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"Observation unit"

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https://www.readbyqxmd.com/read/29891715/widespread-loss-of-intermediate-soil-horizons-in-urban-landscapes
#1
Dustin L Herrmann, Laura A Schifman, William D Shuster
Soils support terrestrial ecosystem function and therefore are critical urban infrastructure for generating ecosystem services. Urbanization processes modify ecosystem function by changing the layers of soils identified as soil horizons. Soil horizons are integrative proxies for suites of soil properties and as such can be used as an observable unit to track modifications within soil profiles. Here, in an analysis of 11 cities representing 10 of the 12 soil orders, we show that urban soils have ∼50% fewer soil horizons than preurban soils...
June 11, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29849299/remote-management-of-atrial-fibrillation-a-case-report
#2
Alexander Chiu, Michael Kasper, John Rimmer, Meaghan Donnelly, Yangmin Chen, Caroline Chau, Lauren Sidow, Adam Ash
We report a case of new-onset atrial fibrillation with rapid ventricular response in a 37-year-old male who presented to the emergency department. This patient was not admitted to the hospital or placed on observation, but rather placed on a cellular outpatient 12-lead telemetry (COTLT) device with emergency response capabilities and discharged home. We define a new modality that allows these patients to be managed via telemedicine and receive care similar to that which would be rendered in a hospital or observation unit...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29795936/neuroimaging-research-from-null-hypothesis-falsification-to-out-of-sample-generalization
#3
Danilo Bzdok, Gaël Varoquaux, Bertrand Thirion
Brain-imaging technology has boosted the quantification of neurobiological phenomena underlying human mental operations and their disturbances. Since its inception, drawing inference on neurophysiological effects hinged on classical statistical methods, especially, the general linear model. The tens of thousands of variables per brain scan were routinely tackled by independent statistical tests on each voxel. This circumvented the curse of dimensionality in exchange for neurobiologically imperfect observation units, a challenging multiple comparisons problem, and limited scaling to currently growing data repositories...
October 2017: Educational and Psychological Measurement
https://www.readbyqxmd.com/read/29792102/entrusting-internal-medicine-residents-to-use-point-of-care-ultrasound-towards-improved-assessment-and-supervision
#4
Daniel J Schnobrich, Benji K Mathews, Bernard E Trappey, Brian K Muthyala, Andrew P J Olson
BACKGROUND: Internal medicine physicians and trainees are increasingly using, and seeking training in, diagnostic point of care ultrasound (POCUS). Numerous internal medicine training programs have described their curricula, but little has been written about how learners should be assessed, supervised, and allowed to progress toward independent practice, yet these practices are imperative for safe and effective use. Entrustable professional activities (EPAs) offer a practical method to assess observable units of professional work and make supervision decisions...
May 23, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29768698/financial-viability-of-emergency-department-observation-unit-billing-models
#5
Christopher W Baugh, Pawan Suri, Christopher G Caspers, Michael A Granovsky, Keith Neal, Michael A Ross
BACKGROUND: Outpatients receive observation services to determine the need for inpatient admission. These services are usually provided without the use of condition-specific protocols and in an unstructured manner, scattered throughout a hospital in areas typically designated for inpatient care. Emergency department observation units (EDOUs) use protocolized care to offer an efficient alternative with shorter lengths of stay, lower costs and higher patient satisfaction. EDOU growth is limited by existing policy barriers that prevent a "two-service" model of separate professional billing for both emergency and observation services...
May 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29768317/heart-failure-episodes-of-missed-major-cardiac-events-when-applying-the-heart-pathway-to-an-observation-unit-population
#6
Alan Tesson, Rami Abdo, Aparna Kamath, Joanne Sutter, Rachel Cline, Sarah L Hale, Jonathan Bae, Lalit Verma
OBJECTIVE: The HEART Pathway risk prediction tool (HEART score plus serial troponin measures at 0 and 3 hours post-presentation) is used to identify low-risk patients with chest pain who may qualify for safe, early discharge. We calculated the percentage of patients in our observation unit that qualified as low risk using HEART Pathway, as well as their associated outcomes. METHODS: We retrospectively reviewed charts on 966 consecutive patients admitted to our observation unit for chest pain (January 2015 to February 2016); HEART Pathway scores were retrospectively calculated and serial cardiac troponin values logged...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29760842/appropriateness-of-extremity-magnetic-resonance-imaging-examinations-in-an-academic-emergency-department-observation-unit
#7
McKinley Glover, Ravi V Gottumukkala, Yadiel Sanchez, Brian J Yun, Theodore I Benzer, Benjamin A White, Anand M Prabhakar, Ali S Raja
Introduction: Emergency departments (ED) and hospitals face increasing challenges related to capacity, throughput, and stewardship of limited resources while maintaining high quality. Appropriate utilization of extremity magnetic resonance imaging (MRI) examinations within the emergency setting is not well known. Therefore, this study aimed to determine indications for and appropriateness of MRI of the extremities for musculoskeletal conditions in the ED observation unit (EDOU). Methods: We conducted this institutional review board-approved, retrospective study in a large, quaternary care academic center and Level I trauma center...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757891/spinal-epidural-abscess-in-an-infant-presenting-as-fever-and-respiratory-distress
#8
Katherine M Gupta, Khoon-Yen Tay
A 9-month-old healthy female presented during winter to the emergency department with a chief complaint of fever and prominent respiratory symptoms. She was discharged on oseltamivir with a presumptive diagnosis of influenza. She returned to the emergency department 2 days later with continued fever and more upper respiratory symptoms. She was admitted for intravenous hydration to the observation unit with a diagnosis of viral illness (with viral testing that returned positive for adenovirus) and dehydration...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29740921/hospitalization-and-morbidity-due-to-adverse-drug-reactions-in-elderly-patients-a-single-center-study
#9
Silvia Ognibene, Natale Vazzana, Claudio Giumelli, Luisa Savoldi, Luca Braglia, Giuseppe Chesi
BACKGROUND AND AIMS: Adverse drug reaction (ADRs) is a leading but underrecognized cause of illness particularly in frail subjects with multiple comorbidities. We aimed to investigate the frequency, patterns and outcomes of ADRs as a cause of hospitalization in elderly patients admitted to an internal medicine ward. METHODS: We performed a retrospective observational study including every patient aged over 65 years who was admitted to our Department during a 12-month period...
