American journal of preventive medicine
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Alternative measurement approaches for adverse childhood experiences (i.e., count score versus individual adverse childhood experiences measured dichotomously versus individual adverse childhood experiences measured ordinally) can alter the association between adverse childhood experiences and adverse outcomes. This could significantly impact the interpretation of adverse childhood experiences research. ⋯ Alternative methods of measuring adverse childhood experiences can influence understanding of their true impact. These findings suggest that the deleterious effects of imprecise measurement methods may be most pronounced in the populations most at risk of adverse childhood experiences. For the sake of prevention, the measurement of adverse childhood experiences must evolve.
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Despite increased attention on severe maternal morbidity and maternal mortality, scant research exists on adverse maternal outcomes in women with disabilities. This study compares the rates of severe maternal morbidity and maternal mortality in women with and without intellectual and developmental disabilities. ⋯ Women with intellectual and developmental disabilities are at increased risk of severe maternal morbidity and maternal mortality. These findings underscore the need for enhanced monitoring of the needs and maternal outcomes of women with intellectual and developmental disabilities in efforts to improve maternal health.
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This study determines the prevalence and associated correlates of people unaware of their diabetic retinopathy diagnosis in the U.S. ⋯ A substantial proportion of individuals with diabetic retinopathy are unaware of the diagnosis. These data provide a path toward refining efforts to diagnose and treat diabetic retinopathy to decrease the burden of preventable blindness.
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Programs and services available through the aging services network can help community-dwelling older adults to age in place but are often not discussed in routine primary care. The primary care liaison was developed as a novel integration intervention to address this disconnect. ⋯ The primary care liaison model is feasible, fosters ongoing interactions between primary care and Area Agencies on Aging, and connects older adults and their caregivers to relevant programs and services. Adoption of the primary care liaison model by other Area Agencies on Aging across the U.S. may help further the vision of optimized health and well-being of older adults.
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Physicians play a critical role in tobacco treatment, being a frequent link to smokers and a trusted source of information. Unfortunately, barriers exist that limit physicians' implementation of evidence-based interventions. This study examines the implementation and predictors of the Ask, Advise, Assess, Assist, Arrange model of tobacco treatment clinical guidelines among U.S. physicians. ⋯ This national survey highlights the need for increased implementation of all aspects of the latest guidelines for evidence-based tobacco treatments, including community-based resources.