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Steven W Gust, Judy McCormally
PURPOSE OF REVIEW: For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD)...
May 15, 2018: Current Opinion in Psychiatry
Inga Heyman, Emma McGeough
Police officers have increasingly become involved in mental health care responses not traditionally acknowledged as a police function. This has been described as "Florence Nightingale in pursuit of Willie Sutton" (a notorious bank robber) by American sociologist Egon Bittner (1974). In this editorial we present emerging international approaches addressing this shift. This article is protected by copyright. All rights reserved.
May 16, 2018: Journal of Psychiatric and Mental Health Nursing
Ambrose H Wong, Halley Ruppel, Lauren J Crispino, Alana Rosenberg, Joanne D Iennaco, Federico E Vaca
BACKGROUND: The rising agitated patient population presenting to the emergency department (ED) has caused increasing safety threats for health care workers and patients. Development of evidence-based strategies has been limited by the lack of a structured framework to examine agitated patient care in the ED. In this study, a systems approach from the patient safety literature was used to derive a comprehensive theoretical framework for addressing ED patient agitation. METHODS: A mixed-methods approach was used with ED staff members at an academic site and a community site of a regional health care network...
May 2018: Joint Commission Journal on Quality and Patient Safety
Jennifer L Skeem, Lina Montoya, Sarah M Manchak
OBJECTIVE: Specialty mental health probation reduces the likelihood of rearrest for people with mental illness, who are overrepresented in the justice system. This study tested whether specialty probation was associated with lower costs than traditional probation during the two years after placement in probation. METHODS: A longitudinal, matched study compared costs of behavioral health care and criminal justice contacts among 359 probationers with mental illness at prototypic specialty or traditional agencies...
May 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Colin A Morton, Lasse R Braathen
Topical photodynamic therapy (PDT) using daylight is effective in the treatment of actinic keratoses (AKs), offering the potential for treatment of large fields such as full face and balding scalp, but with minimal therapy-associated pain. Comparison with conventional PDT indicates similar efficacy for thin and moderate-thickness AKs, but with significantly less discomfort/pain, driving a patient preference for daylight-mediated PDT (DL-PDT) compared with conventional PDT using high-intensity office/hospital-based light sources...
May 11, 2018: American Journal of Clinical Dermatology
Anand M Prabhakar, Ravi V Gottumukkala, Wenyi Wang, Danny R Hughes, Richard Duszak
OBJECTIVE: Nationally, nonradiologists interpret an increasing proportion of lower extremity venous duplex ultrasound (LEVDU) examinations. We aimed to study day of week, site of service, and patient complexity differences in LEVDU services interpreted by radiologists versus nonradiologists. MATERIALS AND METHODS: Using carrier claims files for a 5% national sample of Medicare beneficiaries from 2012 to 2015, we retrospectively classified all LEVDU examinations by physician specialty (radiologist versus nonradiologist), day of week (weekday versus weekend), site of service, and patient Charlson Comorbidity Index (CCI) scores...
May 7, 2018: Journal of the American College of Radiology: JACR
Kimberley A McClure, Katherine L McGuire, Denis M Chapan
Policy on officer-involved shootings is critically reviewed and errors in applying scientific knowledge identified. Identifying and evaluating the most relevant science to a field-based problem is challenging. Law enforcement administrators with a clear understanding of valid science and application are in a better position to utilize scientific knowledge for the benefit of their organizations and officers. A recommended framework is proposed for considering the validity of science and its application. Valid science emerges via hypothesis testing, replication, extension and marked by peer review, known error rates, and general acceptance in its field of origin...
