Acute Cognitive Therapy in Reducing Suicide Risk Following a Presentation to an Emergency Department

2009 ◽  
Vol 26 (1) ◽  
pp. 16-26 ◽  
Author(s):  
Albert Anthony Catanese ◽  
Michael Stephen John ◽  
John Di Battista ◽  
David M. Clarke
Keyword(s):  
Emergency Department ◽  
Cognitive Therapy ◽  
Suicidal Behaviour ◽  
Emergency Departments ◽  
Suicide Risk ◽  
Medium Term ◽  
Short Term ◽  
Therapy Program ◽  
Psychosocial Crisis

AbstractThe ACT (Acute Cognitive Therapy) Program was implemented as a patient follow-up initiative to respond to people presenting to emergency departments with suicidal behaviour or ideation, in a psychosocial crisis. Over 12 months 188 patients were referred to the program of which 160 attended at least one appointment and 109 completed the program. Pre- and postmeasures indicated that significant improvement occurred in those who completed the program, that improvements were maintained at 6 months and representation rates were reduced. Immediate short-term directed treatment appears beneficial in the short and medium term, and the rapidity and location of follow-up appears to promote compliance.

Tracking the Rise of Geriatric Emergency Departments in the United States

2018 ◽  
Vol 39 (8) ◽  
pp. 871-879 ◽  
Author(s):  
John G. Schumacher ◽  
Jon Mark Hirshon ◽  
Phillip Magidson ◽  
Marilyn Chrisman ◽  
Terisita Hogan
Keyword(s):  
Emergency Department ◽  
Emergency Care ◽  
Emergency Departments ◽  
The United States ◽  
Transitions Of Care ◽  
Emergency Department Care ◽  
Equipment And Supplies ◽  
Care Services ◽  
Physical Environments

The traditional model of emergency care no longer fits the growing needs of the over 20 million older adults annually seeking emergency department care. In 2007 a tailored “geriatric emergency department” model was introduced and rapidly replicated among hospitals, rising steeply over the past 5 years. This survey examined all U.S. emergency departments self-identifying themselves as Geriatric Emergency Departments (GEDs) and providing enhanced geriatric emergency care services. It was guided by the recently adopted Geriatric Emergency Department Guidelines and examined domains including, GED identity, staffing, and administration; education, equipment, and supplies; policies, procedures, and protocols; follow-up and transitions of care; and quality improvement. Results reveal a heterogeneous mix of GED staffing, procedures, physical environments and that GEDs’ familiarity with the GED Guidelines is low. Findings will inform emergency departments and gerontologists nationwide about key GED model elements and will help hospitals to improve ED services for their older adult patients.

scholarly journals The effectiveness of M-Health associated with cardiac rehabilitation on functional capacity and cardiovascular risk factors: a systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A C Campagnolo Goncalves Toledo ◽  
N Soares De Almeida ◽  
A Pierucci ◽  
A Straioto Salomao ◽  
I Ribeiro Lemes ◽  
...  
Keyword(s):  
Functional Capacity ◽  
Meta Analysis ◽  
Medium Term ◽  
Short Term ◽  
High Quality ◽  
Quality Of Evidence ◽  
High Quality Evidence ◽  
Quality Evidence

