FSM
This project developed a COPD quality of life instrument based on computerized adaptive testing methods for use as research and clinical management instrument to assess quality of life in Chronic Obstructive Pulmonary Disease (COPD) patients.
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The main overall goal of this project is to develop a high-impact patient safety education tool. The first phase of the project, funded by this award: gathered existing curricular materials and identified gaps; selected the first target portion of health care delivery institutions for whom the program will be targeted; selected institutions for pilot program; identified leaders in the field; established opportunities for institutional capacity development that graduates of this program will be positioned to lead.
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Polypharmacy and non-adherence to medication are two well-documented public health problems, especially among elder patients. However, the interaction between polypharmacy and non-adherence is less well understood and previous studies have produced mixed results. This study characterized the prevalence of polypharmacy and its association with adherence in elderly patients with two co-existing common health problems, hyperlipedemia and congestive heart failure. Ultimately we provided a better understanding of the use and impact of polypharmacy on disease outcomes that will lead to improvements in the quality of medication use among elderly patients.
CUSP has been used to reduce central line-associated bloodstream infections in the Michigan Hospital Association's Keystone Project. Building on the success of the Keystone results, the current project is rolling out CUSP/CLABSI in 50 states. The Northwestern University subcontract will be working with HRET to teach educational methodologies and coaching skills to the state leads for the CUSP training.
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This project builds on the success of the Education in Palliative and End-of-life Care (EPEC) Project by pursuing the following specific aims: 1) adapt current EPEC curriculum in order to better meet the needs of Veterans, including a Spanish translation of the complete curriculum; 2) disseminate core EPEC training throughout the VA; and 3) evaluate the effectiveness of dissemination.
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This project will develop an adaptation of the Education in Palliative and End-of-life Care (EPEC) Curriculum and will disseminate the newly adaptad curriculum through distance learning, conference and professional development training. The EPEC Program at Northwestern University will provide guidance on development of the EPEC - Pediatrics Curriculum; will oversee development and production of educational conferences in the project's early years; will lead distance learning and database development, design, data collection and analysis.
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The goal of this project will be to establish a sure foundation for a sustainable national research program that will progressively build an empirical database that documents chaplaincy care's contributions to health and health care.
This project seeks to support family and informal caregivers of frail older adults by identifying and training 'caregiver champions' to serve as peer facilitators, advocates, and experts. The Northwestern University subcontract will develop and collate pre-test and post-test evaluation tools; correlate and provide accurate evaluation of the data; and provide the written report of research findings.
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The aims of this study include: 1) To test the psychometric properties of the REACH core battery of measures and to examine the effect of language and culture on item response; and 2) To compare the measurement equivalence of the socio-demographic and clinical groups of subjects on the core battery of measures in terms of other psychometric characteristics, and to explore the sensitivity to clinical change over time.
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This project examined the perceived experience and impact of breast cancer on family caregivers of breast cancer survivors. This two-phase research study recruited family caregivers of breast cancer survivors (at early and late stages). During phase one, caregivers participated in one of several focus groups, sharing their experiences in caring for a family member with breast cancer and the impact on their family; their experiences of stress and coping across the trajectory of the disease; and, finally, if and to what extent they accessed and used social support and how the level of support affected their experiences. Using feedback from the family caregivers who participated in the focus group, Dr. Witt developed an interview questionnaire to further explore these issues. Phase two of the project consisted of in-depth, one-on-one interviews with family members who were caring for their loved ones with breast cancer. Dr. Witt is analyzing the caregivers` sources of stress resulting from their caregiving experience. In addition, she is identifying the kind of social support that best alleviates these stressors. Her work will help family caregivers identify their sources of caregiving stress and find interventions that alleviate that stress.
The project on older immigrants who immigrated at mid-life investigated (1) the effects of immigration as a period of encoding sensitivity on the distribution of memories across the lifespan and (2) the influence of language of retrieval on memories originally encoded in another language. The Principal Investigator on this grant is David C. Rubin of the Department of Psychology and Brain Sciences at Duke University.
