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https://www.readbyqxmd.com/read/27912976/implications-of-a-negative-abdominal-ct-in-the-management-of-pediatric-blunt-abdominal-trauma
#1
Sarah Braungart, Thomas Beattie, Paula Midgley, Mark Powis
BACKGROUND: No consensus exists on management of children with a negative trauma CT following blunt abdominal trauma (BAT). Asymptomatic children are frequently "admitted for observation" following negative CT owing to concerns about missing an intraabdominal injury (IAI) without evidence for this practice. We aimed to investigate the feasibility of discharge following a negative CT scan in children sustaining blunt abdominal trauma. METHODS: Retrospective audit at a UK paediatric major trauma center and review of the literature...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27912928/translating-self-persuasion-into-an-adolescent-hpv-vaccine-promotion-intervention-for-parents-attending-safety-net-clinics
#2
Austin S Baldwin, Deanna C Denman, Margarita Sala, Emily G Marks, L Aubree Shay, Sobha Fuller, Donna Persaud, Simon Craddock Lee, Celette Sugg Skinner, Deborah J Wiebe, Jasmin A Tiro
OBJECTIVE: Self-persuasion is an effective behavior change strategy, but has not been translated for low-income, less educated, uninsured populations attending safety-net clinics or to promote human papillomavirus (HPV) vaccination. We developed a tablet-based application (in English and Spanish) to elicit parental self-persuasion for adolescent HPV vaccination and evaluated its feasibility in a safety-net population. METHODS: Parents (N=45) of age-eligible adolescents used the self-persuasion application...
November 20, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27905450/cities-new-fringes-to-act-as-safety-nets
#3
Pranab Chatterjee, Manish Kakkar, Tamoghna Biswas
No abstract text is available yet for this article.
November 30, 2016: Nature
https://www.readbyqxmd.com/read/27903790/association-between-health-related-beliefs-and-oral-health-behaviors-among-uninsured-primary-care-patients
#4
Akiko Kamimura, Bethany Gull, Shannon Weaver, Lindsey Wright, Jeanie Ashby, Lea E Erickson
INTRODUCTION: The collaborations between dental care providers and other health care providers are especially needed for underserved populations. There is a deficit of research focused on underserved populations who utilize a safety net facility such as a free clinic in the United States. The purpose of this study is to examine the association between health-related beliefs and oral health behaviors among uninsured adults utilizing a primary care free clinic providing oral health care...
November 29, 2016: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/27903138/partnerships-between-health-care-and-legal-providers-in-the-veterans-health-administration
#5
Jack Tsai, Margaret Middleton, Randye Retkin, Cindy Johnson, Kevin Kenneally, Scott Sherman, Robert A Rosenheck
Medical-legal partnerships (MLPs) represent an innovative service model in which lawyers are integrated into health care teams to address diverse legal problems that affect vulnerable populations. The Veterans Health Administration (VHA) operates the largest safety-net health care system in the country and serves many low-income and disabled veterans who could benefit from MLP services. In this column, the authors describe the development and operations of MLPs at four VHA medical centers that serve veterans who are homeless or who have serious mental illness...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27902550/-salt-in-the-wound-safety-net-clinician-perspectives-on-performance-feedback-derived-from-ehr-data
#6
Arwen E Bunce, Rachel Gold, James V Davis, MaryBeth Mercer, Victoria Jaworski, Celine Hollombe, Christine Nelson
Electronic health record (EHR) data can be extracted for calculating performance feedback, but users' perceptions of such feedback impact its effectiveness. Through qualitative analyses, we identified perspectives on barriers and facilitators to the perceived legitimacy of EHR-based performance feedback, in 11 community health centers (CHCs). Providers said such measures rarely accounted for CHC patients' complex lives or for providers' decisions as informed by this complexity, which diminished the measures' perceived validity...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27898668/the-long-term-safety-public-health-impact-and-cost-effectiveness-of-routine-vaccination-with-a-recombinant-live-attenuated-dengue-vaccine-dengvaxia-a-model-comparison-study
#7
Stefan Flasche, Mark Jit, Isabel Rodríguez-Barraquer, Laurent Coudeville, Mario Recker, Katia Koelle, George Milne, Thomas J Hladish, T Alex Perkins, Derek A T Cummings, Ilaria Dorigatti, Daniel J Laydon, Guido España, Joel Kelso, Ira Longini, Jose Lourenco, Carl A B Pearson, Robert C Reiner, Luis Mier-Y-Terán-Romero, Kirsten Vannice, Neil Ferguson
BACKGROUND: Large Phase III trials across Asia and Latin America have recently demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia) over the first 25 mo following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. We here report predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine vaccination with Dengvaxia in a range of transmission settings, as characterised by seroprevalence levels among 9-y-olds (SP9)...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27893953/leveraging-telehealth-to-bring-volunteer-physicians-into-underserved-communities
#8
Lori Uscher-Pines, Robert Rudin, Ateev Mehrotra
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute...
