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https://www.readbyqxmd.com/read/29679440/effects-of-a-prior-authorization-policy-for-extended-release-long-acting-opioids-on-utilization-and-outcomes-in-a-state-medicaid-program
#1
Shellie L Keast, Hyunjee Kim, Richard A Deyo, Luke Middleton, K John McConnell, Kun Zhang, Sharia M Ahmed, Nancy Nesser, Daniel M Hartung
BACKGROUND AND AIMS: In response to the opioid overdose epidemic, USA state Medicaid programs have adopted restrictive policies for opioid analgesics, yet effects on prescribing patterns and health outcomes are uncertain. This study aimed to examine effects of a prior authorization policy for extended-release/long-acting (ER/LA) opioids on opioid use in the Oklahoma, USA state Medicaid program. DESIGN: Retrospective difference-in-differences design study comparing changes in opioid use in Oklahoma Medicaid to control (Oregon Medicaid)...
April 20, 2018: Addiction
https://www.readbyqxmd.com/read/29679408/prehospital-emergency-care-nurses-strategies-while-caring-for-patients-with-limited-swedish-english-proficiency
#2
A Alm Pfrunder, A Falk, V Vicente, V Lindström
AIMS AND OBJECTIVES: To explore the strategies of nurses working in the ambulance service while caring for patients with limited Swedish-English proficiency. BACKGROUND: Communication difficulties due to lack of mutual language is a challenge in health care systems around the world. Little is known about nurses' strategies while caring for patients with whom they do not share a mutual language in an unstructured, unplanned prehospital emergency environment, the ambulance service...
April 20, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29679360/mental-health-of-the-male-adolescent-and-young-man-the-copenhagen-statement
#3
REVIEW
Timothy R Rice, Lesha D Shah, Pilar Trelles, Shih-Ku Lin, Dinne Skjærlund Christensen, Andreas Walther, Leo Sher
BACKGROUND: Male adolescents and young men benefit when their mental health care is specialized to match their unique gendered and developmental needs. Sensitivity to the social circumstances of this population is important; additionally, the emerging ability to tailor care through knowledge gleaned from the intersection of psychiatry, neurology, and endocrinology informs care. DATA SOURCES: This article summarized the views of six experts in the area of the adolescent and young adult male mental health...
April 20, 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29678969/reducing-the-default-dispense-quantity-for-new-opioid-analgesic-prescriptions-study-protocol-for-a-cluster-randomised-controlled-trial
#4
Marcus A Bachhuber, Denis Nash, William N Southern, Moonseong Heo, Matthew Berger, Mark Schepis, Chinazo O Cunningham
INTRODUCTION: As opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#5
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29673804/infectious-disease-health-services-for-refugees-and-asylum-seekers-during-a-time-of-crisis-a-scoping-study-of-six-european-union-countries
#6
Kayvan Bozorgmehr, Mariya Samuilova, Roumyana Petrova-Benedict, Enrico Girardi, Pierluca Piselli, Alexander Kentikelenis
BACKGROUND: Systematic information on infectious disease services provided to refugees and asylum seekers in the European Union (EU) is sparse. We conducted a scoping study of experts in six EU countries in order to map health system responses related to infectious disease prevention and control among refugees and asylum seekers. METHODS: We conducted 27 semi-structured in-depth interviews with first-line staff and health officials to collect information about existing guidelines and practices at each stage of reception in first-entry (Greece/Italy), transit (Croatia/Slovenia), and destination countries (Austria/Sweden)...
April 11, 2018: Health Policy
https://www.readbyqxmd.com/read/29673360/identifying-barriers-for-out-of-hospital-emergency-care-in-low-and-low-middle-income-countries-a-systematic-review
#7
Antony Gatebe Kironji, Peter Hodkinson, Sarah Stewart de Ramirez, Trisha Anest, Lee Wallis, Junaid Razzak, Alexander Jenson, Bhakti Hansoti
BACKGROUND: Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income countries to identify barriers to and key interventions for OHEC delivery. METHODS: We performed a systematic review of the peer reviewed literature from January 2005 to March 2015 in PubMed, Embase, Cochrane, and Web of Science. All articles referencing research from low and low-middle income countries addressing OHEC, emergency medical services, or transport/transfer of patients were included...
April 19, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29673266/level-of-agreement-between-medical-record-and-icd-10-am-coding-of-mental-health-alcohol-and-drug-conditions-in-trauma-patients
#8
Tu Q Nguyen, Pamela M Simpson, Sandra C Braaf, Peter A Cameron, Rodney Judson, Belinda J Gabbe
BACKGROUND: Despite the reliance on administrative data in epidemiological studies, there is little information on the completeness of co-morbidities in administrative data coded from medical records. OBJECTIVE: The aim of this study was to quantify the agreement between the International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM) administrative coding of mental health, drug and alcohol co-morbidities and medical records in a severely injured patient population...
