scholarly journals Assessing follow-up care compliance in children hospitalized for traumatic brain injuries

2020 ◽  
Vol 3 ◽  
Author(s):  
Hannah Bozell ◽  
Ashley Vetor ◽  
Jodi Raymond ◽  
Alexandra Hochstetler ◽  
Teresa Bell
Keyword(s):  
Healthcare Utilization ◽  
Information Exchange ◽  
Brain Injuries ◽  
Injury Severity ◽  
Limited Information ◽  
Post Discharge ◽  
Follow Up Care ◽  
Ed Visits

Background and Hypothesis: There is limited information regarding healthcare utilization and outcomes in children hospitalized for traumatic brain injury (TBI). Nearly 50% of adults hospitalized for trauma do not attend follow-up appointments, although completion of post-discharge care is associated with improved outcomes and decreased likelihood of subsequent emergency department (ED) visits. The Regestrief Institute Indiana Network for Patient Care (INPC) is a regional health information exchange (HIE) with health record data. This includes inpatient, outpatient, and ED visits, as well as imaging and lab data. The objective of this study is to use HIE data to assess long-term healthcare utilization, complications, and sequelae of pediatric patients hospitalized for TBI to see if follow-up compliance can identify patients at risk for post-TBI complications, including unplanned care, as well as long-term secondary health conditions.    Methods: 387 patients treated at a pediatric level 1 trauma center in Indiana admitted for TBI were identified using trauma registry data. EHR data in the INPC on patients for two years post-discharged were analyzed. Associations between compliance with follow-up care instructions given at discharge/subsequent medical visits and longitudinal utilization/outcomes were examined using Fisher’s exact test.     Results: After reviewing patient records, we found that 60.7% of patients received all follow-up care and 8.5% of patients received partial follow-up care, leaving 25.1% of patients receiving no follow up care and 5.7% of patients lost to follow-up after discharge. 12% of patients went to the ER for an injury-related issue and 6.2% of patients were readmitted. 19.4% of individuals experienced complications from injury while 12.4% of individuals had suspected sequela. Factors influencing recovery included race, age, insurance, injury severity, ICU admission, and ventilator usage.    Implications and Importance: Using HIE data can identify factors of hospitalized children vulnerable to not achieving optimal recovery and determine what care is critical to improving long-term health and quality of life outcomes. 

A-14 Factors Impacting Long-Term Proactive and Reactive Healthcare Utilization in Cognitively Healthy Older Adults

2021 ◽  
Vol 36 (6) ◽  
pp. 1055-1055
Author(s):  
Katie Stypulkowski ◽  
Jamie Hansel ◽  
Rachel Thayer
Keyword(s):  
Older Adults ◽  
Healthcare Utilization ◽  
Cognitive Training ◽  
Mmse Score ◽  
Female Gender ◽  
Rural Setting ◽  
Healthy Older Adults ◽  
Ed Visits

Abstract Objective Ongoing preventive healthcare is critical to support physical and cognitive health with aging. Several demographic factors have been identified as impacting older adult’s healthcare utilization (HCU), and cognitive training (CT) may prime for proactive (regular doctor’s visits) versus reactive (emergency department [ED] visits) HCU. This study sought to explore older adults’ HCU patterns, including predictors of CT and demographic factors, in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) data set. Method The full ACTIVE study included 2802 community-dwelling adults age 65+ without cognitive impairment. Available data were comprised of N&#3f909 across six US sites at baseline and five-year follow up. Multiple linear regression was used to predict five-year doctor’s visits and ED visits from age, race, gender, education, MMSE score, community type, and cognitive training group. Results The model significantly predicted doctor’s visits but accounted for a low amount of the total variance [R2 = 0.025, F(7,885) = 3.21, p = 0.002]. Rural setting (β = 0.090, p = 0.012), female gender (β = 0.086, p = 0.012), higher MMSE (β = 0.079, p = 0.031), and higher education (β = 0.076, p = 0.041) predicted more doctor’s visits. Similarly, the overall model accounted for limited variance in ED visits [R2 = 0.016, F(7,888) = 3.21, p = 0.044], and older age was the only significant predictor (β = 0.089, p = 0.009). Conclusions CT did not significantly predict HCU at five-year follow up. Those living in a rural setting, of female gender, and with higher MMSE score and education level had higher proactive HCU at five years, whereas only older age predicted higher ED visits. Additional exploration of factors impacting long-term HCU within a diverse sample of healthy older adults is needed.

scholarly journals Self-reported late effects and long-term follow-up care among 1889 long-term Norwegian Childhood, Adolescent, and Young Adult Cancer Survivors (the NOR-CAYACS study)

