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https://www.readbyqxmd.com/read/28651153/the-role-of-marijuana-use-disorder-in-predicting-emergency-department-and-inpatient-encounters-a-retrospective-cohort-study
#1
Cynthia I Campbell, Amber L Bahorik, Andrea H Kline-Simon, Derek D Satre
BACKGROUND: Marijuana use disorder (MUD) is the most common illegal drug use disorder and its prevalence is increasing. It is associated with psychiatric and medical problems, but little is known about its impact on emergency department (ED) and inpatient utilization rates. DESIGN: In a retrospective cohort design, we used electronic health record (EHR) data to identify patients with MUD (n=2752) and demographically matched patients without MUD (n=2752) in 2010...
June 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#2
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650248/health-services-utilization-among-fee-for-service-medicare-and-medicaid-patients-under-age-65-with-behavioral-health-illness-at-an-urban-safety-net-hospital
#3
Ramon S Cancino, Brian W Jack, John Jarvis, Alice Kate Cummings, Ellie Cooper, Pierre-Yves Cremieux, James F Burgess
BACKGROUND: In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. OBJECTIVE: To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. METHODS: This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650227/facilitators-and-barriers-to-participation-in-prep-hiv-prevention-trials-involving-transgender-male-and-female-adolescents-and-emerging-adults
#4
Celia B Fisher, Adam L Fried, Margaret Desmond, Kathryn Macapagal, Brian Mustanski
Despite the disproportionate burden of HIV facing transgender youth, they continue to be under-represented in studies to provide an empirical basis for pre-exposure prophylaxis (PrEP) programs that can meet the unique needs of this population. This study examined facilitators and barriers to participation in a PrEP adherence study, determined through an online survey administered to 90 transgender male and 60 transgender female 14-21-year-olds attracted to cisgender male sexual partners. Approximately 50% reported likely to participate in the PrEP study...
June 2017: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
https://www.readbyqxmd.com/read/28649417/pilot-study-of-a-randomized-trial-to-evaluate-a-web-based-intervention-targeting-adolescents-presenting-to-the-emergency-department-with-acute-asthma
#5
Christine L M Joseph, Prashant Mahajan, Stephanie Stokes-Buzzelli, Dayna A Johnson, Elizabeth Duffy, Renee Williams, Talan Zhang, Dennis R Ownby, Shannon Considine, Mei Lu
BACKGROUND: Low-income African-American adolescents use preventive medical services less frequently than their White counterparts, indicating a need for effective interventions targeting this group. Puff City is a Web-based, asthma management program for urban adolescents that has been evaluated in high school settings with promising results. The objective of this pilot was to assess the feasibility of initiating Puff City (treatment) in an emergency department setting, thereby informing the conduct of an individual randomized trial to evaluate its effectiveness compared to a generic, Web-based program (control) in preventing subsequent emergency department (ED) visits...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28648313/cost-of-osteoporotic-fractures-in-singapore
#6
Charmaine Shuyu Ng, Tang Ching Lau, Yu Ko
OBJECTIVES: To estimate the 3-month direct and indirect costs associated with osteoporotic fractures from both the hospital's and patient's perspectives in Singapore and to compare the cost between acute and prevalent osteoporotic fractures. METHODS: Resource use and expenditure data were collected using interviewer-administered questionnaires at baseline and at a 3-month follow-up between July 2013 and January 2014. Estimated osteoporotic fracture-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, medications, transportation, health care and community services, special equipment and home/car modifications, and productivity loss...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28647945/the-emerging-adult-with-diabetes-transitioning-from-pediatric-to-adult-care
#7
Jodi Krall, Ingrid Libman, Linda Siminerio
Transfer from pediatric to adult health care is a significant life event for youth with chronic medical conditions. Unfortunately, youth may not be well prepared to navigate the shift in health care services, increasing their risk for loss to follow up and poor health outcomes. This review explores transition in care through the lens of type 1 diabetes, highlighting current practices and guidelines and offering recommendations for future consideration. Limited evidence suggests that transition programs that focus on strategies to prepare youth developmentally and equip the health care system appropriately have positive impact on the hand off of care, and health outcomes...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647723/a-retrospective-cohort-study-of-high-impact-users-among-patients-with-cerebrovascular-conditions
#8
