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health outcomes trauma

Paul L Weygandt, Scott M Dresden, Emilie S Powell, Joe Feinglass
Introduction: Illinois hospitals have experienced a marked decrease in the number of uninsured patients after implementation of the Affordable Care Act (ACA). However, the full impact of health insurance expansion on trauma mortality is still unknown. The objective of this study was to determine the impact of ACA insurance expansion on trauma patients hospitalized in Illinois. Methods: We performed a retrospective cohort study of 87,001 trauma inpatients from third quarter 2010 through second quarter 2015, which spans the implementation of the ACA in Illinois...
March 2018: Western Journal of Emergency Medicine
Eric J Charles, Nicholas J Napoli, Lily E Johnston, Carrie A Foster, Deirdre A Goode, Trevor B Parker, Eleanor A Sharp, Laura Barnes, Jeffrey S Young
The most common mechanism of traumatic injury is ground-level fall. The objective of this study was to understand how patients sustaining falls and their outcomes have evolved. An institutional trauma database was used to identify adult patients who suffered a fall and were admitted to a Level I trauma center during two distinct time periods: 1998 to 2003 (past) and 2008 to 2013 (current). Data on anticoagulant use and comorbidities was gathered by retrospective chart review of patients treated during 2003 and 2013...
March 1, 2018: American Surgeon
Lucy A Stephenson, Katherine Beck, Paula Busuulwa, Camilla Rosan, Carmine M Pariante, Susan Pawlby, Vaheshta Sethna
Childhood sexual abuse (CSA) is a worldwide problem with severe long-term consequences. A history of CSA can impact the childbearing experience of mothers and fathers; affecting their mental health, parenting skills and compromising infant development. Nonetheless, the perinatal period offers huge opportunity for intervention and hope. This literature review collates evidence for perinatal psychosocial interventions targeting both mothers and fathers who are survivors of CSA. Publications dating from 1970 to June 2016 were searched using Medline, Maternity and Infant Health, PsychINFO, PsychArticles, PubMed and the International Bibliography of the Social Sciences (IBSS)...
March 17, 2018: Child Abuse & Neglect
Alpesh A Patel, Shah-Nawaz M Dodwad, Barrett S Boody, Surabhi Bhatt, Jason W Savage, Wellington K Hsu, Nan E Rothrock
STUDY DESIGN: Prospective, cohort study. OBJECTIVE: Demonstrate validity of PROMIS physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. SUMMARY OF BACKGROUND DATA: There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints...
March 19, 2018: Spine
V N Okoje, T O Aladelusi, T A Abimbola
Aim: The study presents a case series which evaluates the presentation, management and outcome of TMJ dislocation in a tertiary health centre in Nigeria. Materials and methods: Case review of 11 patients with TMJ dislocation seen in the University College Hospital (UCH) Ibadan over a period of 10 years. The criteria for the diagnosis of TMJ dislocation were based on history, clinical examination and radiologic findings. Results: Mean age of patients was 44...
December 2017: Annals of Ibadan Postgraduate Medicine
Shanta R Dube
Currently, in the U.S. and worldwide, childhood trauma is a public health crisis. Childhood adversities, such as abuse, neglect, and related household stressors, are common, interrelated and contribute to multiple adverse social, behavioral and health outcomes throughout the lifespan. The present article provides further discussion regarding adverse childhood experiences (ACEs) screening in healthcare utilizing the etic and emic perspectives. Screening in the healthcare system leans toward the etic view: objective observations of symptoms, which may then lead to intervention delivery...
March 16, 2018: Child Abuse & Neglect
Richard Sola, Valerie A Waddell, Shawn D St Peter, Pablo Aguayo, David Juang
INTRODUCTION: Non-accidental trauma (NAT) has significant societal and health care implications. Standardized care has been shown to improve outcomes. The purpose of our study was to survey trauma centers and elucidate the continued variable management of NAT. METHODS: After institutional review board approval, an email survey was sent to Level 1 and 2 ACS verified trauma centers along with general and pediatric surgery training programs. Trauma hospital characteristics and NAT management were analyzed...
