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Trauma informed care

Kaila A Holtz, Elena Szefer, Vanessa K Noonan, Brian K Kwon, Patricia B Mills
STUDY DESIGN: Prospective cohort study using the Rick Hansen SCI Registry (RHSCIR) and retrospective medical chart review. OBJECTIVE: To describe treatment patterns of in-patient anti-spasticity medication use following traumatic spinal cord injury (SCI) in acute and rehabilitation hospital settings in British Columbia, Canada. SETTING: Quaternary trauma center, rehabilitation center. METHODS: Individuals with traumatic SCI between 2005 and 2014 enrolled in the Vancouver RHSCIR site (N = 917) were eligible for inclusion...
June 14, 2018: Spinal Cord
Helmut A Schmelz, Max Geraedts
BACKGROUND: Growing numbers of patients in orthopaedic and trauma surgery are obese. The risks involved are e.g. surgical complications, higher costs for longer hospital stays or special operating tables. It is a moot point whether revenues in the German DRG system cover the individual costs in relation to patients' body mass index (BMI) and in which area of hospital care potentially higher costs occur. MATERIAL AND METHODS: Data related to BMI, individual costs and revenues were extracted from the hospital information system for 13,833 patients of a large hospital who were operated in 2007 to 2010 on their upper or lower extremities...
June 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
(no author information available yet)
The global refugee/migrant crisis of displacement because of persecution and conflict carries staggering implications of ambiguity and loss for the individuals affected. In 2013, approximately 25,000 displaced people sought asylum in the United States; many of whom have experienced state-sponsored physical and psychological torture. With Physicians for Human Rights (PHR), several medical student clinics work closely with immigration attorneys and University and Community based clinicians to assist U.S. asylum seekers in their asylum claims...
June 2018: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Mercedes Bern-Klug, Elizabeth Byram, Nadia Sabbagh Steinberg, Herminia Gamez Garcia, Kyle C Burke
Background and Objective: The federal government holds nursing homes (NHs) responsible for assessing and addressing resident psychosocial needs. The staff person most responsible for psychosocial care planning is the social worker. However, the federal government requires only NHs with 120+ beds to employ one full-time social worker, and that person need not hold a social work degree. We compare/contrast state laws against federal laws and professional standards in terms of the minimum qualifications of NH social workers to determine in which states NH residents are legally entitled to receive services from a professional social work staff member...
June 13, 2018: Gerontologist
Wataru Ode, Violeta Lopez, Mun Loke Wong, Lone Schou, Victoria Soo Hoon Yu
BACKGROUND/AIM: Patients suffering dental trauma are unprepared for the disability challenge and necessary rehabilitation, while a traumatic event places an expanded demand on the dentist who is focused on treating disease. The aim of this study was to examine the impact of traumatic dental injuries (TDI) on patients, and to compare patients' and dentists' perceptions of the event. MATERIAL AND METHODS: TDI patients (aged ≥ 21 years) attending a tertiary dental hospital from 2011 - 2013 and their dentists were recruited with informed consent...
June 13, 2018: Dental Traumatology: Official Publication of International Association for Dental Traumatology
Lisa C Lindley, Elspeth M Slayter
CONTEXT: Children in foster care suffer with serious illness at end of life. However, the relationship between prior trauma exposure and serious illness has received little empirical attention. OBJECTIVES: The objectives were to examine the prevalence and type of trauma exposure, and investigate the relationship between prior trauma and serious illness among foster children at end of life. METHODS: We used national longitudinal foster care data...
June 8, 2018: Journal of Pain and Symptom Management
John K Yue, Angel Ordaz, Ethan A Winkler, Hansen Deng, Catherine G Suen, John F Burke, Andrew K Chan, Geoffrey T Manley, Sanjay S Dhall, Phiroz E Tarapore
OBJECTIVE: Predictors of surgical outcomes following traumatic axis (C2) fractures in octogenarians remain undercharacterized. METHODS: Patients aged ≥80-years undergoing cervical spine surgery following traumatic C2 fractures were extracted from the National Sample Program of the National Trauma Data Bank (2003-2012). Outcomes include overall inpatient complications, individual complications >1% incidence, hospital length of stay (HLOS), discharge disposition, and mortality...
