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public health at the emergency department

Joyce Cheng, Paul Benassi, Claire De Oliveira, Juveria Zaheer, Michael Collins, Paul Kurdyak
OBJECTIVE: Despite the high prevalence of mental illnesses and addictions, treatment rates remain low. In April 2010, a regional mass media campaign was implemented to increase awareness of mental health services in central Toronto, Canada. We studied the impact of this campaign on rates of psychiatric emergency department (PED) visits among all hospital emergency departments (EDs) located in Toronto. DESIGN: Monthly PED visit totals were obtained for all Toronto EDs from April 1, 2007 to March 31, 2012 (n = 148,704)...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Prakash Chandra Pandey, Sarita Bajaj, Anubha Srivastava
OBJECTIVE: Snake bite in India is a common medical emergency and an occupational hazard for majority of Indian population especially farmers. Epidemiological data on snake bite from the North India is sparse. Hence we conducted this study to find clinico-epidemiological profile of neuroparalytic snake bite. METHODS: This is a record-based, descriptive study carried out at the Department of Medicine, M.L.N. Medical College and associated Swaroop Rani Nehru Hospital, Allahabad, U...
August 2016: Journal of the Association of Physicians of India
Sandy Middleton, Chris Levi, Simeon Dale, N Wah Cheung, Elizabeth McInnes, Julie Considine, Catherine D'Este, Dominique A Cadilhac, Jeremy Grimshaw, Richard Gerraty, Louise Craig, Verena Schadewaldt, Patrick McElduff, Mark Fitzgerald, Clare Quinn, Greg Cadigan, Sonia Denisenko, Mark Longworth, Jeanette Ward
BACKGROUND: Internationally recognised evidence-based guidelines recommend appropriate triage of patients with stroke in emergency departments (EDs), administration of tissue plasminogen activator (tPA), and proactive management of fever, hyperglycaemia and swallowing before prompt transfer to a stroke unit to maximise outcomes. We aim to evaluate the effectiveness in EDs of a theory-informed, nurse-initiated, intervention to improve multidisciplinary triage, treatment and transfer (T(3)) of patients with acute stroke to improve 90-day death and dependency...
October 18, 2016: Implementation Science: IS
Mari-Lynn Drainoni, Elisa A Koppelman, James A Feldman, Alexander Y Walley, Patricia M Mitchell, Jacqueline Ellison, Edward Bernstein
BACKGROUND: The increase in opioid overdose deaths has become a national public health crisis. Naloxone is an important tool in opioid overdose prevention. Distribution of nasal naloxone has been found to be a feasible, and effective intervention in community settings and may have potential high applicability in the emergency department, which is often the initial point of care for persons at high risk of overdose. One safety net hospital introduced an innovative policy to offer take-home nasal naloxone via a standing order to ensure distribution to patients at risk for overdose...
October 18, 2016: BMC Research Notes
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
BACKGROUND: Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. OBJECTIVE: To describe the availability of faculty in medical schools in Tanzania. DESIGN: We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
2016: Global Health Action
Yuri P Springer, Roy Gerona, Erich Scheunemann, Sarah L Shafer, Thomas Lin, Samuel D Banister, Michael P Cooper, Louisa J Castrodale, Michael Levy, Jay C Butler, Joseph B McLaughlin
In July 2015, personnel in the Alaska Division of Public Health's Section of Epidemiology became aware of an increase in the number of patients being treated in Anchorage hospital emergency departments for adverse reactions associated with use of synthetic cannabinoids (SCs). SCs are a chemically diverse class of designer drugs that bind to the same cannabinoid receptors as tetrahydrocannabinol, the main psychoactive component of cannabis. A public health investigation was initiated to describe clinical outcomes, characterize the outbreak, and identify SC chemicals circulating in Anchorage...
October 14, 2016: MMWR. Morbidity and Mortality Weekly Report
Alexis José Ormeño Julca
Exposure to potentially toxic substances represents 0.3% of annual visits to a pediatric emergency department, being a situation likely to be prevented and that generates a non-negligible morbidity and mortality. The most common route of exposure is the oral and drugs are the products most frequently involved. Esophagitis caustic ingestion of corrosive substances in childhood is now a public health problem in developing countries. Clinical manifestations vary from no injuries serious commitment to high risk of death observed more frequently in patients between one and three years old...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Jeremy A Franklin, Evan J Anderson, Xionghua Wu, Christopher S Ambrose, Eric A F Simões
Background.  Database studies have identified that public health insurance status is associated with an increased risk of severe respiratory syncytial virus (RSV) disease in US infants. However, these studies did not adjust for the presence of other risk factors and did not evaluate the risk in preterm infants. Methods.  In this study, we evaluate the independent association between public insurance and severe RSV disease outcomes adjusting for other risk factors. The prospective, observational RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study was conducted over 2 consecutive RSV seasons at 188 US clinical sites that enrolled preterm infants born at 32-35 wGA who had not received RSV immunoprophylaxis with palivizumab...
