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https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#1
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29340508/-space-time-and-power-in-hospital-health-care-contributions-based-on-the-ethnography-of-an-obstetric-center
#2
María Guadalupe García, María Laura Recoder, Susana Margulies
This paper presents the results of an ethnographic study of an obstetric center within a hospital of Greater Buenos Aires and an analysis of the spatio-temporal dimension of hospital care. The fieldwork, carried out between 2007 and 2011, followed the everyday dynamics of the hospital and included observation in the obstetrics unit (waiting areas, the obstetric center where births and emergencies receive care, and the ambulatory care, ultrasound, and hospitalization rooms, among others) as well as spaces such as the appointments and statistics offices, the office of social services, the central hall, the pharmacy, and hallway waiting areas...
July 2017: Salud Colectiva
https://www.readbyqxmd.com/read/29336958/prehospital-emergencies-in-illegal-gold-mining-sites-in-french-guiana
#3
Gérald Egmann, Pierre Tattevin, Renaud Palancade, Matthieu Nacher
INTRODUCTION: Illegal gold mining is flourishing in French Guiana, existing outside the law due to both the high cost of gold mining permits and the challenges of law enforcement within the Amazon forest. We report the characteristics of, and the medical responses to, medical emergencies in illegal gold mining sites. METHODS: We performed a retrospective study of all medical emergencies reported from illegal gold mining sites to the centralized call office of SAMU 973 from 1998 through 2000 and from 2008 through 2010...
January 11, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29330584/a-dedicated-neurologist-at-the-emergency-department-during-out-of-office-hours-decreases-patients-length-of-stay-and-admission-percentages
#4
M Christien van der Linden, Crispijn L van den Brand, Ido R van den Wijngaard, Roeline A Y de Beaufort, Naomi van der Linden, Korné Jellema
BACKGROUND: Emergency departments (EDs) worldwide face crowding, which hampers patient flow. In this study, the impact of a dedicated neurologist present at the ED on patient flow during out-of-office hours was assessed. METHODS: A cross-sectional, mixed methods study was undertaken at a Dutch ED, including a pre-post analysis of data of patients who had a primary neurological disease (n = 458) and staff surveys (n = 152). Descriptive statistics and content analysis were used for analyses...
January 12, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29329727/parent-activation-in-the-pediatric-emergency-department-theory-vs-reality
#5
Danica B Liberman, Phung K Pham
OBJECTIVE: To measure parent activation and test for its associations with sociodemographics, clinical factors, and short-term outcomes. METHODS: By convenience sampling, 246 parents of children treated in an emergency department (ED) of a children's hospital completed the Parent-Patient Activation Measure (P-PAM) and answered sociodemographic questions. Clinical information was abstracted from medical records. Phone calls to parents and primary care physician offices were conducted within one-month post-ED visit for information about short-term outcomes...
January 8, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29329234/poor-people-are-hospitalized-three-times-more-for-mental-health-services-than-the-non-poor-in-central-valley-california
#6
Gyanesh Lama, Emmanuel Alcala, John A Capitman
Introduction: Providing health insurance to the poor has become a standard policy response to health disparities between the poor and the non-poor. It is often assumed that if the poor people are given health insurance, they will use preventative care, which will prevent more expensive emergency visits and inpatient hospitalization, and in turn, it will save healthcare cost in the long run. This paper presents the findings from our study in California about what happens to the poor when they are given health insurance...
January 12, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29328879/modeling-health-care-expenditures-and-use
#7
Partha Deb, Edward C Norton
Health care expenditures and use are challenging to model because these dependent variables typically have distributions that are skewed with a large mass at zero. In this article, we describe estimation and interpretation of the effects of a natural experiment using two classes of nonlinear statistical models: one for health care expenditures and the other for counts of health care use. We extend prior analyses to test the effect of the ACA's young adult expansion on three different outcomes: total health care expenditures, office-based visits, and emergency department visits...
January 12, 2018: Annual Review of Public Health
https://www.readbyqxmd.com/read/29325400/eliminating-healthcare-associated-infections-in-iran-a-qualitative-study-to-explore-stakeholders-views
#8
Atefeh Esfandiari, Hedayat Salari, Arash Rashidian, Hossein Masoumi Asl, Abbas Rahimi Foroushani, Ali Akbari Sari
BACKGROUND: Although preventable, healthcare-associated infections (HAIs) continue to pose huge health and economic burdens on countries worldwide. Some studies have indicated the numerous causes of HAIs, but only a tiny literature exists on the multifaceted measures that can be used to address the problem. This paper presents stakeholders' opinions on measures for controlling HAIs in Iran. METHODS: We used the qualitative research method in studying the phenomenon...
