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A Mixed Method Review of Tobacco Cessation for the Cardiopulmonary Rehabilitation Clinician

Mola, Ana; Lloyd, Madeleine M; Villegas-Pantoja, Miguel A
PURPOSE: To systematically survey the literature, describe the current tobacco science, and perform a mixed method review of randomized control trials of tobacco research in the cardiopulmonary population. METHODS: Mixed method review was conducted on major resource databases. Inclusion criteria were English language with a minimum follow-up of 6 months, published between January 1, 2007, and June 30, 2016; adult smokers >/=18 years of age with cardiovascular and/or pulmonary disease; initiation of subject recruitment from hospital or community; tobacco cessation (TC) as the main aim of the study; biometric validation of smoking status; first-line TC medications; and nonpharmacological treatments. RESULTS: The pooling of the 10 studies through forest plot analysis revealed the effect of tobacco continuous abstinence rates significant at 3, 6, and 12 months (total OR = 3.73; 95% CI, 2.58-5.38). Also, tobacco point prevalence rates of TC treatments demonstrated overall effects that were significant at the different end points (total OR = 2.63; 95% CI, 1.90-3.64). In both cases, the higher ORs were found in the 3 months end point. Most successful interventions consisted of a combination of pharmacological and nonpharmacological therapy (predominantly counseling). CONCLUSIONS: The evidence continues to support the recommended first-line TC pharmacotherapy and nonpharmacological practices published in the 2008 national guidelines. Implications for cardiopulmonary rehabilitation clinicians are discussed.
PMID: 28448378
ISSN: 1932-751x
CID: 2544192

Placing DDS and NP students together in advanced patient physical assessment

Chapter by: Schenkel, Andrew; Dorsen, Caroline; Wholihan, Dorothy; Lloyd, Madeleine; Haber, Judith; Wolff, Mark
in: RSE : Research Scholarship Expo by
[S.l. : NYU College of Dentistry], 2017
pp. 051-051
ISBN: n/a
CID: 2890082

Haber et al. Respond

Haber, Judith; Hartnett, Erin; Allen, Kenneth; Hallas, Donna; Dorsen, Caroline; Lange-Kessler, Julia; Lloyd, Madeleine; Thomas, Edwidge; Wholihan, Dorothy
We thank Lord for her thoughtful letter in response to our recent article. We salute the physician assistant (PA) profession for their commitment to increasing the integration of oral health and its relation to overall health in the curriculum of PA programs. The comparison between her 2008 and 2014 data for responding PA programs (n = 125) is noteworthy; to achieve a greater than 75% uptake in the PA program integration of oral health topics in six years is impressive. (Am J Public Health. Published online ahead of print March 19, 2015: e1. doi:10.2105/AJPH.2015.302648).
PMCID:4386532
PMID: 25790420
ISSN: 0090-0036
CID: 1505362

The Lived Experience of Family Nurse Practitioners who Perform a Sexual Health Assessment on Adults [Meeting Abstract]

Lloyd, Madeleine
ISI:000351633500260
ISSN: 1538-9847
CID: 1539182

Putting the Mouth Back in the Head: HEENT to HEENOT

Haber, Judith; Hartnett, Erin; Allen, Kenneth; Hallas, Donna; Dorsen, Caroline; Lange-Kessler, Julia; Lloyd, Madeleine; Thomas, Edwidge; Wholihan, Dorothy
Improving oral health is a leading population health goal; however, curricula preparing health professionals have a dearth of oral health content and clinical experiences. We detail an educational and clinical innovation transitioning the traditional head, ears, eyes, nose, and throat (HEENT) examination to the addition of the teeth, gums, mucosa, tongue, and palate examination (HEENOT) for assessment, diagnosis, and treatment of oral-systemic health. Many New York University nursing, dental, and medical faculty and students have been exposed to interprofessional oral health HEENOT classroom, simulation, and clinical experiences. This was associated with increased dental-primary care referrals. This innovation has potential to build interprofessional oral health workforce capacity that addresses a significant public health issue, increases oral health care access, and improves oral-systemic health across the lifespan. (Am J Public Health. Published online ahead of print January 20, 2015: e1-e5. doi:10.2105/AJPH.2014.302495).
PMCID:4330841
PMID: 25602900
ISSN: 0090-0036
CID: 1441192