Abstract Introduction Smartphone applications for health (M-Health) seem to overcome barriers to access Cardiovascular Rehabilitation Programs (CRP), because of their high degree of acceptance and also their potential to influence the frequency of physical exercise in weight loss. Objective To analyze the effectiveness of the combination of M-Health and CRP compared to CRP alone on functional capacity, adherence to CRP, management of cardiovascular risk factors in cardiac patients. Design Systematic Review and Meta-Analysis. Methods The following databases were used Medline via Ovid, EMBASE, Central, PEDro and SPORTDiscus via EBSCOhost from their inception until July/2020. We included randomized controlled trials investigating the effects of M-Health in combination with CRP compared to CRP alone in adults with heart disease, and the interventions with M-Health consisted of text messages, e-mails, and applications. The primary outcome of this review was functional capacity, measured by VO2peak, or self-reported physical activity (METs.min/week). PEDro scale was used to assess the methodological quality of the studies and the GRADE approach to assess the overall quality of evidence. Pooled estimates were calculated using a random effect model to obtain mean difference (MD) or standardized mean differences (SMD) and their respectives 95% confidence intervals (CI). Results Nineteen RCTs were eligible, the median risk of bias was 7 out of 10 points. The primary endpoint was analyzed by subgroups, time of intervention and kind of type CRP, eigthteen of these studies assessed functional capacity. CRP in combination with a m-health intervention was more effective than CRP alone in improving VO2peak, ml/min/kg, (MD: 0.84, CI: 0.30 to 1.38; I2=0%, high quality evidence, 12 trials, n=1889) at short-term follow-up, but at medium-term follow-up (MD: 0.84, CI: −0.26 to 1.41; I2=0%, high quality evidence, 8 trials, n=927,). Similarly, CRP associated with m-health was superior to CRP alone in increasing self-reported at short-term, METs.min/week, (MD:1.31, CI: −0.24 to 2.37; I2 = not aplicable, very low quality evidence, 1 trial, n=18), and at medium-term follow-up (MD: 0.18, CI: −0.01 to 0.36; I2=56%, moderate quality evidence, 4 trials, n=1107). Conclusion High quality of evidence shows that M-Health improves cardiorespiratory fitness at short-term follow-up. In addition, supervised program showed to be more effective than non-supervised. Funding Acknowledgement Type of funding sources: None.

scholarly journals Three-month and six-month outcomes of patients with COVID-19 associated hyperinflammation treated with short-term immunosuppressive therapy: follow-up of the CHIC study

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e001906
Author(s):  
Marlou THF Janssen ◽  
Sofia Ramiro ◽  
Rémy LM Mostard ◽  
Cesar Magro-Checa ◽  
Robert BM Landewé
Keyword(s):  
Immunosuppressive Therapy ◽  
Outcome Measures ◽  
Normal Population ◽  
Immunosuppressive Treatment ◽  
Control Group ◽  
Medium Term ◽  
Short Term ◽  
Function Tests ◽  
Patient Reported

ObjectivesTo prospectively investigate differences in medium-term patient-reported outcome measures and objective functional outcome measures, between patients receiving and those not receiving intensive short-term immunosuppressive therapy for coronavirus disease 19 (COVID-19)-associated hyperinflammation.MethodsPatients previously included in the COVID-19 High-intensity Immunosuppression in Cytokine storm syndrome (CHIC) study who received immunosuppressive treatment versus standard of care for COVID-19-associated hyperinflammation were invited for follow-up at 3 and 6 months after hospitalisation. At both visits, patients were assessed by a pulmonologist, completed quality of life (QoL) questionnaires and performed pulmonary and exercise function tests. At 3 months, patients additionally completed questionnaires on dyspnoea, anxiety, depression and trauma. Outcomes were compared between patients receiving and those not receiving intensive short-term immunosuppressive therapy for COVID-19-associated hyperinflammation.Results131 (66.5%) patients survived hospitalisation due to COVID-19-associated hyperinflammation and 118 (90.1%) were included. QoL questionnaires, pulmonary- and exercise function tests showed improvement between 3 and 6 months after discharge, which was similar in both groups. Assessed patients reached levels that were close to levels predicted from the normal population. In contrast, diffusing capacity of the lung for carbon monoxide was disturbed in both groups: 69.6% predicted (SD 16.2) and 73.5% predicted (SD 16.5) in control group and treated group, respectively.ConclusionsNo differences in medium-term outcomes are demonstrated in survivors of COVID-19-associated hyperinflammation treated or not treated with methylprednisolone with or without tocilizumab during the acute phase. Short-term benefits of this therapy, as showed in the baseline CHIC study analysis, are thus not hampered by medium-term adverse events.