2020 ◽  
Author(s):  
A. V. Mellblom ◽  
C. E. Kiserud ◽  
C. S. Rueegg ◽  
E. Ruud ◽  
J. H. Loge ◽  
...  
Keyword(s):  
Young Adult ◽  
Late Effects ◽  
Adolescent And Young Adult ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Follow Up Care ◽  
Long Term Follow Up ◽  
Young Adult Cancer

Abstract Purpose The majority of childhood, adolescent, and young adult cancer survivors (CAYACS) are at risk of late effects but may not receive long-term follow-up care for these. Here, we investigated (1) self-reported late effects, (2) long-term follow-up care, and (3) factors associated with receiving follow-up care in a population-based sample of Norwegian long-term CAYACS. Methods Survivors were identified by the Cancer Registry of Norway. All > 5-year survivors diagnosed between 1985 and 2009 with childhood cancer (CCS, 0–18 years old, excluding CNS), breast cancer (BC, stages I–III), colorectal cancer (CRC), leukemias (LEUK), non-Hodgkin lymphoma (NHL), or malignant melanoma (MM) at age 19–39 years were mailed a questionnaire (NOR-CAYACS study). Descriptive statistics and logistic regression models were used to analyze occurrence of late effects, long-term follow-up care for these, and associated factors. Results Of 2104 responding survivors, 1889 were eligible for analyses. Of these, 68% were females, with a mean age of 43 years at survey, on average 17 years since diagnosis, and diagnosed with CCS (31%), BC (26%), CRC (8%), NHL (12%), LEUK (7%), and MM (16%). Overall, 61.5% reported the experience of at least one late effect, the most common being concentration/memory problems (28.1%) and fatigue (25.2%). Sixty-nine percent reported not having received long-term follow-up care focusing on late effects. Lower age at survey (p = 0.001), higher education (p = 0.012), and increasing number of late effects (p = < 0.001) were associated with increased likelihood of follow-up care in the multivariate model. Conclusions The majority of survivors reported at least one late effect, but not receiving specific follow-up care for these. This indicates a need for structured models of long-term follow-up to ensure adequate access to care.

Esthetic Restorative Options for Pulpotomized Primary Molars: A Review of Literature

2011 ◽  
Vol 36 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Marcio Guelmann ◽  
Joseph Shapira ◽  
Daniela Silva ◽  
Anna Fuks
Keyword(s):  
Hybrid Composites ◽  
Primary Molars ◽  
Glass Ionomer ◽  
Limited Information ◽  
Resin Modified Glass Ionomer ◽  
Alternative Materials ◽  
Long Term Follow Up ◽  
Better Than

Objective: The goal of this manuscript was to review the existing literature in regards to esthetic options to restore pulpotomized primary molars. Study design: A pubmed literature search has been performed and all relevant studies were assessed. Results: Two laboratory, 3 restrospective and 4 prospective clinical studies were found, reviewed and analyzed. Conclusions: Based on the limited information available, we concluded that tooth colored and bonded restorations showed promising results as alternative materials to replace stainless steel crowns after pulpotomies in primary molars. Hybrid composites tend to perform better than compomers. Resin modified glass ionomer cements demonstrated excellent marginal seal and retention. More long-term follow up studies are necessary until more definitive recommendations can be made.

scholarly journals Male Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: A Report From the Children's Oncology Group

2012 ◽  
Vol 30 (27) ◽  
pp. 3408-3416 ◽  
Author(s):  
Lisa B. Kenney ◽  
Laurie E. Cohen ◽  
Margarett Shnorhavorian ◽  
Monika L. Metzger ◽  
Barbara Lockart ◽  
...  
Keyword(s):  
Young Adult ◽  
Reproductive Health ◽  
Task Force ◽  
Young Male ◽  
Adolescent And Young Adult ◽  
Male Survivors ◽  
Male Health ◽  
Follow Up Care

The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors.

scholarly journals Neonatal outcomes in pregnant women infected with COVID-19 in Babol, North of Iran: retrospective study with short-term follow-up

2021 ◽  
Author(s):  
Zahra Akbarian-Rad ◽  
Mohsen Haghshenas Mojaveri ◽  
Zinatossadat Bouzari ◽  
Farzin Sadeghi ◽  
Yousef Yahyapour ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Characteristics ◽  
Neonatal Outcomes ◽  
Short Term ◽  
Post Discharge ◽  
Reactive Protein ◽  
Clinical Presentations ◽  
North Of Iran

Abstract During the Coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks post-discharge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 who were admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6 − 40) and 3077.50 ± 697.64 gr (1720–3900) respectively. Apgar score of the first and fifth minutes in all neonates was ≥ 8 and ≥ 9 out of 10 respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP), in three infants, are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results almost similar to those described for non-pregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.

scholarly journals TIA and minor stroke: A qualitative study of long-term impact and experiences of follow-up care

