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https://www.readbyqxmd.com/read/28916666/regional-evaluation-of-the-severity-based-stroke-triage-algorithm-for-emergency-medical-services-using-discrete-event-simulation
#1
Brittany M Bogle, Andrew W Asimos, Wayne D Rosamond
BACKGROUND AND PURPOSE: The Severity-Based Stroke Triage Algorithm for Emergency Medical Services endorses routing patients with suspected large vessel occlusion acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region. METHODS: We developed a discrete event simulation environment to model patients with suspected stroke transported according to algorithm specifications, which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28915164/organizational-and-environmental-factors-influencing-hospital-community-orientation
#2
JʼAime C Jennings, Amy Y Landry, Larry R Hearld, Robert Weech-Maldonado, Scott W Snyder, Patricia A Patrician
BACKGROUND: Community orientation refers to hospitals' efforts to assess and meet the health needs of the local population. Variations in the number of community orientation-related activities offered by hospitals may be attributed to differences in organizational and environmental characteristics. Therefore, hospitals have to strategically respond to these internal and external constraints to improve community health. Understanding the facilitators and barriers of hospital community orientation is important to health care managers facing pressure from the external environment to meet the expectations of the community as well as Affordable Care Act guidelines...
September 15, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28911351/comprehensive-understanding-of-health-seeking-behaviour-among-pulmonary-tuberculosis-patients-in-china
#3
Y Jiang, B Cao, N Ohmagari, A-H Wu, Y-X Liu, L-P Guo
SETTING: In China, there were 918 000 tuberculosis (TB) cases in 2015 alone. The primary challenge facing TB control is the allocation of limited health care resources. OBJECTIVE: To gain a comprehensive understanding of the first choice of health care facility among Chinese patients with suspected pulmonary TB (PTB) and the number of visits required to make the diagnosis. DESIGN: Relevant full-text articles in three Chinese and one English literature databases up to November 2016 were reviewed...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28910207/challenges-of-using-probabilistic-linkage-methodology-to-characterize-post-cardiac-arrest-care-in-michigan
#4
Robert Swor, Lihua Qu, Kevin Putman, Kelly N Sawyer, Robert Domeier, Jennifer Fowler, William Fales
BACKGROUND: To improve survival of patients resuscitated from out of hospital cardiac arrest (OCHA), data is needed to assess and improve inpatient post-resuscitation care. Our objective was to apply probabilistic linkage methodology to link EMS and inpatient databases and evaluate whether it may be used to describe post-arrest care in Michigan. METHODS: We performed a retrospective study to describe post-cardiac arrest care in adult OHCA patients who were transported to Michigan hospitals from July 1, 2010, to June 30, 2013...
September 14, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28905296/potentially-preventable-medical-hospitalizations-and-emergency-department-visits-by-the-behavioral-health-population
#5
Eric M Schmidt, Simone Behar, Alinne Barrera, Matthew Cordova, Leonard Beckum
This study investigated geographic variation in potentially preventable medical outcomes that might be used to monitor access to high-quality medical care in the behavioral health population. Analyzing public and non-public data sources from California on adults admitted between 2009 and 2011 to all non-federal licensed medical inpatient (N = 6,603,146) or emergency department units (N = 21,011,958) revealed that 33.6% of nearly 1 million potentially preventable hospitalizations and 9.8% of 1.5 million potentially preventable emergency department visits were made by people with mental or substance use disorder diagnoses...
