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Preventable emergency visits

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https://www.readbyqxmd.com/read/29790923/missed-opportunities-to-prescribe-preexposure-prophylaxis-in-south-carolina-2013-2016
#1
Dawn K Smith, Man-Huei Chang, Wayne A Duffus, Stella Okoye, Sharon Weissman
Introduction: Expanding use of preexposure prophylaxis (PrEP) in ways that address current racial/ethnic disparities is an important HIV prevention goal. We investigated missed opportunities to provide PrEP during healthcare visits occurring prior to HIV infection. Methods: This retrospective cohort study linked South Carolina HIV case surveillance data to 3 statewide healthcare databases. Characteristics of patients, health care visits and providers, sexually transmitted diseases (STD), and other diagnoses, were assessed for medical encounters occurring before an initial HIV diagnosis...
May 22, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29789336/illness-identity-a-novel-predictor-for-healthcare-use-in-adults-with-congenital-heart-disease
#2
Liesbet Van Bulck, Eva Goossens, Koen Luyckx, Leen Oris, Silke Apers, Philip Moons
BACKGROUND: To optimize healthcare use of adults with congenital heart disease, all important predictors of healthcare utilization should be identified. Clinical and psychological characteristics (eg, age and depression) have been found to be associated with healthcare use. However, the concept of illness identity, which assesses the degree to which congenital heart disease is integrated into one's identity, has not yet been investigated in association with healthcare use. Hence, the purpose of the study is to examine the predictive value of illness identity for healthcare use...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29788913/prevalence-and-outcome-of-injury-in-patients-visiting-the-emergency-department-of-yirgalem-general-hospital-southern-ethiopia
#3
Abel Negussie, Andarge Getie, Elias Manaye, Tamrat Tekle
BACKGROUND: Traumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia. METHODS: A facility-based prospective cross sectional study was conducted from March, 27 - April, 30/2017...
May 22, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29785703/a-cross-sectional-study-evaluating-the-use-of-free-clinics-in-syracuse-ny-patient-demographics-and-barriers-to-accessing-healthcare-in-traditional-settings
#4
Simone Arvisais-Anhalt, Matthew MacDougall, Michael Rosenthal, Peter Congelosi, Daniel F Farrell, Paula Rosenbaum
Free clinics provide healthcare to underserved patient populations, playing a critical role in the medical safety-net. Syracuse, New York has notable racial, socioeconomic, and educational disparities and is home to four free clinics. Little is known about these clinics' patient population. This study attempts to better define this population and the barriers they face accessing traditional care. We developed a 27-question survey investigating patient demographics, barriers to traditional healthcare, and experience at local free clinics...
May 21, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29784607/telestroke-adoption-among-community-hospitals-in-north-carolina-a-cross-sectional-study
#5
Christopher M Shea, Amir Alishahi Tabriz, Kea Turner, Steve North, Kristin L Reiter
OBJECTIVE: This study identifies community and hospital characteristics associated with adoption of telestroke among acute care hospitals in North Carolina (NC). METHODS: Our sample included 107 hospitals located in NC. Our analytic dataset included variables from the American Hospital Association (AHA) annual survey, AHA Health IT supplement, Healthcare Cost Report Information System, and Centers for Disease Control and Prevention's WONDER online database. We supplemented our secondary sources with data on telestroke adoption and market-level variables developed for NC...
May 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29781523/a-case-study-illustrating-the-use-of-an-attachment-video-feedback-intervention-strategy
#6
George M Tarabulsy, Karine Dubois-Comtois, Claire Baudry, Ellen Moss, Annie Roberge, Laura-Emilie Savage, Chantal Cyr, Diane St-Laurent, Annie Bernier
Children from high-risk environments are more likely to experience problems in development. Many difficulties are linked to early experiences in the context of the emerging attachment relationship. Over the past 20 years, our group has collaborated with government agencies to develop and implement an attachment-based video-feedback intervention strategy (AVI) that targets parental sensitivity and attachment. This case study presents the manner in which a young mother and her 6-month-old son experienced AVI...
