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Critical care outreach

Mary E Northridge, Sara S Metcalf, Stella Yi, Qiuyi Zhang, Xiaoxi Gu, Chau Trinh-Shevrin
Introduction: While the US health care system has the capability to provide amazing treatment of a wide array of conditions, this care is not uniformly available to all population groups. Oral health care is one of the dimensions of the US health care delivery system in which striking disparities exist. More than half of the population does not visit a dentist each year. Improving access to oral health care is a critical and necessary first step to improving oral health outcomes and reducing disparities...
2018: Frontiers in Public Health
Martin J Downing, Dominique Brown, Jeffrey Steen, Ellen Benoit
BACKGROUND: Childhood sexual abuse (CSA) remains a critical public health issue among black and Latino men who have sex with men (MSM), as it is associated with multiple negative outcomes including substance misuse, poor mental health, revictimization, and high-risk sexual behavior. Most CSA research with MSM relies on quantitative assessment that often precludes consideration of cultural variations in how formative sexual experiences are understood and is based on inconsistent or overly restrictive definitions of abuse, and therefore may fail to detect certain abusive experiences (eg, those involving female perpetrators), which can have harmful health consequences if they remain unrecognized...
February 26, 2018: JMIR Research Protocols
Brigitte Lemyre, Linh Ly, Vann Chau, Anil Chacko, Nicholas Barrowman, Hilary Whyte, Steven P Miller
Objective: To identify factors associated with early initiation and achievement of therapeutic hypothermia (TH) in newborns with hypoxic-ischemic encephalopathy (HIE). Methods: Retrospective cohort study of newborns who received TH according to National Institute of Child Health and Human Development (NICHD) criteria in two academic level 3 Neonatal Intensive Care Units (NICU) between 2009 and 2013. All infants were transported by a neonatal transport team (NNTT)...
August 2017: Paediatrics & Child Health
Romina Alicia Ortiz, Steven Witte, Arvin Gouw, Ana Sanfilippo, Richard Tsai, Danielle Fumagalli, Christine Yu, Karla Lant, Nicole Lipintz, Jennifer Shepphird, Fidelia B Alvina, Jimmy Cheng-Ho Lin
BACKGROUND: Genetic sequencing is critically important to diagnostic health care efforts in the United States today, yet it is still inaccessible to many. Meanwhile, the internet and social networking have made crowdfunding a realistic avenue for individuals and groups hoping to fund medical and research causes, including patients in need of whole exome genetic sequencing (WES). OBJECTIVE: Amplify Hope is an educational program designed to investigate what factors affect the success of medical crowdfunding campaigns...
February 5, 2018: Interactive Journal of Medical Research
Miya L Barnett, Anna S Lau, Jeanne Miranda
Mobilizing lay health workers (LHWs) to deliver evidence-based treatments (EBTs) is a workforce strategy to address mental health disparities in underserved communities. LHWs can be leveraged to support access to EBTs in a variety of ways, from conducting outreach for EBTs delivered by professional providers to serving as the primary treatment providers. This critical review provides an overview of how LHW-supported or -delivered EBTs have been leveraged in low-, middle-, and high-income countries (HICs). We propose a conceptual model for LHWs to address drivers of service disparities, which relate to the overall supply of the EBTs provided and the demand for these treatments...
January 31, 2018: Annual Review of Clinical Psychology
Claudia Der-Martirosian, Anne R Griffin, Karen Chu, Aram Dobalian
Background Like other integrated health systems, the US Department of Veterans Affairs has widely implemented telehealth during the past decade to improve access to care for its patient population. During major crises, the US Department of Veterans Affairs has the potential to transition healthcare delivery from traditional care to telecare. This paper identifies the types of Veterans Affairs telehealth services used during Hurricane Sandy (2012), and examines the patient characteristics of those users. Methods This study conducted both quantitative and qualitative analyses...
