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https://www.readbyqxmd.com/read/28911749/effect-of-participatory-women-s-groups-and-counselling-through-home-visits-on-children-s-linear-growth-in-rural-eastern-india-caring-trial-a-cluster-randomised-controlled-trial
#1
Nirmala Nair, Prasanta Tripathy, H S Sachdev, Hemanta Pradhan, Sanghita Bhattacharyya, Rajkumar Gope, Sumitra Gagrai, Shibanand Rath, Suchitra Rath, Rajesh Sinha, Swati Sarbani Roy, Suhas Shewale, Vijay Singh, Aradhana Srivastava, Anthony Costello, Andrew Copas, Jolene Skordis-Worrall, Hassan Haghparast-Bidgoli, Naomi Saville, Audrey Prost
BACKGROUND: Around 30% of the world's stunted children live in India. The Government of India has proposed a new cadre of community-based workers to improve nutrition in 200 districts. We aimed to find out the effect of such a worker carrying out home visits and participatory group meetings on children's linear growth. METHODS: We did a cluster-randomised controlled trial in two adjoining districts of Jharkhand and Odisha, India. 120 clusters (around 1000 people each) were randomly allocated to intervention or control using a lottery...
October 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28905296/potentially-preventable-medical-hospitalizations-and-emergency-department-visits-by-the-behavioral-health-population
#2
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/28902402/safety-net-versus-private-hospital-setting-for-brain-metastasis-patients-treated-with-radiosurgery-alone-disparities-in-follow-up-care-and-outcomes
#3
Kevin Diao, Yanqing Sun, Stella K Yoo, Cheng Yu, Jason C Ye, Nicholas Trakul, Richard L Jennelle, Paul E Kim, Gabriel Zada, John P Gruen, Eric L Chang
BACKGROUND: Stereotactic radiosurgery (SRS) alone is an increasingly accepted treatment for brain metastases, but it requires adherence to frequently scheduled follow-up neuroimaging because of the risk of distant brain metastasis. The effect of disparities in access to follow-up care on outcomes after SRS alone is unknown. METHODS: This retrospective study included 153 brain metastasis patients treated consecutively with SRS alone from 2010 through 2016 at an academic medical center and a safety-net hospital (SNH) located in Los Angeles, California...
September 13, 2017: Cancer
https://www.readbyqxmd.com/read/28891715/-where-it-falls-apart-barriers-to-retention-in-hiv-care-in-latino-immigrants-and-migrants
#4
Julie H Levison, Laura M Bogart, Iman F Khan, Dianna Mejia, Hortensia Amaro, Margarita Alegría, Steven Safren
Latino immigrants in the United States are disproportionately affected by HIV. Barriers to consistent attendance (retention) in HIV primary care constrain opportunities for HIV treatment success, but have not been specifically assessed in this population. We conducted semistructured interviews with 37 HIV-infected Latinos (aged ≥18 years and born in Puerto Rico or a Latin American Spanish-speaking country) and 14 HIV providers in metropolitan Boston (total n = 51). The Andersen Model of Healthcare Utilization informed a semistructured interview guide, which bilingual research staff used to explore barriers to HIV care...
September 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28885858/the-latino-integrative-medical-group-visit-as-a-model-for-pain-reduction-in-underserved-spanish-speakers
#5
Oscar Cornelio-Flores, Anna Sophia Lestoquoy, Sheila Abdallah, Amanda DeLoureiro, Karla Lorente, Bryan Pardo, Joseph Olunwa, Paula Gardiner
OBJECTIVES: Chronic pain is a common problem in the United States, one for which there is a dearth of effective treatments. Nonpharmacological options are a promising alternative, especially for Spanish-speaking Latinos. This pilot study would like to assess the feasibility of an adapted Integrative Medical Group Visit (IMGV) curriculum for a Spanish-speaking Latino chronic pain population. DESIGN AND INTERVENTION: We translated and adapted the curriculum of the IMGV for a Spanish-speaking Latino chronic pain population...
