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Crisis Care

Tala Al-Rousan, Zaker Schwabkey, Lara Jirmanus, Brett D Nelson
Background: The United Nations has declared the Syrian refugee crisis to be the biggest humanitarian emergency of our era. Neighbouring countries, such as Jordan, strain to meet the health needs of Syrian refugees in addition to their own citizens given limited resources. Objectives: This study aimed to determine the perspectives of Syrian refugees in Jordan, Jordanian health care providers and other stakeholders in addressing the public health issues of the refugee crisis...
June 10, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Hiroyuki Ohbe, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
INTRODUCTION: In contrast to information on the effects of organophosphate, pesticide, or environmental exposures, data on cholinergic crisis caused by pharmaceutical cholinesterase inhibitors are sparse. The present study aimed to describe the characteristics, demographics, and mortality of patients with cholinergic crisis caused by pharmaceutical cholinesterase inhibitors using a nationwide inpatient database in Japan. METHODS: We identified patients diagnosed with cholinergic crisis as a result of taking cholinesterase inhibitor medications in the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2016...
June 15, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Paul B Rizzoli
Some of the principles of the pharmacologic management of migraine are echoed in urgent discussions of the future of headache care in the USA and around the world. From adverse events to tolerance, addiction, medication overuse and medication persistence, solutions to the pathophysiologic puzzles, and management difficulties in migraine can be found by paying closer attention to patient reports and by facilitating greater patient involvement in the treatment process. Similarly, listening to the patient as customer in the process of value-based care, so adaptable for the problem of migraine, is the solution to the health care crisis we face in so many countries...
June 2018: Neurological Sciences
(no author information available yet)
The global refugee/migrant crisis of displacement because of persecution and conflict carries staggering implications of ambiguity and loss for the individuals affected. In 2013, approximately 25,000 displaced people sought asylum in the United States; many of whom have experienced state-sponsored physical and psychological torture. With Physicians for Human Rights (PHR), several medical student clinics work closely with immigration attorneys and University and Community based clinicians to assist U.S. asylum seekers in their asylum claims...
June 2018: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Travis Labrum, Phyllis Solomon
In this period of post-deinstitutionalization, much of the care for people with severe psychiatric disorders (PD) is provided by their families. A primary stressor for caregivers is fears regarding their own safety and that of others, which has been virtually unexplored. To fill this gap, factors in three domains were assessed: (1) relatives with PD, (2) family caregivers, and (3) interactions with each other. This investigation was a secondary analysis of data obtained from a national survey of caregivers of adults with mental illness conducted by the National Alliance for Caregiving...
June 13, 2018: Health & Social Work
Aisling A Jennings, Tony Foley, Kieran A Walsh, Alice Coffey, John P Browne, Colin P Bradley
OBJECTIVES: To synthesise the existing published literature on general practitioners (GP)'s knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia (BPSD) with a view to informing future interventions. METHODS: We conducted a systematic review and synthesis of quantitative and qualitative studies that explored GPs' experiences of managing BPSD (PROSPERO protocol registration CRD42017054916). Seven electronic databases were searched from inception to October 2017...
June 13, 2018: International Journal of Geriatric Psychiatry
Alexandre Assuane Duarte, Shahriar Mohsin, Olga Golubnitschaja
Diabetes mellitus (DM) epidemic-on a global scale-is a major and snowballing threat to public health, healthcare systems and economy, due to the cascade of pathologies triggered in a long-term manner after the DM manifestation. There are remarkable differences in the geographic disease spread and acceleration of an increasing DM prevalence recorded. Specifically, the highest initial prevalence of DM was recorded in the Eastern-Mediterranean region in 1980 followed by the highest acceleration of the epidemic characterised by 0...
June 2018: EPMA Journal
M Eugenia Socías, Evan Wood, Thomas Kerr, Seonaid Nolan, Kanna Hayashi, Ekaterina Nosova, Julio Montaner, M-J Milloy
BACKGROUND: A cascade of care framework has been proposed to identify and address implementation gaps in addiction medicine. Using this framework, we characterized temporal trends in engagement in care for opioid use disorder (OUD) in Vancouver, Canada. METHODS: Using data from two cohorts of people who use drugs, we assessed the yearly proportion of daily opioid users achieving four sequential stages of the OUD cascade of care [linkage to addiction care; linkage to opioid agonist treatment (OAT); retention in OAT; and stability] between 2006 and 2016...
May 29, 2018: Drug and Alcohol Dependence
Madeline C Frost, Emily C Williams, Susan Kingston, Caleb J Banta-Green
OBJECTIVES: Opioid use is a growing problem in the United States. Despite existence of effective treatments (eg, opioid agonist medication), most people with opioid use disorder do not receive treatment. Increasing treatment receipt is an essential component of the response to the opioid crisis. We examined factors associated with interest in getting help to reduce or stop substance use among syringe exchange program (SEP) clients who reported using opioids. METHODS: Surveys were administered at 17 SEPs across Washington State during 2015; 436 respondents who reported recent opioid use and not receiving current treatment were eligible for this analysis...
June 7, 2018: Journal of Addiction Medicine
Ellen A Gnaedinger
OBJECTIVES: The United States has a public health crisis of dental caries in children's primary teeth. Fifty-five percent of children have dental caries by age 8. The majority of these children are nonwhite and poor. Caries could be decreased by 40% if fluoride varnish (FV) application started with tooth eruption. DESIGN AND SAMPLE: A four-month FV application QI project was implemented in a rural pediatric practice. The staff was trained by the Vermont Department of Health using the From the First Tooth protocol...