March 10, 2018: Injury
Suzan Mitwalli, Yoke Rabaia, Hanna Kienzler
BACKGROUND: Since 2013, the community-based rehabilitation programme in the north of the West Bank has established nineteen support groups for mothers following a Multi-Family Approach (MFA), with technical support from the Institute of Community and Public Health (Birzeit University) and the War Trauma Foundation (Netherlands). The main aims of the programme are to improve the wellbeing of mothers who have children with a handicap, to build support networks between vulnerable families, and to counter problems associated with social isolation and stigma...
February 21, 2018: Lancet
Georgios Alexandridis, Amy C Gunning, Ger D J van Olden, Egbert-Jan M M Verleisdonk, Michiel J M Segers, Luke P H Leenen
PURPOSES: Calcaneal fractures are known to influence patients' quality of life negatively. The type of calcaneal fracture might have a relation with the patient outcome. To inform patients in an early stage on how their calcaneal fracture may affect their lives, knowledge of the fracture characteristics is necessary. This study evaluates the association of type of calcaneal fracture, measurement of conventional radiograph angles, and the Sanders classification with patient-reported outcomes...
March 17, 2018: International Orthopaedics
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
Sanju Silwal, Ragnhild Dybdahl, Roshan Chudal, Andre Sourander, Lars Lien
BACKGROUND: In 2015, Nepal was hit by two major earthquakes, which caused 8900 deaths and displaced more than 450,000 people. We assessed the prevalence of post-traumatic stress symptoms (PTSS) and depressive symptoms and explored potential risk factors among adolescents. METHODS: This cross-sectional study comprised 893 students aged 11-17 in school grades 7-10. They lived in two districts affected by the earthquakes: Sindhupalchok and Kathmandu. Psychiatric symptoms were assessed using Child PTSD symptom scale and Depression Self-Rating Scale...
March 7, 2018: Journal of Affective Disorders
Irmela Gnass, Michaela Ritschel, Silke Andrich, Silke Kuske, Kai Moschinski, Annegret Herrmann-Frank, Maria-Inti Metzendorf, Sascha Flohé, Johannes Sturm, Joachim Windolf, Andrea Icks
INTRODUCTION: Survivors of polytrauma experience long-term and short-term burden that influences their lives. The patients' view of relevant short-term and long-term outcomes should be captured in instruments that measure quality of life and other patient-reported outcomes (PROs) after a polytrauma. The aim of this systematic review is to (1) collect instruments that assess PROs (quality of life, social participation and activities of daily living) during follow-up after polytrauma, (2) describe the instruments' application (eg, duration of period of follow-up) and (3) investigate other relevant PROs that are also assessed in the included studies (pain, depression, anxiety and cognitive function)...
March 16, 2018: BMJ Open
Mark Ayoub, William Paul Bassett, Patricia Seuffert, Douglas Matijakovich, Dorene A O Hara, Mark S Butler
OBJECTIVE: Health care costs are increasing in medicine and in orthopedics. Device choice in orthopedic cases can impact the cost of the procedure and thus result in cost savings. This study aims to determine whether orthopedic attendings and residents accurately estimate device costs they are implanting in trauma cases and whether costs would influence their surgical device selection. DESIGN: Using nationally published average cost data for 13 implants, a survey was distributed at 6 US academic centers...
March 13, 2018: Journal of Surgical Education
Myra Sabir, Margaret A Johnson
We articulate the lifespan theory of change by which an attachment-focused integrative reminiscence intervention, "Life Writing", is expected to interrupt the continuing problem of insecure attachment in adults and reverse associated reduced health and well-being outcomes. Based on preliminary studies and previous research, Life Writing is expected to foster earned-secure attachment in adults who work through subjective memories of unresolved attachment trauma. Roughly two decades of research on integrative reminiscence interventions like Life Writing show their consistent and wide-ranging positive impact...
