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OBJECTIVE Timely availability of intravenous infusion pumps is critical for high-quality care delivery. Pumps are shared among hospital units, often without central management of their distribution. This study seeks to characterize unit-to-unit pump sharing and its impact on shortages, and to evaluate a system-control tool that balances inventory across all care areas, enabling increased availability of pumps. MATERIALS AND METHODS A retrospective study of 3832 pumps moving in a network of 5292 radiofrequency and infrared sensors from January to November 2017 at The Johns Hopkins Hospital in Baltimore, Maryland. We used network analysis to determine whether pump inventory in one unit was associated with inventory fluctuations in others. We used a quasi-experimental design and segmented regressions to evaluate the effect of the system-control tool on enabling safe inventory levels in all care areas. RESULTS We found 93 care areas connected through 67,111 pump transactions and 4 discernible clusters of pump sharing. Up to 17% (95% confidence interval, 7%-27%) of a unit's pump inventory was explained by the inventory of other units within its cluster. The network analysis supported design and deployment of a hospital-wide inventory balancing system, which resulted in a 44% (95% confidence interval, 36%-53%) increase in the number of care areas above safe inventory levels. CONCLUSIONS Network phenomena are essential inputs to hospital equipment fleet management. Consequently, benefits of improved inventory management in strategic unit(s) are capable of spreading safer inventory levels throughout the hospital. © The Author(s) 2020. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email [email protected] literacy is individuals' motivation and ability to obtain, understand, evaluate and use health information. Health literacy is very important during university education when students have the ability to acquire and accumulate knowledge of the best way. The aim of this study was to determine the health literacy of university students. The sample of this descriptive cross-sectional study was composed of 365 students who were first-time visitors at the health center of a private university in Northern Cyprus between May and July 2017. An introductory information form and the Adult Health Literacy Scale (AHLS) were used as data collection tools. The mean AHLS score of the students was found as 13.91 ± 2.90. Health literacy was found to be lower for male students and students with more years of study. The students with low daily alcohol use had higher AHLS scores. The results of the study suggest that curricula should be revised to raise the health literacy of university students to the highest level. It is important to organize conferences, seminars and scientific activities to improving the health literacy of male students and students with more years of study. Due to the limitations of studies of health literacy in North Cyprus, future studies should be conducted with larger samples and different measurement tools. © The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email [email protected] coordination is a core part of human interaction, and its underlying mechanisms have been extensively studied using social paradigms such as joint finger tapping. Here, individual and dyadic differences have been found to yield a range of dyadic synchronization strategies, such as mutual adaptation, leading-leading, and leading-following behaviour, but the brain mechanisms that underlie these strategies remain poorly understood. To identify individual brain mechanisms underlying emergence of these minimal social interaction strategies, we contrasted EEG-recorded brain activity in two groups of musicians exhibiting the mutual adaptation and leading-leading strategies. We found that the individuals coordinating via mutual adaptation exhibited a more frequent occurrence of phase-locked activity within a transient action-perception related brain network in the alpha range, as compared to the leading-leading group. Furthermore, we identified parietal and temporal brain regions that changed significantly in the directionality of their within-network information flow. Our results suggest that the stronger weight on extrinsic coupling observed in computational models of mutual adaptation as compared to leading-leading might be facilitated by a higher degree of action-perception network coupling in the brain. © The Author(s) 2020. Published by Oxford University Press.BACKGROUND Lack of health insurance coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in coverage are common among low-income populations; but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival. PF07265807 METHODS We conducted a systematic review of studies of health insurance coverage disruptions and cancer care and outcomes published between 1980 and 2019. We used the PubMed, EMBASE, Scopus, and CINAHL databases and identified 29 observational studies. Study characteristics and key findings were abstracted and synthesized qualitatively. RESULTS Studies evaluated associations between coverage disruptions and prevention or screening (31.0%), treatment (13.8%), end-of-life care (10.3%), stage at diagnosis (44.8%) and survival (20.7%). Coverage disruptions ranged from 4.3% to 32.8% of patients age-eligible for breast, cervical or colorectal cancer screening. Between 22.1% and 59.5% of patients with Medicaid gained coverage only at or after cancer diagnosis. Coverage disruptions were consistently statistically significantly associated with lower receipt of prevention, screening, and treatment. Among patients with cancer, those with Medicaid disruptions were statistically significantly more likely to have advanced stage (odds ratios 1.2 to 3.8) and worse survival (hazard ratios 1.28 to 2.43) than patients without disruptions. CONCLUSION Health insurance coverage disruptions are common and adversely associated with receipt of cancer care and survival. Improved data infrastructure and quasi-experimental study designs will be important for evaluating the associations of federal and state policies on coverage disruptions and care and outcomes. Published by Oxford University Press 2020.
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