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  1. Article: Characteristics of California Emergency Departments in Centers for Disease Control and Prevention-Designated HIV Priority Counties.

    Bennett, Christopher L / Clay, Carson E / Siddiqi, Khairul A / Olatosi, Bankole A / Parsonnet, Julie / Camargo, Jr Carlos A

    The Journal of emergency medicine

    2023  Volume 64, Issue 1, Page(s) 93–102

    Abstract: Background: Refocused national HIV testing initiatives include a geographic focus.: Objective: Using a geographic focus, we sought to identify which emergency departments (EDs) might be the most efficient targets for future HIV testing efforts, using ...

    Abstract Background: Refocused national HIV testing initiatives include a geographic focus.
    Objective: Using a geographic focus, we sought to identify which emergency departments (EDs) might be the most efficient targets for future HIV testing efforts, using California as an example.
    Methods: Retrospective analysis of California EDs, emergency physicians, and patients served, along with county-level estimates of HIV prevalence and proportion of the population living in poverty. Emphasis was placed on characterizing EDs affiliated with teaching hospitals and those located in Centers for Disease Control (CDC) and Prevention HIV priority counties.
    Results: Of the 320 EDs studied, 178 were in priority counties, 29 were affiliated with teaching hospitals, and 24 had both characteristics. Of the 12,869,889 ED visits included, 61.8% occurred in priority counties, 14.7% in EDs affiliated with teaching hospitals, and 12.0% in EDs with both characteristics. The subset of EDs in priority counties with teaching hospital affiliations (compared with priority and nonpriority county ED groups without a teaching hospital affiliation) had higher overall median visit volumes and higher proportions of visits by at-risk and CDC-targeted populations (e.g., individuals who were homeless, those who identified as Black or African American race, and those who identified as Hispanic or Latino ethnicity, all p < 0.01).
    Conclusions: EDs in priority counties affiliated with teaching hospitals are major sources of health care in California. These EDs more often serve populations disproportionately impacted by HIV. These departments are efficient targets to direct testing efforts. Increasing testing in these EDs could reduce the burden of undiagnosed HIV in California.
    MeSH term(s) Humans ; United States ; Retrospective Studies ; Emergency Service, Hospital ; California ; Hospitals, Teaching ; HIV Infections/diagnosis ; Centers for Disease Control and Prevention, U.S.
    Language English
    Publishing date 2023-01-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2022.10.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Substance use as a mediator of the association between demographics, suicide attempt history, and future suicide attempts in emergency department patients

    Arias, Sarah A. / Dumas, Orianne / Sullivan, Ashley F. / Boudreaux, Edwin D. / Miller, Ivan / Camargo Jr., Carlos A.

    Crisis

    2016  Volume 37, Issue 5, Page(s) 385–391

    Abstract: Background: Identification of factors that predict and protect against attempted suicide are critical for the development of effective suicide prevention and intervention programs. Aims: To examine whether substance use mediates the association between ... ...

    Abstract Background: Identification of factors that predict and protect against attempted suicide are critical for the development of effective suicide prevention and intervention programs. Aims: To examine whether substance use mediates the association between demographic characteristics, suicide attempt history, and reports of a suicide attempt within 12 months after screening positive for active suicidal ideation or behavior during the index emergency department (ED) visit. Method: Data were collected during the first two phases of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study. Data collection included baseline interview; 6- and 12-month chart reviews; and 6-, 12-, 24-, 36-, and 52-week telephone follow-up assessments. Structural equation modeling was used. All p values were two-tailed, with p < .05 considered statistically significant. Results: Among the 874 subjects, 195 (22%) reported a suicide attempt within 12 months after the index ED visit. Of participants reporting a suicide attempt, 59% were < 40 years old, 59% female, and 76% non-Hispanic White. Associations between race, sex, and suicide attempt 12 months after the index ED visit may be mediated by a combination of alcohol misuse and cocaine use. Conclusion: Findings from the mediation analyses provide insight into the impact of substance use on future suicide attempts in various sociodemographic groups.
    Keywords Attempted Suicide ; Demographic Characteristics ; Demographische Merkmale ; Drogenkonsum ; Drug Usage ; Emergency Services ; Hospitalized Patients ; Krankengeschichte ; Notdienste ; Patient History ; Stationäre Patientinnen und Patienten ; Suizidversuch
    Language English
    Document type Article
    ZDB-ID 801380-9
    ISSN 2151-2396 ; 0227-5910
    ISSN (online) 2151-2396
    ISSN 0227-5910
    DOI 10.1027/0227-5910/a000380
    Database PSYNDEX

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  3. Article ; Online: Confirmatory spirometry for adults hospitalized with a diagnosis of asthma or chronic obstructive pulmonary disease exacerbation

    Prieto Centurion Valentin / Huang Frank / Naureckas Edward T / Camargo Jr Carlos A / Charbeneau Jeffrey / Joo Min J / Press Valerie G / Krishnan Jerry A

    BMC Pulmonary Medicine, Vol 12, Iss 1, p

    2012  Volume 73

    Abstract: Abstract Background Objective measurement of airflow obstruction by spirometry is an essential part of the diagnosis of asthma or COPD. During exacerbations, the feasibility and utility of spirometry to confirm the diagnosis of asthma or chronic ... ...

    Abstract Abstract Background Objective measurement of airflow obstruction by spirometry is an essential part of the diagnosis of asthma or COPD. During exacerbations, the feasibility and utility of spirometry to confirm the diagnosis of asthma or chronic obstructive pulmonary disease (COPD) are unclear. Addressing these gaps in knowledge may help define the need for confirmatory testing in clinical care and quality improvement efforts. This study was designed to determine the feasibility of spirometry and to determine its utility to confirm the diagnosis in patients hospitalized with a physician diagnosis of asthma or COPD exacerbation. Methods Multi-center study of four academic healthcare institutions. Spirometry was performed in 113 adults admitted to general medicine wards with a physician diagnosis of asthma or COPD exacerbation. Two board-certified pulmonologists evaluated the spirometry tracings to determine the proportion of patients able to produce adequate quality spirometry data. Findings were interpreted to evaluate the utility of spirometry to confirm the presence of obstructive lung disease, according to the 2005 European Respiratory Society/American Thoracic Society recommendations. Results There was an almost perfect agreement for acceptability (κ = 0.92) and reproducibility (κ =0.93) of spirometry tracings. Three-quarters (73%) of the tests were interpreted by both pulmonologists as being of adequate quality. Of these adequate quality tests, 22% did not present objective evidence of obstructive lung disease. Obese patients (BMI ≥30 kg/m 2 ) were more likely to produce spirometry tracings with no evidence of obstructive lung disease, compared to non-obese patients (33% vs. 8%, p = 0.007). Conclusions Adequate quality spirometry can be obtained in most hospitalized adults with a physician diagnosis of asthma or COPD exacerbation. Confirmatory spirometry could be a useful tool to help reduce overdiagnosis of obstructive lung disease, especially among obese patients.
    Keywords Asthma ; COPD ; Exacerbation ; Hospitalization ; Spirometry ; Quality improvement ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Subject code 610
    Language English
    Publishing date 2012-12-01T00:00:00Z
    Publisher BioMed Central
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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