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150 results on '"Flahive, Julie M."'

1. Actigraphy: An Adjunctive Method to Measure Irritability in Opioid-Exposed Newborns.

Author

Liu, Vivian Y., Flahive, Julie M., and Bloch-Salisbury, Elisabeth

Subjects
STATISTICAL correlation, PEARSON correlation (Statistics), REPEATED measures design, NEONATAL abstinence syndrome, INFANT psychology, RESEARCH funding, NURSING assessment, ACTIGRAPHY, DESCRIPTIVE statistics, INFANT care, NARCOTICS, RESEARCH, DATA analysis software
Abstract

Background and purpose: Conventional measures of withdrawal in newborns with prenatal opioid exposure (POE) rely on nursing assessments, including the subjective judgment of infant irritability. This study investigated limb movement actigraphy as a tool for providing an objective, quantifiable measure of underlying distress. Methods: Correlational analyses compared continuous physiological-detected movement actigraphy and clinical intervallic-scored symptomology (modified Finnegan system) obtained from a control cohort of 37 term neonates with POE studied in their crib in the newborn unit (1–8 days). Results: Infants spent 15% crib time in high movement activity (>100 movements/minute; index irritability) and 38% crib time in low activity (0–5 movements/minute; index calm). There was a significant positive association between actigraphy and Finnegan composite score (r =.28, p =.001) and between actigraphy and subcomponent scores (i.e., central nervous system, gastrointestinal, and metabolic-vasomotor-respiratory). Conclusion: Movement activity via actigraphy captures underlying distress and calm not measured by conventional assessments. Such objective, quantifiable measures can serve to promote equitable assessment and treatment of hospitalized newborns with POE. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Survivorship care planning, quality of life, and confidence to transition to survivorship: A randomized controlled trial with women ending treatment for breast cancer

Author

O’Hea, Erin L., primary, Creamer, Samantha, additional, Flahive, Julie M., additional, Keating, Beth A., additional, Crocker, Candace R., additional, Williamson, Shannon R., additional, Edmiston, Kathryn L., additional, Harralson, Tina, additional, and Boudreaux, Edwin D., additional

Published
2021
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23. Survivorship care planning, quality of life, and confidence to transition to survivorship: A randomized controlled trial with women ending treatment for breast cancer.

Author

O'Hea, Erin L., Creamer, Samantha, Flahive, Julie M., Keating, Beth A., Crocker, Candace R., Williamson, Shannon R., Edmiston, Kathryn L., Harralson, Tina, and Boudreaux, Edwin D.

Subjects
BREAST tumor treatment, CONFIDENCE, TIME, ONCOLOGY, MEDICAL protocols, CANCER patients, RANDOMIZED controlled trials, QUALITY of life, DESCRIPTIVE statistics, TERMINATION of treatment, STATISTICAL sampling
Abstract

The Polaris Oncology Survivorship Transition (POST) system is a computer-based program that integrates information from the electronic health record, oncology team, and the patient to produce a personalized Survivorship Care Plan. The purpose of this study was to compare the POST to treatment as usual on confidence, quality of life, and interest in mental health referrals in women ending treatment for breast cancer. Two hundred women (100 POST, 100 treatment as usual) ending treatment for breast cancer were enrolled in a randomized controlled trial. Women randomized to the POST condition received a personalized care plan during a baseline/intervention appointment. At enrollment and baseline/intervention, a number of outcomes were examined in this study, including confidence to enter survivorship measured by the Confidence in Survivorship Index (CSI) and Quality of Life (QOL). One, three, and six month follow up assessments were also conducted. Treatment groups did not differ in terms of QOL scores at any time points. Mean CSI scores were statistically different between POST and treatment as usual at baseline for the total CSI score and both subscales, but only for confidence in knowledge about prevention and treatment at the 1-month follow-up. All significant differences were in favor of the POST intervention as mean CSI scores were higher for participants who received the POST intervention as opposed to treatment as usual. These findings disappeared at the 3 and 6 month follow up assessments. Finally, patients who received the POST intervention were twice as likely to request mental health/social services referrals compared to women who received treatment as usual. Oncologists may use the POST to build personalized care plans for women ending treatment for cancer, which may enhance patients' confidence in the short term as well as encourage use of mental health resources. [ABSTRACT FROM AUTHOR]

Published
2022
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24. Impact of Survivorship Care Planning of Oncology Care at the End of Treatment for Breast Cancer: A Randomized Controlled Trial.

Author

Williamson-Butler, Shannon, Creamer, Samantha, Flahive, Julie M., Keating, Beth A., Crocker, Candace R., Edmiston, Kathryn L., Harralson, Tina, Boudreaux, Edwin D., and O'Hea, Erin L.