September 8, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28876296/neighborhood-health-care-access-and-sexually-transmitted-infections-among-women-in-the-southern-united-states-a-cross-sectional-multilevel-analysis
#6
Danielle F Haley, Andrew Edmonds, Nadya Belenky, DeMarc A Hickson, Catalina Ramirez, Gina M Wingood, Hector Bolivar, Elizabeth Golub, Adaora A Adimora
INTRODUCTION: The United States has experienced an increase in reportable sexually transmitted infections (STIs) while simultaneously experiencing a decline in safety net services for STI testing and treatment. This multilevel study assessed relationships between neighborhood-level access to health care and STIs among a predominantly Human Immunodeficiency Virus (HIV)-seropositive cohort of women living in the south. METHODS: This cross-sectional multilevel analysis included baseline data from HIV-seropositive and HIV-seronegative women enrolled in the Women's Interagency HIV Study sites in Alabama, Florida, Georgia, Mississippi, and North Carolina between 2013 and 2015 (N = 666)...
August 2, 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28876293/the-spatial-association-between-federally-qualified-health-centers-and-county-level-reported-sexually-transmitted-infections-a-spatial-regression-approach
#7
Kwame Owusu-Edusei, Thomas L Gift, Jami S Leichliter, Raul A Romaguera
BACKGROUND: The number of categorical sexually transmitted disease (STD) clinics is declining in the United States. Federally qualified health centers (FQHCs) have the potential to supplement the needed sexually transmitted infection (STI) services. In this study, we describe the spatial distribution of FQHC sites and determine if reported county-level nonviral STI morbidity were associated with having FQHC(s) using spatial regression techniques. METHODS: We extracted map data from the Health Resources and Services Administration data warehouse on FQHCs (ie, geocoded health care service delivery [HCSD] sites) and extracted county-level data on the reported rates of chlamydia, gonorrhea and, primary and secondary (P&S) syphilis (2008-2012) from surveillance data...
August 16, 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28874494/despite-boosting-children-s-coverage-rates-to-historic-levels-medicaid-and-chip-face-an-uncertain-future
#8
Tricia A Brooks
The Children's Health Insurance Program (CHIP), which was enacted twenty years ago, covers uninsured children who do not qualify for Medicaid but lack access to affordable coverage. Together these safety-net programs have boosted the health insurance coverage rate among US children to historic levels, exceeding 95 percent of children in 2015. However, the future of both CHIP and Medicaid is uncertain. In the current congressional debate over the Affordable Care Act, Medicaid has become a target for potential funding reductions and other changes that would undermine the scope of children's coverage...
September 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28873161/effect-of-colonoscopy-outreach-vs-fecal-immunochemical-test-outreach-on-colorectal-cancer-screening-completion-a-randomized-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Amit G Singal, Samir Gupta, Celette Sugg Skinner, Chul Ahn, Noel O Santini, Deepak Agrawal, Christian A Mayorga, Caitlin Murphy, Jasmin A Tiro, Katharine McCallister, Joanne M Sanders, Wendy Pechero Bishop, Adam C Loewen, Ethan A Halm
Importance: Mailed fecal immunochemical test (FIT) outreach is more effective than colonoscopy outreach for increasing 1-time colorectal cancer (CRC) screening, but long-term effectiveness may need repeat testing and timely follow-up for abnormal results. Objective: Compare the effectiveness of FIT outreach and colonoscopy outreach to increase completion of the CRC screening process (screening initiation and follow-up) within 3 years. Design, Setting, and Participants: Pragmatic randomized clinical trial from March 2013 to July 2016 among 5999 participants aged 50 to 64 years who were receiving primary care in Parkland Health and Hospital System and were not up to date with CRC screenings...
September 5, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28865432/a-mixed-methods-investigation-of-incident-hemodialysis-access-in-a-safety-net-population
#10
Nicole C Rich, Shant M Vartanian, Shimi Sharief, Daniel J Freitas, Delphine S Tuot
BACKGROUND: Despite improved health outcomes associated with arteriovenous fistulas, 80% of Americans initiate hemodialysis using a catheter, influenced by low socioeconomic status among other factors. Risk factors for incident catheter use in safety-net populations are unknown. Our objective was to identify factors associated with incident catheter use among hemodialysis patients at one safety-net hospital, with a goal of informing fistula placement initiatives targeted at safety-net populations more generally...
