A Portrait of Informal Caregivers in America, 2001

Explores the experiences of caregivers of the chronically ill, including what caregivers are feeling about providing care and what they need from the healthcare and social services systems

A Portrait of the Chronically Ill in America, 2001

Looks at how well Americans are living with chronic illness, how well they are able to care for themselves, and how well health professionals and healthcare organizations are delivering care to their patients

A Portrait of Adolescents in America, 2001

Examines the health and healthcare experiences of adolescents. Looks at the perceptions and behaviors that promote or threaten their health, focusing on teens that have risky health behaviors, symptoms of depression, or special healthcare needs

Physical Distancing With Social Connectedness

Recognizing and supporting the many ways of investing in relationship has great potential to create a positive sea change in a health care system that currently feels fragmented and depersonalized to both patients and health care providers. The current COVID-19 pandemic is full of opportunity to use remote communication to develop healing human relationships. What we need in a pandemic is not social distancing, but physical distancing with social connectedness.In light of concerns over the potential detrimental effects of declining care continuity, and the need for connection between patients and health care providers, our multidisciplinary group considered the possible ways that relationships might be developed in different kinds of health care encounters. We were surprised to discover many avenues to invest in relationships, even in non-continuity consultations, and how meaningful human connections might be developed even in telehealth visits.Opportunities range from the quality of attention or the structure of the time during the visit, to supporting relationship development in how care is organized at the local or system level and in the use of digital encounters. These ways of investing in relationships can exhibit different manifestations and emphases during different kinds of visits, but most are available during all kinds of encounters. Recognizing and supporting the many ways of investing in relationships has great potential to create a positive sea change in a health care system that currently feels fragmented and depersonalized to both patients and health care clinicians. The current COVID-19 pandemic is full of opportunity to use remote communication to develop healing human relationships. What we need in a pandemic is not social distancing, but physical distancing with social connectedness.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154577/1/StangeAFM-674-19 ms.pdfDescription of StangeAFM-674-19 ms.pdf : Final pdf for DeepBlue deposi

A New Performance Measurement System for Maternal and Child Health in the United States

Abstract Objective The Title V Maternal and Child Health (MCH) Block Grant is the linchpin for US MCH services. The first national performance measures (NPMs) for MCH were instituted in 1997. Changing trends in MCH risk factors, outcomes, health services, data sources, and advances in scientific knowledge, in conjunction with budgetary constraints led the Maternal and Child Health Bureau (MCHB) to design a new performance measurement system. Methods A workgroup was formed to develop a new system. The following guiding principles were used: (1) Afford States more flexibility and reduce the overall reporting burden; (2) Improve accountability to better document Title V's impact; (3) Develop NPMs that encompass measures in: maternal and women's health, perinatal health, child health, children with special health care needs, adolescent health, and cross-cutting areas. Results A three-tiered performance measurement system was proposed with national outcome measures (NOMs), NPMs and evidence-based/informed strategy measures (ESMs). NOMs are the ultimate goals that MCHB and States are attempting to achieve. NPMs are measures, generally associated with processes or programs, shown to affect NOMs. ESMs are evidence-based or informed measures that each State Title V program develops to affect the NPMs. There are 15 NPMs from which States select eight, with at least one from each population area. MCHB will provide the data for the NOMs and NPMs, when possible. Conclusions The new performance measurement system increases the flexibility and reduces the reporting burden for States by allowing them to choose 8 NPMs to target, and increases accountability by having States develop actionable ESMs

Children with Frequent or Severe Headache: New Data on Population Prevalence, Characteristics, Health Status and Needs and Access to Health Care

Little is known about the population-based prevalence, sociodemographic characteristics, health status and health needs and use of children in America with frequent or severe headache, including migraine. This information is needed to guide the development and implementation effective health care and efforts to target and address the health care service needs of children and adolescents with frequent or severe headache. The purpose of this study to is determine the population prevalence, sociodemographic characteristics, health status and health care service needs and use of all children and children with special health care needs (CSHCN) ages 3-17 who experience frequent or severe headache, as confirmed by a child’s health care provider and reported by a child’s parent

An Evaluation on the Role of Non-Coding RNA in HIV Transcription and Latency: A Review

The existence of latent cellular reservoirs is recognized as the major barrier to an HIV cure. Reactivating and eliminating "shock and kill" or permanently silencing "block and lock" the latent HIV reservoir, as well as gene editing, remain promising approaches, but so far have proven to be only partially successful. Moreover, using latency reversing agents or "block and lock" drugs pose additional considerations, including the ability to cause cellular toxicity, a potential lack of specificity for HIV, or low potency when each agent is used alone. RNA molecules, such as microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) are becoming increasingly recognized as important regulators of gene expression. RNA-based approaches for combatting HIV latency represent a promising strategy since both miRNAs and lncRNAs are more cell-type and tissue specific than protein coding genes. Thus, a higher specificity of targeting the latent HIV reservoir with less overall cellular toxicity can likely be achieved. In this review, we summarize current knowledge about HIV gene expression regulation by miRNAs and lncRNAs encoded in the human genome, as well as regulatory molecules encoded in the HIV genome. We discuss both the transcriptional and post-transcriptional regulation of HIV gene expression to align with the current definition of latency, and describe RNA molecules that either promote HIV latency or have anti-latency properties. Finally, we provide perspectives on using each class of RNAs as potential targets for combatting HIV latency, and describe the complexity of the interactions between different RNA molecules, their protein targets, and HIV