Subjects
BREAST cancer treatment, WOMEN'S health, CANCER relapse, PSYCHOSOCIAL factors, RANDOMIZED controlled trials
Abstract

Background: In 2006, the Institute of Medicine (IOM) issued a report recommending that all cancer survivors receive a customized survivorship care plan (SCP) to increase survivors' understanding of diagnoses, long-term treatment effects, and ideas for improving overall health. Therefore, the purpose of this study was to compare a tailored SCP program (POST) to treatment as usual (TAU) on patient ratings of quality and content of discussion with providers at the end of their breast cancer treatment. Methods: Two hundred participants were randomized to receive either the POST treatment (n=100) or TAU (n=100) at their last treatment visit. Women were presented with a checklist of 29 survivorship topics and indicated whether their healthcare provider discussed it at their last visit. They were also asked to rate overall quality of discussion (QOD) with their providers and across several QOD subscales. Results: Analyses indicated that on average, POST women endorsed 20 out of the 29 topics compared to 14 topics endorsed by TAU. Additionally, POST women reported a better QOD overall and across all subscales. Conclusion: POST women remembered discussing more survivorship topics and reported better discussions with their providers. As a practical implication, cancer survivors should receive an individualized SCP to ensure that patients feel well informed of their road to survivorship. [ABSTRACT FROM AUTHOR]

Published
2022
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41. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) Score Correlates With the Intensity of Multimodal Limb Treatment and Patient-Centered Outcomes in Patients With Threatened Limbs Managed in a Limb Preservation Center

Author

Robinson, William P., primary, Loretz, Lorraine, additional, Hanesian, Colleen, additional, Flahive, Julie M., additional, Bostrom, John A., additional, Lunig, Nicholas, additional, Schanzer, Andres, additional, and Messina, Louis M., additional

Published
2016
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43. Clinical and Financial Impact of Readmissions Following Colorectal Resection: An Analysis of Predictors, Outcomes, and Cost

Author

Damle, Rachelle N., Cherng, Nicole, Flahive, Julie M., Davids, Jennifer S., Maykel, Justin A., Sturrock, Paul R., Sweeney, W. Brian, and Alavi, Karim

Abstract

Background: Following passage of the Affordable Care Act, 30day readmissions have come under greater scrutiny, with penalties levied for higher than expected readmission rates. We examined risk factors for 30day readmission following colorectal resection and evaluated the financial impact of readmissions on the healthcare system. Methods: The University HealthSystem Consortium Clinical Database was queried for adults undergoing colorectal surgery for cancer, diverticular disease, inflammatory bowel disease, or benign tumors from 2008-2012. Predictors of 30day readmission were assessed with multivariable logistic regression. Additional endpoints included time to readmission, readmission diagnosis, readmission length of stay (LOS), and readmission cost. Results: A total of 70,484 patients met study inclusion criteria, 13.7% (9,632) of which were readmitted within 30 days of discharge. The strongest independent predictors of readmission were: LOS ≥4 days (OR 1.44; 95% CI 1.32-1.57), stoma (OR 1.54; 95% CI 1.46-1.51), and non-home discharge (OR 1.68; 95% CI 1.57-1.81). Of those readmitted, half occurred within 7 days, 13% required ICU care, 6% had a reoperation, and 2% died during the readmission stay. The median combined total direct hospital cost was over two times higher ($26,917 v. $13,817; p

Published
2014
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44. Impact of Pre-Injury Warfarin Use Among Medicare Beneficiaries With Head Trauma

Author

Collins, Courtney E., Witkowski, Elan R., Flahive, Julie M., Emhoff, Timothy A., Anderson Jr., Frederick A., and Santry, Heena P.

Abstract

Introduction: The effect of warfarin on outcomes of head injured patients remains controversial. Yet more than 2 million Americans, many of them elderly, are started on warfarin annually. Meanwhile, with the aging US population, elderly Americans are becoming an increasingly large proportion of head injured patients. We studied a national cohort of Medicare beneficiaries with head injuries to determine the effects of pre-injury warfarin on outcomes. Methods: A retrospective review of a 5% random sample of Medicare claims data (2009-2010) was performed for enrollees with at least 1 year of Medicare eligibility. Head injury cases were identified using ICD-9 codes for intracranial hemorrhage with or without accompanying skull fractures. Using Part D prescription drug claims, warfarin exposure was defined as >2 warfarin prescriptions filled within 60 days prior to injury. Characteristics and outcomes (mortality, length of stay (LOS), ICU LOS) between warfarin users and patients not on warfarin (non-users) were compared using univariate tests of association. Multivariable models adjusting for patient characteristics, concomitant torso injuries/long-bone fractures, and need for ICU care were conducted to measure the independent effect of warfarin on in-hospital mortality. Results: We identified 3,420 head injured patients,6.6% of whom were treated with warfarin. Warfarin users were more likely to be female (74.2%vs.65.6%, p

Published
2013
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45. Rates of Insurance for Injured Patients before and after Health Care Reform in Massachusetts: Another Case of Double Jeopardy?

Author

Santry, Heena P., Collins, Courtney E., Wiseman, Jason T., Flahive, Julie M., Psoinos, Charles M., Chau, Zeling, Shah, Shimul A., and Kiefe, Catarina I.

Abstract

Background: As a result of healthcare reform (HCR), insurance rates among Massachusetts (MA) residents increased from 86.6% (2006) to 94.4% (2010) and conferred a 7.6% higher probability of being insured compared to neighboring states. The effect of an individual mandate on insurance rates among trauma patients is unknown. Methods: This was retrospective analysis of adult (18-64yrs) trauma patients from MA and surrounding states (NH, RI, CT, NY, VT) treated at our level 1 trauma center in central MA before (2004-2005) and after (2009-2010) MA-HCR. We estimated changes in insurance rates across time-periods and state-residence. Results: Before MA-HCR, 76.7% (1647/2,148) of injured MA residents had insurance compared to 84.3% (2088/2477) post-HCR (p

Published
2013
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