September 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28865428/psychosocial-stressors-contributing-to-emergency-psychiatric-service-utilization-in-a-sample-of-ethno-culturally-diverse-clients-with-psychosis-in-toronto
#11
Martin Rotenberg, Andrew Tuck, Kwame McKenzie
BACKGROUND: Understanding the psychosocial stressors of people with psychoses from minority ethnic groups may help in the development of culturally appropriate services. This study aimed to compare psychosocial factors associated with attendance at an emergency department (ED) for six ethnic groups. Preventing crises or supporting people better in the community may decrease hospitalization and improve outcomes. METHOD: A cohort was created by retrospective case note analysis of people of East-Asian, South-Asian, Black-African, Black-Caribbean, White-North American and White-European origin groups attending a specialized psychiatric ED in Toronto with a diagnosis of psychosis between 2009 and 2011...
September 2, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28861544/transgender-and-gender-nonconforming-in-emergency-departments-a-qualitative-report-of-patient-experiences
#12
Makini Chisolm-Straker, Logan Jardine, Cyril Bennouna, Nina Morency-Brassard, Lauren Coy, Maria Olivia Egemba, Peter L Shearer
Background: Individuals who have a transgender or gender nonconforming (TGGNC) experience belong to a marginalized segment of the U.S. population, and healthcare can be difficult for them to navigate. Although emergency departments (EDs) traditionally serve as healthcare "safety nets" for vulnerable populations, quantitative studies outside the United States have found that TGGNC-experienced persons tend to avoid EDs and/or have negative experiences. This qualitative study primarily describes the ED experiences of people with a TGGNC history; furthermore, the study explores reasons why this population avoids U...
2017: Transgender Health
https://www.readbyqxmd.com/read/28856475/race-ethnicity-specific-disparities-in-the-severity-of-disease-at-presentation-in-adults-with-ulcerative-colitis-a-cross-sectional-study
#13
Garland Castaneda, Benny Liu, Sharon Torres, Taft Bhuket, Robert J Wong
BACKGROUND: While ulcerative colitis (UC) is well studied in Caucasian populations, less data are available on UC patients of racial/ethnic minorities, including variations in disease severity at presentation. AIM: To evaluate race/ethnicity-specific disparities in UC disease presentation among an ethnically diverse underserved population. METHODS: We performed a cross-sectional study of all consecutive UC adults among a large ethnically diverse safety-net hospital from July 2014 to May 2016 to compare race/ethnicity-specific disparities in severity of disease at presentation...
August 30, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28833882/change-in-care-transition-practice-for-patients-with-non-specific-chest-pain-after-ed-evaluation-2006-2012
#14
Maame Yaa A B Yiadom, Cathy A Jenkins, Christopher W Baugh, Sean P Collins, Monisha C Bhatia, Robert S Dittus, Alan B Storrow
OBJECTIVES: From 2005-2010 healthcare financing shifts in the United States may have affected care transition practices for emergency department (ED) patients with non-specific chest pain (CP) after ED evaluation. Despite being less acutely ill than those with myocardial infarction, these patients' management can be challenging. The risk of missing acute coronary syndrome is considerable enough to often warrant admission. Diagnostic advances and reimbursement limitations on the use of inpatient admission are encouraging the use of alternative ED care transition practices...
August 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28831638/health-insurance-status-and-eligibility-among-patients-who-seek-healthcare-at-a-free-clinic-in-the-affordable-care-act-era
#15
Kristen Sessions, Amal Hassan, Thomas G McLeod, Mark L Wieland
Free clinics provide care to over 1.8 million people in the United States every year and are a valuable safety net for uninsured and underinsured patients. The Affordable Care Act has resulted in millions of newly insured Americans, yet there is continued demand for healthcare at free clinics. In this study, we assessed health insurance status and eligibility among 489 patients who visited a free clinic in 2016. Eighty-seven percent of patients seen were uninsured, 53.1% of whom were eligible for health insurance (Medicaid or subsidized insurance premiums)...