September 2016: Open Forum Infectious Diseases
Christoffer Torgaard Thomsen, Michael Eriksen Benros, Lene Halling Hastrup, Per Kragh Andersen, Domenico Giacco, Merete Nordentoft
INTRODUCTION: Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes...
2016: BMJ Open
Shun-Xian Zhang, Li Li, Jian-Wen Yin, Miao Jin, Xiang-Yu Kong, Li-Li Pang, Yong-Kang Zhou, Li-Guang Tian, Jia-Xu Chen, Xiao-Nong Zhou
BACKGROUND: Acute diarrhea is one of the most serious problems in global public health that causes considerable morbidity and mortality worldwide. Human caliciviruses (HuCV) including norovirus (NoV, genogroup GI and GII) and sapovirus (SaV), is a leading cause of acute sporadic diarrhea in individuals across all age groups. However, few studies had been conducted clarifying the characteristics of HuCV in diarrhea cases across all age groups in China. Our study was aimed at assessing the HuCV-related diarrhea burden and NoV genotypes distribution in southwest China...
2016: BMC Infectious Diseases
Samantha Hollingworth, Jianzhen Zhang, Bharat Phani Vaikuntam, Claire Jackson, Geoffrey Mitchell
BACKGROUND: To plan integrated care at end of life for people with either heart failure or lung disease, we used a case conference between the patient's general practitioner (GP), specialist services and a palliative care consultant physician. This intervention significantly reduced hospitalisations and emergency department visits. This paper reports estimates of potential savings of reduced hospitalisation through end of life case conferences in a pilot study. METHODS: We used Australian Refined Diagnosis Related Group codes to obtain data on hospitalisations and costs...
2016: BMC Palliative Care
Feryal Erhun, Elizabeth Malcolm, Maziyar Kalani, Kimberly Brayton, Christine Nguyen, Steven M Asch, Terry Platchek, Arnold Milstein
OBJECTIVES: Nearly 57 million outpatient surgeries-invasive procedures performed on an outpatient basis in hospital outpatient departments (HOPDs) or ambulatory surgery centers (ASCs)-produced annually in the United States account for roughly 7% of healthcare expenditures. Although moving inpatient surgeries to outpatient settings has lowered the cost of care, substantial opportunities to improve the value of outpatient surgery remain. To exploit these remaining opportunities, we composed an evidence-based care delivery composite for national discussion and pilot testing...
2016: American Journal of Managed Care
Glendon Diehl, Nicole Bradstreet, Felicia Monahan
Tasked with analyzing the effectiveness of the Department of Defense's (DoD's) global health engagements, the Uniformed Services University of the Health Sciences (USU) used the Measures Of Effectiveness in Defense Engagement and Learning (MODEL) study to conduct a qualitative analysis of the DoD's response efforts to the Ebola pandemic in West Africa. The research aims to summarize the findings of studies that monitor and evaluate the DoD's response to the Ebola pandemic or compare the effectiveness of different DoD response activities; it further aims to identify common themes around positive and negative lessons learned and recommendations that can be applied to future DoD humanitarian assistance and disaster response efforts...
September 2016: Health Security
Dan Todkill, Helen E Hughes, Alex J Elliot, Roger A Morbey, Obaghe Edeghere, Sally Harcourt, Tom Hughes, Tina Endericks, Brian McCloskey, Mike Catchpole, Sue Ibbotson, Gillian Smith
: Introduction In preparation for the London 2012 Olympic Games, existing syndromic surveillance systems operating in England were expanded to include daily general practitioner (GP) out-of-hours (OOH) contacts and emergency department (ED) attendances at sentinel sites (the GP OOH and ED syndromic surveillance systems: GPOOHS and EDSSS). Hypothesis/Problem The further development of syndromic surveillance systems in time for the London 2012 Olympic Games provided a unique opportunity to investigate the impact of a large mass-gathering event on public health and health services as monitored in near real-time by syndromic surveillance of GP OOH contacts and ED attendances...