June 10, 2018: Public Health Nursing
Vari M Drennan, Melania Calestani, Fiona Ross, Mary Saunders, Peter West
Despite policy intentions for more healthcare out of hospital, district nursing services face multiple funding and staffing challenges, which compromise the care delivered and policy objectives. OBJECTIVES: What is the impact of the adapted Buurtzorg model on feasibility, acceptability and effective outcomes in an English district nursing service? DESIGN: Mixed methods case study. SETTING: Primary care. PARTICIPANTS: Neighbourhood nursing team (Buurtzorg model), patients and carers, general practitioners (GPs), other health professionals, managers and conventional district nurses...
June 6, 2018: BMJ Open
Chengli Bei, Manjiao Fu, Yao Zhang, Hebin Xie, Ke Yin, Yanke Liu, Li Zhang, Bangruan Xie, Fang Li, Hua Huang, Yuhong Liu, Li Yang, Jing Zhou
BACKGROUND: Limited treatment options of extensive drug-resistant tuberculosis (XDR-TB) have led to its high mortality worldwide. Relevant data about mortality of XDR-TB patients in literature are limited and likely underestimate the real situation in China, since the majority of patients with XDR-TB are lost to follow-up after discharge from TB hospitals. In this study, we sought to investigate the mortality and associated risk factors of Human Immunodeficiency Virus (HIV)-negative patients with XDR-TB in China...
June 7, 2018: BMC Infectious Diseases
Frances A Carter, M Joan Taylor, Madeline J Weston, Teresa A Quigley, John H Beveridge, Robert Aj Green, Steve Duffy
AIM: To systematically assess the service satisfaction of consumers, their families and referrers with crisis resolution (CR). METHODS: Consecutive consumers discharged after receiving CR over a five-week period were potentially eligible for participation, together with their family and referrer (broadly defined). Structured telephone interviews were conducted and involved forced-choice questions assessing global satisfaction and satisfaction with specific aspects of care, plus two open-ended questions...
June 8, 2018: New Zealand Medical Journal
Simon Grima, Jonathan V Spiteri, Mihajlo Jakovljevic, Carl Camilleri, Sandra C Buttigieg
In this study, we analyzed healthcare provision and health expenditure across six Mediterranean countries that adopt the National Health System (Beveridge model) and that form part of the European Union (EU) with the main aim being that of analyzing and comparing out-of-pocket health spending in countries with a European Mediterranean connection. To this end, we considered various economic indicators and statistics to derive commonalities and differences across these countries and also compared trends in these indicators to those observed across the rest of the EU...
2018: Frontiers in Public Health
Robert Hromas, Robert Leverence, Lazarus K Mramba, J Larry Jameson, Caryn Lerman, Thomas L Schwenk, Ellen M Zimmermann, Michael L Good
Economic pressure has led the evolution of the role of the medical school dean from a clinician educator to a health care system executive. In addition, other dynamic requirements also have likely led to changes in their leadership characteristics. The most important relationship a dean has is with the chairs, yet in the context of the dean's changing role, little attention has been paid to this relationship. To frame this discussion, we asked medical school chairs what characteristics of a dean's leadership were most beneficial...
2018: Journal of Healthcare Leadership
John Torous, Jennifer Nicholas, Mark E Larsen, Joseph Firth, Helen Christensen
The potential of smartphone apps to improve quality and increase access to mental health care is increasingly clear. Yet even in the current global mental health crisis, real-world uptake of smartphone apps by clinics or consumers remains low. To understand this dichotomy, this paper reviews current challenges surrounding user engagement with mental health smartphone apps. While smartphone engagement metrics and reporting remains heterogeneous in the literature, focusing on themes offers a framework to identify underlying trends...
June 5, 2018: Evidence-based Mental Health
Jennifer M Reingle Gonzalez, Michael S Businelle, Darla Kendzor, Michele Staton, Carol S North, Michael Swartz
BACKGROUND: There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid)...
June 5, 2018: JMIR Research Protocols
Lucy Chamberlain, Carole Anderson, Chris Knifton, Gayle Madden
With an ageing population comes an increasing risk of illnesses such as dementia and a growing need for care. There are 670,000 informal, unpaid carers in the UK, reducing costs for health and social care services but presenting other concerns for healthcare professionals. Carer burden and carer stress are well-documented concepts, and can lead to depression and a risk of suicide in some individuals. It is important that this risk is considered when supporting informal carers of people living with dementia...
June 5, 2018: Nursing Older People
Alejandro Porras-Segovia, Eulalio Valmisa, Blanca Gutiérrez, Isabel Ruiz, Miguel Rodríguez-Barranco, Jorge Cervilla
BACKGROUND: Major depression is one of the world's leading causes of disability. Up-to-date information about the epidemiology of this disorder is key to health care planning. AIM: The aim of our study is to report prevalence and correlates of current major depressive disorder (MDD) in the province of Granada, Southern Spain. METHODS: The GranadΣp is a cross-sectional study based on a community-dwelling adult population living in the province of Granada, Southern Spain...
May 1, 2018: International Journal of Social Psychiatry
Karl Puchner, Evika Karamagioli, Anastasia Pikouli, Costas Tsiamis, Athanasios Kalogeropoulos, Eleni Kakalou, Elena Pavlidou, Emmanouil Pikoulis
In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx-taking the global scale into account-might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects...
May 28, 2018: International Journal of Environmental Research and Public Health
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