September 13, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/28905004/gastroenteritis-aggressive-versus-slow-treatment-for-rehydration-gastro-a-pilot-rehydration-study-for-severe-dehydration-who-plan-c-versus-slower-rehydration
#6
Kirsty A Houston, Jack G Gibb, Ayub Mpoya, Nchafatso Obonyo, Peter Olupot-Olupot, Margeret Nakuya, Jennifer A Evans, Elizabeth C George, Diana M Gibb, Kathryn Maitland
BACKGROUND: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28899451/hand-hygiene-improvement-and-sustainability-assessing-a-breakthrough-collaborative-in-western-switzerland
#7
Anthony Staines, Isabelle Amherdt, Estelle Lécureux, Christiane Petignat, Philippe Eggimann, Marcos Schwab, Didier Pittet
OBJECTIVE To assess hand hygiene improvement and sustainability associated with a Breakthrough Collaborative. DESIGN Multicenter analysis of hand hygiene compliance through direct observation by trained observers. SETTING A total of 5 publicly funded hospitals in 14 locations, with a total of 1,152 beds, in the County of Vaud, Switzerland. PARTICIPANTS Clinical staff. INTERVENTIONS In total, 59,272 opportunities for hand hygiene were monitored for the duration of the study, for an average of 5,921 per audit (range, 5,449-6,852)...
September 13, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28895893/applying-nonparametric-methods-to-analyses-of-short-term-fine-particulate-matter-exposure-and-hospital-admissions-for-cardiovascular-diseases-among-older-adults
#8
Louis Anthony Tony Cox, Xiaobin Liu, Liuhua Shi, Ke Zu, Julie Goodman
Short-term exposure to fine particulate matter (PM2.5) has been associated with increased risks of cardiovascular diseases (CVDs), but whether such associations are supportive of a causal relationship is unclear, and few studies have employed formal causal analysis methods to address this. We employed nonparametric methods to examine the associations between daily concentrations of PM2.5 and hospital admissions (HAs) for CVD among adults aged 75 years and older in Texas, USA. We first quantified the associations in partial dependence plots generated using the random forest approach...
September 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28891716/implementation-of-a-county-township-village-allied-hiv-prevention-and-control-intervention-in-rural-china
#9
Jun Yu, Yi Zhang, Junjun Jiang, Qinglin Lu, Bingyu Liang, Deping Liu, Keyong Fang, Jiegang Huang, Yang He, Chuanyi Ning, Yanyan Liao, Jingzhen Lai, Wudi Wei, Fengxiang Qin, Li Ye, Wenkui Geng, Hao Liang
In China, rural areas are a weak link of HIV/AIDS prevention and control. From September 2011, an innovative "county-township-village" allied intervention was implemented in Longzhou County, Guangxi, which assigned the tasks of HIV/AIDS prevention and control to the county Centers for Disease Control and Prevention (CDC), township hospitals, and village clinics, respectively, instead of traditional intervention in which the county CDC undertook the entire work. A 6-year consecutive cross-sectional survey, including 3-year traditional intervention (2009-2011) and 3-year innovative intervention (2012-2014), was conducted to evaluate the effects of the new intervention...
September 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28891553/hyperthyroidism-and-sick-sinus-syndrome-a-rare-but-challenging-association-a-study-of-three-cases
#10
M Tudoran, C Tudoran
Hyperthyroidism is usually associated with sinus tachycardia or supraventricular tachyarrhythmias, but rarely with dysfunction of the sinus node or other conduction disturbances. Evidence of bradyarrhythmia in patients with hyperthyroidism is clinically relevant, but the fact that several drugs with negative chronotropic effects (beta-blockers and calcium channel antagonists) are frequently used in the management of these patients must be taken into account. In the presence of sick sinus syndrome (SSS) or other conductance disturbances, therapy with agents that delay the activity of sinus node or atrioventricular conduction can lead to extreme bradycardia with syncope...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28891252/the-incidence-and-prevalence-of-systemic-lupus-erythematosus-in-new-york-county-manhattan-new-york-the-manhattan-lupus-surveillance-program
#11
Peter M Izmirly, Isabella Wan, Sara Sahl, Jill P Buyon, H Michael Belmont, Jane E Salmon, Anca Askanase, Joan M Bathon, Laura Geraldino-Pardilla, Yousaf Ali, Ellen M Ginzler, Chaim Putterman, Caroline Gordon, Charles G Helmick, Hilary Parton
OBJECTIVE: The Manhattan Lupus Surveillance Program (MLSP) is a population-based registry designed to determine the prevalence of systemic lupus erythematosus (SLE) in 2007 and the incidence from 2007 to 2009 among residents of New York County (Manhattan), New York, and to characterize cases by race/ethnicity, including Asians and Hispanics, for whom data are lacking. METHODS: We identified possible SLE cases from hospital records, rheumatologist records, and administrative databases...