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This research in psychometrics provided for the adaptation of a Spanish (Spain) version of the English National Adult Reading Test, called the Word Accentuation Test, to Spanish speaking populations in the United States.
This project proposes to build two distance learning applications of the Education for Physicians in End-of-Life Care (EPEC) Project, with both designs being driven by educational needs, one having no human interactivity (standard web-only programming or WP), the other having interactivity (standard interactive programming)
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This award provides companion funding for the National Institutes of Health GEMSSTAR R03, which is an early career award with the goal of helping researchers establish a research track record in the field of geriatrics research while at once nurturing their academic career though formal class room education or other means of career development. This award provides the career development funding to match the federal research support.
This project aims to systematically explore: informal/family caregivers financial and social experiences; whether creating a healthcare employment option based on training and certification of informal caregiving in palliative care would be a welcomed option by many informal caregivers who face the challenges of terminal illness in their families; and to examine how to accomplish such an large scale add-on intervention.
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This seed grant for the Alliance for Research in Chicagoland Communities (ARCC) supports community-academic partnerships to improve community health. Dr. Lau is collaborating with the Japanses American Service Committee on this research project to describe intergenerational communication about health issues in Nikkei families, explore target recipient(s) of educational materials in Nikkei families to increase colorectal cancer (CRC) screening among Nikkei elders, and assess potential attitude change of adult-offspring caregivers toward CRC screening. This one-year study will provide preliminary data on how to better serve and improve the health of Chicagoland`s Nikkei community.
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This project aims to advance the safety of health services by synthesizing the strongest components of educational interventions and disseminating them effectively to teams of clinicians and administrators.
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In this second phase of PSEP, we convened a meeting at the Institute of Medicine in May 2006 with a Governing Council of patient safety pioneers and stakeholder representatives including top leaders from education; accreditation; the medical profession; nursing; healthcare organizations; plan purchasers; the international community; and healthcare consumers. The Governing Council effectively convened leadership that continues to oversee development of and generate buy-in for the overall design and content of the core curriculum, a function analogous to the role played by the Australian Council for Safety and Quality in Health Care in the development of the NPSEF.
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This first phase of the overall patient safety education allowed for the development of a national consensus-based core PSEP curriculum (the Core Safety Curriculum), using existing materials when possible, under the guidance of our Governing Council and Advisory Group.
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This project fostered collegial and intellectual links among education and research leaders in patient safety, social change, and long-term care and developed a research agenda to improve safety in long-term care settings. The one-day working group meeting, entitled Patient-Centered Safety in Long-Term Care Facilities, was held in December 2005 in New York. Buehler faculty members Denys Lau, PhD and Celia Berdes, PhD, MSPH also participated in this meeting.
This project allowed for the launching of the Novel Pain Assessment and Intervention Network (or the NoPAIN Network) by bringing together local and selected national experts in medical informatics, clinical and nursing research, and the social sciences to discuss one important topic in medical care that is inherently interdisciplinary, namely pain among older patients. The project also designed and implemented a prototype of an integrated clinical decision support system in pain (CDSS-Pain) by engaging interdisciplinary experts in the creation of collective analytical methodology on an ongoing basis. The preliminary results of our research in this study allowed for additional NIH funding on the primary focus of the network.
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Through analysis of in-depth interviews and documentary evidence of three firms (Sears, Roebuck and Company; Aon Corporation; and the East bank Club), this project delineated strategies that work for successful employment of people with disabilities.
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The objectives of this project were 1) To educate medical students in core concepts of geriatrics. 2) To mentor medical students in a summer research experience. 3) To encourage students to pursue careers in geriatrics.