November 28, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27893694/the-safety-and-efficacy-of-vitamin-k-antagonist-in-atrial-fibrillation-patients-with-previous-ulcer-bleeding-long-term-results-from-a-multicenter-study
#9
Seung-Jun Lee, Jung-Hoon Sung, Jin-Bae Kim, Min-Soo Ahn, Hye Young Lee, Jae-Sun Uhm, Hui-Nam Pak, Moon-Hyoung Lee, Jong-Yun Kim, Boyoung Joung
This study aimed to evaluate the safety and efficacy of vitamin K antagonist (VKA) in atrial fibrillation (AF) patients with previous ulcer bleeding.In this multicenter, retrospective analysis, clinical outcomes of 754 AF patients with a history of ulcer bleeding were evaluated. After ulcer treatment, 458 patients (61%) were treated with VKA, and the outcomes were compared to 296 patients (39%) without VKA.VKA treatment significantly increased major bleeding (7.3%/year vs 3.2%/year, P < 0.001), and reduced major adverse cardiac events (MACE) (5...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27884850/comparative-effectiveness-and-safety-of-oral-anticoagulants-for-atrial-fibrillation-in-real-world-practice-a-population-based-cohort-study-protocol
#10
Anne Holbrook, Colin Dormuth, Richard Morrow, Agnes Lee, Sue Troyan, Guowei Li, Eleanor Pullenyegum
INTRODUCTION: Anticoagulants are arguably the most important drug family of all, based on the frequency and duration of their use, and the clinical importance and frequency of benefits and harms. Several direct acting oral anticoagulants (DOACs) have recently joined warfarin for the treatment of atrial fibrillation, with a resultant significant expansion in use of oral anticoagulants (OACs). Our objectives are to compare safety and effectiveness of DOACs versus warfarin in a full population where anticoagulation management is good and to identify which types of patients do better with DOACs versus warfarin and vice versa...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27882775/association-between-availability-of-care-providers-and-healthcare-utilizations-among-adults-with-asthma
#11
Minchul Kim, Carl V Asche, William Tillis, Jinma Ren
BACKGROUND: Limited accessibility to providers may delay appropriate control of asthma exacerbations. The objective of our study is to estimate the contributors to the hospital/emergency department (ED) visits among adults with asthma focusing on the availability of healthcare providers. METHODS: We conducted a pooled cross-sectional analysis using the 2011-2013 Asthma Call-Back Survey linked with 2012-2016 Area Health Resource Files. We employed multivariable logistic regression with dichotomous outcomes of hospitalization and ED visits...
December 2, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27881926/improving-pain-care-through-implementation-of-the-stepped-care-model-at-a-multisite-community-health-center
#12
Daren R Anderson, Ianita Zlateva, Emil N Coman, Khushbu Khatri, Terrence Tian, Robert D Kerns
PURPOSE: Treating pain in primary care is challenging. Primary care providers (PCPs) receive limited training in pain care and express low confidence in their knowledge and ability to manage pain effectively. Models to improve pain outcomes have been developed, but not formally implemented in safety net practices where pain is particularly common. This study evaluated the impact of implementing the Stepped Care Model for Pain Management (SCM-PM) at a large, multisite Federally Qualified Health Center...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27878820/youth-and-the-great-recession-are-values-achievement-orientation-and-outlook-to-the-future-affected
#13
Ingrid Schoon, Jeylan Mortimer
This special section brings together leading experts in psychology and sociology to examine the consequences of the Great Recession for young people's values, achievement orientation, and outlook to the future. Evidence from Europe and the United States suggests that the impact of the recession varies for distinct outcomes and by age, the latter pointing to potential sensitive periods for interventions. Although the direct effects of the recession are not strong, they accelerate pre-existing trends towards more prolonged and precarious transitions to independence, and are likely to bring with them long-term scarring with respect to health and well-being...
