for various neutron energies and to calibrate the neutron detector for absolute neutron yields at about 2.45 MeV.
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Affiliation(s)
- D Klir
- Faculty of Electrical Engineering, Czech Technical University in Prague, Technicka 2, 16627 Prague 6, Czech Republic.
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Ayoub A, Goodrich J, Tressler R, Ryst E, Rajicic N, Tomaszewski K, Mayer HB. Incidence of infections in treatment-experienced (TE) patients in the MOTIVATE studies of maraviroc (MVC) plus optimized background therapy (OBT). J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Tomaszewski K. Separation of poly(ethylene glycols) into fractions by sequential liquidâliquid extraction. Talanta 1999; 50:299-306. [DOI: 10.1016/s0039-9140(99)00024-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/1998] [Revised: 12/07/1998] [Accepted: 12/08/1998] [Indexed: 10/17/2022]
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Tomaszewski K, Adam I, Hinze L. [Health-related behavior and coping with problems by adolescents in relation to social change in new unified Germany]. Soz Praventivmed 1998; 42:268-75. [PMID: 9480591 DOI: 10.1007/bf01592323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Young people in East Germany are faced with problems specific to their development which are added to through adjusting to conditions caused by transformation. Psychosocial pressure, attitudes to personal health and resources to problem solving in interaction with each other form a significant part of young people's lives. They shall be represented in selected conclusions below. In a questionnaire of 1764 young people themes to relating attitudes to personal health, psychosocial pressure as well as personal problem solving were raised. A main concern of social change raised by parents' new employment situation hasn't led to any negative attitudes to personal health nor to social pressure which surpasses the results of other investigations. At the time of investigation (1993) young people have coped altogether well with the social changes.
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Affiliation(s)
- K Tomaszewski
- Institut für Sozialmedizin, Medizinische Fakultät Otto-von-Guericke-Universität Magdeburg
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Tomaszewski K, Motwani J. Ethical issues in purchasing: a field study of Midwest hospitals. J Hosp Mark 1995; 10:77-89. [PMID: 10156186 DOI: 10.1300/j043v10n01_07] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
A large sum of money is spent annually by salespeople on gifts and favors for purchasing executives. The provision of gifts and favors to buyers remains a common practice despite the fact that it often leads to ethical conflicts for purchasing executives, sales managers, and salespeople. This paper investigates the perceptions of 51 purchasing executives of midwest hospitals regarding their behavior towards certain buying practices, the favors offered by vendors, favors actually accepted, as well as purchasers' discomfort and repayment levels regarding indebtedness. Based on the data analysis, this paper provides conclusions and directions for future research.
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Bukowczyk A, Knapik Z, Hańczycowa H, Tomaszewski K, Kozioł E. [Peptic ulcer and various personality characteristics]. Wiad Lek 1980; 33:1525-9. [PMID: 7467324] [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: 01/25/2023]
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Bryś J, Tomaszewski K, Wasik A, Bukowczyk A. [Captagon--a new psychotonic agent]. Psychiatr Pol 1969; 3:341-6. [PMID: 5805112] [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: 01/16/2023]
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