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https://www.readbyqxmd.com/read/28209195/qualitative-exploration-of-why-people-repeatedly-attend-emergency-departments-for-alcohol-related-reasons
#1
Tom Parkman, Joanne Neale, Ed Day, Colin Drummond
BACKGROUND: Understanding why people repeatedly attend Emergency Departments (EDs) for alcohol-related reasons is an important prerequisite to identifying ways of reducing any unnecessary demands on hospital resources. We use Andersen's Behavioural Model of Health Services Use to explore factors that contributed to repeat ED attendances. METHODS: Qualitative interviews were conducted with 30 people who repeatedly attended EDs for alcohol-related reasons (≥10 attendances in the past 12 months)...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28173785/hcv-screening-in-a-cohort-of-hiv-infected-and-uninfected-homeless-and-marginally-housed-women-in-san-francisco-california
#2
Kimberly Page, Michelle Yu, Jennifer Cohen, Jennifer Evans, Martha Shumway, Elise D Riley
BACKGROUND: Hepatitis C virus (HCV) screening has taken on new importance as a result of updated guidelines and new curative therapies. Relatively few studies have assessed HCV infection in homeless populations, and a minority include women. We assessed prevalence and correlates of HCV exposure in a cohort of homeless and unstably housed women in San Francisco, and estimated the proportion undiagnosed. METHODS: A probability sample of 246 women were recruited at free meal programs, homeless shelters, and low-cost single room occupancy hotels in San Francisco; women with HIV were oversampled...
February 7, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28161401/enhancing-public-health-hiv-interventions-a-qualitative-meta-synthesis-and-systematic-review-of-studies-to-improve-linkage-to-care-adherence-and-retention
#3
Joseph D Tucker, Lai Sze Tso, Brian Hall, Qingyan Ma, Rachel Beanland, John Best, Haochu Li, Mellanye Lackey, Gifty Marley, Zachary C Rich, Ka-Lon Sou, Meg Doherty
Although HIV services are expanding, few have reached the scale necessary to support universal viral suppression of individuals living with HIV. The purpose of this systematic review was to summarize the qualitative evidence evaluating public health HIV interventions to enhance linkage to care, antiretroviral drug (ARV) adherence, and retention in care. We searched 19 databases without language restrictions. The review collated data from three separate qualitative evidence reviews addressing each of the three outcomes along the care continuum...
January 31, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28121601/medicaid-acos-innovation-follows-the-brave
#4
Michael D Dalzell
Applying the ACO framework to Medicaid runs head on into a stubborn challenge: the disproportionate impact of socioeconomic factors on health in the Medicaid population. Poor health outcomes in low-income populations are often exacerbated by unstable employment and housing, transportation difficulties, and lack of access to nutritious food.
November 2016: Managed Care
https://www.readbyqxmd.com/read/28108194/psychiatric-risk-in-unstably-housed-sexual-minority-women-relationship-between-sexual-and-racial-minority-status-and-human-immunodeficiency-virus-and-psychiatric-diagnoses
#5
Annesa Flentje, Martha Shumway, Lauren H Wong, Elise D Riley
BACKGROUND: Stress associated with minority statuses has been linked to mental health disorders. However, research conducted exclusively among impoverished women, a population known to be at risk for poor health owing to overlapping risks, is sparse. We sought to determine if homeless and unstably housed sexual minority (i.e., nonheterosexual) women were at greater psychiatric risk than their heterosexual counterparts. We also sought to determine if racial/ethnic minority and human immunodeficiency virus status contributed to psychiatric risks...
January 17, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28103125/opt-out-patient-navigation-to-improve-breast-and-cervical-cancer-screening-among-homeless-women
#6
Ramin Asgary, Ramesh Naderi, Juan Wisnivesky
BACKGROUND: A patient navigation model was implemented to improve breast and cervical cancer screening among women who were homeless in five shelters and shelter clinics in New York City in 2014. MATERIALS AND METHODS: Navigation consisted of opt-out screening to eligible women; cancer health and screening education; scheduling and following up for screening completion, obtaining, and communicating results to patients and providers; and care coordination with social services organizations...
January 19, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28103065/civil-legal-services-and-medical-legal-partnerships-needed-by-the-homeless-population-a-national-survey
#7
Jack Tsai, Darlene Jenkins, Ellen Lawton
OBJECTIVES: To examine civil legal needs among people experiencing homelessness and the extent to which medical-legal partnerships exist in homeless service sites, which promote the integration of civil legal aid professionals into health care settings. METHODS: We surveyed a national sample of 48 homeless service sites across 26 states in November 2015. The survey asked about needs, attitudes, and practices related to civil legal issues, including medical-legal partnerships...