February 13, 2018: Evaluation and Program Planning
Tine K Jensen, Tonje Holt, Silje Mørup Ormhaug, Krister W Fjermestad, Tore Wentzel-Larsen
Posttraumatic stress symptoms (PTSS) are associated with serious impairments in psychological, social, and academic functioning in youth. The aim of this study was to investigate whether changes in posttraumatic cognitions mediate treatment effects. Participants were multitraumatized youth (N = 156, mean age = 15.1 years, range = 10-18; 79.5% girls) randomly assigned to receive trauma-focused cognitive-behavioral therapy (TF-CBT) or treatment-as-usual (TAU). Mixed-effects models were applied to investigate the impact of treatment conditions on posttraumatic cognitions...
March 2018: Journal of Counseling Psychology
Eiman Zargaran, Richard Spence, Lauren Adolph, Andrew Nicol, Nadine Schuurman, Pradeep Navsaria, Damon Ramsey, S Morad Hameed
Importance: Collection and analysis of up-to-date and accurate injury surveillance data are a key step in the maturation of trauma systems. Trauma registries have proven to be difficult to establish in low- and middle-income countries owing to the burden of trauma volume, cost, and complexity. Objective: To determine whether an electronic trauma health record (eTHR) used by physicians can serve as simultaneous clinical documentation and data acquisition tools. Design, Setting, and Participants: This 2-part quality improvement study included (1) preimplementation and postimplementation eTHR study with assessments of satisfaction by 41 trauma physicians, time to completion, and quality of data collected comparing paper and electronic charting; and (2) prospective ecologic study describing the burden of trauma seen at a Level I trauma center, using real-time data collected by the eTHR on consecutive patients during a 12-month study period...
March 14, 2018: JAMA Surgery
Kallio Hunnicutt-Ferguson, Katarzyna E Wyka, Melissa Peskin, Judith Cukor, Megan Olden, JoAnn Difede
Posttraumatic stress disorder (PTSD) is associated with functional deficits, poor physical health, and diminished quality of life. Limited research has examined PTSD symptom clusters and their associations with functioning and distress among disaster recovery workers, a population at high risk for PTSD due to potential for repeated trauma. The purpose of this study was to investigate associations between overall PTSD severity, as well as PTSD symptom clusters, and social and occupational functioning and subjective distress in World Trade Center (WTC) disaster workers after the terrorist attacks on September 11, 2001 (9/11)...
March 14, 2018: Journal of Traumatic Stress
Ellen W Blair, Jyoti Chhabra, Cynthia Belonick, Maria Tackett
Potential for suicide risk can be a safety concern for patients in all health care settings. Inadequate training of nurses in suicide assessment and prevention is a serious patient safety concern. A non-randomized pre-/postintervention research design was used to measure the effects of education on non-psychiatric nurses' perceived self-efficacy in assessment and inquiry about suicide risk and in implementing suicide prevention strategies. The intervention was an educational module about suicide prevention and care delivered to non-psychiatric nurses employed on a neuro-trauma unit in an acute care urban hospital setting...
March 14, 2018: Journal of Psychosocial Nursing and Mental Health Services
Antonio Ernstberger, Michael Koller, Florian Zeman, Maximilian Kerschbaum, Franz Hilber, Eva Diepold, Julika Loss, Tanja Herbst, Michael Nerlich
BACKGROUND: Trauma is a global burden of disease and one of the main causes of death worldwide. Therefore, many countries around the world have implemented a wide range of different initiatives to minimize mortality rates after trauma. One of these initiatives is the bundling of treatment expertise in trauma centers and the establishment of trauma networks. Germany has a decentralized system of trauma care medical centers. Severely injured patients ought to receive adequate treatment in both level I and level II centers...
2018: PloS One
Klaus Bsl Batista, Badri Thiruvenkatachari, Jayne E Harrison, Kevin D O'Brien
BACKGROUND: Prominent upper front teeth are a common problem affecting about a quarter of 12-year-old children in the UK. The condition develops when permanent teeth erupt. These teeth are more likely to be injured and their appearance can cause significant distress. Children are often referred to an orthodontist for treatment with dental braces to reduce the prominence of their teeth. If a child is referred at a young age, the orthodontist is faced with the dilemma of whether to treat the patient early or to wait and provide treatment in adolescence...
March 13, 2018: Cochrane Database of Systematic Reviews
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