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Trauma-informed AND primary Care

Michael P Girouard, Hilary Goldhammer, Alex S Keuroghlian
Although little is known about the specific burden of the opioid epidemic on lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, there is evidence to suggest that opioid use disorders are disproportionately prevalent in the LGBTQ community. In this commentary, we present an overview of the current state of evidence on opioid use and misuse among LGBTQ-identified people in the United States and suggest ways to adapt behavioral health interventions to the specific needs of this population. Programs that integrate behavioral health with primary care, address minority stress, and use a trauma-informed approach have the most potential to produce effective, long-term benefits for LGBTQ-identified people with opioid use disorders...
February 13, 2019: Substance Abuse
Karen G Rentas, Laura Buckley, Dawn Wiest, Cortney A Bruno
BACKGROUND: A small percentage of patients relies extensively on hospital-based care and account for a disproportionately high share of health care spending in the United States. Evidence shows that behavioral health conditions are common among these individuals, but understanding of their behavioral health needs is limited. This study aimed to understand the behavioral health characteristics and needs of patients with high hospital utilization patterns in Camden, New Jersey. METHODS: The sample consisted of patients in a care management intervention for individuals with patterns of high hospital utilization who were referred for behavioral health assessments (N = 195)...
February 8, 2019: BMC Health Services Research
Brian Rinker
At a San Francisco primary care clinic, trauma is recognized as a root cause of many health challenges.
February 2019: Health Affairs
Candice N Selwyn, Mallory Schneider, Caitlin Anderson, Jennifer Langhinrichsen-Rohling
Youth are commonly exposed to potentially traumatic events (PTEs). Following exposure, approximately 25% develop persistent mental and behavioral health (M/BH) symptoms, yet many go untreated or are misdiagnosed and suffer adverse outcomes. Primary care is an ideal setting for detection of trauma-related symptoms. The current article uses archival data to (1) examine the prevalence of posttraumatic stress symptoms that are unlikely, possible, and likely to meet diagnostic criteria for posttraumatic stress disorder (PTSD) and the M/BH and physical health concerns that co-occur with PTSD symptoms among adolescents (n = 133, mean age = 15...
February 2019: Psychological Services
Mukesh Kumar Singhal, Ramakant Dandriyal, Asish Aggarwal, Anshika Agarwal, Sudhir Yadav, Prashant Baranwal
Implant placement is a challenge in the anterior maxilla if the available bone is reduced and esthetics is challenging. The ideal implant position should be considered in all three dimensions: mesiodistal, apicocoronal, and orofacial. This article includes a review and a case report for the anatomical and clinical perspective of implant placement in nasopalatine foramen (near incisal canal). In this case report, the edentulous space is mutilated in between the area #12 and #21 teeth. Therefore, only one, 3...
July 2018: Annals of Maxillofacial Surgery
Brienna N Meffert, Danielle M Morabito, Danielle A Sawicki, Catherine Hausman, Steven M Southwick, Robert H Pietrzak, Adrienne J Heinz
Objective: To examine sociodemographic and military characteristics of US veterans who do and do not utilize Veterans Affairs (VA) health care services as their primary source of health care and examine the relationship between VA utilization and medical and psychosocial characteristics. Methods: Participants were a nationally representative sample of 3,152 military veterans (89.8% male, 83.5% white, 6.0% black, mean age = 62.0 [SD = 13.1] years) who completed a survey in 2011 assessing health care utilization, sociodemographic, military service, medical, and psychosocial characteristics...
January 17, 2019: Primary Care Companion to CNS Disorders
Tom J Crijns, Tyler Caton, Teun Teunis, Jacob T Davis, Kindra McWilliam-Ross, David Ring, Hugo B Sanchez
Background: Proximal femur fractures are prevalent among the elderly and associated with substantial morbidity, mortality, and early readmission. Early readmission is gaining popularity as a measure of quality of hospital care and can lower reimbursement. A better understanding of the patient and treatment characteristics associated with readmission may help inform program improvement initiatives. This study tested the primary null hypothesis that length of stay is not associated with higher rates of readmission within 30 days and 1 year in patients having operative treatment of a proximal femur fracture, accounting for discharge destination and other factors...