April 15, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29323930/the-economic-burden-of-asthma-in-the-united-states-2008-2013
#9
Tursynbek Nurmagambetov, Robin Kuwahara, Paul Garbe
RATIONALE: Asthma is a chronic disease that affects quality of life, productivity at work and school, healthcare use, and can result in death. Measuring the current economic burden of asthma provides important information on the impact of asthma on society. This information can be used to make informed decisions about allocation of limited public health resources. OBJECTIVES: In this paper, we provide a comprehensive approach to estimate current prevalence, medical costs, cost of absenteeism (missed work and schooldays) and mortality attributable to asthma from a national perspective...
January 11, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29318171/mobile-web-based-follow-up-for-postoperative-acl-reconstruction-a-single-center-experience
#10
James Higgins, John Semple, Lucas Murnaghan, Sarah Sharpe, John Theodoropoulos
Background: The initial 6 weeks after surgery has been identified as an area for improvement in patient care. During this period, the persistence of symptoms that go unchecked can lead to unscheduled emergency room and clinic visits, calls to surgeons' offices, and readmissions. Purpose: To analyze postoperative data from a previous study examining postoperative outcomes in 2 patient populations following breast reconstruction and anterior cruciate ligament (ACL) reconstruction with use of a patient-centered mobile application...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29315727/considerations-for-optimal-blood-pressure-goals-in-the-elderly-population-a-review-of-emergent-evidence
#11
Diana X Cao, Rebecca J C Tran
Recent hypertension clinical trials and national guideline updates have created a debate on the most appropriate treatment goals in elderly patients with hypertension. In 2014, recommendations by the Eighth Joint National Committee (JNC 8) allowed a more lenient goal for patients 60 years and older compared with previous guidelines. Since then, several large clinical trials and meta-analyses have added more information regarding strict versus lenient treatment goals. Most recently, the American College of Cardiology and American Heart Association Task Force published their highly-anticipated hypertension guideline developed in conjunction with nine additional interdisciplinary organizations...
January 8, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29313458/clinician-perspectives-on-strategies-to-improve-patient-maternal-immunization-acceptability-in-obstetrics-and-gynecology-practice-settings
#12
Paula M Frew, Laura A Randall, Fauzia Malik, Rupali Lamaye, Andrew Wilson, Sean T O'Leary, Daniel Salmon, Meghan Donnelly, Kevin Ault, Matthew Z Dudley, Vincent L Fenimore, Saad B Omer
Pregnancy is an ideal time to communicate with women about vaccines for themselves and their infants, yet maternal immunization rates remain suboptimal. This study aimed to identify clinic, provider, and staff-related attributes and facilitators to be utilized for a comprehensive vaccine intervention in ob-gyn clinical settings. We conducted in-depth interviews with 24 providers, both healthcare providers (e.g., physicians, nurse practitioners, midwives) and practice managers, from urban and suburban ob-gyn practices in Georgia and Colorado about their immunization attitudes, practices, and patient experiences...
January 9, 2018: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29305643/treatment-of-soft-tissue-filler-complications-expert-consensus-recommendations
#13
REVIEW
Fernando Urdiales-Gálvez, Nuria Escoda Delgado, Vitor Figueiredo, José V Lajo-Plaza, Mar Mira, Antonio Moreno, Francisco Ortíz-Martí, Rosa Del Rio-Reyes, Nazaret Romero-Álvarez, Sofía Ruiz Del Cueto, María A Segurado, Cristina Villanueva Rebenaque
BACKGROUND: Dermal fillers have been increasingly used in minimally invasive facial esthetic procedures. This widespread use has led to a rise in reports of associated complications. The aim of this expert consensus report is to describe potential adverse events associated with dermal fillers and to provide guidance on their treatment and avoidance. METHODS: A multidisciplinary group of experts in esthetic treatments convened to discuss the management of the complications associated with dermal fillers use...
January 5, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29304461/legacy-and-emerging-organophosph%C3%AE-rus-flame-retardants-in-car-dust-from-greece-implications-for-human-exposure
#14
Christina Christia, Giulia Poma, Athanasios Besis, Constantini Samara, Adrian Covaci
Organophosphorus flame retardants (PFRs) and emerging PFRs (ePFRs) are two groups of compounds used as replacements for brominated flame retardants (BFRs). They have already been detected in indoor dust (mainly in homes and offices). To date, few studies investigated the occurrence of FRs in car dust and the information of possible health risks is still limited. The present study reports on the investigation of the levels and profiles of eight target PFRs: tris(2-ethylhexyl) phosphate (TEHP), tris(2-chloroethyl) phosphate (TCEP), tris(2-butoxyethyl) phosphate (TBEP), triphenyl phosphate (TPHP), 2-ethylhexyl diphenyl phosphate (EHDPHP), tris(1-chloro-2-propyl) phosphate (TCIPP), tri cresyl phosphate (TCP), tris(1,3-dichloro-2-propyl) phosphate (TDCIPP) and four target ePFRs; 2,2-bis(chloromethyl)propane-1,3-diyltetrakis(2-chloroethyl)bisphosphate (V6), isodecyl diphenyl phosphate (iDDPHP), resorcinol bis(diphenylphosphate) (RDP) and bisphenol A-bis(diphenyl phosphate) (BDP) in car dust from Greece...
