Publications by authors named "Apoorva Salvi"
Objective: Among children transported by ambulance across the United States, we used machine learning models to develop a risk prediction tool for firearm injury using basic demographic information and home ZIP code matched to publicly available data sources.
Methods: We included children and adolescents 0-17 years transported by ambulance to acute care hospitals in 47 states from January 1, 2014 through December 31, 2022. We used 96 predictors, including basic demographic information and neighborhood measures matched to home ZIP code from 5 data sources: EMS records, American Community Survey, Child Opportunity Index, County Health Rankings, and Social Vulnerability Index.
Importance: High emergency department (ED) pediatric readiness is associated with improved survival among children receiving emergency care, but state and national costs to reach high ED readiness and the resulting number of lives that may be saved are unknown.
Objective: To estimate the state and national annual costs of raising all EDs to high pediatric readiness and the resulting number of pediatric lives that may be saved each year.
Design, Setting, And Participants: This cohort study used data from EDs in 50 US states and the District of Columbia from 2012 through 2022.
Article Synopsis
- The study investigates how changes in pediatric readiness in emergency departments (EDs) at US trauma centers from 2013 to 2021 relate to the mortality rates of injured children.
- It used the weighted Pediatric Readiness Score (wPRS) to categorize EDs into four readiness change groups, allowing for a comparison of outcomes based on their level of readiness.
- Results showed that higher ED pediatric readiness is linked to fewer pediatric deaths, emphasizing the importance of improved emergency care for children in trauma settings.
Article Synopsis
- A study focused on understanding the causes and timing of deaths among children needing emergency care was conducted, aiming to improve interventions.
- The research involved over 546,000 children across six states from 2012 to 2017, highlighting that 2.2% of injured children and 1.4% of medically ill children died within a year.
- Most deaths occurred in emergency departments or hospitals, with major causes being motor vehicle collisions and infant-related conditions, suggesting that enhancing emergency care could improve pediatric outcomes.
Background: Veterans Affairs (VA) home-based primary care (HBPC) provides comprehensive longitudinal care to patients with complex, chronic disabling disease. While enrollment is associated with lower hospitalization rates and costs, detailed trajectories have not been well described.
Methods: We performed a longitudinal descriptive study of patients newly enrolled in VA HBPC in fiscal year (FY) 2015.
Importance: Emergency department (ED) pediatric readiness is associated with improved survival among children. However, the association between geographic access to high-readiness EDs in US trauma centers and mortality is unclear.
Objective: To evaluate the association between the proximity of injury location to receiving trauma centers, including the level of ED pediatric readiness, and mortality among injured children.
Importance: Emergency departments (EDs) with high pediatric readiness (coordination, personnel, quality improvement, safety, policies, and equipment) are associated with lower mortality among children with critical illness and those admitted to trauma centers, but the benefit among children with more diverse clinical conditions is unknown.
Objective: To evaluate the association between ED pediatric readiness, in-hospital mortality, and 1-year mortality among injured and medically ill children receiving emergency care in 11 states.
Design, Setting, And Participants: This is a retrospective cohort study of children receiving emergency care at 983 EDs in 11 states from January 1, 2012, through December 31, 2017, with follow-up for a subset of children through December 31, 2018.
Objective: We used machine learning to identify the highest impact components of emergency department (ED) pediatric readiness for predicting in-hospital survival among children cared for in US trauma centers.
Background: ED pediatric readiness is associated with improved short-term and long-term survival among injured children and part of the national verification criteria for US trauma centers. However, the components of ED pediatric readiness most predictive of survival are unknown.
Background: Quality of life outcomes have been used frequently in clinical trials of oral health interventions. This study assessed the effects of a randomized trial on oral health related quality of life comparing an individual-based oral hygiene intervention to a community-based intervention.
Methods: Participants were recruited from six low-income senior housing residences.
Background: This paper compares the relationship between theoretically-driven mechanisms of change and clinical outcomes across two different interventions to improve oral hygiene of older adults participating in a group randomized trial.
Methods: Six low-income senior residences were paired and randomized into two groups. The first received a face to face counseling intervention (AMI) and the second, a peer-facilitated health campaign (three oral health fairs).
Objectives: To evaluate whether the cumulative effect of an individual-level intervention followed by a building-level intervention, both based on Fishbein's Integrated Model of Behavior Change, has a better effect on oral hygiene clinical outcomes than the sequence of the building-level intervention followed by the individual-level intervention; to determine the added effect of each intervention on the other; to identify the psychosocial mechanisms that might explain the differences.
Methods: Six low-income senior housing complexes were enrolled in the study, and participants were recruited from these buildings. Buildings were randomly assigned to receive either the individual counselling intervention first followed by the building-level intervention, or the building-level intervention first followed by the individual intervention.
Inconsistent outcomes of oral hygiene interventions require testable theories combining cognitive and behavioral domains to guide intervention and improve results. This article evaluates the integrated model as a cognitive-behavioral approach to improve oral health clinical outcomes in ethnically diverse low-income older adults. Baseline data from a clinical trial utilizing the integrative model (IM) model evaluated predictors of gingival index (GI) and plaque score (PS).
View Article and Find Full Text PDFObjective: This paper describes a new scale to measure worries about self-management of oral hygiene in low-income older adults.
Background: Oral hygiene that prevents oral diseases and worsening of chronic conditions improves with instruction, but other cognitive/emotional factors impede oral hygiene practice especially among older adults. Many scales measure dental anxiety, but none measures oral hygiene self-management worries.
The Impact of Perceptions of Community Stigma on Utilization of HIV Care Services.
J Racial Ethn Health Disparities
April 2020
The relationship between perceived community stigma and treatment adherence has been established in previous literature. Yet, less is known about explicit circumstances in which perceived community stigma deters people living with HIV (PLWH) from maintaining care. This research examines the impact of perceived community stigma against PLWH on self-reported barriers and supports to remain in HIV care services.
View Article and Find Full Text PDFObjective: Nearly 300 million people in India use some type of tobacco product, with about 60% of those using smokeless tobacco. Smokeless tobacco use has been associated with a number adverse health outcomes in India and across South Asia.
Method: A cross-sectional study of outpatients at a dental hospital in Navi Mumbai, India was conducted between January and June 2015.