November 2018: Archives of Bone and Joint Surgery
Anthony E Pusateri, Mary J Homer, Todd E Rasmussen, Kevin R Kupferer, W Keith Hoots
Intensive blood use is expected to occur at levels, which will overwhelm blood supplies as they exist with current capabilities and technologies, both in civilian mass casualty events and military battlefield trauma. New technologies are needed for trauma care, and specifically to provide safer, more effective, and more logistically supportable blood products to treat patients with, or at risk of developing, acquired bleeding disorders resulting from trauma, acute radiation exposure, or other causes. Three of the primary agencies with major research and development programs related to blood products, the Biomedical Advanced Research and Development Authority (BARDA), the Department of Defense (DoD), and the National Heart, Lung, and Blood Institute are uniquely positioned to partner in addressing these issues, which have significant implications for each respective agency, as well as for the US population...
July 2018: American Journal of Disaster Medicine
Efren A Salinero, Jose Ramirez, Kelly Cramm-Morgan, Linda Papa
OBJECTIVES: Compliance with recommended follow-up from the pediatric emergency department (PED) has been shown to be poor. This study evaluated whether a text message reminder to the caregivers after discharge from the PED improved compliance with recommended primary care follow-up. METHODS: This was a blinded randomized control trial conducted at a level 1 pediatric trauma center. The intervention was a text message sent to the caregiver within 24 hours of discharge from the PED reminding them to follow up with their primary care doctor...
December 27, 2018: Pediatric Emergency Care
Andy Barlow, M Smith
BACKGROUND: General Practice training in the civilian and military environments follows a common training pathway, yet the scope of practice of a military General Practitioner (GP) varies significantly. A level of care for the acutely unwell and traumatically injured patients is frequently provided in austere environments remotely located from definitive medical care. This qualitative service needs evaluation scopes current level of trauma and acute care training and requirement for further training within military GPs and GP trainees...
December 19, 2018: Journal of the Royal Army Medical Corps
Ali Abdulkarim, Fiachra Richard Power, Peter Coffey, Eoin Sheehan
BACKGROUND: The Irish equestrian industry provides over 12,500 full-time jobs and contributes in excess of €454 million to the Irish exchequer annually. For such a vital industry, there is a dearth of information relating to equestrian-associated injuries. AIMS: The aim of this study was to determine the demographics, characteristics and outcomes of equestrian-related injuries presenting to the emergency department of a regional trauma centre in Ireland over the course of 1 year...
December 18, 2018: Irish Journal of Medical Science
Susan Jo Roberts, Genevieve E Chandler, Karen Kalmakis
Childhood trauma has been associated with negative health behaviors and conditions in adulthood. However, few primary care providers screen for trauma or alter their care to accommodate the multiple effects of trauma on patient health. The purposes of this article were to discuss the health consequences of childhood trauma and to offer a model for trauma-informed primary care (TIPC). The TIPC model provides a guide for primary care providers to screen for adverse childhood experiences and personalize the care of patients with a history of childhood trauma...
December 12, 2018: Journal of the American Association of Nurse Practitioners
Colin K Cantrell, Nicholas J Dahlgren, Bradley L Young, Kimberly M Hendershot
OBJECTIVES: Surgical residents are increasingly pursuing fellowships and rely heavily on fellowship programs' web sites as a primary source of information. Accessibility, quality, and content of a program web site can encourage or deter an applicant from applying to a particular program. The goal of this study was to perform an analysis of trauma, surgical critical care, and acute care surgery fellowship program web sites. MATERIALS AND METHODS: A list of trauma, surgical critical care, and acute care surgery fellowship programs was obtained from the Eastern Association for the Surgery of Trauma (EAST) web site...
