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Trauma-informed AND primary Care

Daniel Stuart, Robin Christian, Hartmut Uschmann, Michelle Palokas
OBJECTIVE: The objective of this review was to determine the effectiveness of intrathecal nicardipine compared to usual care on cerebral vasospasm and its impact on the following outcome measures: mean flow velocities, angiographic and/or clinical vasospasm, and infection rates. INTRODUCTION: The results of non-traumatic (aneurysmal) subarachnoid hemorrhage can have devastating effects on patients in terms of functional outcomes. Although other medications have been and continue to be used, Nimodipine is the only Food and Drug Administration-approved medication for treating and improving outcomes following non-traumatic subarachnoid hemorrhage, which may be caused by aneurysmal rupture or arteriovenous malformation...
October 2018: JBI Database of Systematic Reviews and Implementation Reports
Joon-Myoung Kwon, Youngnam Lee, Yeha Lee, Seungwoo Lee, Hyunho Park, Jinsik Park
AIM: Triage is important in identifying high-risk patients amongst many less urgent patients as emergency department (ED) overcrowding has become a national crisis recently. This study aims to validate that a Deep-learning-based Triage and Acuity Score (DTAS) identifies high-risk patients more accurately than existing triage and acuity scores using a large national dataset. METHODS: We conducted a retrospective observational cohort study using data from the Korean National Emergency Department Information System (NEDIS), which collected data on visits in real time from 151 EDs...
2018: PloS One
Eve Rittenberg
No abstract text is available yet for this article.
October 10, 2018: New England Journal of Medicine
Daniel H Wiznia, Mike Wang, Chang-Yeon Kim, Michael P Leslie
The purpose of this study is to assess the effect of insurance type (Medicaid, Medicare, private insurance) on the ability for patients with operative ankle fractures to access orthopedic traumatologists. The research team called 245 board-certified orthopedic surgeons specializing in orthopedic trauma within 8 representative states. The caller requested an appointment for their fictitious mother in order to be evaluated for an ankle fracture which was previously evaluated by her primary care physician and believed to require surgery...
September 2018: American Journal of Orthopedics
Obada Hasan, Adeel Samad, Zohaib Nawaz, Tashfeen Ahmad, Zehra Abdul Muhammad, Shahryar Noordin
Introduction: Injuries are the second most common cause of disability, the fifth most common cause of healthy years of life lost per 1000 people and unfortunately 90% of mortality takes place in low-to middle-income countries. Trauma registries guide policymakers and health care providers in decision making in terms of resource allocation as well as enhancing trauma care outcomes. Furthermore data from these registries inform policy makers to decrease the rate of death and disability occurring as a result of injuries...
November 2018: Annals of Medicine and Surgery
Josefin Sjömark, Thomas Parling, Maria Jonsson, Margareta Larsson, Agneta Skoog Svanberg
BACKGROUND: About one-third of women report their childbirth as traumatic and up to 10% have severe traumatic stress responses to birth. The prevalence of Posttraumatic stress disorder following childbirth (PTSD FC) is estimated to 3%. Women with PTSD FC report the same symptoms as other patients with PTSD following other types of trauma. The effect of psychological treatment for women with PTSD FC has only been studied in a few trials. Similarly, studies on treatment needs for women not diagnosed as having PTSD FC but who nevertheless face psychological problems are lacking...
October 1, 2018: BMC Pregnancy and Childbirth
Annette J Browne, Colleen Varcoe, Marilyn Ford-Gilboe, C Nadine Wathen, Victoria Smye, Beth E Jackson, Bruce Wallace, Bernadette Bernie Pauly, Carol P Herbert, Josée G Lavoie, Sabrina T Wong, Amelie Blanchet Garneau
BACKGROUND: The health care sector has a significant role to play in fostering equity in the context of widening global social and health inequities. The purpose of this paper is to illustrate the process and impacts of implementing an organizational-level health equity intervention aimed at enhancing capacity to provide equity-oriented health care. METHODS: The theoretically-informed and evidence-based intervention known as 'EQUIP' included educational components for staff, and the integration of three key dimensions of equity-oriented care: cultural safety, trauma- and violence-informed care, and tailoring to context...