The overall aim of this project is to advance scholarship at the interface of social and biomedical sciences that will promote and extend our ability to move emerging oncofertility technology from the bench to the bedside. Specifically, to explore cancer patients`concerns regarding fertility and to examine how patients, along with their families and physicians, make fertility-related healthcare decisions and to understand the social, legal, and ethical factors that surround those decisions at the time of cancer diagnosis.
This project seeks to develop and test a Tailored Implementation of Practice Standards (TIPS) package for rapid-relief pain management in Emergency Departments.
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Dr. Joshua Hauser recently assumed leadership for this project from Dr. Linda Emanuel. The overall goal of this project is to a) achieve dissemination through EPEC / EPEC-O`s proven, highly effective mechanism, b) using a mechanism that coordinated clinicians and survivors in their expectations and role relationships throughout the care process so that synergy rather than contentiousness occurs.
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This project augmented the education in palliative care by providing a curriculum that will provide a standard for both education and care in the field. We adapted the EPEC Curriculumfor the India context and culture which is currently being built into the infrastructure of palliative care education and service delivery that already exist in India.
Linda Emanuel, MD, PhD is the lead investigator on the project Developing a Needs Near the End-of-life Screening Tool (NEST) Whole-Person-Care Guide, which is funded for two years from 2005-2007 by the American Cancer Society. Other Buehler Center faculty members involved in this project are Chih-Hung Chang, PhD; Joshua Hauser, MD; and Whitney Witt, PhD, MPH. The NEST tool is an unfolding questionnaire with four themes - Needs of a social nature; Existential needs; Symptoms; and Therapeutic matters. The goals of the study are to apply the NEST tool to: better detect patients` care needs; better align the patient`s and clinician`s goals of care; and bring whole-person palliative care to oncology patients. Interviews with oncology patients and their caregivers occur at Northwestern Memorial Hospital.
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Ensuring safety in the home and community for elders is an important public health concern especially for elders as they age. A small-scale pilot study was conducted to retrospectively investigate the potential causes of adverse events that resulted in an emergency department visit at an academic hospital in Chicago among individuals aged 65 and older living in the community. Medical illness could comprise some, but not all of the factors involved in emergency visits, and that a root-cause approach would reveal additional factors amenable to preventive interventions in the community setting. The adverse health events that resulted in hospital admissions included falls, stomach pain, constipation, edema, chest pain, medication problems, visual changes, and weakness. Preventable contributing factors to these events fell into four general categories: (1) lack of care coordination and follow-up between healthcare providers and patient/informal caregivers; (2) financial barriers to medication or healthcare services; (3) lack of knowledge regarding emergency services; and (4) unsafe home environment. Future large-scale studies are needed to identify the root-causes of the events and analyze the relationship between causal factors and patient/caregiver characteristics. Once these are understood, interventions may be designed to improve the health and independence of this population.
The Education in Palliative and End-of-life Care (EPEC) Project is an initiative to provide training to health care professionals in end-of-life and palliative care. The EPEC Project conducts train-the-trainer and professional development conferences, provides extensive educational materials, as well an online learning adaptation of the complete EPEC Curriculum for Continuing Medical Education (CME) credit. For more information, please visit the EPEC web site.
The main goals of this project are to: 1) identify and refine the domains of palliative care, using existing theoretical frameworks as a guide; 2) compile the items for multidimensional palliative care item bank, drawing from existing measures and supplementing with newly written items; 3) empirically construct a palliative care item bank using item response theory (IRT); and 4) pilot test a computerized adaptive testing (CAT) platform to dynamically administer palliative care assessment in clinical settings.
