Parkview Health Research Repository
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The Significance of Sexual Debut in Women’s Lives
No full textPurpose of Review
For decades, researchers have been examining the correlates, outcomes, and contexts related to sexual debut. Early inquiries employed mostly retrospective methods with convenience samples, focusing on the negative correlates of early sexual debut. However, recent research has been more nuanced, using longitudinal methods with nationally representative samples around the globe, accounting for relevant covariates, and examining the correlates of early, later, and nonexistent sexual debut. In this review, we discuss the significance of the timing and context of sexual debut for women’s sexual lives, focusing especially on the new conceptualizations and insights gained from research in the past five years. Findings
Although early sexual debut relative to one’s peers typically has been considered problematic in terms of later sexual health and psychological well-being, more recent research has demonstrated that other factors, including individual characteristics and family and peer influences, are co-occurring risk factors that may better explain these significant relationships. More recent research has demonstrated that sexual competence at debut (i.e., maturity and preparedness) has greater predictive utility of later sexual health and wellness, including positive affect and appraisals of sexual desirability. Summary and Future Directions
From both a sociocultural and a methodological perspective, the framing of sexual debut has changed considerably in the past few decades. Accordingly, it is time to reconsider the framing of sexual debut to account for the wide range of sexual activities and relationship configurations that exist. Moreover, the study of sexual debut needs to include the individual, sociocultural, and contextual factors that might influence the way that the event is interpreted in an individual’s lifelong sexual trajectory
Addition of chemotherapy improves overall survival in patients with T2N0M0 non-small cell lung cancer undergoing definitive radiation therapy: An analysis of the SEER database
No full textObjectives: Despite recommendations by clinical guidelines, an advantage of adding systemic chemotherapy to definitive radiation in patients with early stage non-small cell lung cancer (NSCLC) has never been demonstrated by randomized or large-scale studies. This study evaluates the role of chemotherapy in T2N0M0 NSCLC patients who did not undergo surgical resection. Materials and methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we screened for patients with T2N0M0 NSCLC who received radiation therapy without surgical resection from 2004 to 2015. T-staging was defined according to the American Joint Committee on Cancer (AJCC) 6th (Year 2004+) and 7th (Year 2010+) versions. Overall survival based on chemotherapy status was assessed by univariate and multivariate analyses. Results: A total of 6075 and 3138 patients were identified for AJCC 6th (T2; 3–7cm) and 7th (T2a; 3–5 cm, T2b; 5–7 cm) version, respectively. Administration of chemotherapy was associated with younger age, male sex, non-adenocarcinoma, and high pathologic grade. Kaplan–Meier’s estimates demonstrated that the chemotherapy group had a statistically significant longer five-year overall survival than the non- chemotherapy group in patients with AJCC 6th T2 (19.9% vs 15.8%, p= 0.0023) and AJCC 7th T2b (5– 7 cm, 20.9% vs 13.6%, p= 0.0046) but not those with AJCC 7th T2a (3–5 cm, 24.3% vs 21.1%, p= 0.4369).Multivariate analyses also revealed that the use of chemotherapy was an independent prognostic factor in AJCC 6th T2 and AJCC 7th T2b. Conclusions: This study strongly suggests that chemotherapy may benefit non-adenocarcinoma patients with primary tumor larger than 5 cm (AJCC 8th T3) undergoing chest radiation
Near-resolution of persistent idiopathic facial pain with low-dose lumbar intrathecal ziconotide: a case report.
Get PDFPurpose: Persistent idiopathic facial pain (PIFP) is a poorly defined and debilitating chronic pain state with a challenging and often inadequate treatment course. This is the first case report identifying the novel use of low-dose lumbar intrathecal ziconotide to successfully treat PIFP with nearly complete resolution of pain and minimal to no side effects.
Methods: The patient was a 37 year-old female whose PIFP was refractory to multimodal medication management and multiple neurovascular surgical interventions. A single-shot lumbar intrathecal trial of ziconotide (2.5 mL, equivalent 2.5 μg) was injected when she was at her baseline pain level - VAS 7/10. She received complete resolution of her pain for about 9 hours, concordant with ziconotide\u27s half-life. She was subsequently implanted with a lumbar intrathecal delivery system.
Results: The patient experienced complete resolution of her facial pain with a single-shot intrathecal trial of ziconotide. The intrathecal pump system has provided nearly complete (VAS 1/10) pain relief. Two flares of pain occurred 10 and 18 months after pump placement, which subsequently resolved after increasing the ziconotide dose by 0.5 μg/day on each occasion. The patient is currently maintained on a dose of 2.0 μg/day and is pain-free.