June 7, 2018: World Neurosurgery
Marc Gutenstein, Sampsa Kiuru
We describe a phenomenon of self-reinforcing inequality between New Zealand rural hospitals and urban trauma centres. Rural doctors work in remote geographical locations, with rare exposure to managing critical injuries, and with little direct support when they do. Paradoxically, but for the same reasons, they also have little access to the intensive training resources and specialist oversight of their university hospital colleagues. In keeping with international experience, we propose that using simulation-based education for rural hospital trauma and emergency team training will mitigate this effect...
June 8, 2018: New Zealand Medical Journal
Eleftheria Matsa, Junxin Shi, Krista K Wheeler, Tara McCarthy, Mary Lou McGregor, Julie C Leonard
Importance: There is a lack of literature describing the incidence of pediatric acute ocular injury and associated likelihood of vision loss in the United States. Understanding national pediatric eye injury trends may inform future efforts to prevent ocular trauma. Objective: To characterize pediatric acute ocular injury in the United States using data from a stratified, national sample of emergency department (ED) visits. Design, Setting, and Participants: A retrospective cohort study was conducted...
June 7, 2018: JAMA Ophthalmology
Ecaterina Oaie, Emma Piepenstock, Lisa Williams
Introduction: Psychosocial screening of burn-injured patients is a National Burn Care Guideline and is increasingly used to identify individuals most in need of support. It can also generate data that can inform our understanding of patient reported concerns following a burn injury. Method: As part of routine care, 461 patients admitted to a burns unit were screened soon after admission using a psychosocial screen designed by the service. The questionnaire included items on pre-existing social support, coping, emotional and psychological difficulties, as well as current trauma symptoms and current level of concern about changed appearance following the burn...
January 2018: Scars, burns & healing
Tu Q Nguyen, Pamela M Simpson, Sandra C Braaf, Peter A Cameron, Rodney Judson, Belinda J Gabbe
BACKGROUND: Many outcome studies capture the presence of mental health, drug and alcohol comorbidities from administrative datasets and medical records. How these sources compare as predictors of patient outcomes has not been determined. The purpose of the present study was to compare mental health, drug and alcohol comorbidities based on ICD-10-AM coding and medical record documentation for predicting longer-term outcomes in injured patients. METHODS: A random sample of patients (n = 500) captured by the Victorian State Trauma Registry was selected for the study...
June 5, 2018: BMC Health Services Research
Kate Radford, Chris Sutton, Tracey Sach, Jain Holmes, Caroline Watkins, Denise Forshaw, Trevor Jones, Karen Hoffman, Rory O'Connor, Ruth Tyerman, Jose Antonio Merchán-Baeza, Richard Morris, Emma McManus, Avril Drummond, Marion Walker, Lelia Duley, David Shakespeare, Alison Hammond, Julie Phillips
BACKGROUND: Up to 160,000 people incur traumatic brain injury (TBI) each year in the UK. TBI can have profound effects on many areas of human functioning, including participation in work. There is limited evidence of the clinical effectiveness and cost-effectiveness of vocational rehabilitation (VR) after injury to promote early return to work (RTW) following TBI. OBJECTIVE: To assess the feasibility of a definitive, multicentre, randomised controlled trial (RCT) of the clinical effectiveness and cost-effectiveness of early, specialist VR plus usual care (UC) compared with UC alone on work retention 12 months post TBI...
May 2018: Health Technology Assessment: HTA
Amy C Weintrob, Clinton K Murray, Jiahong Xu, Margot Krauss, William Bradley, Tyler E Warkentien, Bradley A Lloyd, David R Tribble
BACKGROUND: During the conflicts in Iraq and Afghanistan, more than 52,000 U.S. military members were wounded in action. The battlefield mortality rate was lower than in past conflicts, however, those surviving often had complex soft tissue and bone injuries requiring multiple surgeries. This report describes the rates, types, and risks of infections complicating the care of combat casualties. PATIENTS AND METHODS: Infection and microbiology data obtained from the Trauma Infectious Disease Outcomes Study (TIDOS), a prospective observational study of infections complicating deployment-related injuries, were used to determine the proportion of infection, types, and associated organisms...