January 1, 2018: Journal of Telemedicine and Telecare
Rosemary Ogu, Omosivie Maduka, Folusho Alamina, Obelebra Adebiyi, Vetty Agala, Gracia Eke, Ibimonye Porbeni, Nnesochi Offor, Claribel Abam, Alice Nte, Friday Okonofua
Background Youth friendly services, an evidence based approach to overcome the barriers experienced by youths in accessing care, is poorly implemented. The Medical Women's Association of Nigeria (MWAN) Rivers State chapter, was supported by Ford Foundation to mainstream youth-friendly health services (YFHS) into existing primary health care facilities in two hard-to-reach communities. This paper presents the interventions, findings, challenges and recommendations. Methods This study project was implemented in stages: design, baseline survey, interventions and evaluation, between 2014 and 2016...
January 25, 2018: International Journal of Adolescent Medicine and Health
Janet B Lee, Grisselle DeFrank, John Gaipa, Martha Arden
BACKGROUND: Since the 1960s, school-based health centers (SBHC) in the United States have emerged and grown with the mission of providing primary medical, reproductive, and mental health services, as well as comprehensive health education, to all students who are enrolled in the participating school. SBHCs have demonstrated a unique ability to reduce barriers to medical care for underserved populations in New York City, including undocumented immigrants and those who are of lower income status...
September 2017: Annals of Global Health
Mark Wilson
UK prescribing legislation changes made in 2006 and 2012 enabled appropriately qualified nurses to prescribe any licensed medication, and all controlled drugs in schedule 2-5 of the Misuse of Drugs Regulations 2001, for any medical condition within their clinical competence. Critical Care Outreach nurses who are independent nurse prescribers are ideally placed to ensure that acutely ill patients receive treatment without delay. The perceived challenge was how Critical Care Outreach nurses would be able to safely prescribe for a diverse patient group...
December 15, 2017: Nursing in Critical Care
Mark Erik Larsen, Fiona Shand, Kirsten Morley, Philip J Batterham, Katherine Petrie, Bill Reda, Sofian Berrouiguet, Paul S Haber, Gregory Carter, Helen Christensen
BACKGROUND: Suicide is a leading cause of death, particularly among young people. Continuity of care following discharge from hospital is critical, yet this is a time when individuals often lose contact with health care services. Offline brief contact interventions following a suicide attempt can reduce the number of repeat attempts, and text message (short message service, SMS) interventions are currently being evaluated. OBJECTIVE: The aim of this study was to extend postattempt caring contacts by designing a brief Web-based intervention targeting proximal risk factors and the needs of this population during the postattempt period...
December 13, 2017: JMIR Mental Health
Sarah Crowe, Lisa Ewart, Sarah Derman
The ability to quickly and reliably detect a clinically deteriorating patient and intervene appropriately is a skill nurses are expected to bring into practice. Simulation education has been shown to improve nurses' knowledge, confidence and communication, especially when focused on deteriorating patients. In a simulation center at a large tertiary level Canadian teaching hospital, a 4 h simulation based education session was developed for general medicine nursing staff. The education included a didactic lecture followed by four 40 min simulation scenarios focused on deteriorating patient...
November 26, 2017: Nurse Education in Practice
Laurie Lachance, R Patrick Kelly, Margaret Wilkin, Jodi Burke, Sandra Waddell
Social determinants of health likely play a significant role in the development of type 2 diabetes for women in vulnerable communities. Adult African American women diagnosed with or at-risk for diabetes in Inkster, Michigan (n = 113) and a group of demographically similar women in Flint, Michigan (n = 48) participated in programs aimed at increasing diabetes-related self-management behaviors through peer coaching, health literacy training, and social support. Participants completed surveys to measure changes in health, health behaviors, health literacy, and social support...
November 13, 2017: Journal of Community Health
Daniel A Potter, Nicholas Wroe, Helen Redhead, Andrew Jp Lewington
Introduction: This study investigated outcomes in critically unwell acute kidney injury patients and the role of the National Early Warning Score and other factors in identifying patients who experience negative outcomes. Methods: Retrospective cohort study investigating 64 patients seen by Critical Care Outreach between November 2014 and February 2015. Mortality at one year was analysed using multivariate regression; all other statistical tests were non-parametric...
