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https://www.readbyqxmd.com/read/28339989/pain-management-strategies-and-health-care-use-in-community-dwelling-individuals-living-with-chronic-pain
#1
Elizabeth G Mann, Ana Johnson, Ian Gilron, Elizabeth G VanDenKerkhof
Objective. : To describe factors associated with high clinic and emergency room (ER) use among individuals with chronic pain. Design. : This study is part of a larger cross-sectional survey on the epidemiology of chronic pain in Canada. The current analysis was guided by the Andersen-Newman Service Utilization Model. Methods. : Respondents (N = 702) were grouped into high (top 10%) and low (bottom 90%) users based on the number of visits made to clinics and ERs over the past year...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339988/utilization-of-health-care-services-and-ambulatory-resources-associated-with-chronic-noncancer-pain
#2
Cynthia Kay, Erica Wozniak, Joanne Bernstein
Objective.:  Examine traditional and uncompensated health care utilization associated with chronic noncancer pain. Design.:  Retrospective chart review. Setting.:  Tertiary academic medical center. Subjects.:  Internal medicine patients on long-term opioids for chronic noncancer pain with or without a pain agreement between April 1, 2014, and April 1, 2015 (N = 834). Patients without pain served as controls (N = 782)...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339320/basic-life-support-access-to-injectable-epinephrine-across-the-united-states
#3
Ian D Brasted, Michael W Dailey
BACKGROUND:  Aggressive epinephrine administration has growing support in the treatment of anaphylaxis, a life-threatening allergic reaction. Emergency Medical Services (EMS) providers are frequently in a position to provide the first care to someone experiencing an anaphylactic reaction. Intramuscular injection of epinephrine is the definitive pharmacologic treatment for many associated symptoms. While easy to use, epinephrine autoinjectors (EAI) are prohibitively expensive, having increased in price ten-fold in ten years...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28333367/community-paramedicine-applied-in-a-rural-community
#4
Kevin J Bennett, Matt W Yuen, Melinda A Merrell
RESEARCH OBJECTIVE: Abbeville County Emergency Management Services (ACEMS) began a community paramedicine (CP) program to utilize trained paramedics to serve patients who frequently use the emergency department (ED) and have 1 or more of the following diagnoses: hypertension, diabetes, chronic heart failure, asthma, and chronic obstructive pulmonary disease. The objective of this study was to determine if the CP program reduced ED visits in Abbeville while improving patient outcomes. DESIGN: A pre/posttest with a comparison group study design was used to evaluate the CP program...
March 23, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28332936/ethical-concerns-about-emerging-treatment-paradigms-for-gender-dysphoria
#5
Stephen B Levin
The increasing incidence of request for medical services to support gender transition for children, adolescents and adults has consequences for society, governmental institutions, schools, families, health care professionals, and, of course, patients. The sociological momentum to recognize and accommodate to trans phenomena has posed ethical dilemmas for endocrinologists, mental health professionals and sexual specialists as they experience within themselves the clash between Respect for Patient Autonomy, Beneficence, Nonmalficience, and Informed Consent...
March 23, 2017: Journal of Sex & Marital Therapy
https://www.readbyqxmd.com/read/28331550/experiences-of-mobility-for-people-living-with-rheumatoid-arthritis-who-are-receiving-biologic-drug-therapy-implications-for-podiatry-services
#6
Lucy Sanders, Margaret Donovan-Hall, Alan Borthwick, Catherine J Bowen
BACKGROUND: Despite significant advancements in new treatment modalities for rheumatoid arthritis with biological therapies, foot complications remain a disabling and common feature of the disease. In this study the aim was to explore and describe the personal experiences of people with rheumatoid arthritis in receipt of biologic treatments in a bid to understand the impact of this form of medication on their mobility. METHODS: An interpretative phenomenological analysis (IPA) was undertaken to explore in depth the individual experience of rheumatoid disease through personal accounts of the patient journey spanning both 'before' and 'after' the instigation of biologic therapy...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28328394/proposing-telecardiology-services-on-cloud-for-different-medical-institutions-a-model-of-reference
#7
Isabel De la Torre-Díez, Begoña Garcia-Zapirain, Miguel López-Coronado, Joel J P C Rodrigues
INTRODUCTION: For a cloud-based telecardiology solution to be established in any scenario, it is necessary to ensure optimum levels of security, as patient's data will not be in the same place from where access is gained. The main objective of this article is to present a secure, cloud-based solution for a telecardiology service in different scenarios: a hospital, a health center in a city, and a group of health centers in a rural area. METHODS: iCanCloud software is used to simulate the scenarios...
