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Trauma-informed AND primary Care

Colin K Cantrell, Nicholas J Dahlgren, Bradley L Young, Kimberly M Hendershot
OBJECTIVES: Surgical residents are increasingly pursuing fellowships and rely heavily on fellowship programs' web sites as a primary source of information. Accessibility, quality, and content of a program web site can encourage or deter an applicant from applying to a particular program. The goal of this study was to perform an analysis of trauma, surgical critical care, and acute care surgery fellowship program web sites. MATERIALS AND METHODS: A list of trauma, surgical critical care, and acute care surgery fellowship programs was obtained from the Eastern Association for the Surgery of Trauma (EAST) web site...
December 2018: Journal of Surgical Research
Esther Mm Van Lieshout, Daan T Van Yperen, Margriet E Van Baar, Suzanne Polinder, Doeke Boersma, Anne Ymvp Cardon, Piet Ar De Rijcke, Marc Guijt, Taco Mal Klem, Koen Ww Lansink, Akkie N Ringburg, Maarten Staarink, Leon Van de Schoot, Alexander H Van der Veen, Floortje C Van Eijck, Percy V Van Eerten, Paul A Vegt, Dagmar I Vos, Marco Waleboer, Michael Hj Verhofstad, Cornelis H Van der Vlies
INTRODUCTION: The Emergency Management of Severe Burns (EMSB) referral criteria have been implemented for optimal triaging of burn patients. Admission to a burn centre is indicated for patients with severe burns or with specific characteristics like older age or comorbidities. Patients not meeting these criteria can also be treated in a hospital without burn centre. Limited information is available about the organisation of care and referral of these patients. The aims of this study are to determine the burn injury characteristics, treatment (costs), quality of life and scar quality of burn patients admitted to a hospital without dedicated burn centre...
November 15, 2018: BMJ Open
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No abstract text is available yet for this article.
December 2018: Nurse Practitioner
Sanjeev Bhoi, Ajai Singh, Tej Prakash Sinha, Ranabir Pal, Sagar Galwankar, Arushi Baluja, Sabir Ali, Vidhu Sharma, Amit Agrawal
Background: Helmet, as a protective gear to prevent fatal injuries while riding two-wheelers, needs to be evaluated by quality data. The aim of the study was to find out spectrum of injuries sustained with downstream outcomes in relation to acceptable ways of use of crash-proof helmet among motorized two-wheeler riders compared to nonuse following road traffic accidents. Methods: The present study was an analytical cross-sectional multicentric study conducted at three dedicated trauma care centers of India: (a) Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, (b) King George's Medical University, Lucknow, Uttar Pradesh, and (c) Narayana Medical College and Hospital, Nellore, Andhra Pradesh...
July 2018: Journal of Emergencies, Trauma, and Shock
Naomi Ennis, Iris Sijercic, Candice M Monson
BACKGROUND: Over 75% of individuals are exposed to a traumatic event, and a substantial minority goes on to experience mental health problems that can be chronic and pernicious in their lifetime. Early interventions show promise for preventing trauma following psychopathology; however, a face-to-face intervention can be costly, and there are many barriers to accessing this format of care. OBJECTIVE: The aim of this study was to systematically review studies of internet-delivered early interventions for trauma-exposed individuals...
November 14, 2018: Journal of Medical Internet Research
Fernando Landreau, Oscar Valcarcel, Juan Noir, Guadalupe Pernía, María L Orzábal, Sergio Martínez, Alejandro Tobar, Mariana Isola, Mariano Núñez, Pablo Martínez, Cristian Cuellar, Federico Villagrán, Alberto Crescenti
As part of the emergency medical care system, helicopter emergency medical services (HEMS) have a different crew composition from the traditional team. HEMS consist of a pilot, doctor, and firefighter with rescue skills and training in basic life support on board an air ambulance. This allows the adaptation to different environments and increases the varieties of air procedures normally performed. HEMS began operating relatively recently in Buenos Aires. Yet, in 3 years, its use grew to such an extent that in 2015 it tripled, and by 2016 the number of medical assists was 4 times greater than in 2014...
November 2018: Air Medical Journal
I-Lin Hsu, Chung-Yi Li, Da-Chen Chu, Li-Chien Chien
Traumatic head injuries occur frequently in Taiwan, having catastrophic consequences for the victims, their families, and society as a whole. However, little is known about the risk factors at the population level in Taiwan. The primary aim of this study was to obtain more information on these variables and their relationships. Another aim was to analyze the effects of independent variables such as sex, age, residency, pre-existing conditions, mechanisms of injury, associated injuries, and severity on the probability of in-hospital death...
November 4, 2018: International Journal of Environmental Research and Public Health
Joyce Li, Genie Roosevelt, Kerry McCabe, Jane Preotle, Faria Pereira, James K Takayesu, Michael Monuteaux, Richard G Bachur
Objective: While emergency medicine (EM) physicians treat the majority of pediatric EM (PEM) patients in the United States, little is known about their PEM experience during training. The primary objective was to characterize the pediatric case exposure and compare to established EM residency training curricula among EM residents across five U.S. residency programs. Methods: We performed a multicenter medical record review of all pediatric patients (aged < 18 years) seen by the 2015 graduating resident physicians at five U...
October 2018: AEM education and training
Emanuele Rezoagli, Stefano Gatti, Silvia Villa, Giulia Villa, Stefano Muttini, Fabio Rossi, Loredana Faraldi, Roberto Fumagalli, Giacomo Grasselli, Giuseppe Foti, Giacomo Bellani
INTRODUCTION: ABO blood type A was reported to correlate with an increased risk of acute respiratory distress syndrome (ARDS) in white patients with severe sepsis and major trauma compared with patients with other blood types. Information regarding ABO phenotypes and major outcomes in patients with ARDS is unavailable. The primary aim was to determine the relationship between ABO blood type A and intensive care unit (ICU) mortality in patients with acute hypoxemic respiratory failure (AHRF)...
2018: PloS One
Marilyn Ford-Gilboe, C Nadine Wathen, Colleen Varcoe, Carol Herbert, Beth E Jackson, Josée G Lavoie, Bernadette Bernie Pauly, Nancy A Perrin, Victoria Smye, Bruce Wallace, Sabrina T Wong, Annette J Browne For The Equip Research Program
Policy Points: A consensus regarding the need to orient health systems to address inequities is emerging, with much of this discussion targeting population health interventions and indicators. We know less about applying these approaches to primary health care. This study empirically demonstrates that providing more equity-oriented health care (EOHC) in primary health care, including trauma- and violence-informed, culturally safe, and contextually tailored care, predicts improved health outcomes across time for people living in marginalizing conditions...
October 22, 2018: Milbank Quarterly
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
Today, it was my third patient of the morning: a woman with a history of childhood sexual abuse and an abusive marriage. She shared with me her distress, her escalating nightmares and flashbacks over the past week. She held out her left arm to me, where for the first time since her adolescence, she..
November 29, 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
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