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Over the course of this project, Dr. Lau worked with the Japanese American Service Committee to conduct an assessment among isolated, high-risk Japanese American seniors to identify: (1) their needs, (2) the barriers to meeting their needs, their current coping mechanisms, and (3) potential interventions according to the individual and cultural preferences. Specifically, over the one-year period, Dr. Lau directed the following tasks: (1) develop the assessment design; (2) design culturally sensitive and linguistically appropriate assessment instruments with input from an advisory panel consist of clients/seniors, caregivers & service providers; (3) ensure that the confidentiality and informed consent of study participants are protected according to HIPAA rules; (4) train culturally competent and peer reflective interviewers and focus group facilitators; (5) collect, analyze, and interpret the data; (6) write the report on the findings; (7) present findings to community stakeholders; and (8) publish them in scientific journals. The findings of this assessment were used to identify & develop culturally competent interventions that JASC can now integrate into their new services planning for vulnerable Japanese American seniors to help them age successfully in a safe and healthy manner.
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This project fostered collaboration between palliative medicine and rehabilitation medicine to enhance survivor care through education of health care professionals. Advisory board members include Buehler Center faculty Linda Emanuel, MD, PhD and Michael Preodor, MD, FACP.
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The EPEC-Oncology (EPEC-O) program was developed with support from the National Cancer Institute, the Lance Armstrong Foundation. This project adapts the EPEC curriculum for the oncology medicine specialty. This new, comprehensive curriculum for oncologists aims to specifically meet the educational needs of practicing and in-training oncologists and related care professionals in the area of palliative care for cancer patients.The final EPEC-O curriculum was completed in May 2005 and the initial launch of the dissemination phase was conducted in partnership with the American Society of Clinical Oncology in June 2005 to overwhelming appeal. The EPEC-O Project continues to provide conference training annually.
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This fellowship award provides funding to support the refinement of the Patient Safety Education Project (PSEP) curriculum in progress. This award will also support Master Facilitator training for select HRET and AHA Quality Center staff.
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This pilot study provided understanding of the psychoimmunology of caregiving among family caregivers of prostate cancer patients. The physiological response to such stressors, and the relationship to perceived stress, has not been examined adequately among caregivers of patients with prostate cancer and such research might further help to understand the increased risk for and development of physical and mental health problems in these families.
The Phase I project aims resulted in 1) focus groups, interviews and site visits to collect system functional and operational requirements; 2) literature reviews to assess scientific and technical feasibility; 3) the creation of system design specifications; 4) development and pilot testing of a prototype system; and 5) the construction of the initial PRO item bank focusing on breast cancer.
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This project seeks to develop an educational curriculum to support implementation of patient safety practices that will be effective in nursing home settings. The Northwestern University subcontract will assist in all aspects of the proposed study and will lead the development of three curricular modules for front-line nursing home personnel to improve patient safety.
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The main goals of this project is to create: 1) a curriculum-driven, train-the-trainer emergency oncology palliative care education program, and 2) Extend its impact in two strategic sites by coupling it with clinical practice reminders linked to curriculum learning objectives.
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The research phase of PSEP - Canada will continue dissemination and evaluate the effectiveness of the newly adapted PSEP - Canada Curriculum. The program will reach all provinces in Canada through 'Become a Patient Safety Trainer' Conferences and Professional Development Workshop (PDW) training which will provide advanced instruction on effective teaching methods including interactive lecture, case-based learning, and role play as well as instruction of the quality improvement (QI) principles utilized in developing an effective patient safety training program.
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This project evaluated the effects of a visual arts program on depressive characteristics for older adult residents at Presbyterian Homes (PH) in Evanston, Illinois. The art classes were led by professional, trained artists from the Lillstreet Learning Center and took place twice a week for ten weeks at PH. Participants were evaluated before and after the ten-week program for depressive characteristics.
This project aims to centralize patient and family education through a central Patient Education Director to improve delivery, management and quality of cancer patient education.
The EPEC Project and Mt. Sinai Hospital in Chicago partnered together to produce a series of grand rounds presentations and small group sessions for healthcare professionals interested in palliative and end-of-life care. Six grand rounds presentations were conducted over the two-year project, directed towards residents and attending physicians, to cover the modules from the EPEC Curriculum. Part of the needs assessment that began this project included conducting five focus groups, with several in Spanish, to stimulate discussion in lay audiences about end-of-life care and to solicit their views regarding quality and availability. The results of these focus groups were incorporated into the teaching materials.