March 1, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28327914/neurosurgical-emergency-transfers-an-analysis-of-deterioration-and-mortality
#8
Ali Alaraj, Darian R Esfahani, Ahmed E Hussein, Ioana Darie, Sepideh Amin-Hanjani, Konstantin V Slavin, Xinjian Du, Fady T Charbel
BACKGROUND: Neurological deterioration and mortality are frequent in neurosurgical patients transferred to tertiary centers, but the precise predictors leading to them are unclear. OBJECTIVE: To analyze and quantify risk factors predicting deterioration and death in neurosurgery transfers. METHODS: A consecutive review of all transfers with cranial pathology to a tertiary academic neurosurgery service was performed over a 2-year period. Risk factors including demographics, medical comorbidities, hydrocephalus, anticoagulant use, transfer diagnosis, Glasgow Coma Scale score, and transfer time were reviewed...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327835/-external-workplace-violence-against-doctors-in-hospital-services-in-lima-metropolitana-peru-2014
#9
Ximena Tuya-Figueroa, Edward Mezones-Holguin, Eduardo Monge, Ricardo Arones, Milagros Mier, Mercedes Saravia, Jose Torres, Percy Mayta-Tristán
Objectives: . To calculate the frequency and factors associated with external workplace violence (EWV) against doctors in health inpatient services in the metropolitan area of Lima (Spanish: Lima Metropolitana), Peru. Materials and methods: . A cross-sectional analytic study, which included doctors from the Ministry of Health (MINSA), Social Security (EsSalud), and the private subsector, was carried out. The frequency of EWV was measured throughout the entire professional practice during the previous 12 months and during the last month...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28326628/incidence-recurrence-and-cost-of-hyperglycaemic-crises-requiring-emergency-treatment-in-andalusia-spain
#10
R J Barranco, F Gomez-Peralta, C Abreu, M Delgado-Rodriguez, A Moreno-Carazo, F Romero, M A de la Cal, J M Barranco, F J Pasquel, G E Umpierrez
AIMS: Hyperglycaemic crises (diabetic ketoacidosis and hyperosmolar hyperglycaemic state) are medical emergencies in people with diabetes. We aimed to determine their incidence, recurrence and economic impact. METHODS: An observational study of hyperglycaemic crises cases using the database maintained by the out-of-hospital emergency service, the Healthcare Emergency Public Service (EPES) during 2012. The EPES provides emergency medical services to the total population of Andalusia, Spain (8...
March 22, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28324902/dysphagia-management-in-the-schools-past-present-and-future
#11
Cynthia R O'Donoghue, Elizabeth E Nottingham
As the number of speech-language pathologists (SLPs) responsible for swallowing and feeding services in the educational setting increases, guidance informing this specialized practice continues to emerge. Although SLPs have provided dysphagia management for children in medical settings for many years, the extension of dysphagia services to the schools is comparatively new. This shift in care delivery for what was previously a hospital-based practice is now occurring more frequently, and in an environment void of extensive medical supports (i...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28323477/-the-service-i-rendered-was-just-as-true-african-american-soldiers-and-veterans-as-activist-patients
#12
Jessica L Adler
In this article, I examine how African American soldiers and veterans experienced and shaped federally sponsored health care during and after World War I. Building on studies of the struggles of Black leaders and health care providers to win professional and public health advancement in the 1920s and 1930s, and of advocates to mobilize for health care rights in the mid-20th century, I focus primarily on the experiences and activism of patients in the interwar years. Private and government correspondence, congressional testimony, and reports from Black newspapers reveal that African American soldiers and veterans communicated directly with policymakers and bureaucrats regarding unequal treatment, assuming roles as "policy actors" who viewed health and medical care as "politics by other means...
March 21, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28323083/new-signs-to-encourage-the-use-of-automated-external-defibrillators-by-the-lay-public
#13
Christopher M Smith, Michael C Colquhoun, Marc Samuels, Mark Hodson, Sarah Mitchell, Judy O'Sullivan
INTRODUCTION: Public Access Defibrillation - the use of Automated External Defibrillators (AEDs) by lay bystanders before the arrival of Emergency Medical Services - is an important strategy in delivering prompt defibrillation to victims of out-of-hospital cardiac arrest and can greatly improve survival rates. Such public-access AEDs are used rarely: one barrier might be poor understanding and content of current signage to indicate their presence. The aim of this project was to develop a sign, with public consultation, that better indicated the function of an AED, and an associated poster to encourage its use...
