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https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#1
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28796652/acyanotic-hypoxia-in-a-febrile-child
#2
Fiona Murphy, Julian Blackham, John Moppett, Mark Lyttle
Glucose-6-phosphate dehydrogenase deficiency affects approximately 400 million people worldwide and is an X-linked disorder most commonly found in individuals of African, Asian, Mediterranean, and Middle Eastern descent. It can present with acute hemolysis in response to certain drugs, infections, or fava beans, and affected individuals may not be aware that they have glucose-6-phosphate dehydrogenase deficiency. This case illustrates the importance of those working in the acute and urgent care sector having an awareness of the condition and the value of a full set of vital signs in an unwell child...
August 7, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28775192/seeking-ambulance-treatment-for-primary-care-problems-a-qualitative-systematic-review-of-patient-carer-and-professional-perspectives
#3
Matthew J Booker, Sarah Purdy, Alison R G Shaw
OBJECTIVES: To understand the reasons behind, and experience of, seeking and receiving emergency ambulance treatment for a 'primary care sensitive' condition. DESIGN: A comprehensive, qualitative systematic review. Medline, Embase, PsychInfo, Cumulative Index of Nursing and Allied Health, Health Management Information Systems, Healthcare Management Information Consortium, OpenSigle, EThOS and Digital Archive of Research Theses databases were systematically searched for studies exploring patient, carer or healthcare professional interactions with ambulance services for 'primary care sensitive' problems...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28765414/acute-geriatrics-at-the-front-door
#4
Simon Conroy, Stuart Parker
Older people with frailty and urgent care needs are major uses of health and social care services. Comprehensive geriatric assessment (CGA) is an evidence-based approach to improving their outcomes, as well as improving service outcomes. Geriatricians form a small proportion of the overall workforce and cannot address the population need alone, so all clinicians (doctors, nurses, therapists and so on) need to engage in delivering CGA as a process of care, underpinned by specific competencies - which can be developed...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28756933/pericardial-herniation-of-small-bowel-post-minimally-invasive-hybrid-maze-of-atrial-fibrillation
#5
David A Farcy, Angelo Lapietra, Benjamin N Abo, Michael Dalley
BACKGROUND: Herniation of intraabdominal contents into the pericardial cavity is exceptionally rare, and when seen, it is most often the result of trauma, postsurgical complication, or genetic defect. There have been only a few case reports describing spontaneous bowel herniation into the pericardium in minimally invasive cardiac procedures like cardiac ablation, pacemaker placement, and minimally invasive coronary artery bypass graft. CASE REPORT: We report the case of a 65-year-old man who presented to an urgent care center complaining of abdominal and chest pain...
July 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28756082/asthma-morbidity-comorbidities-and-modifiable-factors-among-older-adults
#6
Joy Hsu, Jessica Chen, Maria C Mirabelli
BACKGROUND: Asthma morbidity is increased among older adults, especially older adult women. Interventions to improve asthma control in this population are not well described. OBJECTIVE: The objective of this study was to identify risk factors (including modifiable factors) associated with asthma-related hospitalizations and emergency department or urgent care center visits (ED/UCV) among older adults. A secondary objective was to investigate sex differences in variables relevant to asthma control...
July 19, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28753678/coughing-sneezing-and-aching-online-twitter-and-the-volume-of-influenza-like-illness-in-a-pediatric-hospital
#7
David M Hartley, Courtney M Giannini, Stephanie Wilson, Ophir Frieder, Peter A Margolis, Uma R Kotagal, Denise L White, Beverly L Connelly, Derek S Wheeler, Dawit G Tadesse, Maurizio Macaluso
This study investigates the relation of the incidence of georeferenced tweets related to respiratory illness to the incidence of influenza-like illness (ILI) in the emergency department (ED) and urgent care clinics (UCCs) of a large pediatric hospital. We collected (1) tweets in English originating in our hospital's primary service area between 11/1/2014 and 5/1/2015 and containing one or more specific terms related to respiratory illness and (2) the daily number of patients presenting to our hospital's EDs and UCCs with ILI, as captured by ICD-9 codes...