May 9, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29716787/management-of-acute-retinal-ischemia-follow-the-guidelines
#10
REVIEW
Valérie Biousse, Fadi Nahab, Nancy J Newman
Acute retinal arterial ischemia, including vascular transient monocular vision loss (TMVL) and branch (BRAO) and central retinal arterial occlusions (CRAO), are ocular and systemic emergencies requiring immediate diagnosis and treatment. Guidelines recommend the combination of urgent brain magnetic resonance imaging with diffusion-weighted imaging, vascular imaging, and clinical assessment to identify TMVL, BRAO, and CRAO patients at highest risk for recurrent stroke, facilitating early preventive treatments to reduce the risk of subsequent stroke and cardiovascular events...
April 30, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29701496/evaluation-of-hospital-length-of-stay-and-revenues-as-a-function-of-admission-mode-clinical-pathways-including-observation-unit-stay-and-hospitalization-characteristics
#11
Enrique Casalino, Anne Perozziello, Christophe Choquet, Sonia Curac, Christophe Leroy, Romain Hellmann
Objectives Hospital length of stay (days) and revenues per day (euros) could be different depending on admission mode. To determine the impact of admission mode as a function of clinical pathway, we conducted the present study. DATA SOURCES: We included 159,206 admissions to three academic hospitals during a four-year period. Data were obtained from the electronic system of the hospital trust. Study design A case (through-emergency department)-control (elective (EA)) study was conducted (77,052), matched by age, stay severity and type, disease-related group, and discharge mode...
January 1, 2018: Health Services Management Research
https://www.readbyqxmd.com/read/29698343/the-effect-of-an-observation-unit-on-pediatric-minor-head-injury
#12
Yusuke Hagiwara, Nobuaki Inoue
OBJECTIVE: The aim of this study was to evaluate the effect of an observation unit (OU) in an emergency department on reducing unnecessary use of computed tomography (CT) for minor blunt head trauma. METHODS: This study was a retrospective before-and-after study of pediatric patients 18 years or younger with minor blunt head trauma. Patients with a Glasgow Coma Scale score of 14 or 15 who presented to the emergency department were included in the analysis. The rates of head CT use in the period before and after the institution of the OU were compared...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29661692/hospital-ambulatory-medicine-a-leading-strategy-for-internal-medicine-in-europe
#13
Xavier Corbella, Vasco Barreto, Stefano Bassetti, Monica Bivol, Pietro Castellino, Evert-Jan de Kruijf, Francesco Dentali, Mine Durusu-Tanriöver, Carmen Fierbinţeanu-Braticevici, Thomas Hanslik, Radovan Hojs, Soňa Kiňová, Leonid Lazebnik, Evija Livčāne, Matthias Raspe, Luis Campos
Addressing the current collision course between growing healthcare demands, rising costs and limited resources is an extremely complex challenge for most healthcare systems worldwide. Given the consensus that this critical reality is unsustainable from staff, consumer, and financial perspectives, our aim was to describe the official position and approach of the Working Group on Professional Issues and Quality of Care of the European Federation of Internal Medicine (EFIM), for encouraging internists to lead a thorough reengineering of hospital operational procedures by the implementation of innovative hospital ambulatory care strategies...
April 13, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29619807/-recommendations-for-the-care-of-patients-with-community-acquired-pneumonia-in-the-emergency-department
#14
A Julián-Jiménez, I Adán Valero, A Beteta López, L M Cano Martín, O Fernández Rodríguez, R Rubio Díaz, M A Sepúlveda Berrocal, J González Del Castillo, F J Candel González
The incidence of community-acquired pneumonia (CAP) ranges from 2-15 cases / 1,000 inhabitants / year, being higher in those older than 65 years and in patients with high co-morbidity. Around 75% of all CAP diagnosed are treated in the Emergency Department (ED). The CAP represents the main cause for sepsis and septic shock in ED, and the most frequent cause of death and admission to the Intensive Care Unit (ICU) due to infectious disease. Overall mortality is 10-14% according to age and associated risk factors...