March 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28323081/prevalence-of-advance-directives-and-impact-on-advanced-life-support-in-out-of-hospital-cardiac-arrest-victims
#14
Paul-Georges Reuter, Jean-Marc Agostinucci, Philippe Bertrand, Géraldine Gonzalez, Carla De Stefano, Brigitte Hennequin, Pierre Nadiras, Didier Biens, Hervé Hubert, Pierre-Yves Gueugniaud, Frédéric Adnet, Frédéric Lapostolle
AIM: To evaluate the prevalence of advance directives and their impact on the management of out-of-hospital cardiac arrest (OHCA) victims. METHODS: We analyzed data extracted from the French national registry of adult OHCA patients (RéAC). The data concerned the emergency medical services (EMS) of a Paris suburb over the period 01/01/2013 to 30/11/2015. The primary endpoint was the prevalence of advance directives. Secondary endpoints were the characteristics of the population, of cardiac arrest, and of basic life support as well as outcomes in patients with or without advance directives...
March 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28318461/the-event-chain-of-survival-in-the-context-of-music-festivals-a-framework-for-improving-outcomes-at-major-planned-events
#15
Adam Lund, Sheila Turris
Despite the best efforts of event producers and on-site medical teams, there are sometimes serious illnesses, life-threatening injuries, and fatalities related to music festival attendance. Producers, clinicians, and researchers are actively seeking ways to reduce the mortality and morbidity associated with these events. After analyzing the available literature on music festival health and safety, several major themes emerged. Principally, stakeholder groups planning in isolation from one another (ie, in silos) create fragmentation, gaps, and overlap in plans for major planned events (MPEs)...
March 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28317095/evaluating-helicopter-emergency-medical-missions-a-reliability-study-of-the-hems-benefit-and-naca-scores
#16
L Raatiniemi, J Liisanantti, M Tommila, S Moilanen, P Ohtonen, M Martikainen, V Voipio, J Reitala, T Iirola
BACKGROUND: The benefits of the Helicopter Emergency Medical Service (HEMS) and dispatch accuracy are continuously debated, and a widely accepted score to measure the benefits of the mission is lacking. The HEMS Benefit Score (HBS) has been used in Finnish helicopter emergency medical services, but studies are lacking. The National Advisory Committee for Aeronautics (NACA) score is widely used to measure the severity of illness or injury in the pre-hospital setting, but it has many critics due to its subjectivity...
March 19, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28315728/can-ambulance-telephone-triage-using-nhs-pathways-accurately-identify-paediatric-cardiac-arrest
#17
Charles D Deakin, Simon England, Debbie Diffey, Ian Maconochie
BACKGROUND: Most out-of-hospital paediatric cardiac arrests (CA) are not identified until a call is made to the emergency medical services. Accurate identification increases overall survival by enabling immediate ambulance dispatch and delivery of bystander CPR. European ambulance services use a variety of didactic telephone scripts to interrogate the caller and rapidly identify paediatric CA. The performance of these scripts has not been reported. This study aims to evaluate the diagnostic accuracy of the NHS Pathways as a telephone triage tool to identify patients less than 16 years age in cardiac arrest...
March 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28314501/legal-and-regulatory-barriers-to-reverse-innovation
#18
Virginia Rowthorn, Alexander J Plum, John Zervos
BACKGROUND: Reverse innovation, or the importation of new, affordable, and efficacious models to high-income countries from the developing world, has emerged as a way to improve the health care system in the United States. Reverse innovation has been identified as a key emerging trend in global health systems in part because low-resourced settings are particularly good laboratories for low-cost/high-impact innovations that are developed out of necessity. A difficult question receiving scant attention is that of legal and regulatory barriers...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#19
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28306386/perceived-discrimination-among-racial-and-ethnic-minority-drug-users-and-the-association-with-health-care-utilization
#20
Courtney McKnight, Martha Shumway, Carmen L Masson, Enrique R Pouget, Ashly E Jordan, Don C Des Jarlais, James L Sorensen, David C Perlman
People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency departments (EDs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs' use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care utilization among respondents (N = 192) recruited from methadone maintenance treatment programs (36%), HIV primary care clinics (35%), and syringe exchange programs (29%) in New York City (n = 88) and San Francisco (n = 104)...
March 17, 2017: Journal of Ethnicity in Substance Abuse
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