November 2017: Journal of the Intensive Care Society
Daniel Cabrera, Durga Roy, Margaret S Chisolm
Traditionally, scholars focused their efforts in the domains of clinical care, research, and education; however, the last decade has witnessed the rise of novel areas of development such as innovation, quality improvement, informatics, and recently, digital scholarship. Academic institutions adapted and began considering these fields for academic promotion and tenure. Social media has become a critical space for the dissemination of knowledge and outreach to community and policy makers and also for the creation of communities of practice...
November 6, 2017: Journal of the American College of Radiology: JACR
Pamela S Belperio, Maggie Chartier, David B Ross, Poonam Alaigh, David Shulkin
The U.S. Department of Veterans Affairs (VA) is the nation's largest care provider for hepatitis C virus (HCV)-infected patients and is uniquely suited to inform national efforts to eliminate HCV. An extensive array of delivery of services, policy guidance, outreach efforts, and funding has broadened the reach and capacity of the VA to deliver direct-acting antiviral (DAA) HCV therapy, supported by an infrastructure to effectively implement change and informed by extensive population health data analysis. The VA has treated more than 92 000 HCV-infected veterans since all-oral DAAs became available in January 2014, with cure rates exceeding 90%; only 51 000 veterans in VA care are known to remain potentially eligible for treatment...
October 3, 2017: Annals of Internal Medicine
Mya Sherman, Hannah Covert, Laila Fox, Maureen Lichtveld
CONTEXT: Community health workers (CHWs) are an increasingly viable component of the American health system. While organizations may be interested in incorporating CHWs into the health care workforce, there are challenges to doing so. OBJECTIVE: This study characterizes the successes and lessons learned from implementing new CHW programs in clinical and community-based settings in 4 US Gulf states. DESIGN: Semistructured interviews were conducted with CHWs and their supervisors...
November 2017: Journal of Public Health Management and Practice: JPHMP
Katherine Kirkland, Mya Sherman, Hannah Covert, Grace Barlet, Maureen Lichtveld
CONTEXT: Integration of environmental and occupational health (EOH) into primary care settings is a critical step to addressing the EOH concerns of a community, particularly in a postdisaster context. Several barriers to EOH integration exist at the physician, patient, and health care system levels. PROGRAM: This article presents a framework for improving the health system's capacity to address EOH after the Deepwater Horizon oil spill and illustrates its application in the Environmental and Occupational Health Education and Referral (EOHER) program...
November 2017: Journal of Public Health Management and Practice: JPHMP
C L Mulder, J van Weeghel, A Wierdsma, J Zoeteman, A Schene
'Bewildered persons' have often been in the news over the last few years. There has been much discussion about the meaning of the term 'bewildered persons', the number of people involved, the way the problem should be tackled and the role of the mental health services.<br/> AIM: To look critically at the term 'bewildered persons' and to discuss the suspected increase in numbers and the role of mental health services.<br/> METHOD: Review and discussion of the relevant literature relating to 'bewildered persons' which has been published in the last 25 years...
2017: Tijdschrift Voor Psychiatrie
Meghan McCullough, Alex Campbell, Armando Siu, Libby Durnwald, Shubha Kumar, William P Magee, Jordan Swanson
BACKGROUND: The unmet burden of surgical disease represents a major global health concern, and a lack of trained providers is a critical component of the inadequacy of surgical care worldwide. Competency-based training has been advanced in high-income countries, improving technical skills and decreasing training time, but it is poorly understood how this model might be applied to low- and middle-income countries. We describe the development of a competency-based program to accelerate specialty training of in-country providers in cleft surgery techniques...
September 6, 2017: World Journal of Surgery
Hoa T Vo, Rachael Burgower, Ilya Rozenberg, Marc Fishman
Early experience with relapse prevention medications in the treatment of opioid addiction in youth has been positive, but barriers to effectiveness and broader adoption have included problems with adherence and retention, and lack of evidence or consensus about implementation. In particular there is relatively little known about either the effectiveness of extended release naltrexone (XR-NTX) in youth, or optimal models of care for its delivery. The purpose of this study is to report on a pilot initiative to improve the effectiveness of XR-NTX by delivering doses at home with assertive outreach to patients enrolled in a community treatment outpatient program...
August 31, 2017: Journal of Substance Abuse Treatment
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