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  1. Article ; Online: An Understaffed Hospital Battles COVID-19.

    Scales, David

    Health affairs (Project Hope)

    2020  Volume 39, Issue 8, Page(s) 1450–1452

    Abstract: During the peak of the COVID-19 pandemic, staffing ratios reached untenable levels. ...

    Abstract During the peak of the COVID-19 pandemic, staffing ratios reached untenable levels.
    MeSH term(s) COVID-19 ; Cause of Death ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Disease Progression ; Female ; Hospital Mortality/trends ; Hospitals, Community/organization & administration ; Humans ; Intensive Care Units/organization & administration ; Male ; Narration ; New York City ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Risk Assessment ; Workforce/organization & administration
    Keywords covid19
    Language English
    Publishing date 2020-07-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632712-6
    ISSN 1544-5208 ; 0278-2715
    ISSN (online) 1544-5208
    ISSN 0278-2715
    DOI 10.1377/hlthaff.2020.00810
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    Zs.A 2118: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Opportunities and Challenges for Developing Syndromic Surveillance Systems for the Detection of Social Epidemics.

    Scales, David

    Online journal of public health informatics

    2020  Volume 12, Issue 1, Page(s) e6

    Abstract: This commentary explores the potential and challenges of developing syndromic surveillance systems with the ability to more rapidly detect epidemics of addiction, poverty, housing instability, food insecurity, social isolation and other social ... ...

    Abstract This commentary explores the potential and challenges of developing syndromic surveillance systems with the ability to more rapidly detect epidemics of addiction, poverty, housing instability, food insecurity, social isolation and other social determinants of health (SDoH). Epidemiologists tracking SDoH heavily rely on expensive government surveys released annually, delaying for months if not years the timely detection of social epidemics, defined as sudden, rapid or unexpected changes in social determinants of population health. Conversely, infectious disease syndromic surveillance is an effective early warning tool for epidemic diseases using various types of non-traditional epidemiological data from emergency room chief complaints to search query data. Based on such experience, novel social syndromic surveillance systems for early detection of social epidemics with health implications are not only possible but necessary. Challenges to their widespread implementation include incorporating disparate proprietary data sources and database integration. Significantly more resources are critically needed to address these barriers to allow for accessing, integrating and rapidly analyzing appropriate data streams to make syndromic surveillance for social determinants of health widely available to public health professionals.
    Language English
    Publishing date 2020-06-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2606835-7
    ISSN 1947-2579
    ISSN 1947-2579
    DOI 10.5210/ojphi.v12i1.10579
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  3. Article ; Online: Ethical Implications for Potential Placebo Effects of Point of Care Ultrasound.

    Scales, David

    Perspectives in biology and medicine

    2019  Volume 62, Issue 4, Page(s) 717–736

    Abstract: Anecdotally, practitioners of point of care ultrasound (POCUS) describe instances where patients appear to experience a placebo-like response after the examination, also described as a positive care effect. Extensive study of therapeutic ultrasound has ... ...

    Abstract Anecdotally, practitioners of point of care ultrasound (POCUS) describe instances where patients appear to experience a placebo-like response after the examination, also described as a positive care effect. Extensive study of therapeutic ultrasound has yet to reveal differences between intervention and placebo, both of which respond to therapy. Indeed, POCUS is exemplary in incorporating many components known to modulate placebo-like effects. Patient expectations, ritualistic aspects of hands-on care, symbolic power of sophisticated medical instruments, the power of real-time POCUS images, therapeutic practitioner-patient communication, and the effect of cultural and linguistic concordance all have significant potential to modulate positive or negative care effects of POCUS. Drawing from complementary and alternative medicine's discussion of characteristic and incidental factors, this review argues that POCUS should be studied as a complex medical intervention intertwined with and inextricable from diagnostic and care processes in the hospital setting. Since POCUS is a diagnostic tool with care effect potential, its similarity to the physical exam can guide preliminary ethical guidance on disclosure of potential placebo effects or efforts to maximize that potential effect. However, more data is needed to balance the benefits and risks of effective diagnosis and overdiagnosis, respectively.
    MeSH term(s) Complementary Therapies ; Heart/diagnostic imaging ; Humans ; Placebo Effect ; Point-of-Care Systems/ethics ; Ultrasonography/ethics ; Ultrasonography/psychology
    Language English
    Publishing date 2019-11-14
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80373-x
    ISSN 1529-8795 ; 0031-5982
    ISSN (online) 1529-8795
    ISSN 0031-5982
    DOI 10.1353/pbm.2019.0042
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    In stock of ZB MED Cologne/Königswinter