September 27, 2018: International Journal for Equity in Health
Oisin Breathnach, Marc O'Reilly, Keith Morrissey, Breda Conlon, Eoin Sheehan
INTRODUCTION: Virtual fracture clinics (VFC) are now prevalent across many orthopaedic services in the UK and Ireland. The management of a variety of musculoskeletal injuries using the VFC model has been demonstrated to be safe, cost-effective and associated with high levels of patient satisfaction. Referrals were made available through the National Integrated Medical Imaging System (NIMIS). NIMIS allows for electronic movement of patient images throughout the Irish health service. METHODS: A retrospective review of 157 orthopaedic fracture referrals from a regional hospital was performed...
September 18, 2018: Irish Journal of Medical Science
Melinda A Stanley, Nancy L Wilson, Srijana Shrestha, Amber B Amspoker, Paula Wagener, Jane Bavineau, Marla Turner, Terri L Fletcher, Jessica Freshour, Cynthia Kraus-Schuman, Mark E Kunik
OBJECTIVE: To determine whether Calmer Life (CL) improved worry, generalized anxiety disorder-related (GAD-related) symptoms, anxiety, depression, sleep, trauma-related symptoms, functional status, and quality of life better than Enhanced Community Care with Resource Counseling (ECC-RC) at 6 months and 9 months. METHODS: A randomized, controlled, comparative-effectiveness study involving underserved, low-income, mostly minority neighborhoods in Houston, Texas, looked at individuals ≥50 with significant worry and interest in psychosocial treatment...
August 7, 2018: American Journal of Geriatric Psychiatry
Melissa E Dichter, Anne Teitelman, Heather Klusaritz, Douglas M Maurer, Peter F Cronholm, Chyke A Doubeni
BACKGROUND AND OBJECTIVES: Experiences of psychological trauma are common among primary care patient populations, and adversely affect patients' health and health care utilization. Trauma-informed care (TIC) is a framework for identifying and responding to patients' experiences of psychological trauma to avoid retraumatization. The purpose of this study was to evaluate the current state of TIC training in family medicine residency programs in the United States in order to identify opportunities for and barriers to TIC training...
September 2018: Family Medicine
Rafael Figueiredo, Jordan Rattai, Kerri Fournier, Liran Levin
BACKGROUND/AIMS: Dental trauma represents a significant cause for concern in emergency department (ED). The aim of this study was to report on the prevalence of ED visits for dental problems associated with trauma (DPAT) in Alberta, Canada. The specific objectives were to provide up-to-date information regarding ED utilization for dental trauma concerning the demographics of users and distribution of ED visits across the Province of Alberta, allowing for an assessment of possible trends over the period of time observed...
September 6, 2018: Dental Traumatology: Official Publication of International Association for Dental Traumatology
Firas Mourad, Filippo Maselli, Alberto Patuzzo, Alessio Siracusa, Luigi Di Filippo, James Dunning, César Fernández de Las Peñas
Background and purpose: Elbow pain is common in young gymnasts and is frequently encountered by physical therapists working in direct access outpatient clinics. Most elbow pain is benign; however, non-specific symptoms can mask serious medical pathologies, as is the case with osteochondritis dissecans (OCD). OCD is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. Risk factor analysis, palpable joint tenderness and swelling, joint locking, and a history of high intensity repetitive activities may inform the clinical reasoning; however, the diagnosis of OCD is best made using magnetic resonance imaging (MRI)...
August 2018: International Journal of Sports Physical Therapy
Pierre Desmoineaux
After rotator cuff repair, few patients require revision surgery, and failure to heal does not always translate into clinical failure, although healing is associated with better outcomes. Failure of rotator cuff repair is perceived differently by the patient, by the surgeon, and in terms of social and occupational abilities. The work-up of failed cuff repair differs little from the standard work-up of cuff tears. Information must be obtained about the circumstances of the first repair procedure, a possible diagnostic inadequacy and/or technical error, and early or delayed trauma such as an aggressive rehabilitation programme...
August 18, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
F L Brown, K Carswell, J Augustinavicius, A Adaku, M R Leku, R G White, P Ventevogel, C S Kogan, C García-Moreno, R A Bryant, R J Musci, M van Ommeren, W A Tol
Background: Exposure to armed conflict and forced displacement constitute significant risks for mental health. Existing evidence-based psychological interventions have limitations for scaling-up in low-resource humanitarian settings. The WHO has developed a guided self-help intervention, Self Help Plus (SH+), which is brief, implemented by non-specialists, and designed to be delivered to people with and without specific mental disorders. This paper outlines the study protocol for an evaluation of the SH+ intervention in northern Uganda, with South Sudanese refugee women...