March 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28079645/the-role-of-patient-navigators-in-building-a-medical-home-for-multiply-diagnosed-hiv-positive-homeless-populations
#8
Mariana Sarango, Alexander de Groot, Melissa Hirschi, Chukwuemeka Anthony Umeh, Serena Rajabiun
CONTEXT: People living with human immunodeficiency virus (HIV) (PLWH) who are most at risk for falling out of HIV primary care and detectable viral loads include homeless and unstably housed individuals and those codiagnosed with behavioral health disorders. The patient-centered medical home (PCMH) is a model that promotes provision of comprehensive, patient-centered, accessible, coordinated, and quality care for patients. This initiative provided patient navigation to HIV-positive homeless and unstably housed individuals codiagnosed with a mental health or substance use disorder as a means to create an adapted PCMH to meet the specific needs of this population...
January 11, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28048355/th-cd-207a-04-optimized-respiratory-gating-for-abnormal-breathers-in-pancreatic-sbrt
#9
W Campbell, M Miften, T Schefter, K Goodman, B Jones
PURPOSE: Pancreatic SBRT is uniquely challenging due to both the erratic/unstable motion of the pancreas and the close proximity of the radiosensitive small bowel. Respiratory gating can mitigate this effect, but the irregularity of motion severely affects traditional phase-based gating. The purpose of this study was to analyze real-time motion data of pancreatic tumors to optimize the efficacy and accuracy of respiratory gating, with the overall goal of enabling dose escalated pancreatic SBRT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046446/su-c-202-06-design-and-development-of-a-non-rigid-phantom-ventilating-air-quantitatively-evaluating-ct-based-pulmonary-ventilation-imaging
#10
S Miyakawa, H Tachibana, S Moriya, T Kurosawa, M Sato
PURPOSE: A validation study using human or sheep for CT pulmonary ventilation (CT-V) imaging are inefficient and partially unstable. In this study, we designed and developed non-rigid phantom ventilating air to quantitatively evaluate the CT-V image. METHODS: The phantom consisted of an acryl cylinder filled with polyurethane foam designed to pulmonic alveoli and a polyurethane membrane was attached to the inferior end of the phantom to simulate a lung diaphragm...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042394/network-approaches-to-substance-use-and-hiv-hepatitis-c-risk-among-homeless-youth-and-adult-women-in-the-united-states-a-review
#11
Kirk Dombrowski, Kelley Sittner, Devan Crawford, Melissa Welch-Lazoritz, Patrick Habecker, Bilal Khan
During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures...
September 2016: Health
https://www.readbyqxmd.com/read/28033027/implementation-of-evidence-based-patient-navigation-programs
#12
Karen M Freund
BACKGROUND: Patient navigation refers to a direct patient care role that links patients with clinical providers and their support system and provides individualized support during cancer care, ensuring that patients have access to the knowledge and resources necessary to complete recommended treatment. While most reports have studied the role of patient navigators during the cancer screening or diagnostic process, emerging evidence indicates the benefits of patient navigation during active cancer treatment...
December 29, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/28001292/predictors-for-unplanned-hospitalization-of-new-home-care-clients
#13
Jukka K Rönneikkö, Matti Mäkelä, Esa R Jämsen, Heini Huhtala, Harriet Finne-Soveri, Anja Noro, Jaakko N Valvanne
OBJECTIVES: To identify factors predicting unplanned hospitalization of new home care clients using the Resident Assessment Instrument for Home Care (RAI-HC). DESIGN: A register-based study based on RAI-HC assessments and nationwide hospital discharge records. SETTING: Municipal home care services in Finland. PARTICIPANTS: New Finnish home care clients aged 63 and older (N = 15,700). MEASUREMENTS: Information from home care clients' first RAI-HC assessment was connected to information regarding their first hospitalization over 1 year of follow-up...
December 21, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27996091/finding-home-a-qualitative-approach-to-understanding-adolescent-mothers-housing-instability
#14
Margaret C Elliott, Elizabeth A Shuey, Natalya Zaika, Lauren Mims, Tama Leventhal
Many low-income Latina adolescent mothers face instability in their housing circumstances, which has implications for their long-term prospects and that of their children. This study used longitudinal, ethnographic data from Welfare, Children, and Families: A Three City Study to explore experiences of low-income, Latina adolescent mothers (N = 15) with unstable housing who primarily rely on their families or the families of their significant others for housing support. Results of analysis employing grounded theory and narrative approaches suggested two types of instability: "Horizontal moves" between family homes and "vertical moves" between family homes and independent living...