April 2018: Surgical Infections
Nikolas H Kazmers, Christopher H Judson, Angela P Presson, Yizhe Xu, Andrew R Tyser
PURPOSE: Distal radius fracture open reduction and internal fixation (ORIF) represents a considerable cost burden to the health care system. We aimed to elucidate demographic-, injury-, and treatment-specific factors influencing surgical encounter costs for distal radius ORIF. METHODS: We retrospectively reviewed adult patients treated with isolated distal radius ORIF between November 2014 and October 2016 at a single tertiary academic medical center. Using our institution's information technology value tools-which allow for comprehensive payment and cost data collection and analysis on an item-level basis-we determined relative costs (RC) for each factor potentially influencing total direct costs (TDC) for distal radius ORIF using univariate and multivariable gamma regression analyses...
May 31, 2018: Journal of Hand Surgery
Benhildah N Rumbwere Dube, Tom P Marshall, Ronan P Ryan, Modupe Omonijo
BACKGROUND: Early diagnosis of human immunodeficiency virus (HIV) is important because antiretroviral therapies are more effective if infected individuals are diagnosed early. Diagnosis of HIV relies on laboratory testing and determining the demographic and clinical characteristics of undiagnosed HIV-infected patients may be useful in identifying patients for testing. This systematic review aims to identify characteristics of HIV-infected adults prior to diagnosis that could be used in a prediction model for early detection of patients for HIV testing in UK primary care...
June 2, 2018: Systematic Reviews
Paulina Sockolow, Meredith Joppa, Jichen Zhu
Adolescent sexual risk behavior (SRB), a major public health problem affects urban Black adolescent girls increasing their health disparities and risks for sexually transmitted infections. Collaborating with these adolescents, we designed a game for smartphones that incorporates elements of trauma-informed care and social cognitive theory to reduce SRB. Game researchers promote use of a comprehensive, multipurpose framework for development and evaluation of games for health applications. Our first game development step was framework selection and measurable health outcomes identification...
2018: Studies in Health Technology and Informatics
Stephanie A Bryson, Harvey Bosma
Highlighting a strong human rights and social justice orientation underlying health social work in Canada, this paper describes recent contributions of Canadian health social work practitioners and scholars to five areas identified by Auslander (2001) in a delphi study of health social work in its first century. Five current 'trends' are discussed which correspond with Auslander's themes of professional legitimacy and scope, social causation, dissemination of knowledge, interventions, and cultural appropriateness...
May 30, 2018: Social Work in Health Care
Paul T Engels, Nori L Bradley, Chad G Ball
General surgeons provide life-saving trauma care to a large portion of Canadians. Although trauma care has evolved significantly over the last few decades and now requires fewer operations, when a life-saving operation is required the expectation of competence to perform this operation has not been reduced. A recent study from the United States found decreased resident case-log volumes of trauma operations. Such findings raise the alarm of declining exposure of residents to trauma operations and beg the question of whether graduating residents are competent to care for trauma patients...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Kristin DeGirolamo, Karan D'Souza, Sameer Apte, Chad G Ball, Christopher Armstrong, Artan Reso, Sandy Widder, Sarah Mueller, Lawrence M Gillman, Ravinder Singh, Rahima Nenshi, Kosar Khwaja, Samuel Minor, Chris de Gara, S Morad Hameed
BACKGROUND: Emergency general surgery (EGS) services are gaining popularity in Canada as systems-based approaches to surgical emergencies. Despite the high volume, acuity and complexity of the patient populations served by EGS services, little has been reported about the services' structure, processes, case-mix or outcomes. This study begins a national surveillance effort to define and advance surgical quality in an important and diverse surgical population. METHODS: A national cross-sectional study of EGS services was conducted during a 24-hour period in January 2017 at 14 hospitals across 7 Canadian provinces recruited through the Canadian Association of General Surgeons Acute Care Committee...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Lakshmi Neelakantan, Sarah Hetrick, Daniel Michelson
Trauma-focused cognitive behavioural therapy (TF-CBT) is an effective intervention for post-traumatic stress disorder, yet implementation may be hindered by practitioners' concerns about how treatment is experienced by users. This metasynthesis systematically reviews qualitative evidence on youth and caregivers' experiences of TF-CBT to better understand user perspectives on process and outcomes of treatment. A systematic review and metasynthesis were undertaken for qualitative studies of treatment experience related to TF-CBT...
May 25, 2018: European Child & Adolescent Psychiatry
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