2018: Global Mental Health
Bart N Green, Claire D Johnson, Scott Haldeman, Edward J Kane, Michael B Clay, Erin A Griffith, Juan M Castellote, Matthew Smuck, Shanmuganathan Rajasekaran, Eric L Hurwitz, Margareta Nordin, Kristi Randhawa, Hainan Yu
PURPOSE: The purpose of this study was to develop recommendations for prevention interventions for spinal disorders that could be delivered globally, but especially in underserved areas and in low- and middle-income countries. METHODS: We extracted risk factors, associations, and comorbidities of common spinal disorders (e.g., back and neck pain, spinal trauma, infection, developmental disorders) from a scoping review of meta-analyses and systematic reviews of clinical trials, cohort studies, case control studies, and cross-sectional studies...
September 2018: European Spine Journal
Laura A Voith, Patricia Logan-Greene, Terri Strodthoff, Anna E Bender
Intimate partner violence (IPV) is a significant public health problem affecting women, men, and children across the United States. Batterer intervention programs (BIPs) serve as the primary intervention for men who use violence, employing three primary modalities: psychoeducation, cognitive-behavioral therapy (CBT), and other forms of group therapy such as alcohol or drug treatment. However, research indicates that program effectiveness of the primary BIP modalities is limited, due, in part, to the theoretical underpinnings guiding intervention such as learned behavior (psychoeducation), patriarchy as the root cause (Duluth model), and "dysfunctional" thinking (CBT)...
July 30, 2018: Trauma, Violence & Abuse
Nynke M Swart, Kim van Oudenaarde, Sita Ma Bierma-Zeinstra, Hans Jl Bloem, Wilbert B van den Hout, Paul R Algra, Patrick Je Bindels, Bart W Koes, Rob Ghh Nelissen, Jan An Verhaar, Monique Reijnierse, Pim Aj Luijsterburg
OBJECTIVE: To determine whether referral to MRI by the general practitioner (GP) is non-inferior to usual care (no access to MRI by GPs) in patients with traumatic knee complaints regarding knee-related daily function. METHODS: This was a multicentre, non-inferiority randomised controlled trial with 1-year follow-up. GPs invited eligible patients during or after their consultation. Eligible patients (18-45 years) consulted a GP with knee complaints due to a trauma during the previous 6 months...
July 24, 2018: British Journal of Sports Medicine
Eric D Schadler, Bernhard Ortel, Stephanie L Mehlis
Psoriasis is a chronic, systemic, inflammatory disease that affects approximately 7.5 million people in the United States. The disease results in significant suffering, morbidity, and economic impact. Psoriasis is considered a multifaceted disease with a strong genetic component. Genetic data has revealed the presence of particular risk alleles found in patients with psoriasis. Triggers of the disease have been elucidated and include factors such as trauma, obesity, infection, stress, and medications. At its core, psoriasis is a result of a dysfunctional immune response with T-cells at the center of immunogenesis...
July 20, 2018: Disease-a-month: DM
Sarah L Canham, Shelly Davidson, Karen Custodio, Celine Mauboules, Chloe Good, Andrew V Wister, Harvey Bosma
Being homeless has a negative effect on health and the health needs of individuals experiencing homelessness are complex and challenging to address. As a result of limited access to and use of primary healthcare, the main point of entry into the healthcare system for individuals experiencing homelessness is often hospitals and emergency departments. Persons experiencing homelessness are commonly discharged from hospital settings to locations that do not support recovery or access to follow-up care (e.g. shelters or the street)...
July 16, 2018: Health & Social Care in the Community
Sara Nasirian, Monika Fagevik Olsén, My Engström
Injuries due to trauma are the leading cause of death in Sweden among people younger than 45 years, and more than 120,000 patients were admitted to hospitals in 2014 as a result of trauma. Patients suffering from less serious physical trauma are often discharged directly from the trauma unit, commonly without any follow-up plans. There is a lack of knowledge about how these patients experience their recovery process.Eight women and 6 men were interviewed 3 months after being directly discharged from a trauma unit...
July 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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