Ahsan Rao, Alice Jones, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: To apply group-based trajectory modelling (GBTM) to the hospital administrative data to evaluate, model and visualise trends and changes in the frequency of long-term hospital care use of the subgroups of patients with cerebrovascular conditions. DESIGN: A retrospective cohort study of patients with cerebrovascular conditions. SETTINGS: Secondary care of all patients with cerebrovascular conditions admitted to English National Hospital Service hospitals...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28646876/not-all-waits-are-equal-an-exploratory-investigation-of-emergency-care-patient-pathways
#9
Dawn Swancutt, Sian Joel-Edgar, Michael Allen, Daniel Thomas, Heather Brant, Jonathan Benger, Richard Byng, Jonathan Pinkney
BACKGROUND: Increasing pressure in the United Kingdom (UK) urgent care system has led to Emergency Departments (EDs) failing to meet the national requirement that 95% of patients are admitted, discharged or transferred within 4-h of arrival. Despite the target being the same for all acute hospitals, individual Trusts organise their services in different ways. The impact of this variation on patient journey time and waiting is unknown. Our study aimed to apply the Lean technique of Value Stream Mapping (VSM) to investigate care processes and delays in patient journeys at four contrasting hospitals...
June 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28646858/reasons-for-encounter-by-different-levels-of-urgency-in-out-of-hours-emergency-primary-health-care-in-norway-a-cross-sectional-study
#10
Guttorm Raknes, Steinar Hunskaar
BACKGROUND: Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels. METHODS: We analyzed data on RFEs in Norwegian OOH services. International Classification of Primary Care (ICPC-2) RFE codes were recorded in all contacts to eight representative OOH casualty clinics in 2014 and 2015 covering 20 municipalities with a total population of 260 196...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28646851/development-of-an-education-campaign-to-reduce-delays-in-pre-hospital-response-to-stroke
#11
Caterina Caminiti, Peter Schulz, Barbara Marcomini, Elisa Iezzi, Silvia Riva, Umberto Scoditti, Andrea Zini, Giovanni Malferrari, Maria Luisa Zedde, Donata Guidetti, Enrico Montanari, Mario Baratti, Licia Denti
BACKGROUND: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness. METHODS: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28646584/prehospital-advanced-cardiac-life-support-for-out-of-hospital-cardiac-arrest-a-cohort-study
#12
Alexis Cournoyer, Eric Notebaert, Massimiliano Iseppon, Sylvie Cossette, Luc Londei-Leduc, Yoan Lamarche, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Catalina Sokoloff, Yiorgos Alexandros Cavayas, Jean Paquet, André Denault
OBJECTIVES: Out-of-hospital advanced cardiac life support (ACLS) has not consistently shown a positive impact on survival. Extracorporeal cardiopulmonary resuscitation (E-CPR) could render prolonged on-site resuscitation (ACLS or basic cardiac life support [BCLS]) undesirable in selected cases. The objectives of this study were to evaluate, in patients suffering from out-of-hospital cardiac arrest (OHCA) and in a subgroup of potential E-CPR candidates, the association between the addition of prehospital ACLS to BCLS and survival to hospital discharge, prehospital return of spontaneous circulation (ROSC) and delay from call to hospital arrival...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28645984/facilitators-and-barriers-to-participation-of-private-sector-health-facilities-in-government-led-schemes-for-maternity-services-in-india-a-qualitative-study
#13
Vikas Yadav, Somesh Kumar, Sudharsanam Balasubramaniam, Ashish Srivastava, Suranjeen Pallipamula, Parvez Memon, Dinesh Singh, Saurabh Bhargava, Greeshma Ann Sunil, Bulbul Sood
OBJECTIVE: Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645946/risk-factors-for-admission-at-three-urban-emergency-departments-in-england-a-cross-sectional-analysis-of-attendances-over-1-month
#14
Sharif A Ismail, Ian Pope, Benjamin Bloom, Raquel Catalao, Emilie Green, Rebecca E Longbottom, Gwyneth Jansen, David McCoy, Tim Harris
OBJECTIVE: To investigate factors associated with unscheduled admission following presentation to emergency departments (EDs) at three hospitals in England. DESIGN AND SETTING: Cross-sectional analysis of attendance data for patients from three urban EDs in England: a large teaching hospital and major trauma centre (site 1) and two district general hospitals (sites 2 and 3). Variables included patient age, gender, ethnicity, deprivation score, arrival date and time, arrival by ambulance or otherwise, a variety of ED workload measures, inpatient bed occupancy rates and admission outcome...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645394/physician-medical-direction-of-emergency-medical%C3%A2-services-education-program
#15
EDITORIAL
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No abstract text is available yet for this article.