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  4. Article ; Online: Communicating Against the Current.

    Scales, David

    Journal of health care for the poor and underserved

    2018  Volume 29, Issue 3, Page(s) 1046–1053

    Abstract: Communicating with patients who speak different languages in health care environments is a well-known challenge, for which there are myriad solutions to provide increased access for patients with low proficiency in the language of care. Clinicians often ... ...

    Abstract Communicating with patients who speak different languages in health care environments is a well-known challenge, for which there are myriad solutions to provide increased access for patients with low proficiency in the language of care. Clinicians often overlook communication challenges with patients for whom language is not a barrier, but mismatches in cultural and personal communication styles can lead to poor communication between doctor and patient that can negatively affect the clinical relationship and patient care. Just as patients who require interpreters require more time, clinicians must expect to spend more time to navigate different communication styles. Physicians should have a high index of suspicion for communication challenges, and hospitals and clinics must provide flexible clinic environments that allow clinicians the time required to overcome them.
    MeSH term(s) Aged ; Communication Barriers ; Cultural Characteristics ; Dominican Republic/ethnology ; Hispanic Americans/psychology ; Hispanic Americans/statistics & numerical data ; Humans ; Language ; Male ; Physician-Patient Relations ; Physicians/psychology
    Language English
    Publishing date 2018-08-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1142637-8
    ISSN 1548-6869 ; 1049-2089
    ISSN (online) 1548-6869
    ISSN 1049-2089
    DOI 10.1353/hpu.2018.0078
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3605: Show issues Location:
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    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 493: Show issues

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  5. Article: An Understaffed Hospital Battles COVID-19

    Scales, David

    Health Aff (Millwood)

    Abstract: During the peak of the COVID-19 pandemic, staffing ratios reached untenable levels. ...

    Abstract During the peak of the COVID-19 pandemic, staffing ratios reached untenable levels.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #707008
    Database COVID19

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  6. Article: Multiple Evanescent White Dot Syndrome Developing Three Days following Administration of mRNA-1273 Booster Vaccine: Case Report.

    Alhabshan, Rashed / Scales, David

    Case reports in ophthalmology

    2022  Volume 13, Issue 2, Page(s) 570–577

    Abstract: Little is known about the potential ocular adverse events following mRNA-1273 vaccine. We aimed to report a case of multiple evanescent white dot syndrome (MEWDS) developing 3 days following the administration of mRNA-1273 vaccine booster. A 71-year-old ... ...

    Abstract Little is known about the potential ocular adverse events following mRNA-1273 vaccine. We aimed to report a case of multiple evanescent white dot syndrome (MEWDS) developing 3 days following the administration of mRNA-1273 vaccine booster. A 71-year-old white myopic female presented with complaints of seeing "pulsating light" and scotoma with her left eye that started about 3 days following mRNA-1273 vaccine booster administration. The patient was found to have multiple scattered white-yellow outer retinal lesions on dilated fundus exam of the left eye. Visual symptoms and exam findings continued to improve without any intervention confirming a short-lived and self-limiting disease course. Clinical presentation was consistent with a clinical diagnosis of MEWDS. Ophthalmologists need to take detailed vaccination history in patients presenting with MEWDS.
    Language English
    Publishing date 2022-07-18
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2577666-6
    ISSN 1663-2699
    ISSN 1663-2699
    DOI 10.1159/000525687
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  7. Article ; Online: Screening for Information Environments: A Role for Health Systems to Address the Misinformation Crisis.