Conclusion: This is the first case report describing the use of a single-shot lumbar intrathecal trial of ziconotide and subsequent placement of lumbar (as opposed to thoracic) intrathecal ziconotide pump for PIFP. A single-injection intrathecal trial is a low-risk, viable option for patients with this debilitating and frustrating pain condition. Successful trials and subsequent intrathecal pump placement with ziconotide may supplant multimodal medication management and/or invasive orofacial surgical intervention for PIFP
Clear cell adenocarcinoma of the lung: a SEER analysis.
No full textClear cell adenocarcinoma (CCA) in lung has been considered as a rare subtype of lung adenocarcinoma. However, recent classifications of lung adenocarcinoma proposed to discontinue CCA due to lack of available data with clinical significance. Patients with CCA and lung adenocarcinoma not otherwise specified (LANOS) were queried from The Surveillance, Epidemiology, and End Results Program (SEER) database. Cancer-specific survival was studied according to gender (male, female), age (0-69, 70+), SEER specific stage A system (localized, regional and distant), year of diagnosis (1973-2000, 2001-2013), surgery (yes, no), and radiation therapy (yes, no) using Kaplan-Meier curves. Multivariate analysis was used to study independent predictors of cancer-specific survival. A total of 1,227 and 233,154 patients with the diagnosis of CCA and LANOS respectively were found in the SEER database. CCA histology was significantly associated with an early year of diagnosis, younger age, early stage, surgery, and lack of radiation. Kaplan-Meier curves showed that patients with CCA histology had significantly better cancer-specific survival (
Using Data to Lower Indiana Infant Mortality Rate
Get PDFA nonprofit group that uses medical data and technology to improve healthcare outcomes is targeting the Indiana\u27s high infant mortality rate. The state chapter of the Healthcare Information and Management Systems Society is hosting a competition intended to uncover ways to improve health outcomes for Indiana mothers and infants.
Original article link: Inside Indiana Busines
What’s New in Civic Tech: WaTech Launches GIS Data Portal
Get PDFPlus, a data competition aims to reduce Indiana’s infant mortality rate; Code for America’s GetCalFresh program works to reach eligible self-employed residents; and Louisiana has a new Medicaid enrollment app.
Original online article lin
Uncertainty Management among Older Adults with Heart Failure
No full textHeart failure (HF) is a complex chronic illness that affects the older adult population, requiring medical therapy and day-to-day management to prevent worsening and exacerbation. Patients with HF are often treated with cardiac implanted electronic devices (CIEDs) which capture diagnostic and predictive parameters for HF. In this work we explore how patients would respond to receiving data from an implanted device, using a fictitious scenario interview method with 24 older adults with HF. We applied an uncertainty management lens to better understand how patients face uncertain outcomes and integrate novel data into their decision making. The findings provide insight into how patients would engage and respond to a technology which provides an indicator of their HF status from an implanted device
The Emeritus Nurse: Retired, Rehired, and Revolutionary.
No full textA strong culture rooted in excellent nursing practice is essential to the future success of healthcare organizations. Nursing leaders face the challenge of establishing and retaining this culture with the exodus of nursing knowledge and clinical reasoning expertise from retirements of experienced nurses. This article presents a novel plan to mitigate this looming problem by rehiring and reengaging recently retired nurses to return to practice for an emeritus RN program
Inferior Vena Cava Filter Clinic and Hospital Registry: One Year Review
Get PDFPoster Presentation-
Background: Inferior vena cava (IVC) filters are small, cage-like devices placed percutaneously into the inferior vena cava to prevent propagation of thrombus into the pulmonary arteries. Currently, there are two available types of filters, permanent and temporary. Retrievable inferior vena cava (IVC) filter use has increased over 115% since the Food and Drug Administration (FDA) approval in 2009. Likewise, there has been a marked increase in complications related to their increased use. In 2014, the FDA initiated a comprehensive analysis of filter placement and issued the following recommendation: “The FDA recommends that implanting physicians and clinicians responsible for the ongoing care of patients with retrievable IVC filters consider removing the filter as soon as protection from pulmonary embolism is no longer needed.” Therefore, it is imperative that a hospital system develop a comprehensive approach to IVC filter placement and follow up to ensure good patient outcomes and comply with FDA mandates
Cross-day influences between couple closeness and coparenting support among new parents.
Get PDFThe couple and coparenting relationships are demonstrated to be prospectively and bidirectionally associated over months to years during the early parenting years. However, little is known about these associations at the daily level within the first year of parenthood, when coparenting first emerges. The goal of the current study was to examine the association between couples\u27 daily feelings of relationship closeness and coparenting support in first-time parents and determine directionality of these effects using a dyadic daily diary design. At 10 months postpartum, heterosexual couples