scholarly journals The Role of Caregiver-Reported Risks in Predicting Adverse Pediatric Outcomes

2020 ◽  
Vol 45 (8) ◽  
pp. 957-970
Author(s):  
Louise E Vaz ◽  
David V Wagner ◽  
Rebecca M Jungbauer ◽  
Katrina L Ramsey ◽  
Celeste Jenisch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Disease ◽  
Care Coordination ◽  
Demographic Data ◽  
Disease Status ◽  
Emergency Department Visits ◽  
Inpatient Admission ◽  
Social Risk ◽  
Social Risk Factors ◽  
Future Health

Abstract Objective Certain social risk factors (e.g., housing instability, food insecurity) have been shown to directly and indirectly influence pediatric health outcomes; however, there is limited understanding of which social factors are most salient for children admitted to the hospital. This study examines how caregiver-reported social and medical characteristics of children experiencing an inpatient admission are associated with the presence of future health complications. Methods Caregivers of children experiencing an inpatient admission (N = 249) completed a predischarge questionnaire designed to capture medical and social risk factors across systems (e.g., patient, caregiver, family, community, healthcare environment). Electronic health record (EHR) data were reviewed for child demographic data, chronic disease status, and subsequent emergency department visits or readmissions (i.e., acute events) 90 days postindex hospitalization. Associations between risk factors and event presence were estimated using odds ratios (ORs) and confidence intervals (CI), both unadjusted and adjusted OR (aOR) for chronic disease and age. Results Thirty-three percent (N = 82) of children experienced at least one event. After accounting for child age and chronic disease status, caregiver perceptions of child’s health being generally “poor” or “not good” prior to discharge (aOR = 4.7, 95% CI = 2.3, 9.7), having high care coordination needs (aOR = 3.2, 95% CI = 1.6, 6.1), and experiencing difficulty accessing care coordination (aOR = 2.5, 95% CI = 1.4, 4.7) were significantly associated with return events. Conclusions Caregiver report of risks may provide valuable information above and beyond EHR records to both determine risk of future health problems and inform intervention development.

An Approach to Selecting Single or Multiple Social Risk Factors for Clinic-Based Screening

2021 ◽  
Author(s):  
John F. Steiner ◽  
Glenn K. Goodrich ◽  
Kelly R. Moore ◽  
Spero M. Manson ◽  
Laura M. Gottlieb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Risk ◽  
Social Risk Factors

СОСТОЯНИЕ ПРОБЛЕМЫ НАРКОЛОГИЧЕСКИХ РАССТРОЙСТВ В КУРСКОЙ ОБЛАСТИ И СОПРЕДЕЛЬНЫХ ТЕРРИТОРИЯХ В 2014-2019 ГОДАХ

Innova ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 33-38
Author(s):  
Владимир Игоревич Тимошилов ◽  
◽  
Альберт Генрихович Ластовецкий
Keyword(s):  
Risk Factors ◽  
Drug Addiction ◽  
Epidemiological Data ◽  
Drug Prevention ◽  
Social Risk ◽  
Social Risk Factors ◽  
Social Instability ◽  
Lower Incidence Rate ◽  
Kursk Region ◽  
Active Substances

Period 2014-2019 characterized by a certain increase in social instability in Russia, which led to an increase of social risk factors for drug addiction. In the Kursk region, at the same time, there have been changes in the regulation of anti-drug prevention, a large number of specialists have been trained, and a movement of competent volunteers has developed. In this regard, the epidemiological data for 2014-2019 are of particular interest. For the period from 2005 to 2019 the primary incidence of alcohol use disorders in Russia decreased from 147.4 to 48.3, in the Kursk region – from 106 to 53.5 cases per 100 000 population per year. Of the adjacent regions in 2019, a lower incidence rate than in the Kursk region was noted only in the Belgorod region – 39.4 cases per 100,000 population. Primary incidence of disorders associated with the use of narcotic active substances, during 2014-2019 in Russia as a whole decreased from 15 to 9.8, in the Kursk region – from 11.3 to 4 new cases per 100 000 inhabitants per year. In 2019, the detection rate of primary incidence of drug addiction and substance abuse was significantly higher than in the Kursk region in Bryansk and Lipetsk. Despite favorable trends, it was noted that the coronavirus pandemic and the restrictions introduced to combat it can have a significant impact on the risk factors for drug addiction, which requires the adaptation of preventive programs to new conditions.

