A5076285729- Musculoskeletal pain and rehabilitation
- Spine and Intervertebral Disc Pathology
- Health Systems, Economic Evaluations, Quality of Life
- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Meta-analysis and systematic reviews
- Clinical practice guidelines implementation
- Health and Medical Research Impacts
- Opioid Use Disorder Treatment
- Palliative Care and End-of-Life Issues
- Health Policy Implementation Science
- Pharmaceutical Practices and Patient Outcomes
- Electronic Health Records Systems
- Patient Satisfaction in Healthcare
- Geriatric Care and Nursing Homes
- Disaster Response and Management
- Pharmaceutical industry and healthcare
- Health Sciences Research and Education
- Cardiac, Anesthesia and Surgical Outcomes
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Global Health Workforce Issues
- Global Health Care Issues
- Patient Safety and Medication Errors
- Child Nutrition and Feeding Issues
- Attention Deficit Hyperactivity Disorder
University of North Carolina at Chapel Hill
2014-2024
Employment Agency
2017
Cecil College
2003-2015
Coastal Area Health Education Center
2015
RTI International
2006-2013
Communities In Schools of Orange County
1996-2012
Oregon Health & Science University
2012
Agency for Healthcare Research and Quality
2012
Duke University
2008-2012
University of Pennsylvania
2011
National or state-level estimates on trends in the prevalence of chronic low back pain (LBP) are lacking. The objective this study was to determine whether LBP and demographic, health-related, health care-seeking characteristics individuals with condition have changed over last 14 years.A cross-sectional, telephone survey a representative sample North Carolina households conducted 1992 repeated 2006. A total 4437 were contacted 5357 2006 identify noninstitutionalized adults 21 years older...
This DataWatch examines the potential impact of socioeconomic differences on rates hospitalization, based patterns hospital use in New York City 1988. The research suggests that lack timely and effective outpatient care may lead to higher hospitalization low-income areas. For certain conditions identified as ambulatory sensitive, were areas than they higher-income where appropriate was more readily available. Further study is needed determine relative various economic, structural, cultural...
Patients with back pain receive quite different care from types of health practitioners. We performed a prospective observational study to determine whether the outcomes and charges for differ among primary practitioners, chiropractors, orthopedic surgeons.
Background Although similar to cancer patients regarding symptom burden and prognosis, with heart failure ( HF ) tend receive palliative care far less frequently. We sought explore factors perceived by cardiology, primary care, providers impede referral for patients. Methods Results conducted semistructured interviews (1) needs of advanced ; (2) knowledge, attitudes, experiences specialist care; (3) indications optimal timing in (4) barriers referral. Two investigators analyzed data using...
<h3>Importance</h3> In advanced dementia, goals of care decisions are challenging and medical is often more intensive than desired. <h3>Objective</h3> To test a (GOC) decision aid intervention to improve quality communication palliative for nursing home residents with dementia. <h3>Design, Setting, Participants</h3> A single-blind cluster randomized clinical trial, including 302 dementia their family makers in 22 homes. <h3>Interventions</h3> GOC video plus structured discussion health...
The authors assessed the relationship between having a regular doctor and access to care, as measured by set of preventive primary care utilization indicators recommended Institute Medicine. 1987 National Medical Expenditure Survey was used in analyses (n = 30,012). results regression suggest that individuals with any type source had better than those without care. Persons site but no doctor. However, apparent advantage over disappeared when only reporting physician's office, clinic, or...
Patients who require tracheostomy for prolonged mechanical ventilation have poor outcomes and high costs of care. However, recent longitudinal trends relevant to these patients their care not been described. We aimed describe in the annual incidence timing ventilation, as well patient resource utilization overall in-hospital mortality.Retrospective review North Carolina Hospital Discharge Database, a comprehensive record all state nonfederal, nonpsychiatric hospital discharges between 1993...
Telephone interviews were conducted with a random sample of adults in 4437 North Carolina households. The response rate was 79%.The prevalence low back pain and the correlates care-seeking defined population examined.Previous research on has used varying definitions illness pain, admixed patients acute chronic pain. Acute examined this study as distinct phenomenon separate from pain.Respondents completed detailed interview regarding occurrence care sought for 1991. functionally limiting...
Study Design. A 22-month prospective cohort study. Objectives. To describe the course of an inception patients with chronic low back pain. Summary Background Data. Chronic pain is a debilitating condition great medical and social cost. Methods. 1246 acute who sought treatment from 208 North Carolina providers was observed. Patients developed were identified. Entry criteria less than 10 weeks’ duration, no previous care for this episode pain, spine surgery, not pregnant, nonskin malignancy,...
BACKGROUND Multiple measures of adherence have been reported in the research literature and it is difficult to determine which best, as each nuanced. Occurrences medication switching polypharmacy or therapeutic duplication can substantially complicate calculations when a class sought. OBJECTIVE To contrast Proportion Days Covered (PDC) metric with 2 variants Medication Possession Ratio (MPR, truncated MPR). METHODS This study was retrospective analysis North Carolina Medicaid administrative...
This was a stratified, random telephone survey of adults in North Carolina.To determine the prevalence chronic low back pain and extent to which treatment is sought for this condition.Chronic major problem. Previous studies often have combined acute pain.Telephone interviews regarding were conducted with 4437 Carolina during 1992.Chronic affects 3.9% population. Thirty-four percent considered themselves permanently disabled 52% assessed their overall health as fair or poor. The median number...
To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia.Cluster randomized controlled trial.Twenty-four nursing homes North Carolina.Residents with dementia and problems their surrogates.Intervention surrogates received an audio or print on dementia. Controls usual care.Primary outcome was the Decisional Conflict Scale (range: 1-5) measured at 3 months; other main outcomes were surrogate knowledge, frequency communication providers,...
The number of critical care beds in the United States has been increasing considerably, but it is unclear how these additional have used. Mechanical ventilation for acute respiratory failure almost always demands ICU and likely to be a reliable indicator resource requirements on population level. objective this study was measure changes yearly incidence mechanical statewide population. North Carolina Hospital Discharge Database contains data all discharges from nonfederal, nonpsychiatric...
The HERO registry was established to support research on the impact of COVID-19 pandemic US healthcare workers. Describe experiences and effects individuals participating in registry. Cross-sectional, self-administered enrollment survey conducted from April 10 July 31, 2020. Participants worked hospitals (74.4%), outpatient clinics (7.4%), other settings (18.2%) located throughout nation. A total 14,600 exposure, viral antibody testing, diagnosis COVID-19, job burnout, physical emotional...
To explore the relationship between type of initial care as well likelihood recurrence and consequent seeking behavior.Prospective observational cohort recruited from 208 randomly selected North Carolina practices. Cohort study examined low back pain among patients free 3 months after their index visit to a practitioner for that problem. The following four strata were examined: primary providers, chiropractors, orthopedic surgeons, practitioners in group model HMO. Patients interviewed by...
In Brief Study Design. A cross-sectional, telephone survey of a representative sample North Carolina households in 2006. Objective. The primary objectives these analyses were to describe health care use (providers, medications, treatments, diagnostic tests) for chronic low back pain (LBP) and relate current patterns best evidence the condition. Summary Background Data. Chronic LBP is common expensive. Prior research on utilization often was derived from medical claims databases, reflecting...