Audit of emergency department assessment and management of patients presenting with community-acquired needle stick injuries

2011 ◽  
Vol 35 (1) ◽  
pp. 57 ◽  
Author(s):  
Antonio Celenza ◽  
Lloyd J. D'Orsogna ◽  
Shervin H. Tosif ◽  
Samantha M. Bateman ◽  
Debra O'Brien ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Emergency Department ◽  
Hepatitis B ◽  
Emergency Departments ◽  
Hepatitis B Vaccination ◽  
Needle Stick Injury ◽  
Needle Stick ◽  
Post Exposure ◽  
Needle Stick Injuries

Objectives. To describe characteristics and management of people with community acquired needle stick injuries (CANSI) attending urban emergency departments; and suggest a guideline to improve assessment, management, and documentation. Methods. A retrospective analysis of cases with CANSI attending emergency departments in two tertiary hospitals between 2001 and 2005 using medical record review with follow up phone and written survey. Results. Thirty-nine cases met the criteria for CANSI. Persons younger than 30 years sustained 48.72% of all injuries. Source serology was available for only five cases (12.82%). Thirty-one of thirty-nine patients (79.49%) were classed as not immune to hepatitis B but only four of these (12.90%) received both hepatitis B vaccination and hepatitis B immunoglobulin. Six patients (15.38%) received HIV prophylaxis; of which two (33.33%) did not receive baseline HIV testing. Of ten patients referred to immunology clinic for follow up only two (20.00%) attended at 6 months. Conclusion. We have identified groups that are at high risk of CANSI, including young males, security workers and cleaners. In the majority of cases protection against hepatitis B was inadequately provided, and a substantial proportion had inadequate baseline assessment and documentation. A guideline is suggested that may be used to improve these deficits. What is known about this topic? Occupationally acquired needle stick injury guidelines are well established, but no guidelines currently exist for community acquired needle stick injuries (CANSI) which may require different risk stratification, assessment and management. Management of CANSI in Emergency Departments has not been well described. What does this paper add? An audit of Emergency Department management of community acquired needle stick injuries demonstrates deficits in risk assessment, documentation and use of post-exposure immunisation and prophylaxis. A guideline is suggested that may be used to improve these deficits. What are the implications for practitioners? Practitioners need to perform and document a risk assessment of the injury, perform baseline serology, and provide tetanus and hepatitis B immunisation. Use of HIV post-exposure prophylaxis is determined by local prevalence of disease, injury risk assessment, source serology if known, and time since injury.

The Lower Extremity Functional Scale Has Good Clinimetric Properties in People With Ankle Fracture

2009 ◽  
Vol 89 (6) ◽  
pp. 580-588 ◽  
Author(s):  
Chung-Wei Christine Lin ◽  
Anne M. Moseley ◽  
Kathryn M. Refshauge ◽  
Anita C. Bundy
Keyword(s):  
Lower Extremity ◽  
Internal Consistency ◽  
Ankle Fracture ◽  
Activity Limitation ◽  
Medium Term ◽  
Short Term ◽  
Functional Scale ◽  
High Internal Consistency ◽  
Lower Extremity Functional Scale

Background: There is limited information on the clinimetric properties of questionnaires of activity limitation in people after ankle fracture.Objective: The purpose of this study was to investigate the clinimetric properties of the Lower Extremity Functional Scale, an activity limitation questionnaire, in people with ankle fracture.Design: This was a measurement study using data collected from 2 previous randomized controlled trials and 1 inception cohort study.Methods: Participants with ankle fracture (N=306) were recruited within 7 days of cast removal. Data were collected at baseline and at short- and medium-term follow-ups. Internal consistency and construct validity were assessed using Rasch analysis. Concurrent validity, responsiveness, and floor and ceiling effects were evaluated.Results: The Lower Extremity Functional Scale demonstrated high internal consistency (α>.90). The variance in activity limitation explained by the items was high (98.3%). Each item had a positive correlation with the overall scale, and most items supported the unidimensionality of the scale. These findings suggest that the scale has high internal consistency and construct validity. The scale also demonstrated high concurrent validity and responsiveness in the short term and no floor or ceiling effects. However, the scale would benefit from more-challenging items, as evident at the medium-term follow-up.Limitations: This was a secondary analysis of existing data sets.Conclusion: The Lower Extremity Functional Scale is a useful tool to monitor activity limitation in people with ankle fracture up to the short-term follow-up. More- difficult items may need to be added to improve the responsiveness of the scale for longer-term follow-up.