scholarly journals DEVELOPMENT OF A STANDARDIZED APPROACH FOR THE ASSESSMENT OF BOWEL AND BLADDER DYSFUNCTION IN COMMUNITY PAEDIATRICS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e6-e7
Author(s):  
Rebecca Wang ◽  
Ronik Kanani ◽  
Niraj Mistry ◽  
Yara El Bardisi ◽  
Joana Dos Santos
Keyword(s):  
Risk Factors ◽  
Bladder Dysfunction ◽  
Neuropsychiatric Symptoms ◽  
Iterative Refinement ◽  
Social Risk ◽  
Red Flags ◽  
Social Risk Factors ◽  
Voiding Symptoms ◽  
Bowel And Bladder Dysfunction ◽  
Psychosocial History

Abstract BACKGROUND Bowel and bladder dysfunction (BBD) is a common yet underdiagnosed paediatric condition that describes a constellation of lower urinary tract symptoms (LUTS) associated with constipation and/or encopresis. Many children with BBD have co-morbid neuropsychiatric symptoms (e.g., inattention, anxiety) and psychosocial stressors. Thus, clinical assessment of behavioural symptoms and social risk factors in this population is essential. However, there is no standardized approach for a comprehensive assessment of BBD. OBJECTIVES We aim to develop and evaluate physician and parent perceptions with 1) a standardized BBD history and physical intake form for physicians, and 2) a parent-reported intake form. DESIGN/METHODS From June to Oct 2017, a quality improvement study was conducted in the BBD network, an existing paediatric collaborative initiative consisting of 7 community sites with support of the paediatric urology division in a tertiary hospital. Based on literature review and expert opinions, a standardized intake form was developed for BBD assessment with targeted questions for LUTS, constipation, behavioural, dietary, and psychosocial history, along with a physical exam checklist for neurological red flags. Further, a shorter parent-reported intake questionnaire was developed to clarify patterns of dysfunctional voiding symptoms, dietary recall and stool history. Both forms underwent usability testing and iterative refinement. Prior to clinic, families of children referred for BBD were mailed an intake package for completion. During the clinic, physicians were asked to use the standardized intake form for new referrals. Afterwards, both physicians and parents were given anonymous surveys to evaluate their perceptions of the intake process. RESULTS A total of 8 physicians and 20 parents responded, with 60% of patients being between ages 4–10 and 55% male. Physicians found the standardized intake form to be a useful guide that reminded them to ask about specific urinary symptoms (88% of the time), constipation (75%), and psychosocial history (76%). The majority of physicians (75%) agreed they would use the intake form again and recommended its implementation. Further, parents responded positively by agreeing that the intake package was easy to complete (65%), felt included in care decisions (95%), and had questions answered appropriately (100%). CONCLUSION In assessment of BBD, a standardized intake form can help guide physicians to efficiently gather a comprehensive history, rule out red flags, and screen for psychosocial risk factors. With refinements, it can potentially help create a common clinical experience and empower more community paediatricians to manage BBD in the future.

Psychiatric, Behavioural and Social Risk Factors for HIV Infection Among Female Drug Users

2011 ◽  
Vol 15 (8) ◽  
pp. 1834-1843 ◽  
Author(s):  
Gail Gilchrist ◽  
Alicia Blazquez ◽  
Marta Torrens
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Drug Users ◽  
Social Risk ◽  
Social Risk Factors ◽  
Female Drug Users
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