    Scales, David / Gorman, Jack

    Journal of primary care & community health

    2022  Volume 13, Page(s) 21501319221087870

    Abstract: Misinformation about health topics is a public health issue. We are bombarded with information from many sources, across many digital means of communication, affecting the ways in which we are born, grow, work, live, and age. This makes information ... ...

    Abstract Misinformation about health topics is a public health issue. We are bombarded with information from many sources, across many digital means of communication, affecting the ways in which we are born, grow, work, live, and age. This makes information environments a social determinant of health (SDoH), but one not currently adequately addressed by clinical or public health practitioners. Since health systems are already screening for social determinants of health, existing mechanisms can additionally screen for unhealthy information environments. Then, for those patients who screen positive, we can apply best practices learned from initiatives addressing vaccine hesitancy: providing a non-judgmental environment in which to discuss health beliefs, using motivational interviewing techniques to gage patient perspectives and readiness for change, and taking a harm-reduction approach in recognizing that behavior change evolves over time. Displacing misinformation is a process, not an event. As such, we need to address the underlying psychological and sociological reasons that people maintain unscientific beliefs as we would hope to do with any other SDoH. Furthermore, as information environments are the product of both individual choices and structural factors, clinicians should approach patients immersed in unhealthy information environments without blame or ostracism, much as we would approach any patient adversely impacted by social determinants of health.
    MeSH term(s) Communication ; Government Programs ; Humans ; Mass Screening ; Public Health ; Research
    Language English
    Publishing date 2022-03-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2550221-9
    ISSN 2150-1327 ; 2150-1319
    ISSN (online) 2150-1327
    ISSN 2150-1319
    DOI 10.1177/21501319221087870
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  8. Article ; Online: Point-of-care ultrasound (POCUS): Assessing patient satisfaction and socioemotional benefits in the hospital setting.

    Balmuth, Evan A / Luan, Danny / Jannat-Khah, Deanna / Evans, Arthur / Wong, Tanping / Scales, David A

    PloS one

    2024  Volume 19, Issue 2, Page(s) e0298665

    Abstract: Point-of-care ultrasound (POCUS) is an imaging modality used to make expedient patient care decisions at bedside. Though its diagnostic utility has been extensively described, POCUS is not yet considered standard of care in inpatient settings. Data from ... ...

    Abstract Point-of-care ultrasound (POCUS) is an imaging modality used to make expedient patient care decisions at bedside. Though its diagnostic utility has been extensively described, POCUS is not yet considered standard of care in inpatient settings. Data from emergency department settings suggest that POCUS may yield socioemotional benefits beyond its diagnostic utility; furthermore, elements of the POCUS experience are known to promote placebo effects. These elements likely contribute to a placebo-like "POCUS positive care effect" (PPCE) with socioemotional benefits for receptive patients. Our objective is to provide the first characterization of the PPCE and its facilitating factors in an inpatient setting. In this novel mixed-methods study, we recruited 30 adult patients admitted to internal medicine floors in an urban academic medical center, recorded observations during their routine POCUS encounters, and administered post-encounter surveys. We conducted complementary quantitative and qualitative analyses to define and assess the magnitude of the PPCE. We also aimed to identify factors associated with and facilitating receptiveness to the PPCE. The results indicated that POCUS improves patients' satisfaction with their hospital providers and care overall, as well as perceived care efficiency. Mutual engagement, strong therapeutic alliances, and interpreting POCUS images to provide reassurance are most closely associated with this PPCE. Patients who have lower anxiety levels, less severe illness, and received efficient care delivery during their hospitalizations are most receptive to the PPCE. We conclude that diagnostic POCUS has the potential to exert a positive care effect for hospitalized patients. This PPCE is associated with modifiable factors at the patient, provider, and environment levels. Together, our findings lay the groundwork for an optimized "therapeutic POCUS" that yields maximal socioemotional benefits for receptive patients.
    MeSH term(s) Adult ; Humans ; Point-of-Care Systems ; Patient Satisfaction ; Point-of-Care Testing ; Emergency Service, Hospital ; Ultrasonography/methods ; Hospitals ; Inpatients
    Language English
    Publishing date 2024-02-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0298665
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  9. Article ; Online: Screening for Information Environments