September 19, 2016: Prehospital and Disaster Medicine
Agda Maria Oliveira, Carolina Portugal Vieira, Margareth Regina Dibo, Marluci Monteiro Guirado, Lilian Aparecida Colebrusco Rodas, Francisco Chiaravalloti-Neto
Visceral leishmaniasis (VL), a neglected disease, is a serious public health problem that affects millions of people worldwide. The objectives of the study were to evaluate the sensitivity of Lutzomyia longipalpis and canine VL (CVL) autochthony early detection and describe the spatial and temporal dispersal of vector and expansion of VL in a Brazilian state. We obtained data on the leishmaniasis vector and VL cases in São Paulo State (SP), Brazil, from the Division of Endemic Disease Control and from the Epidemiological Surveillance Center of the São Paulo State Department of Health...
September 15, 2016: Acta Tropica
Brenda Silverman, Brenda Chen, Nancy Brener, Judy Kruger, Nevin Krishna, Paul Renard, Sandra Romero-Steiner, Rachel Nonkin Avchen
The unique characteristics of children dictate the need for school-based all-hazards response plans during natural disasters, emerging infectious diseases, and terrorism (1-3). Schools are a critical community institution serving a vulnerable population that must be accounted for in public health preparedness plans; prepared schools are adopting policies and plans for crisis preparedness, response, and recovery (2-4). The importance of having such plans in place is underscored by the development of a new Healthy People 2020 objective (PREP-5) to "increase the percentage of school districts that require schools to include specific topics in their crisis preparedness, response, and recovery plans" (5)...
2016: MMWR. Morbidity and Mortality Weekly Report
Mary R Janevic, Shelley Stoll, Margaret Wilkin, Peter X K Song, Alan Baptist, Marielena Lara, Gilberto Ramos-Valencia, Tyra Bryant-Stephens, Victoria Persky, Kimberly Uyeda, Julie Kennedy Lesch, Wen Wang, Floyd J Malveaux
OBJECTIVES: To assess the effect of care coordination on asthma outcomes among children in underserved urban communities. METHODS: We enrolled children, most of whom had very poorly or not well-controlled asthma, in medical-social care coordination programs in Los Angeles, California; Chicago, Illinois; Philadelphia, Pennsylvania; and San Juan, Puerto Rico in 2011 to 2014. Participants (n = 805; mean age = 7 years) were 60% male, 50% African American, and 42% Latino...
November 2016: American Journal of Public Health
Tayebeh Movahedinejad, Mohsen Adib-Hajbaghery, Mohammad Reza Zahedi
BACKGROUND: Eye trauma is among the most common reasons for referral to hospital emergency departments and ophthalmologists' offices. It also is a common cause of vision loss worldwide. However, few studies are available on the changes in the epidemiology of eye trauma in Iran in recent years. OBJECTIVES: This study aimed to investigate the characteristics of hospital admissions for eye trauma in Kashan from August 2011 to February 2014. PATIENTS AND METHODS: A cross-sectional study was carried out on the hospital records of all patients with eye trauma who were admitted to Kashan's Matini hospital between August 2011 and February 2014...
May 2016: Trauma Monthly
Saira A Mathew, Elise Gane, Kristiann C Heesch, Steven M McPhail
BACKGROUND: Older adults hospitalized with fragility fractures are at high risk of negative events that can culminate in re-presentations to hospital emergency departments or readmissions to hospital. This systematic review aimed to identify patient, clinical, or hospital-related factors that are identifiable at the index admission and that may be associated with re-presentations to hospital emergency departments or hospital readmissions in older adults following fragility fractures. METHODS: Four electronic databases (PubMed, CINAHL, Embase, and Scopus) were searched...
2016: BMC Medicine
Carolyn L McCarty, Leigh Nelson, Samantha Eitniear, Eric Zgodzinski, Amanda Zabala, Laurie Billing, Mary DiOrio
On August 1, 2014, routine testing at the Collins Park Water Treatment Plant in Lucas County, Ohio, revealed microcystin toxin levels in drinking water had reached 3.19 μg/L, surpassing the Ohio Environmental Protection Agency (EPA) drinking water advisory threshold of 1.0 μg/L. Microcystin is a hepatoxin released by cyanobacteria in certain harmful algal blooms. Exposure to microcystin has been associated with gastrointestinal and hepatic illness in both humans and animals (1-3). On August 2, a do-not-drink advisory was issued, warning community members not to drink, boil, or use the water for cooking or brushing teeth...
2016: MMWR. Morbidity and Mortality Weekly Report
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