December 20, 2016: American Journal of Community Psychology
https://www.readbyqxmd.com/read/27981399/the-usefulness-of-the-crafft-in-screening-for-problematic-drug-and-alcohol-use-among-youth-living-with-hiv
#15
Kristi E Gamarel, Kimberly M Nelson, Larry Brown, M Isabel Fernandez, Sharon Nichols
Substance use is highly prevalent among youth living with HIV (YLWH) and negatively impacts HIV care. This study sought to determine whether the CRAFFT (Car, Relax, Alone, Forget, Friends, and Trouble), designed to screen for problematic substance use, is reliably associated with substance use behaviors among YLWH. A cross-sectional sample of 2216 youth (ages 12-26) were recruited through the adolescent medicine trials network for HIV/AIDS Interventions. Participants completed a self-administered survey. Over half screened positive on the CRAFFT (i...
December 15, 2016: AIDS and Behavior
https://www.readbyqxmd.com/read/27887652/limitations-of-malaria-reactive-case-detection-in-an-area-of-low-and-unstable-transmission-on-the-myanmar-thailand-border
#16
Daniel M Parker, Jordi Landier, Lorenz von Seidlein, Arjen Dondorp, Lisa White, Borimas Hanboonkunupakarn, Richard J Maude, François H Nosten
BACKGROUND: Reactive case detection is an approach that has been proposed as a tool for malaria elimination in low-transmission settings. It is an intuitively justified approach based on the concept of space-time clustering of malaria cases. When an index malaria clinical case is detected, it triggers reactive screening and treatment in the index house and neighbouring houses. However, the efficacy of this approach at varying screening radii and malaria prevalence remains ill defined...
November 25, 2016: Malaria Journal
https://www.readbyqxmd.com/read/27787347/housing-stability-and-medication-adherence-among-hiv-positive-individuals-in-antiretroviral-therapy-a-meta-analysis-of-observational-studies-in-the-united-states
#17
Rebecca Arden Harris, Xiaonan Xue, Peter A Selwyn
BACKGROUND: Previous research has produced inconsistent evidence of an association between housing stability and medication adherence among HIV-positive individuals in antiretroviral therapy. OBJECTIVE: We conducted a meta-analysis of the housing-adherence relationship based on a comprehensive search of observational studies in the PubMed, Embase, and Cochrane databases (January 2000-January 2016). Ten qualifying studies were identified representing 10,556 individuals...
March 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27752312/improving-emergency-department-flow-through-optimized-bed-utilization
#18
Lucas Brien Chartier, Licinia Simoes, Meredith Kuipers, Barb McGovern
Over the last decade, patient volumes in the emergency department (ED) have grown disproportionately compared to the increase in staffing and resources at the Toronto Western Hospital, an academic tertiary care centre in Toronto, Canada. The resultant congestion has spilled over to the ED waiting room, where medically undifferentiated and potentially unstable patients must wait until a bed becomes available. The aim of this quality improvement project was to decrease the 90th percentile of wait time between triage and bed assignment (time-to-bed) by half, from 120 to 60 minutes, for our highest acuity patients...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27750182/prevalence-and-correlates-of-substance-use-among-youth-living-with-hiv-in-clinical-settings
#19
Kristi E Gamarel, Larry Brown, Christopher W Kahler, M Isabel Fernandez, Douglas Bruce, Sharon Nichols
OBJECTIVES: The purpose of this study was to better understand the prevalence and correlates of substance use behaviors among HIV-infected adolescents in HIV care settings. METHODS: A cross-sectional sample of 2216 youth living with HIV (YLWH; ages 12-26) were recruited through the Adolescent Trials Network for HIV Interventions. Participants completed a one-time survey on sociodemographic factors, substance use and health behaviors. We used logistic regression models to understand the correlates of substance use outcomes...
December 1, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27733167/mental-health-among-clients-of-the-sydney-medically-supervised-injecting-centre-msic
#20
Mark Goodhew, Allison M Salmon, Christina Marel, Katherine L Mills, Marianne Jauncey
The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm...
October 12, 2016: Harm Reduction Journal
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