May 7, 2018: Journal of Forensic Sciences
Tomokazu Motomura, Atsushi Hirabayashi, Hisashi Matsumoto, Nobutaka Yamauchi, Mitsunobu Nakamura, Hiroshi Machida, Kenji Fujizuka, Naomi Otsuka, Tomoko Satoh, Hideaki Anan, Hisayoshi Kondo, Yuichi Koido
More than 6,000 people died in the Great Hanshin (Kobe) Earthquake in 1995, and it was later reported that there were around 500 preventable trauma deaths. In response, the Japanese government developed the helicopter emergency medical service in 2001, known in Japan as the "Doctor-Heli" (DH), which had 46 DHs and 2 private medical helicopters as of April 2016. DHs transport physicians and nurses to provide pre-hospital medical care at the scene of medical emergencies. Following lessons learned in the Great East Japan Earthquake in 2011, a research group in the Ministry of Health, Labour and Welfare developed a command and control system for the DH fleet as well as the Disaster Relief Aircraft Management System Network (D-NET), which uses a satellite communications network to monitor the location of the fleet and weather in real-time during disasters...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Francesco Bolzetta, Terrie Wetle, Richard Besdine, Marianna Noale, Alberto Cester, Gaetano Crepaldi, Stefania Maggi, Nicola Veronese
BACKGROUND: Some studies have reported a potential association between usual source of health care and disability, but no one has explored the association with frailty, a state of early and potential reversible disability. We therefore aimed to explore the association between older persons' self-reported usual source of health care at baseline and the onset of frailty. METHODS: Information regarding usual source of health care was captured through self-report and categorized as 1) private doctor's office, 2) public clinic, 3) Health Maintenance Organization (HMO), or 4) hospital clinic/emergency department (ED)...
May 3, 2018: Experimental Gerontology
Laith Hussain-Alkhateeb, Axel Kroeger, Piero Olliaro, Joacim Rocklöv, Maquins Odhiambo Sewe, Gustavo Tejeda, David Benitez, Balvinder Gill, S Lokman Hakim, Roberta Gomes Carvalho, Leigh Bowman, Max Petzold
BACKGROUND: Dengue outbreaks are increasing in frequency over space and time, affecting people's health and burdening resource-constrained health systems. The ability to detect early emerging outbreaks is key to mounting an effective response. The early warning and response system (EWARS) is a toolkit that provides countries with early-warning systems for efficient and cost-effective local responses. EWARS uses outbreak and alarm indicators to derive prediction models that can be used prospectively to predict a forthcoming dengue outbreak at district level...
2018: PloS One
Liam Wilson, Omer Farooq
Operating theatres are dynamic environments that require multi professional team interactions. Effective team working is essential for efficient delivery of safe patient care. A fire in the operating theatre is a rare but potentially life threatening event for both patients and staff. A rapid and cohesive response from theatre and allied staff including porters, fire safety officer etc is paramount. We delivered a training session that utilised in situ simulation (simulation in workplace). After conducting needs analysis, learning objectives were agreed...
January 1, 2018: Journal of Perioperative Practice
Simbarashe Chimhuya, Bothwell Mbuwayesango, Eva M Aagaard, Kusum J Nathoo
BACKGROUND: Calls have been made to reassess the curricula of medical schools throughout the world to adopt competence-based programs that address the healthcare needs of society. Zimbabwe is a country characterized by a high neonatal mortality rate of 24 per 1000 live births. The current research sought to determine the content and appropriate teaching strategies needed to guide the development of an undergraduate neonatal curriculum map for medical students at the University of Zimbabwe College of Health Sciences...
May 2, 2018: BMC Medical Education
Sabine Tong, Caroline Amand, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Acute otitis media (AOM) is the most common cause of pediatric medical visits and antibiotic prescriptions worldwide, but its current impact on the US healthcare system is not clear. The aim of this study was to investigate changes in the incidence of AOM from 2008, just before 13-valent pneumococcal conjugate vaccine was introduced, to 2014 using US insurance records in the Truven MarketScan® database. The study also examined the costs associated with index AOM events during the two most recent years for which data were available (2013-2014)...