December 2018: Journal of Surgical Research
Esther Mm Van Lieshout, Daan T Van Yperen, Margriet E Van Baar, Suzanne Polinder, Doeke Boersma, Anne Ymvp Cardon, Piet Ar De Rijcke, Marc Guijt, Taco Mal Klem, Koen Ww Lansink, Akkie N Ringburg, Maarten Staarink, Leon Van de Schoot, Alexander H Van der Veen, Floortje C Van Eijck, Percy V Van Eerten, Paul A Vegt, Dagmar I Vos, Marco Waleboer, Michael Hj Verhofstad, Cornelis H Van der Vlies
INTRODUCTION: The Emergency Management of Severe Burns (EMSB) referral criteria have been implemented for optimal triaging of burn patients. Admission to a burn centre is indicated for patients with severe burns or with specific characteristics like older age or comorbidities. Patients not meeting these criteria can also be treated in a hospital without burn centre. Limited information is available about the organisation of care and referral of these patients. The aims of this study are to determine the burn injury characteristics, treatment (costs), quality of life and scar quality of burn patients admitted to a hospital without dedicated burn centre...
November 15, 2018: BMJ Open
(no author information available yet)
No abstract text is available yet for this article.
December 2018: Nurse Practitioner
Sanjeev Bhoi, Ajai Singh, Tej Prakash Sinha, Ranabir Pal, Sagar Galwankar, Arushi Baluja, Sabir Ali, Vidhu Sharma, Amit Agrawal
Background: Helmet, as a protective gear to prevent fatal injuries while riding two-wheelers, needs to be evaluated by quality data. The aim of the study was to find out spectrum of injuries sustained with downstream outcomes in relation to acceptable ways of use of crash-proof helmet among motorized two-wheeler riders compared to nonuse following road traffic accidents. Methods: The present study was an analytical cross-sectional multicentric study conducted at three dedicated trauma care centers of India: (a) Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, (b) King George's Medical University, Lucknow, Uttar Pradesh, and (c) Narayana Medical College and Hospital, Nellore, Andhra Pradesh...
July 2018: Journal of Emergencies, Trauma, and Shock
Naomi Ennis, Iris Sijercic, Candice M Monson
BACKGROUND: Over 75% of individuals are exposed to a traumatic event, and a substantial minority goes on to experience mental health problems that can be chronic and pernicious in their lifetime. Early interventions show promise for preventing trauma following psychopathology; however, a face-to-face intervention can be costly, and there are many barriers to accessing this format of care. OBJECTIVE: The aim of this study was to systematically review studies of internet-delivered early interventions for trauma-exposed individuals...
November 14, 2018: Journal of Medical Internet Research
Fernando Landreau, Oscar Valcarcel, Juan Noir, Guadalupe Pernía, María L Orzábal, Sergio Martínez, Alejandro Tobar, Mariana Isola, Mariano Núñez, Pablo Martínez, Cristian Cuellar, Federico Villagrán, Alberto Crescenti
As part of the emergency medical care system, helicopter emergency medical services (HEMS) have a different crew composition from the traditional team. HEMS consist of a pilot, doctor, and firefighter with rescue skills and training in basic life support on board an air ambulance. This allows the adaptation to different environments and increases the varieties of air procedures normally performed. HEMS began operating relatively recently in Buenos Aires. Yet, in 3 years, its use grew to such an extent that in 2015 it tripled, and by 2016 the number of medical assists was 4 times greater than in 2014...
November 2018: Air Medical Journal
I-Lin Hsu, Chung-Yi Li, Da-Chen Chu, Li-Chien Chien
Traumatic head injuries occur frequently in Taiwan, having catastrophic consequences for the victims, their families, and society as a whole. However, little is known about the risk factors at the population level in Taiwan. The primary aim of this study was to obtain more information on these variables and their relationships. Another aim was to analyze the effects of independent variables such as sex, age, residency, pre-existing conditions, mechanisms of injury, associated injuries, and severity on the probability of in-hospital death...
November 4, 2018: International Journal of Environmental Research and Public Health
Joyce Li, Genie Roosevelt, Kerry McCabe, Jane Preotle, Faria Pereira, James K Takayesu, Michael Monuteaux, Richard G Bachur
Objective: While emergency medicine (EM) physicians treat the majority of pediatric EM (PEM) patients in the United States, little is known about their PEM experience during training. The primary objective was to characterize the pediatric case exposure and compare to established EM residency training curricula among EM residents across five U.S. residency programs. Methods: We performed a multicenter medical record review of all pediatric patients (aged < 18 years) seen by the 2015 graduating resident physicians at five U...
October 2018: AEM education and training
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