January 1, 2018: Health Information Management: Journal of the Health Information Management Association of Australia
https://www.readbyqxmd.com/read/29672524/point-of-care-tests-for-syphilis-and-yaws-in-a-low-income-setting-a-qualitative-study-of-healthcare-worker-and-patient-experiences
#9
Michael Marks, Tommy Esau, Rowena Asugeni, Relmah Harrington, Jason Diau, Hilary Toloka, James Asugeni, Eimhin Ansbro, Anthony W Solomon, David Maclaren, Michelle Redman-Maclaren, David C W Mabey
INTRODUCTION: The human treponematoses comprise venereal syphilis and the three non-venereal or endemic treponematoses yaws, bejel, and pinta. Serological assays remain the most common diagnostic method for all treponemal infections. Point-of-care tests (POCTs) for syphilis and yaws allow testing without further development of infrastructure in populations where routine laboratory facilities are not available. Alongside the test's performance characteristics assessed through diagnostic evaluation, it is important to consider broader issues when rolling out a POCT...
April 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29672398/evaluating-quality-metrics-and-cost-after-discharge-a-population-based-cohort-study-of-value-in-health-care-following-elective-major-vascular-surgery
#10
Charles de Mestral, Konrad Salata, Mohamad A Hussain, Ahmed Kayssi, Mohammed Al-Omran, Graham Roche-Nagle
BACKGROUND: Early readmission to hospital after surgery is an omnipresent quality metric across surgical fields. We sought to understand the relative importance of hospital readmission among all health services received after hospital discharge. OBJECTIVE: The aim of this study was to characterize 30-day postdischarge cost and risk of an emergency department (ED) visit, readmission, or death after hospitalization for elective major vascular surgery. METHODS: This is a population-based retrospective cohort study of patients who underwent elective major vascular surgery - carotid endarterectomy, EVAR, open AAA repair, bypass for lower extremity peripheral arterial disease - in Ontario, Canada, between 2004 and 2015...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29672283/current-controversies-in-the-management-of-diverticulitis-a-review
#11
Deirdre M Nally, Dara O Kavanagh
BACKGROUND: Symptomatic diverticular disease is challenging for patients, clinicians and health services. The prevalence increases with age and BMI and as such, the burden of this disease is set to increase with higher rates of acute presentations already documented. The natural history of recurrent episodes, complications and symptom progression is not fully understood. Furthermore, medical and surgical management strategies are under constant appraisal, debate and evolution. METHODS: A review of the contemporary literature was performed to examine the emerging trend towards conservative treatment...
April 19, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29671664/burden-of-emergency-medical-services-usage-by-dialysis-patients
#12
John Bartolacci, Judah Goldstein, Bryce Kiberd, Janel Swain, Amanda Vinson, David Clark, Karthik K Tennankore
BACKGROUND: Patients receiving chronic dialysis often require emergent and inpatient care; however, only a minimal amount is known about their out-of-hospital/inter-hospital use of Emergency Medical Services (EMS). The purpose of this study was to describe the utilization of EMS in a cohort of dialysis patients. METHODS: We analyzed a cohort of adult (≥18 years) chronic dialysis patients within the Nova Scotia Health Authority Central Zone Renal Program who initiated chronic dialysis between January 1, 2009 and June 30, 2013 (last follow up July 1, 2015)...
April 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29670768/assessment-of-anti-tb-drug-nonadherence-and-associated-factors-among-tb-patients-attending-tb-clinics-in-arba-minch-governmental-health-institutions-southern-ethiopia
#13
Addisu Alemayehu Gube, Megbaru Debalkie, Kalid Seid, Kiberalem Bisete, Asfaw Mengesha, Abubeker Zeynu, Freselam Shimelis, Feleke Gebremeskel
Background: Tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium tuberculosis . Nonadherence to anti-TB treatment may result in the emergence of multidrug-resistant TB, prolonged infectiousness, and poor tuberculosis treatment outcomes. Ethiopia is one of the seven countries that reported lower rates of treatment success (84%). This study assessed anti-TB drug nonadherence and associated factors among TB patients in Arba Minch governmental health institutions...