May 2, 2018: BMC Health Services Research
Natasha S Crowcroft, Caitlin Johnson, Cynthia Chen, Ye Li, Alex Marchand-Austin, Shelly Bolotin, Kevin Schwartz, Shelley L Deeks, Frances Jamieson, Steven Drews, Margaret L Russell, Lawrence W Svenson, Kimberley Simmonds, Salaheddin M Mahmud, Jeffrey C Kwong
INTRODUCTION: Under-reporting of pertussis cases is a longstanding challenge. We estimated the true number of pertussis cases in Ontario using multiple data sources, and evaluated the completeness of each source. METHODS: We linked data from multiple sources for the period 2009 to 2015: public health reportable disease surveillance data, public health laboratory data, and health administrative data (hospitalizations, emergency department visits, and physician office visits)...
2018: PloS One
Trista H Wright
Mitragynine is a novel psychoactive substance (NPS) that has emerged as a designer opioid being distributed on the street. Mitragynine, also known as kratom, has dose-dependent pharmacological effects and possesses both stimulant-like and sedative effects due to dual-binding of α-adrenergic and μ-opioid receptors. This herbal remedy readily available online has caused adverse effects including tachycardia, agitation, tremors, hallucination and death; however, this is the first reported suspected driving under the influence case involving mitragynine...
April 27, 2018: Journal of Analytical Toxicology
Angela Giarratano, Samantha El Green, David P Nicolau
Pharmacologic management of infections in elderly patients presents multiple challenges to health care professionals due to variable pharmacokinetics, pharmacodynamics, and immune function. Age is a well-established risk factor for infection, but furthermore is a risk factor for prolonged length of hospital stay, increased incidence of complications, and significant and sustained decline in baseline functional status. In 2014, 46.2 million Americans were aged ≥65 years, accounting for 14.5% of the total population...
2018: Clinical Interventions in Aging
Elham Mahmoudi, Philip Zazove, Michelle Meade, Michael M McKee
Importance: Hearing loss (HL) is common among older adults and is associated with poorer health and impeded communication. Hearing aids (HAs), while helpful in addressing some of the outcomes of HL, are not covered by Medicare. Objective: To determine whether HA use is associated with health care costs and utilization in older adults. Design, Setting, and Participants: This retrospective cohort study used nationally representative 2013-2014 Medical Expenditure Panel Survey data to evaluate the use of HAs among 1336 adults aged 65 years or older with HL...
April 26, 2018: JAMA Otolaryngology—Head & Neck Surgery
Rekha Gangadhar Damle, Vasudha Sankararaman, Vandana Sunil Bhide, Vinayak Kashinath Jadhav, Atul Madhukar Walimbe, Mangesh Damodar Gokhale
The spread and establishment of Chandipura virus (CHPV) infection in India has raised serious epidemiological concerns. Virus interface with the vertebrate hosts, humans and vector competence are the important parameters of disease prevalence. Interestingly, in the present study a highly zoophilic species of sandfly Sergentomyia is emerging as a potential vector of CHPV in Gujarat. It is probably the first report from India that male sandflies have been found to be positive for CHPV by RT-PCR. These finding signifies the vertical transmission of the virus among sandflies and has epidemiological significance...
April 27, 2018: Japanese Journal of Infectious Diseases
Marian E Betz, Ashley Brooks-Russell, Sara Brandspigel, Douglas K Novins, Gregory J Tung, Carol Runyan
INTRODUCTION: For ED patients at risk of suicide, counseling to reduce access to lethal means (including firearms) is recommended yet not routine. To enhance practice uptake, we sought to examine the attitudes and beliefs of emergency nurse leaders concerning the acceptability and effectiveness of lethal-means counseling. METHODS: We invited a nurse leader (ED nurse manager or Chief Nursing Officer [CNO]) at each hospital-based emergency department in the 8-state Mountain West region of the United States to complete a closed-ended telephone survey...
April 25, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Madelyn N Stevens, Judy R Dubno, Margaret I Wallhagen, Debara L Tucci
OBJECTIVES: To assess the experiences of people with hearing loss in healthcare environments to characterize miscommunication and unmet needs, and guide recommendations for improving outcomes and access. METHODS: Anonymous survey developed by subject-matter experts was posted on a large national hearing-loss consumer and advocacy organization website and email listserv. Data were collected and managed via RedCAP. RESULTS: Responses were received from 1581 individuals...
March 20, 2018: Clinical Gerontologist
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