This project provided the expansion and continued collaboration between Northwestern University and community-based social service agencies serving the elderly. The results allowed us to build and strengthen capacity within community agencies leading to improved research and program evaluation outcomes.
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The four specific project aims are: 1) to identify and refine the domains of pain assessment for a gero-oncology population using existing theoretical frameworks in biopsychosocial medicine and palliative care as a guide; 2) to compile the items for a multidimensional pain item bank, drawing from existing pain questionnaires and supplementing them with newly written items; 3) to develop empirically a pain item bank applicable to a gero-oncology population; and 4) to pilot test a computerized adaptive testing (CAT) platform to administer individualized pain assessments in clinical settings.
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This project seeks to develop a distance learning program as an extension of the Education in Palliative and End-of-life Care for Oncologists (EPEC-O) program.
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Since its inception in 1997, the overall goal of the Education in Palliative and End-of-life Care (EPEC) Project has been to use a curriculum-driven approach to improve knowledge and attitudes in palliative care of all physicians in the United States. With initial support from the Robert Wood Johnson Foundation and the American Medical Association, the EPEC Project has demonstrated the feasibility of reaching large numbers of physicians.
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The main goals of this project are: (1) develop the concept of caregiving skills in effective medication management, including a conceptual framework describing its domains and relationships with caregiver characteristics, patient health status, and caregiver confidence; (2) develop, refine, and validate an instrument to measure caregiving skills in effective medication management (CG-SEMM instrument); and (3) examine the direct and indirect relationships among caregiving skills in effective medication management, caregiver characteristics, patient health status, and caregiver confidence.
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The second phase of the EPEC-LTC project allowed for the pilot testing of the adapted modules in a single conference at Presbyterian Homes. Portions of the five available modules were covered in a one-day conference, and the train-the-trainer module in an additional half-day for self-selected participants.
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This project developed and tested a novel method to assess the need for person-centered/ palliative care in nursing homes. The results of the needs assessment were be used to create an adaptation of the existing EPEC Curriculum, for use in the long-term care setting. This project included Buehler Center faculty members Linda Emanuel, MD, PhD, Chih-Hung Chang, PhD, Joshua Hauser, MD, and Michael Preodor, MD, FACP.
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Vital Visionaries was created by the National Institute on Aging to foster inter-generational interactions between older adults and first-year medical students through the arts. Its goals are to promote improved understanding and appreciation of older adults by the medical students, and to help older adults understand that they can be creative, healthy and happy at any age. The Buehler Center on Aging, Health & Society partnered with the Mexican Fine Arts Center Museum to host the Vital Visionaries program in the summer of 2006. Medical students from Northwestern University`s Feinberg School of Medicine were partnered one-on-one with adults over the age of 65 who live in the Chicagoland area. Partners met at the Mexican Fine Arts Center Museum for four sessions during July and August, where they created Aztec-style family trees on traditional Mexican papel amate, painted and decorated masks in the traditional carnivale style, made prints, and painted their partners` favorite family recipe in watercolor. Participants also toured the museum`s permanent exhibit, Mexicanidad, as well as a featured exhibit, The African Presence in Mexico. Argelia Morales planned and led the detailed art sessions at the museum. Both young and old participants enjoyed these unique art projects and each other`s company.
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The overall goal of this project that began at the Buehler Center and continues at the University of Wisconsin-Madison, is to examine the impact of childhood chronic illness on the family. As part of this work she will assess and compare the level of psychological stress, both self-reported and biologically measured, between parents of children with chronic illness and parents of children without chronic illness. Moreover, this study will examine the feasibility, performance, and comparability of stress biomarkers and perceived psychological stress among parental caregivers and how such measures are related to child health outcomes.
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The goal of this project is to develop and conduct a preliminary evaluation of an advance care planning worksheet for parents of PICU patients.
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