November 23, 2016: International Journal of Psychology: Journal International de Psychologie
https://www.readbyqxmd.com/read/27877069/risk-factors-and-mortality-associated-with-undertriage-at-a-level-i-safety-net-trauma-center-a-retrospective-study
#14
Chris Barsi, Peter Harris, Rich Menaik, Nicholas C Reis, Swapna Munnangi, Mikhail Elfond
PURPOSE: The primary objective of this study was to determine the risk factors associated with undertriage and the risk factors for mortality among the undertriaged patients at a level I safety-net trauma center. METHODS: A retrospective analysis was performed of all trauma patients who presented to a level I safety-net trauma center with an injury severity score >15 over a 2-year period (2013-2014). Univariate and multivariate regression analyses were used to determine the risk factors predictive of undertriage in major trauma patients (injury severity score >15) and of mortality in undertriaged patients...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27871919/motivational-interviewing-to-promote-long-acting-reversible-contraception-in-postpartum-teenagers
#15
Kristl Tomlin, Tammalynn Bambulas, Maureen Sutton, Vanessa Pazdernik, Dean V Coonrod
STUDY OBJECTIVE: To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing Long-acting Reversible Contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group. DESIGN: Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting and those enrolled in Standard Prenatal Care. PARTICIPANTS: Adolescents between the ages of 13 and 17 receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014...
November 18, 2016: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/27871497/possible-consequences-of-regionally-based-bundled-payments-for-diabetic-amputations-for-safety-net-hospitals-in-texas
#16
Karina Newhall, David Stone, Ryan Svoboda, Philip Goodney
OBJECTIVE: Ongoing health reform in the United States encourages quality-based reimbursement methods such as bundled payments for surgery. The effect of such changes on high-risk procedures is unknown, especially at safety net hospitals. This study quantified the burden of diabetes-related amputation and the potential financial effect of bundled payments at safety net hospitals in Texas. METHODS: We performed a cross-sectional analysis of diabetic amputation burden and charges using publically available data from Centers for Medicare and Medicaid and the Texas Department of Health from 2008 to 2012...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27868070/adaptation-and-feasibility-study-of-a-digital-health-program-to-prevent-diabetes-among-low-income-patients-results-from-a-partnership-between-a-digital-health-company-and-an-academic-research-team
#17
Valy Fontil, Kelly McDermott, Lina Tieu, Christina Rios, Eliza Gibson, Cynthia Castro Sweet, Mike Payne, Courtney R Lyles
Background. The feasibility of digital health programs to prevent and manage diabetes in low-income patients has not been adequately explored. Methods. Researchers collaborated with a digital health company to adapt a diabetes prevention program for low-income prediabetes patients at a large safety net clinic. We conducted focus groups to assess patient perspectives, revised lessons for improved readability and cultural relevance to low-income and Hispanic patients, conducted a feasibility study of the adapted program in English and Spanish speaking cohorts, and implemented real-time adaptations to the program for commercial use and for a larger trial of in multiple safety net clinics...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27866596/clinic-and-community-the-road-to-integration
#18
Laurie L Lachance, Amy R Friedman Milanovich, Ashley N Garrity
INTRODUCTION: There is growing recognition of the important role that social and environmental conditions play in health, and of the interaction needed between clinical providers and the broader community in which patients live, work, play, and manage their health. Through the Safety Net Enhancement Initiative, the Kresge Foundation funded demonstration projects in eight vulnerable communities to address health inequities and increase integration between clinical and community systems...
December 2016: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/27866042/carcinogenic-effects-of-oil-dispersants-a-kegg-pathway-based-rna-seq-study-of-human-airway-epithelial-cells
#19
Yao-Zhong Liu, Lei Zhang, Astrid M Roy-Engel, Shigeki Saito, Joseph A Lasky, Guangdi Wang, He Wang
The health impacts of the BP oil spill are yet to be further revealed as the toxicological effects of oil products and dispersants on human respiratory system may be latent and complex, and hence difficult to study and follow up. Here we performed RNA-seq analyses of a system of human airway epithelial cells treated with the BP crude oil and/or dispersants Corexit 9500 and Corexit 9527 that were used to help break up the oil spill. Based on the RNA-seq data, we then systemically analyzed the transcriptomic perturbations of the cells at the KEGG pathway level using two pathway-based analysis tools, GAGE (generally applicable gene set enrichment) and GSNCA (Gene Sets Net Correlations Analysis)...
November 16, 2016: Gene
https://www.readbyqxmd.com/read/27862831/prostatic-urethral-lift-pul-vs-transurethral-resection-of-the-prostate-turp-2-year-results-of-the-bph6-prospective-multi-center-randomised-study
#20
C Gratzke, N Barber, M Speakman, R Berges, U Wetterauer, D Greene, K-D Sievert, C Chapple, J Sonksen
OBJECTIVES: To compare Prostatic Urethral Lift (PUL) to Transurethral Resection of the Prostate (TURP) with regard to symptoms, recovery experience, sexual function, continence, safety, quality of life, sleep and overall patient perception. SUBJECTS/PATIENTS AND METHODS: 80 patients with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) enrolled in a prospective, randomised, controlled, non-blinded study conducted at 10 European centers. The BPH6 responder endpoint assessed symptom relief, quality of recovery, erectile function preservation, ejaculatory function preservation, continence preservation, and safety...
November 14, 2016: BJU International
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