May 21, 2018: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/29780910/aerial-drone-misadventure-a-novel-case-of-trauma-resulting-in-ocular-globe-rupture
#7
Eliza E Moskowitz, Yonaton M Siegel-Richman, George Hertner, Thomas Schroeppel
Purpose: The purpose of this case report is to present the novel findings of a drone causing such a traumatic ocular injury and provide recommendations for how it might be prevented. Observations: We report on a recent case where a child presented to our Emergency Department after incurring a blow to the face by the propeller of a remote controlled drone. The patient suffered significant trauma including rupture of the right globe. Conclusions: As drone sales continue to rise, it is important that physicians be prepared to treat the potential injuries that may result from using these devices...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29779793/older-adults-response-to-analgesic-adverse-drug-reactions-a-pilot-study
#8
Deborah Dillon McDonald, Sarah Coughlin, Candy Jin
Older adults who take analgesics for chronic pain are at increased risk for adverse drug events (ADEs). The purpose of this descriptive pilot survey was to examine how older adults self-identify analgesic ADEs, and actions they take in response to analgesic ADEs. Twenty-two community dwelling older adults with chronic pain who reported an analgesic ADE associated with their chronic pain management were interviewed and asked to describe their analgesic related ADE. Written responses were content analyzed. Nineteen opioids were reported by 15, 11 NSAIDs were reported by 8, and acetaminophen was reported by 2 older adults as associated with an ADE...
May 17, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29767402/connecting-refugees-to-medical-homes-through-multi-sector-collaboration
#9
Lemaat Michael, Alexandra K Brady, Greg Russell, Scott D Rhodes, Shahla Namak, Laura Cody, Andrea Vasquez, Andrea Caldwell, Jennifer Foy, Julie M Linton
As increasing numbers of refugees have resettled globally, an interdisciplinary group of stakeholders in Forsyth, North Carolina, recognized obstacles preventing coordinated medical care, which inspired the development of our Refugee Health Collaborative. This study assessed the Collaborative's impact on access to coordinated care within patient-centered medical homes (PCMH). A Collaborative-developed novel algorithm guided the process by which refugees establish care in PCMHs. All refugees who established medical care in the two primary health systems in our county (n = 285) were included...
May 16, 2018: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/29765242/claims-based-proxies-of-patient-instability-among-commercially-insured-adults-with-schizophrenia
#10
Charles Ruetsch, Hyong Un, Heidi C Waters
Objective: Schizophrenia (Sz) patients are among the highest utilizers of hospital-based services. Prevention of relapse is in part a treatment goal in order to reduce hospital admissions. However, predicting relapse is a challenge, particularly for payers and disease management firms with only access to claims data. Understandably, such organizations have had little success predicting relapse. A tool that allows payers to identify patients at elevated risk of relapse could facilitate targeted interventions prior to relapse and avoid rehospitalization...
2018: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29760849/acute-pulmonary-embolism-in-emergency-department-patients-despite-therapeutic-anticoagulation
#11
Michelle Y Liu, Dustin W Ballard, Jie Huang, Adina S Rauchwerger, Mary E Reed, Sean C Bouvet, David R Vinson
Introduction: Emergency department (ED) patients with acute pulmonary embolism (PE) despite therapeutic anticoagulation at the time of diagnosis are uncommonly encountered and present a diagnostic and management challenge. Their characterization and outcomes are poorly described. We sought to describe the prevalence and characteristics of therapeutically anticoagulated patients among a population of patients with acute PE in a community setting and to describe treatment changes and 30-day outcomes...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29756746/factors-influencing-consent-to-organ-donation-after-brain-death-certification-a-survey-of-29-intensive-care-units
#12
Guya Piemonte, Maria L Migliaccio, Stefano Bambi, Marco Bombardi, Lorenzo D'antonio, Andrea Guazzini, Caterina Di Pasquale, Laura Tadini-Buoninsegni, Cristiana Guetti, Manuela Bonizzoli, Sara Bagatti, Paolo Lopane, Anna Nativi, Laura Rasero, Adriano Peris
BACKGROUND: Family refusal (FR) to heart beating donation (HBD) in Intensive Care Unit (ICU) is increasing in recent years with a significant impact on the number of transplantable organs. Fostering setting humanization, quality of relationships, respect for will and family reliance towards ICU could be relevant in containing FR to organ donation (OD) in ICU. Our aims were to highlight the effects of structural features of ICUs and humanization determinants on FR in HBD process, and to describe visiting policies, structure and modalities of support in ICUs...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754015/cost-effectiveness-of-a-home-visit-program-for-patients-with-heart-failure-in-brazil-evidence-from-a-randomized-clinical-trial
#13
Karen Brasil Ruschel, Eneida R Rabelo-Silva, Luis Eduardo Rohde, Emiliane N de Souza, Cláudia M Mussi, Carisi A Polanczyk
OBJECTIVE: Estimate the cost-effectiveness of a nurse-led home visit (HV) intervention as compared with the standard HF management, within a randomized clinical trial in Brazil. STUDY DESIGN: Cost-effectiveness study within a randomized trial. METHODS: To assess the cost-effectiveness of four home visits and four telephone calls by nurses in the management of patients with HF within a randomized clinical trial (RCT: NCT01213875) in a perspective Public (PHS-Public Healthcare System) and private healthcare systems of Brazil during time frame of 24 weeks...