August 22, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28830861/addressing-the-social-needs-of-hypertensive-patients-the-role-of-patient-provider-communication-as-a-predictor-of-medication-adherence
#16
Antoinette Schoenthaler, George J Knafl, Kevin Fiscella, Gbenga Ogedegbe
BACKGROUND: Poor medication adherence is a pervasive problem in patients with hypertension. Despite research documenting an association between patient-provider communication and medication adherence, there are no empirical data on how the informational and relational aspects of communication affect patient's actual medication-taking behaviors. The aim of this study was to evaluate the impact of patient-provider communication on medication adherence among a sample of primary care providers and their black and white hypertensive patients...
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28826701/outcomes-of-men-on-active-surveillance-for-low-risk-prostate-cancer-at-a-safety-net-hospital
#17
E Charles Osterberg, Nynikka R A Palmer, Catherine R Harris, Gregory P Murphy, Sarah D Blaschko, Carissa Chu, Isabel E Allen, Matthew R Cooperberg, Peter R Carroll, Benjamin N Breyer
PURPOSE: To characterize demographic, disease, and cancer outcomes of men on active surveillance (AS) at a safety-net hospital and characterize those who were lost to follow-up (LTFU). METHODS: From January 2004 to November 2014, 104 men with low-risk prostate cancer (PCa) were followed with AS at Zuckerberg San Francisco General Hospital (ZSFG). Criteria for AS have evolved over time; however, patients with diagnostic prostate-specific antigen (PSA) 10ng/mL or less, clinical stage T1/2, biopsy Gleason score 3 + 3 or 3 + 4, 33% or fewer positive cores, and 50% or less tumor in any single core were potentially eligible for AS...
August 17, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28820039/sepsis-at-a-safety-net-hospital-risk-factors-associated-with-30-day-readmission
#18
Mark A Weinreich, Kim Styrvoky, Shelley Chang, Carlos E Girod, Rosechelle Ruggiero
BACKGROUND: Sepsis is a leading cause of hospitalization, and subsequent readmissions are frequent and costly. There is an expanding body of literature describing risk factors for readmissions in patients with sepsis. However, there are little data studying medically underserved patients who typically receive their care at a safety net hospital. METHODS: In a retrospective cohort study, we evaluated 1355 sepsis survivors at risk of hospital readmission in fiscal year 2013 at a safety net hospital...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28819068/rural-emergency-care-360%C3%A2-mobilising-healthcare-professionals-decision-makers-patients-and-citizens-to-improve-rural-emergency-care-in-the-province-of-quebec-canada-a-qualitative-study-protocol
#19
Richard Fleet, Gilles Dupuis, Jean-Paul Fortin, Jocelyn Gravel, Mathieu Ouimet, Julien Poitras, France Légaré
INTRODUCTION: Emergency departments (EDs) are an important safety net for rural populations. Results of our earlier studies suggest that rural Canadian hospitals have limited access to advanced imaging services and intensive care units and that patients are transferred over large distances. They also revealed significant geographical variations in rural services. In the absence of national standards, our studies raise questions about inequities in rural access to emergency services and the risks for citizens...
August 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28807202/do-acute-care-surgeons-follow-best-practices-for-breast-abscess-management-a-single-institution-analysis-of-325-consecutive-cases
#20
Alison Unzeitig Barron, Stephen Luk, Herb A Phelan, Brian H Williams
BACKGROUND: The breast surgery community has adopted needle aspiration as the standard of care for breast abscesses, which have a size less than 5 cm on ultrasound, no skin changes, and fewer than 5 days of symptoms. Our acute-care surgery (ACS) service manages all breast abscess consults at our urban safety-net hospital. We undertook this descriptive study to identify the rate of operative incisions and drainage performed by ACS surgeons which were not compatible with best practices for breast abscess management...
August 2017: Journal of Surgical Research
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