Why Do Patients Opt for the Emergency Department over Other Care Choices? A Multi-Hospital Analysis.

Introduction: There are several options for receiving acute care besides emergency departments (ED), such as primary care physician (PCP) offices, urgent care centers (UCC), and telehealth services. It is unknown whether these alternative modes of care have decreased the number of ED visits for patients or whether they are considered before visiting the ED. A comprehensive study considering all potential methods of care is needed to address the evolving landscape of healthcare.

"Are you a homophobic racist?": Applying lay theory of generalized prejudice to the discrimination-distress link.

Objectives: The present research aimed to examine, among lesbian, gay, bisexual, transgender, and queer (LGBTQ +) people of color, whether experiencing discrimination rooted in one stigmatized identity (e.g., racial/ethnic minority identity) would be positively associated with expecting discrimination rooted in both the same (e.

We want to know: patient comfort speaking up about breakdowns in care and patient experience.

Objective: To assess patient comfort speaking up about problems during hospitalisation and to identify patients at increased risk of having a problem and not feeling comfortable speaking up.

Design: Cross-sectional study.

Setting: Eight hospitals in Maryland and Washington, District of Columbia.

The burden of hepatitis C to the United States Medicare system in 2009: Descriptive and economic characteristics.

Unlabelled: The aim of this work was to estimate and describe the Medicare beneficiaries diagnosed with hepatitis C virus (HCV) in 2009, incremental annual costs by disease stage, incremental total Medicare HCV payments in 2009 using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data covering the years 2002 to 2009. We weighted the 2009 SEER-Medicare data to create estimates of the number of patients with an HCV diagnosis, used an inverse probability-weighted two-part, probit, and generalized linear model to estimate incremental per patient per month costs, and used simulation to estimate annual 2009 Medicare burden, presented in 2014 dollars. We summarized patient characteristics, diagnoses, and costs from SEER-Medicare files into a person-year panel data set.

Does suppressing the thought of a self-relevant stigma affect interpersonal interaction?

In the current study, we examined the effects of women's suppressing negative gender stereotypes while interacting with a male confederate. Compared with control participants, those who suppressed negative thoughts about women's ability experienced less self-confidence, lower self-esteem, and were more nonverbally submissive during the interaction, particularly if they were high in stigma consciousness (Pinel, 1999). These findings illustrate the negative intra- and interpersonal consequences of stigma suppression.

Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative.

Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente's Community Health Initiative-a community-based obesity prevention effort.

Using psyscope to conduct IAT experiments on Macintosh computers.

The Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) is one of the most widely used tools for assessing implicit attitudes. To date, most IAT experiments have been run using Inquisit, a PC-based program. In the present article, we describe a method for conducting IAT experiments using PsyScope, a free, downloadable, Macintosh-based program (see Bonatti, n.

Characterization of the human cytomegalovirus gH/gL/UL128-131 complex that mediates entry into epithelial and endothelial cells.

The entry of human cytomegalovirus (HCMV) into biologically relevant epithelial and endothelial cells involves endocytosis followed by low-pH-dependent fusion. This entry pathway is facilitated by the HCMV UL128, UL130, and UL131 proteins, which form one or more complexes with the virion envelope glycoprotein gH/gL. gH/gL/UL128-131 complexes appear to be distinct from the gH/gL/gO complex, which likely facilitates entry into fibroblasts.

Estimated prevalence of peripheral neuropathy and associated pain in adults with diabetes in France.

Objective: To estimate the point prevalence of diabetic peripheral neuropathy (DPN) and pain associated with DPN (pDPN) in French adults with diabetes and compare severity of symptoms across demographic subpopulations.

Design: The participant-administered portion of the Michigan Neuropathy Screening Instrument (MNSI) and selected items of the Brief Pain Inventory (BPI) formed part of a computer-aided telephone survey posed to a representative, random sample of French households from March 1, 2005 to April 30, 2005. Questions from the MNSI and the BPI were used to assess the point prevalence of DPN and pDPN in French adults with self-reported diabetes.

Human cytomegalovirus attenuates interleukin-1beta and tumor necrosis factor alpha proinflammatory signaling by inhibition of NF-kappaB activation.

Viral infection is associated with a vigorous inflammatory response characterized by cellular infiltration and release of the proinflammatory cytokines interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha). In the present study, we identified a novel function of human cytomegalovirus (HCMV) that results in inhibition of IL-1 and TNF-alpha signaling pathways. The effect on these pathways was limited to cells infected with the virus, occurred at late times of infection, and was independent of cell type or virus strain.

An account of co-ordination mechanisms for humanitarian assistance during the international response to the 1994 crisis in Rwanda.

This paper examines the co-ordination strategies developed to respond to the Great Lakes crisis following the events of April 1994. It analyses the different functions and mechanisms which sought to achieve a co-ordinated response--ranging from facilitation at one extreme to management and direction at the other. The different regimes developed to facilitate co-ordination within Rwanda and neighbouring countries, focusing on both inter-agency and inter-country co-ordination issues, are then analysed.

School-based health centers. Students' access, knowledge, and use of services.

Objective: To examine students' knowledge, barriers to access, and use of services at two school-based health centers.

Design: In-person survey.

Settings: Two urban public schools in Baltimore, Md.

Recent trends in the international relief system.

Since 1991 the international relief system has been undergoing a process of rapid and fundamental change associated with the end of the Cold War period. The principal changes concern (i) the international community's approach to national sovereignty and the 'right' of armed intervention in support of humanitarian objectives, and (ii) organisatwnal changes aimed at improving the coordination and effectiveness of the response by donor organisations and the United Nations. This paper describes these changes and attempts to place them in the context of earlier trends within the international relief system, notably the enhanced role of non-governmental organisations, which occurred during the 1980s.

The African food crisis of 1982-1986*.

The crisis cannot be attributed to any one cause, but rather it was the product of a number of interacting factors whose precise combination varied between countries. Drought, internal political and economic factors and an unfavourable external economic environment were significant contributory factors. Civil war and externally financed insurgency were primarily responsible for propelling a food crisis into a famine in four out of the six worst affected countries.