September 10, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28891237/the-incidence-and-prevalence-of-systemic-lupus-erythematosus-in-san-francisco-county-california-the-california-lupus-surveillance-project
#12
Maria Dall'Era, Miriam G Cisternas, Kurt Snipes, Lisa J Herrinton, Caroline Gordon, Charles G Helmick
OBJECTIVE: Estimates of the incidence and prevalence of systemic lupus erythematosus (SLE) in the US have varied widely. The purpose of this study was to conduct the California Lupus Surveillance Project (CLSP) to determine credible estimates of SLE incidence and prevalence, with a special focus on Hispanics and Asians. METHODS: The CLSP, which is funded by the Centers for Disease Control and Prevention, is a population-based registry of individuals with SLE residing in San Francisco County, CA, from January 1, 2007 through December 31, 2009...
September 10, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28886119/intimate-partner-violence-related-hospitalizations-in-appalachia-and-the-non-appalachian-united-states
#13
Danielle M Davidov, Stephen M Davis, Motao Zhu, Tracie O Afifi, Melissa Kimber, Abby L Goldstein, Nicole Pitre, Kelly K Gurka, Carol Stocks
The highly rural region of Appalachia faces considerable socioeconomic disadvantage and health disparities that are recognized risk factors for intimate partner violence (IPV). The objective of this study was to estimate the rate of IPV-related hospitalizations in Appalachia and the non-Appalachian United States for 2007-2011 and compare hospitalizations in each region by clinical and sociodemographic factors. Data on IPV-related hospitalizations were extracted from the State Inpatient Databases, which are part of the Healthcare Cost and Utilization Project...
2017: PloS One
https://www.readbyqxmd.com/read/28880904/prospective-comparison-of-two-models-of-integrating-early-infant-male-circumcision-with-maternal-child-health-services-in-kenya-the-mtoto-msafi-mbili-study
#14
Robert C Bailey, Fredrick Adera, Mary Ellen Mackesy-Amiti, Timothy Adipo, Sherry K Nordstrom, Supriya D Mehta, Walter Jaoko, F L Fredrik G Langi, Walter Obiero, Edmon Obat, Fredrick O Otieno, Marisa R Young
As countries scale up adult voluntary medical male circumcision (VMMC) for HIV prevention, they are looking ahead to long term sustainable strategies, including introduction of early infant male circumcision (EIMC). To address the lack of evidence regarding introduction of EIMC services in sub-Saharan African settings, we conducted a simultaneous, prospective comparison of two models of EIMC service delivery in Homa Bay County, Kenya. In one division a standard delivery package (SDP) was introduced and included health facility-based provision of EIMC services with community engagement for client referral versus in a different division a standard package plus (SDPplus) that included community-delivered EIMC services...
2017: PloS One
https://www.readbyqxmd.com/read/28877729/effect-of-enhanced-feedback-to-hospitals-that-are-part-of-an-emerging-clinical-information-network-on-uptake-of-revised-childhood-pneumonia-treatment-policy-study-protocol-for-a-cluster-randomized-trial
#15
Philip Ayieko, Grace Irimu, Mike English
BACKGROUND: The national pneumonia treatment guidelines in Kenya changed in February 2016 but such guideline changes are often characterized by prolonged delays in affecting practice. We designed an enhanced feedback intervention, delivered within an ongoing clinical network that provides a general form of feedback, aimed at improving and sustaining uptake of the revised pneumonia treatment policy. The objective was to determine whether an enhanced feedback intervention will improve correctness of classification and treatment of childhood pneumonia, compared to an existing approach to feedback, after nationwide treatment policy change and within an existing hospital network...