April 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29617358/what-exactly-is-n-in-cell-culture-and-animal-experiments
#15
Stanley E Lazic, Charlie J Clarke-Williams, Marcus R Munafò
Biologists determine experimental effects by perturbing biological entities or units. When done appropriately, independent replication of the entity-intervention pair contributes to the sample size (N) and forms the basis of statistical inference. If the wrong entity-intervention pair is chosen, an experiment cannot address the question of interest. We surveyed a random sample of published animal experiments from 2011 to 2016 where interventions were applied to parents and effects examined in the offspring, as regulatory authorities provide clear guidelines on replication with such designs...
April 2018: PLoS Biology
https://www.readbyqxmd.com/read/29560059/emergency-department-ed-ed-observation-day-hospital-and-hospital-admissions-for-adults-with-sickle-cell-disease
#16
David M Cline, Susan Silva, Caroline E Freiermuth, Victoria Thornton, Paula Tanabe
Introduction: Use of alternative venues to manage uncomplicated vaso-occlusive crisis (VOC), such as a day hospital (DH) or ED observation unit, for patients with sickle cell anemia, may significantly reduce admission rates, which may subsequently reduce 30-day readmission rates. Methods: In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease (SCD) VOC, we prospectively compared acute care encounters for utilization of 1) emergency department (ED); 2) ED observation unit; 3) DH, and 4) hospital admission, of two different patient cohorts with SCD presenting to our two study sites...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29560046/implementation-of-a-rapid-protocol-based-tia-management-pathway
#17
Susann J Jarhult, Melissa L Howell, Isabelle Barnaure-Nachbar, Yuchiao Chang, Benjamin A White, Mary Amatangelo, David F Brown, Aneesh B Singhal, Lee H Schwamm, Scott B Silverman, Joshua N Goldstein
Introduction: Our goal was to assess whether use of a standardized clinical protocol improves efficiency for patients who present to the emergency department (ED) with symptoms of transient ischemic attack (TIA). Methods: We performed a structured, retrospective, cohort study at a large, urban, tertiary care academic center. In July 2012 this hospital implemented a standardized protocol for patients with suspected TIA. The protocol selected high-risk patients for admission and low/intermediate-risk patients to an ED observation unit for workup...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29550098/evaluating-the-emergency-department-observation-unit-for-the-management-of-hyperglycemia-in-adults
#18
Colin J Crilly, Amy J Allen, Teresa M Amato, Allison Tiberio, Rifka C Schulman, Robert A Silverman
OBJECTIVE: To determine whether hyperglycemic patients can be successfully managed in the Emergency Department Observation Unit (EDOU), as determined by the frequency of inpatient admission following their EDOU stay. METHODS: This was a retrospective chart review of patients≥18years presenting to an academic tertiary care ED between May 1, 2014 and May 31, 2016, found to have a glucose≥300mg/dL, and selected for EDOU admission. Patient demographic information, lab results including an HbA1c, disposition, and hospital revisits within 30days of discharge were recorded...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29548339/population-aging-and-migration-history-and-un-forecasts-in-the-eu-28-and-its-east-and-south-near-neighborhood-one-century-perspective-1950-2050
#19
Mihajlo Michael Jakovljevic, Yael Netz, Sandra C Buttigieg, Roza Adany, Ulrich Laaser, Mirjana Varjacic
BACKGROUND: There is a gap in knowledge on long term pace of population aging acceleration and related net-migration rate changes in WHO European Region and its adjacent MENA countries. We decided to compare European Union (EU-28) region with the EU Near Neighborhood Policy Region East and EU Near Neighborhood Policy Region South in terms of these two essential features of third demographic transition. One century long perspective dating back to both historical data and towards reliable future forecasts was observed...
March 16, 2018: Globalization and Health
https://www.readbyqxmd.com/read/29524340/creation-and-implementation-of-an-outpatient-pathway-for-atrial-fibrillation-in-the-emergency-department-setting-results-of-an-expert-panel
#20
Christopher W Baugh, Carol L Clark, Jason W Wilson, Ian G Stiell, Abraham G Kocheril, Krista K Luck, Troy D Myers, Charles V Pollack, Steven K Roumpf, Gery F Tomassoni, James M Williams, Brian B Patel, Fred Wu, Jesse M Pines
Atrial fibrillation and flutter (AF) is a common condition among emergency department (ED) patients in the United States. Traditionally, ED care for primary complaints related to AF focus on rate control, and patients are often admitted to an inpatient setting for further care. Inpatient care may include further telemetry monitoring and diagnostic testing, rhythm control, a search for identification of AF etiology, and stroke prophylaxis. However, many patients are eligible for safe and effective outpatient management pathways...
March 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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