scholarly journals Primary Meningococcal Type C Arthritis: A Case Report and Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Maximiliano Barahona ◽  
Jaime Catalan ◽  
Yoshiro Sato ◽  
Jaime Hinzpeter
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Literature Review ◽  
Neisseria Meningitidis ◽  
Functional Results ◽  
Clinical Problem ◽  
Short Term ◽  
Type C ◽  
Common Clinical Problem

Acute septic arthritis is a common clinical problem in emergency departments. Primary meningococcal arthritis (PMA) is very rare and few cases are reported in literature. D. B. M. consulted the emergency department for knee pain and fever; analysis showed that the cause was a Neisseria meningitidis type C infection. He received a treatment consisting of 2 arthroscopies and 5 weeks of antibiotics. At five weeks he returned to work and at 2 months he resumed sports (jogging and soccer) without complaints. Primary arthritis of the knee caused by Neisseria meningitidis is very rare. It has a very good response to antibiotics and arthroscopy procedure. Short-term follow-up and functional results are often good or excellent.

How Well Do Patients Obtain Short-term Follow-up After Discharge From the Emergency Department?

1999 ◽  
Vol 34 (5) ◽  
pp. 610-614 ◽  
Author(s):  
David Barlas ◽  
Clark S Homan ◽  
Jeanne Rakowski ◽  
Maureen Houck ◽  
Henry C Thode
Keyword(s):  
Emergency Department ◽  
Short Term

scholarly journals Short Scarf Osteotomy for Hallux Valgus: Short-term and Medium-term Results

2017 ◽  
Vol 4 (1) ◽  
pp. 14-18
Author(s):  
Rajesh Rachha ◽  
Rakesh Dalal ◽  
David Leonard ◽  
Ajay Chourasia ◽  
Saqib Javed
Keyword(s):  
Hallux Valgus ◽  
Operating Time ◽  
Valgus Deformity ◽  
Asia Pacific ◽  
Medium Term ◽  
Short Term ◽  
Scarf Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle

ABSTRACT Aim The scarf osteotomy, as popularized by Barouk, is a versatile osteotomy for the correction of moderate and severe hallux valgus deformity. However, this technique requires extensive exposure, fixation, and increased operative time, and is technically demanding. We describe and present our results of a short scarf osteotomy (SSO), which retains all the cuts of a standard scarf but requires a reduced exposure, less metalwork, less operating time, and is more economical. Materials and methods All patients who underwent SSO between January 2010 and December 2012 with minimum follow-up of 12 months were eligible for the study. Preoperative, intraoperative, and postoperative radiographs were available for radiological assessment. Results In this study, 84 patients and 94 feet were included; 90% of patients were satisfied overall, with 83% of patients recommending this surgery to a friend. The hallux valgus angle improved from a preoperative mean of 30.89° (17.4—46.8) to 12° (4—30) postoperatively (p = 0.0001). The intermetatarsal angle improved from a preoperative mean of 15.05° (10.3—21.1) to 7.14° (4—15.1) postoperatively (p = 0.0001). The average sesamoid coverage improved from grade 2.18 (1—3) preoperatively to 0.57 (0—2) postoperatively (p = 0.0001). The average American Orthopedic Foot and Ankle Score improved from 51.26 (32—88) preoperatively to 91.1 (72—100) postoperatively (p = 0.0001). Conclusion We believe that this osteotomy is a novel procedure producing good to excellent results in most cases of hallux valgus. Biologically, the decreased exposure should improve healing and reduce the risk of avascular necrosis. We strongly recommend this osteotomy for most cases of hallux valgus surgery. How to cite this article Dalal R, Rachha R, Leonard D, Chourasia A, Javed S. Short Scarf Osteotomy for Hallux Valgus: Short-term and Medium-term Results. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):14-18.

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