Patient and Provider Acceptance of Oral HIV Screening in a Dental School Setting

Nassry, David D; Phelan, Joan A; Ghookasian, Miganoush; Barber, Cheryl A; Norman, Robert G; Lloyd, Madeleine M; Schenkel, Andrew; Malamud, Daniel; Abrams, William R
In 2006, the Centers for Disease Control and Prevention (CDC) recommended routine HIV screening in health care settings regardless of the patient's level of risk. This pilot study was developed in response to the suggestion by some health care professionals that dental settings would be appropriate for expansion of HIV testing. This project consisted of two parts: oral fluid HIV testing of patients in the clinic of a dental school and a survey of the clinical dental faculty members' attitudes about acceptability of routine HIV testing in the dental clinic. When patients' agreement to participate in oral fluid HIV testing was examined, 8.2 percent of the patients contacted by the clinic administration staff completed testing. When approached by a faculty member or student during the dental visit admission and tested during the dental visit, however, 88.2 percent completed testing. Of the faculty members who took the survey, 27.4 percent were neutral, 26.4 percent were somewhat in agreement, and 32.1 percent were willing to incorporate HIV testing into routine dental care. In this pilot study, HIV testing of dental patients was most successful when a dental care provider approached patients about testing. If consent was given, the testing was performed during the visit. For the faculty members, the major barrier to testing was a lack of protocol familiarity.
PMCID:4041101
PMID: 22942410
ISSN: 0022-0337
CID: 177175

HIV testing in dental care: opportunities for nurse practitioner and dentist collaboration

Hutchinson, Mary Katherine; Lloyd, Madeleine
PMID: 22334100
ISSN: 0361-1817
CID: 163278

Implementing tobacco use treatment guidelines in public health dental clinics in New York City

Shelley, Donna; Anno, Jaime; Tseng, Tuo-Yen; Calip, Greg; Wedeles, John; Lloyd, Madeleine; Wolff, Mark S
In this study we evaluated the effect of a multicomponent intervention to implement the Public Health Service (PHS) guideline Treating Tobacco Use and Dependence in six randomly selected dental clinics in New York University's College of Dentistry. The main outcome measure-provider adherence to tobacco use treatment guidelines-was assessed by auditing a random selection of patient charts pre (698) and post (641) intervention. The intervention components included a chart reminder and referral system, free nicotine replacement therapy (NRT), and provider training and feedback. The results showed that rates of screening for tobacco use did not change between pre and post test chart audits. However, providers were significantly more likely to offer advice (28.4 percent pre, 49 percent post), assess readiness to quit (17.8 percent pre, 29.9 percent post), and offer assistance (6.5 percent pre and 15.6 percent post) in the post test period. Increases in NRT distribution were associated with booster training sessions but declined in the time periods between those trainings. Research is needed to further define sustainable strategies for implementing tobacco use treatment in dental clinics. The results of this study suggest the feasibility and effectiveness of using a tailored multicomponent approach to implement tobacco use treatment guidelines in dental clinics.
PMID: 21460273
ISSN: 0022-0337
CID: 156295

The oral-systemic connection in primary care [Case Report]

Haber, Judith; Strasser, Sheryl; Lloyd, Madeleine; Dorsen, Caroline; Knapp, Rose; Auerhahn, Carolyn; Kennedy, Robert; Alfano, Michael C; Fulmer, Terry
PMID: 19240637
ISSN: 0361-1817
CID: 156201

A unique collaboration with nurse practitioners

Schenkel A; Lloyd M; Panno FV; Fulmer T; Wiggin J; Haber J; Wolff MS
ORIGINAL:0007225
ISSN: 0022-0337
CID: 154834