July 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28645288/a-cohort-study-of-a-general-surgery-electronic-consultation-system-safety-implications-and-impact-on-surgical-yield
#16
Jesus G Ulloa, Marika D Russell, Alice Hm Chen, Delphine S Tuot
BACKGROUND: Electronic consultation (eConsult) systems have enhanced access to specialty expertise and enhanced care coordination among primary care and specialty care providers, while maintaining high primary care provider (PCP), specialist and patient satisfaction. Little is known about their impact on the efficiency of specialty care delivery, in particular surgical yield (percent of ambulatory visits resulting in a scheduled surgical case). METHODS: Retrospective cohort of a random selection of 150 electronic consults from PCPs to a safety-net general surgery clinic for the three most common general surgery procedures (herniorrhaphy, cholecystectomy, anorectal procedures) in 2014...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28645042/the-changing-health-priorities-of-earthquake-response-and-implications-for-preparedness-a-scoping-review
#17
REVIEW
C Cartwright, M Hall, A C K Lee
OBJECTIVES: Earthquakes have substantial impacts on mortality in low- and middle-income countries (LMIC). The academic evidence base to support Disaster Risk Reduction activities in LMIC settings is, however, limited. We sought to address this gap by identifying the health and healthcare impacts of earthquakes in LMICs and to identify the implications of these findings for future earthquake preparedness. STUDY DESIGN: Scoping review. METHODS: A scoping review was undertaken with systematic searches of indexed databases to identify relevant literature...
June 20, 2017: Public Health
https://www.readbyqxmd.com/read/28644074/reinforcing-marginality-maternal-health-interventions-in-rural-nicaragua
#18
Birgit Kvernflaten
To achieve Millennium Development Goal 5 on maternal health, many countries have focused on marginalized women who lack access to care. Promoting facility-based deliveries to ensure skilled birth attendance and emergency obstetric care has become a main measure for preventing maternal deaths, so women who opt for home births are often considered 'marginal' and in need of targeted intervention. Drawing upon ethnographic data from Nicaragua, this paper critically examines the concept of marginality in the context of official efforts to increase institutional delivery amongst the rural poor, and discusses lack of access to health services among women living in peripheral areas as a process of marginalization...
June 23, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28643708/residency-evaluation-and-adherence-design-study-young-ophthalmologists-perception-of-their-residency-programs-clinical-and-surgical-skills
#19
Parikshit Gogate, Partha Biswas, Sundaram Natarajan, Dandapani Ramamurthy, Debashish Bhattacharya, Karl Golnik, Barun Kumar Nayak
BACKGROUND: Residency training is the basis of good clinical and surgical practice. PURPOSE: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. SETTING: Young ophthalmologists trained in India. METHODS: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014-2016 of young ophthalmologists (those trained between 2002 and 2012, with 2-10 years' postresidency experience) to gauge teaching of clinical and surgical skills during the postgraduate residency program...
June 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28643568/process-mining-based-method-of-designing-and-optimizing-the-layouts-of-emergency-departments-in-hospitals
#20
Farhood Rismanchian, Young Hoon Lee
OBJECTIVE: This article proposes an approach to help designers analyze complex care processes and identify the optimal layout of an emergency department (ED) considering several objectives simultaneously. These objectives include minimizing the distances traveled by patients, maximizing design preferences, and minimizing the relocation costs. BACKGROUND: Rising demand for healthcare services leads to increasing demand for new hospital buildings as well as renovating existing ones...
July 2017: HERD
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