September 7, 2017: Trials
https://www.readbyqxmd.com/read/28876467/nationwide-population-based-study-of-post-radical-prostatectomy-urinary-incontinence-correction-surgery
#16
Eugenio Ventimiglia, Yasin Folkvaljon, Stefan Carlsson, Ola Bratt, Francesco Montorsi, Daniela Volz, Olof Akre, Eva Johansson, Pär Stattin
OBJECTIVES: To assess the use of post radical prostatectomy (RP) urinary incontinence (PPI) surgery and to investigate factors related to its use. METHODS: Cohort study in Prostate Cancer database Sweden (PCBaSe) of men who underwent primary RP between 1998 and 2012. PPI correction procedures were identified in the Patient Registry. Hazard ratios (HR) and 95% confidence intervals (CIs) of PPI surgeries were estimated. RESULTS: Seven hundred eighty-two out of 26 280 (3%) men underwent PPI surgery at a median time of 3 years after RP...
September 6, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28876169/ndm-1-hazard-in-the-balkan-states-evidence-of-the-first-outbreak-of-ndm-1-producing-klebsiella-pneumoniae-in-bulgaria
#17
Encho Savov, Lida Politi, Nicholas Spanakis, Angelina Trifonova, Elena Kioseva, Athanasios Tsakris
New Delhi MBL (NDM) carbapenemase-producing Klebsiella pneumoniae has become one of the most concerning multidrug-resistant pathogens. The Balkan counties are considered a reservoir for the spread of such strains based on several reports documenting NDM infections after hospitalization in this region. Nevertheless, NDM-producing K. pneumoniae have been only occasionally documented from Balkans. The current study documents the first polyclonal outbreak caused by NDM-1-producing K. pneumoniae in Bulgaria. From July 2015 to April 2016, all 25 single-patient carbapenem-nonsusceptible K...
September 6, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/28874938/availability-and-accuracy-of-ems-information-about-chronic-health-and-medications-in-cardiac-arrest
#18
Alexander Foster, Victor Florea, Carol Fahrenbruch, Jennifer Blackwood, Thomas D Rea
INTRODUCTION: Field information available to emergency medical services (EMS) about a patient's chronic health conditions or medication therapies could help direct patient care or be used to investigate outcome disparities. However, little is known about the field availability or accuracy of information of chronic health conditions or chronic medication treatments in emergent circumstances, especially when the patient cannot serve as an information resource. We evaluated the prehospital availability and accuracy of specific chronic health conditions and medication treatments among out-of-hospital cardiac arrest (OHCA) patients...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874496/access-to-obstetric-services-in-rural-counties-still-declining-with-9%C3%A2-percent-losing-services-2004-14
#19
Peiyin Hung, Carrie E Henning-Smith, Michelle M Casey, Katy B Kozhimannil
Recent closures of rural obstetric units and entire hospitals have exacerbated concerns about access to care for more than twenty-eight million women of reproductive age living in rural America. Yet the extent of recent obstetric unit closures has not yet been measured. Using national data, we found that 9 percent of rural counties experienced the loss of all hospital obstetric services in the period 2004-14. In addition, another 45 percent of rural US counties had no hospital obstetric services at all during the study period...
September 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28874259/outcomes-from-a-university-based-low-cost-in%C3%A2-vitro-fertilization-program-providing-access-to-care-for-a-low-resource-socioculturally-diverse-urban-community
#20
Christopher N Herndon, Yanett Anaya, Martha Noel, Hakan Cakmak, Marcelle I Cedars
OBJECTIVE: To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. DESIGN: Retrospective cohort study. SETTING: Academic infertility center. PATIENT(S): Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population...
September 2, 2017: Fertility and Sterility
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