May 10, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29750945/ocular-injury-in-united-states-emergency-departments-seasonality-and-annual-trends-estimated-from-a-nationally-representative-dataset
#14
David A Ramirez, Travis C Porco, Thomas M Lietman, Jeremy D Keenan
PURPOSE: To determine whether ocular trauma occurs more frequently in the summer months. DESIGN: Retrospective, cross-sectional study. METHODS: The Nationwide Emergency Department Sample (NEDS) is a large, publicly available administrative database that provides nationally representative estimates of emergency department (ED) visits in the United States. Billing codes from NEDS from 2006 to 2013 were used to identify all cases of ocular trauma, and the United States decennial census was used to estimate the population at risk for visiting an ED...
May 8, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29747980/taming-asthma-in-school-aged-children-a-comprehensive-review
#15
Ahmad Salaheddine Naja, Perdita Permaul, Wanda Phipatanakul
Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity as measured by school absences, emergency department visits, and hospitalizations. Multiple factors play a role in the development, treatment and prevention of childhood asthma including racial/ethnic and socioeconomic disparities, both the home and school environments, and medication use. The goals of this review are to summarize these aspects of asthma in school-aged children and to present an updated review of medications as it relates to treatment strategies that will help in the care of these children...
May 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29747792/hospital-based-emergency-department-visits-with-dental-conditions-impact-of-the-medicaid-reimbursement-fee-for-dental-services-in-new-york-state-2009-2013
#16
Sankeerth Rampa, Fernando A Wilson, Hongmei Wang, Nizar K Wehbi, Lynette Smith, Veerasathpurush Allareddy
OBJECTIVES: Hospital-based emergency department (ED) visits for dental problems have been on the rise. The objectives of this study are to provide estimates of hospital-based ED visits with dental conditions in New York State and to examine the impact of Medicaid reimbursement fee for dental services on the utilization of EDs with dental conditions. METHODS: New York State Emergency Department Database for the year 2009-2013 and Health Resources and Services Administration's Area Health Resource File were used...
June 2018: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/29746456/deaths-from-falls-among-persons-aged-%C3%A2-65-years-united-states-2007-2016
#17
Elizabeth Burns, Ramakrishna Kakara
Deaths from unintentional injuries are the seventh leading cause of death among older adults (1), and falls account for the largest percentage of those deaths. Approximately one in four U.S. residents aged ≥65 years (older adults) report falling each year (2), and fall-related emergency department visits are estimated at approximately 3 million per year.* In 2016, a total of 29,668 U.S. residents aged ≥65 years died as the result of a fall (age-adjusted rate†  = 61.6 per 100,000), compared with 18,334 deaths (47...
May 11, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29743217/strategies-for-addressing-the-challenges-of-patient-centered-medical-home-implementation-lessons-from-oregon
#18
Sherril Gelmon, Nicole Bouranis, Billie Sandberg, Shauna Petchel
BACKGROUND: Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). METHODS: Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29742757/evaluation-of-a-novel-system-to-enhance-clinicians-recognition-of-preadmission-adverse-drug-reactions
#19
Joshua C Smith, Qingxia Chen, Joshua C Denny, Dan M Roden, Kevin B Johnson, Randolph A Miller
BACKGROUND:  Often unrecognized by providers, adverse drug reactions (ADRs) diminish patients' quality of life, cause preventable admissions and emergency department visits, and increase health care costs. OBJECTIVE:  This article evaluates whether an automated system, the Adverse Drug Effect Recognizer (ADER), could assist clinicians in detecting and addressing inpatients' ongoing preadmission ADRs. METHODS:  ADER uses natural language processing to extract patients' medications, findings, and past diagnoses from admission notes...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29742132/hiv-drug-resistance-patterns-in-pregnant-women-using-next-generation-sequence-in-mozambique
#20
María Rupérez, Marc Noguera-Julian, Raquel González, Sonia Maculuve, Rocío Bellido, Anifa Vala, Cristina Rodríguez, Esperança Sevene, Roger Paredes, Clara Menéndez
BACKGROUND: Few data on HIV resistance in pregnancy are available from Mozambique, one of the countries with the highest HIV toll worldwide. Understanding the patterns of HIV drug resistance in pregnant women might help in tailoring optimal regimens for prevention of mother to child transmission of HIV (pMTCT) and antenatal care. OBJECTIVES: To describe the frequency and characteristics of HIV drug resistance mutations (HIVDRM) in pregnant women with virological failure at delivery, despite pMTCT or antiretroviral therapy (ART)...
2018: PloS One
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