December 23, 2017: Chemosphere
https://www.readbyqxmd.com/read/29304180/the-effect-of-facility-characteristics-on-patient-safety-patient-experience-and-service-availability-for-procedures-in-non-hospital-affiliated-outpatient-settings-a-systematic-review
#15
Nancy F Berglas, Molly F Battistelli, Wanda K Nicholson, Mindy Sobota, Richard D Urman, Sarah C M Roberts
BACKGROUND: Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements...
2018: PloS One
https://www.readbyqxmd.com/read/29297735/national-assessment-of-quality-programs-in-emergency-medical-services
#16
Michael Redlener, Patrick Olivieri, George T Loo, Kevin Munjal, Michael T Hilton, Katya Trudeau Potkin, Michael Levy, Jeffrey Rabrich, Michael R Gunderson, Sabina A Braithwaite
OBJECTIVE: This study aims to understand the adoption of clinical quality measurement throughout the United States on an EMS agency level, the features of agencies that do participate in quality measurement, and the level of physician involvement. It also aims to barriers to implementing quality improvement initiatives in EMS. METHODS: A 46-question survey was developed to gather agency level data on current quality improvement practices and measurement. The survey was distributed nationally via State EMS Offices to EMS agencies nation-wide using Surveymonkey©...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29297410/participatory-monitoring-and-evaluation-approaches-that-influence-decision-making-lessons-from-a-maternal-and-newborn-study-in-eastern-uganda
#17
Rornald Muhumuza Kananura, Elizabeth Ekirapa-Kiracho, Ligia Paina, Ahmed Bumba, Godfrey Mulekwa, Dinah Nakiganda-Busiku, Htet Nay Lin Oo, Suzanne Namusoke Kiwanuka, Asha George, David H Peters
BACKGROUND: The use of participatory monitoring and evaluation (M&E) approaches is important for guiding local decision-making, promoting the implementation of effective interventions and addressing emerging issues in the course of implementation. In this article, we explore how participatory M&E approaches helped to identify key design and implementation issues and how they influenced stakeholders' decision-making in eastern Uganda. METHOD: The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternal and newborn health project that was implemented in three districts in eastern Uganda...
December 28, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/29296770/osteonecrosis-of-the-femoral-head-in-sickle-cell-disease-prevalence-comorbidities-and-surgical-outcomes-in-california
#18
Oyebimpe Adesina, Ann Brunson, Theresa H M Keegan, Ted Wun
Osteonecrosis of the femoral head (ONFH) is a prevalent complication of sickle cell disease (SCD) that has not been well described in population-based cohort studies. Using California's Office of Statewide Planning and Development discharge databases (1991-2013), we estimated the cumulative incidence of ONFH after accounting for the competing risk of death and used a multivariable Cox proportional hazards regression to identify factors associated with ONFH diagnosis. We also calculated rates of readmissions to the hospital or emergency department within 30 to 90 days of hip replacement surgery...
July 11, 2017: Blood Advances
https://www.readbyqxmd.com/read/29294741/factors-associated-with-police-decisions-on-immediate-responses-to-intimate-partner-violence
#19
Merete Berg Nesset, Johan Håkon Bjørngaard, Jim Aage Nøttestad, Richard Whittington, Cecilie Lynum, Cand Psychol, Tom Palmstierna
Police officers are often the first responders to intimate partner violence. The aim of the study was to examine the association between structured police assessments on-site in cases of intimate partner violence, and decisions about immediate arrest of the perpetrator and/or relocation of the victim. Data were extracted from police reports on 124 emergency visits in cases of intimate partner violence perpetrated by men toward women. Six out of totally 15 items of the intimate partner violence risk assessment measure B-SAFER were used by the front line police officers as the basis for decisions on whether or not to arrest the perpetrator or relocate the victim...
May 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29290171/health-care-costs-and-thromboembolic-events-in-hydroxyurea-treated-patients-with-polycythemia-vera
#20
Shreekant V Parasuraman, Nianwen Shi, Dilan C Paranagama, Machaon Bonafede
BACKGROUND: Patients with polycythemia vera (PV) are at increased risk of thromboembolic events (TEs), which are key contributors to reduced overall survival compared with the age- and sex-matched general population. In addition to aspirin and phlebotomy to maintain hematocrit level < 45%, many patients receive cytoreduction with hydroxyurea (HU), which is associated with improved survival and may reduce the risk of cardiovascular events and TEs. However, 1 in 4 patients become resistant to or intolerant of HU...
January 2018: Journal of Managed Care & Specialty Pharmacy
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