2018: Tuberculosis Research and Treatment
https://www.readbyqxmd.com/read/29669612/prehospital-blood-product-administration-opportunities-in-ground-transport-als-ems-a-descriptive-study
#14
Felicia M Mix, Martin D Zielinski, Lucas A Myers, Kathy S Berns, Anurahda Luke, James R Stubbs, Scott P Zietlow, Donald H Jenkins, Matthew D Sztajnkrycer
IntroductionHemorrhage remains the major cause of preventable death after trauma. Recent data suggest that earlier blood product administration may improve outcomes. The purpose of this study was to determine whether opportunities exist for blood product transfusion by ground Emergency Medical Services (EMS). METHODS: This was a single EMS agency retrospective study of ground and helicopter responses from January 1, 2011 through December 31, 2015 for adult trauma patients transported from the scene of injury who met predetermined hemodynamic (HD) parameters for potential transfusion (heart rate [HR]≥120 and/or systolic blood pressure [SBP]≤90)...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669611/needle-thoracostomy-does-changing-needle-length-and-location-change-patient-outcome
#15
Lori A Weichenthal, Scott Owen, Geoffory Stroh, John Ramos
BACKGROUND: Needle thoracostomy (NT) is a common prehospital intervention for patients in extremis or cardiac arrest due to trauma. The purpose of this study is to compare outcomes, efficacy, and complications after a change in policy related to NT in a four-county Emergency Medical Services (EMS) system with a catchment area of greater than 1.6 million people. METHODS: This is a before and after observational study of all patients who had NT performed in the Central California (USA) EMS system...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669574/effects-of-modifiable-prehospital-factors-on-survival-after-out-of-hospital-cardiac-arrest-in-rural-versus-urban-areas
#16
Wenche Torunn Mathiesen, Conrad Arnfinn Bjørshol, Jan Terje Kvaløy, Eldar Søreide
BACKGROUND: The modifiable prehospital system factors, bystander cardiopulmonary resuscitation (CPR), emergency medical services (EMS), response time, and EMS physician attendance, may affect short- and long-term survival for both rural and urban out-of-hospital cardiac arrest (OHCA) patients. We studied how such factors influenced OHCA survival in a mixed urban/rural region with a high survival rate after OHCA. METHODS: We analyzed the association between modifiable prehospital factors and survival to different stages of care in 1138 medical OHCA patients from an Utstein template-based cardiac arrest registry, using Kaplan-Meier type survival curves, univariable and multivariable logistic regression and mortality hazard plots...
April 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29668815/the-physician-in-the-face-of-death-in-the-emergency-room
#17
Janaína de Souza Aredes, Karla Cristina Giacomin, Josélia Oliveira Araújo Firmo
OBJECTIVE: To analyze how physicians, as part of a sociocultural group, handle the different types of death, in a metropolitan emergency service. METHODS: This is an ethnography carried out in one of the largest emergency services in Latin America. We have collected the data for nine months with participant observation and interviews with 43 physicians of different specialties - 25 men and 18 women, aged between 28 and 69 years. RESULTS: The analysis, guided by the model of Signs, Meanings, and Actions, shows a vast mosaic of situations and issues that permeate the medical care in an emergency unit...
2018: Revista de Saúde Pública
https://www.readbyqxmd.com/read/29667705/intellectual-disability-in-cerebral-palsy-a-population-based-retrospective-study
#18
Susan M Reid, Elaine M Meehan, Sarah J Arnup, Dinah S Reddihough
AIM: A population-based observational study design was used to describe the epidemiology of intellectual disability in cerebral palsy (CP) in terms of clinical and neuroimaging associations, and to report the impact of intellectual disability on utilization of health services and length of survival. METHOD: Population CP registry data were used to retrospectively assess the frequency of intellectual disability and strength of associations between intellectual disability and mobility, epilepsy, vision, hearing, communication, and neuroimaging patterns (n=1141)...
April 18, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29667566/us-emergency-medical-services-fellows
#19
Brian Clemency, Christian Martin-Gill, Nicole Rall, Dipesh Patel, Jeffery Myers
IntroductionThe 2015-2016 academic year was the fourth year since the Accreditation Council for Graduate Medical Education (ACGME; Chicago, Illinois USA) accredited Emergency Medical Services (EMS) fellowships, and the first year an in-training examination was given. Soon, ACGME-accredited fellowship education will be the sole path to EMS board certification when the practice pathway closes after 2019. This project aimed to describe the current class of EMS fellows at ACGME-accredited programs and their current educational opportunities to better understand current and future needs in EMS fellowship education...
April 18, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29666145/development-of-sustainable-community-paramedicine-programmes-a-case-study-in-pennsylvania
#20
Yuan-Han Huang, Linlin Ma, Luke A Sabljak, Zachary A Puhala
BACKGROUND: Community paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development. METHODS: A series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively...
April 17, 2018: Emergency Medicine Journal: EMJ
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