2017: PloS One
https://www.readbyqxmd.com/read/28738685/assessing-the-effect-of-the-vha-pcmh-model-on-utilization-patterns-among-veterans-with-ptsd
#8
Ian Randall, Charles Maynard, Gary Chan, Beth Devine, Chris Johnson
OBJECTIVES: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH)-based Patient Aligned Care Teams (PACT) model in 2010. We examined its effects on the utilization of health services among US veterans with posttraumatic stress disorder (PTSD). STUDY DESIGN: We analyzed VHA clinical and administrative data to conduct an interrupted time series study. Encounter-level data were obtained for the period of April 1, 2005, through March 31, 2014...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28731848/usability-acceptability-and-impact-of-a-pediatric-teledermatology-mobile-health-application
#9
Alexander G Fiks, Linda Fleisher, Lindsay Berrigan, Emily Sykes, Stephanie L Mayne, Rachel Gruver, Katherine Halkyard, Olivia S Jew, Patrick FitzGerald, Flaura Winston, Patrick McMahon
OBJECTIVE: Pediatric dermatology appointment wait times often exceed several months. We evaluated the usability, acceptability, and clinical impact of a store-and-forward teledermatology mobile application (app) linking families with pediatric dermatologists. METHODS: Parents of children age 6 weeks to 17 years or individuals 18-21 years old were invited (by e-mail or referral) to participate in this single group, prospective study. Within the app, users photographed the skin condition, answered questions, and submitted their case for review...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28719481/opioid-prescribing-practices-in-pediatric-acute-care-settings
#10
Michelle DePhillips, Jennifer Watts, Jennifer Lowry, M Denise Dowd
OBJECTIVES: Deaths due to prescription opioid overdoses are at record-high levels. Limiting the amount of opioid prescribed has been suggested as a prevention strategy. The purpose of this study was to describe the opioid prescribing practices in the emergency departments and urgent care sites of a Midwestern tertiary care children's hospital system. METHODS: This retrospective medical record review examined the visits from the 2 pediatric emergency departments and 2 pediatric urgent care sites in the system from June 1, 2012, to May 31, 2013, during which an outpatient opioid prescription was written...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28716998/extended-training-to-prepare-gps-for-future-workforce-needs-a-qualitative-investigation-of-a-1-year-fellowship-in-urgent-care
#11
Jeremy Dale, Rachel Russell, Frances Harkness, Veronica Wilkie, Matthew Aiello
BACKGROUND: It has been argued that UK general practice specialist training should be extended to better prepare GPs for the challenges facing 21st-century health care. Evidence is needed to inform how this should occur. AIM: To investigate the experience of recently trained GPs undertaking a 1-year full-time fellowship programme designed to provide advanced skills training in urgent care, integrated care, leadership, and academic practice; and its impact on subsequent career development...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28711194/factors-associated-with-epinephrine-administration-for-anaphylaxis-in-children-before-arrival-to-the-emergency-department
#12
Melissa Robinson, Matthew Greenhawt, David R Stukus
BACKGROUND: Epinephrine is the first-line treatment for anaphylaxis but may be underused by patients and medical personnel. OBJECTIVE: To evaluate factors associated with anaphylaxis management before arrival at the emergency department (ED) or urgent care center (UCC). METHODS: We performed a retrospective review of electronic medical records for all patients aged 0 to 25 years presenting with anaphylaxis to the ED or UCC at a pediatric academic referral center during 2009 to 2013...
June 30, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28710507/inequalities-in-the-utilization-of-health-care-services-in-a-transition-european-country-results-from-the-national-population-health-survey
#13
Janko Janković, Sladjana Šiljak, Miloš Erić, Jelena Marinković, Slavenka Janković
OBJECTIVES: To examine demographic, socio-economic, and health status inequalities in the utilization of health care services (UHCS) in the Republic of Srpska (RS), Bosnia and Herzegovina. METHODS: Data were retrieved from the 2010 National Health Survey for the RS adult population (n = 4128). A complex sample design was taken into account for statistical analysis. RESULTS: As compared to men, a higher percentage of women visited a family physician (FP), urgent care department, dentist and private doctor...
July 14, 2017: International Journal of Public Health
https://www.readbyqxmd.com/read/28710197/cervical-shock-a-complication-of-incomplete-abortion
#14
Julian David Birch, Divyansh Gulati, Sachin Mandalia
A case of a 37-year-old female primagravida who attended the emergency department (ED) via ambulance in hypotensive shock. She was 10 weeks pregnant, but had an inevitable miscarriage confirmed in the local Early Pregnancy Unit 3 weeks previously. She was hypotension (90/60 mm Hg), bradycardic (45 bpm) and was peripherally shut down. A provisional diagnosis of haemorrhagic shock was made, but despite intravenous fluid challenges, she appeared to be deteriorating, so a major haemorrhage protocol was activated...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28708194/getting-into-urgent-care
#15
Sean Price
Many primary care physicians opt to open "urgent care" facilities or add urgent care services to their practices. Although there are advantages - such as billing and appointment scheduling flexibility - there are headaches as well.
July 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28705882/new-law-will-force-hospitals-to-charge-foreign-patients-for-non-urgent-care
#16
Gareth Iacobucci
No abstract text is available yet for this article.
July 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28702185/potential-cost-savings-by-minimisation-of-blood-sample-delays-on-care-decision-making-in-urgent-care-services
#17
David M S Bodansky, Sophie E Lumley, Rudrajoy Chakraborty, Dhanasekaran Mani, James Hodson, Mike T Hallissey, Olga N Tucker
BACKGROUND: Timely availability of blood sample results for interpretation affects planning and delivery of patient care from initial assessment in Accident and Emergency (A&E) departments. MATERIALS AND METHODS: Rates of, and reasons for, rejected blood samples submitted from all clinical areas over one month were evaluated. Haemoglobin (Hb) represented haematology and potassium (K(+)), biochemistry. A prospective observational study evaluated the methodology of sample collection and impact on utility...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28700804/characteristics-of-patients-presenting-to-the-emergency-department-and-urgent-care-for-treatment-of-sunburn
#18
Fan Di Xia, Mary Fuhlbrigge, Michael Waul, Cara Joyce, Arash Mostaghimi
No abstract text is available yet for this article.
July 12, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28698812/treatment-of-community-acquired-pneumonia-a-case-report-and-current-treatment-dilemmas
#19
Glenn Harnett
Resistance to macrolides is rising in the USA and warrants careful consideration when confronted with a patient with suspected pneumonia in the urgent care clinic. This case study exemplifies the potentially serious consequences of treatment failure following prescription of a macrolide for community-acquired bacterial pneumonia. Furthermore, the consequential treatment dilemmas currently faced by physicians are briefly discussed.
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28687951/approach-to-upset-stomach
#20
Rishi Bolia
An "Upset stomach" is a common problem encountered by physicians involved in the care of children. It includes, diarrhea, vomiting or abdominal pain. Though often mild and self-limiting, at times there are uncommon life-threatening conditions that require urgent care. It is important for primary physicians to recognize "alarm signs" and make a referral to the specialist at the right time. At the same time it is important to recognize what is normal and re-assure the caregivers. A detailed history and a proper systemic examination are important at presentation, looking for any "red flags"...
July 8, 2017: Indian Journal of Pediatrics
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