2019 ◽  
Author(s):  
Grace M Turner ◽  
Christel McMullan ◽  
Lou Atkins ◽  
Robbie Foy ◽  
Jonathan Mant ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Stroke Prevention ◽  
Community Care ◽  
Minor Stroke ◽  
Framework Analysis ◽  
Diverse Range ◽  
Follow Up Care ◽  
The Impact

Abstract Background Transient ischaemic attack (TIA) and minor stroke are often considered transient events; however, many patients experience residual problems and reduced quality of life. Current follow-up healthcare focuses on stroke prevention and care for other long-term problems is not routinely provided. We aimed to explore patient and healthcare provider (HCP) experiences of residual problems post-TIA/minor stroke, the impact of TIA/minor stroke on patients’ lives, and current follow-up care and sources of support. Methods This qualitative study recruited participants from three TIA clinics, seven general practices and one community care trust in the West Midlands, England. Semi-structured interviews were conducted with 12 TIA/minor stroke patients and 24 HCPs from primary, secondary and community care with framework analysis. Results A diverse range of residual problems were reported post-TIA/minor stroke, including psychological, cognitive and physical impairments. Consultants and general practitioners generally lacked awareness of these long-term problems; however, there was better recognition among nurses and allied HCPs. Residual problems significantly affected patients’ lives, including return to work, social activities, and relationships with family and friends. Follow-up care was variable and medically focused. While HCPs prioritised medical investigations and stroke prevention medication, patients emphasised the importance of understanding their diagnosis, individualised support regarding stroke risk, and addressing residual problems. Conclusion HCPs could better communicate lay information about TIA/minor stroke diagnosis and secondary stroke prevention, and improve their identification of and response to important residual impairments affecting patients.

Compliance to post discharge follow-up care among adolescent suicide attempters

1998 ◽  
Vol 22 (2) ◽  
pp. 140 ◽  
Author(s):  
Virginie Granboulan ◽  
Françoise Roudot-Thoraval ◽  
Patrick Alvin
Keyword(s):  
Adolescent Suicide ◽  
Post Discharge ◽  
Suicide Attempters ◽  
Follow Up Care ◽  
Adolescent Suicide Attempters

Long-Term Anesthetic-Dependent Hypoactivity after Repetitive Mild Traumatic Brain Injuries in Adolescent Mice

2016 ◽  
Vol 38 (3) ◽  
pp. 220-238 ◽  
Author(s):  
Bridgette D. Semple ◽  
Raha Sadjadi ◽  
Jaclyn Carlson ◽  
Yiran Chen ◽  
Duan Xu ◽  
...  
Keyword(s):  
Brain Injuries ◽  
Injury Severity ◽  
Vasogenic Edema ◽  
Head Injuries ◽  
Traumatic Brain Injuries ◽  
Return To Play ◽  
Brain Maturation ◽  
Long Term Outcomes ◽  
Mild Traumatic Brain Injuries

Recent evidence supports the hypothesis that repetitive mild traumatic brain injuries (rmTBIs) culminate in neurological impairments and chronic neurodegeneration, which have wide-ranging implications for patient management and return-to-play decisions for athletes. Adolescents show a high prevalence of sports-related head injuries and may be particularly vulnerable to rmTBIs due to ongoing brain maturation. However, it remains unclear whether rmTBIs, below the threshold for acute neuronal injury or symptomology, influence long-term outcomes. To address this issue, we first defined a very mild injury in adolescent mice (postnatal day 35) as evidenced by an increase in Iba-1- labeled microglia in white matter in the acutely injured brain, in the absence of indices of cell death, axonal injury, and vasogenic edema. Using this level of injury severity and Avertin (2,2,2-tribromoethanol) as the anesthetic, we compared mice subjected to either a single mTBI or 2 rmTBIs, each separated by 48 h. Neurobehavioral assessments were conducted at 1 week and at 1 and 3 months postimpact. Mice subjected to rmTBIs showed transient anxiety and persistent and pronounced hypoactivity compared to sham control mice, alongside normal sensorimotor, cognitive, social, and emotional function. As isoflurane is more commonly used than Avertin in animal models of TBI, we next examined long-term outcomes after rmTBIs in mice that were anesthetized with this agent. However, there was no evidence of abnormal behaviors even with the addition of a third rmTBI. To determine whether isoflurane may be neuroprotective, we compared the acute pathology after a single mTBI in mice anesthetized with either Avertin or isoflurane. Pathological findings were more pronounced in the group exposed to Avertin compared to the isoflurane group. These collective findings reveal distinct behavioral phenotypes (transient anxiety and prolonged hypoactivity) that emerge in response to rmTBIs. Our findings further suggest that selected anesthetics may confer early neuroprotection after rmTBIs, and as such mask long-term abnormal phenotypes that may otherwise emerge as a consequence of acute pathogenesis.

Sign in / Sign up

Export Citation Format

Share Document