    David Scales / Jack Gorman

    Journal of Primary Care & Community Health, Vol

    A Role for Health Systems to Address the Misinformation Crisis

    2022  Volume 13

    Abstract: Misinformation about health topics is a public health issue. We are bombarded with information from many sources, across many digital means of communication, affecting the ways in which we are born, grow, work, live, and age. This makes information ... ...

    Abstract Misinformation about health topics is a public health issue. We are bombarded with information from many sources, across many digital means of communication, affecting the ways in which we are born, grow, work, live, and age. This makes information environments a social determinant of health (SDoH), but one not currently adequately addressed by clinical or public health practitioners. Since health systems are already screening for social determinants of health, existing mechanisms can additionally screen for unhealthy information environments. Then, for those patients who screen positive, we can apply best practices learned from initiatives addressing vaccine hesitancy: providing a non-judgmental environment in which to discuss health beliefs, using motivational interviewing techniques to gage patient perspectives and readiness for change, and taking a harm-reduction approach in recognizing that behavior change evolves over time. Displacing misinformation is a process, not an event. As such, we need to address the underlying psychological and sociological reasons that people maintain unscientific beliefs as we would hope to do with any other SDoH. Furthermore, as information environments are the product of both individual choices and structural factors, clinicians should approach patients immersed in unhealthy information environments without blame or ostracism, much as we would approach any patient adversely impacted by social determinants of health.
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Demographics of the Population Experiencing Homelessness and Receiving Publicly Funded Substance Use and Mental Health Treatment Services in Delaware.

    Borton, David / Ryding, Rachel / Scales, Meisje J / Fraser, Kris

    Delaware journal of public health

    2023  Volume 9, Issue 2, Page(s) 14–17

    Abstract: Objective: To determine the prevalence of clients experiencing homelessness in publicly funded substance use and mental health services in Delaware and uncover basic patterns in the demographics and service access of said clients.: Methods: We ... ...

    Abstract Objective: To determine the prevalence of clients experiencing homelessness in publicly funded substance use and mental health services in Delaware and uncover basic patterns in the demographics and service access of said clients.
    Methods: We analyzed Consumer Reporting Form data for clients admitted to publicly funded substance use and mental health treatment. All clients who were admitted to services from a publicly-funded provider and completed the CRF between 2019 and 2021 were included in this analysis (n=29,495).
    Results: 5,717 clients (19%) reported experiencing homelessness. 20% of men reported homelessness, compared to 18% of women, and 22% of Black clients reported homelessness, compared to 19% of White clients. 48% of admissions were to substance use treatment, 29% were to mental health treatment, and 23% were to treatment for both.
    Conclusions: Nearly one-fifth of clients who received publicly funded treatment between 2019 and 2021 reported experiencing homelessness, a vast overrepresentation when compared against the less than 1% of the population who was counted as homeless through the annual PIT count in Delaware.
    Policy implications: Homelessness can be experienced across the lifespan and impacts individuals and families of all demographic makeups. Individuals are often unable to access primary care, insurance supported services, and chronic disease management teams resulting in a disproportionately high use of emergency services and departments for acute needs.
    Language English
    Publishing date 2023-06-12
    Publishing country United States
    Document type Journal Article
    ISSN 2639-6378
    ISSN (online) 2639-6378
    DOI 10.32481/djph.2023.06.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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