Preventable Emergency Department Utilization Among Patients With Foster Care History Compared to Patients Without Foster Care History.

Emergency department (ED) utilization for preventable reasons by patients with foster care history is unexplored. Medical records of ED encounters from primary care patients were pulled from a southwestern children's hospital system. Necessity of ED encounter was categorized using the New York University- ED Algorithm into emergent, intermediate, or non-emergent.

Risk Factor Prediction and Categorization for Glenohumeral Osteoarthritis: A Classification and Regression Tree (CART) Analysis.

Objective: This study aimed to apply Classification and Regression Tree (CART) analysis to determine factors associated with glenohumeral osteoarthritis (GH OA) and establish specific cut-off points for risk factors based on this methodology.

Design: The cross-sectional study included 3,383 participants with shoulder pain. Cases were selected for GH OA.

Child maltreatment and behavioral health outcomes in child welfare: Exploring the roles of severity and polyvictimization.

Background: Child maltreatment and polyvictimization are known risk factors for long-term detrimental health and development outcomes, including behavioral health challenges. However, effects from specific types and combinations of maltreatments are unclear. This study examined the association between maltreatment or polyvictimization and behavioral health in a child welfare sample.

Child Care Center Staff Readiness to Change in an Early Childhood Obesity Prevention Program.

Context: The childcare center (CCC) setting has the potential to be a strong foundation that supports the introduction of sustainable healthy lifestyle behaviors to prevent childhood obesity. It is important to assess barriers and facilitators to healthy weight development initiatives via program evaluation, including measuring CCC staff readiness to change.

Objective: The overall goal of this study was to assess the readiness level over 1 school year among CCC staff who participated in "Healthy Caregivers-Healthy Children" (HC2), a cluster randomized controlled trial that evaluated the effectiveness of a childhood obesity prevention program from 2015 to 2018 in 24 low-income, racially/ethnically diverse centers.

Past-Year HIV Testing, Current Antiretroviral Therapy Use, and Participation in Services for People Who Inject Drugs.

Evaluating routine HIV testing and treatment and use of services for people who inject drugs (PWID) is critical to curb the ongoing HIV epidemic. We analyzed data from the 2018 National HIV Behavioral Surveillance of PWID aged 18 years or older, recruited using respondent-driven sampling and offered anonymous HIV testing after survey. We performed bivariate and multivariable analyses with log-linked Poisson regression of the generalized linear models to examine the associations between demographics and PWID service use, past-year HIV testing, and current antiretroviral therapy (ART) use.

Clinical decision support tools useful for identifying sepsis risk.

Purpose: Evaluate the effectiveness of the clinical decision support tools (CDSTs), POC Advisor (POCA), and Modified Early Warning System (MEWS) in identifying sepsis risk and influencing time to treatment for inpatients, comparing their respective alert mechanisms.

Methods: This study was conducted at two academic university medical center hospitals. Data from adult inpatients in medical-surgical and telemetry units were analyzed from January 1, 2020, to December 31, 2020.

Application of inverse weighting analysis to assess the association of youth perceptions with the age of initiation of tobacco products.

Introduction: To examine if perceptions of harmfulness and addictiveness of hookah and cigarettes impact the age of initiation of hookah and cigarettes, respectively, among US youth. Youth (12-17 years old) users and never users of hookah and cigarettes during their first wave of PATH participation were analyzed by each tobacco product (TP) independently. The effect of perceptions of (i) harmfulness and (ii) addictiveness at the first wave of PATH participation on the age of initiation of ever use of hookah was estimated using interval-censoring Cox proportional hazards models.

Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite.

Objectives: The purpose of this pilot study was to obtain baseline quantitative pupillometry (QP) measurements before and after catheter-directed cerebral angiography (DCA) to explore the hypothesis that cerebral angiography is an independent predictor of change in pupillary light reflex (PLR) metrics.

Design: This was a prospective, observational pilot study of PLR assessments obtained using QP 30 min before and after DCA. All patients had QP measurements performed with the NPi-300 (Neuroptics) pupillometer.

Racial and Ethnic Disparities in the Medical Management of Poststroke Complications Among Patients With Acute Stroke.

Background: To inform clinical practice, we sought to identify racial and ethnic differences in the medical management of common poststroke complications.

Methods And Results: A cohort of acutely hospitalized, first-time non-Hispanic White (NHW), non-Hispanic Black, and Hispanic patients with stroke was identified from electronic medical records of 51 large health care organizations (January 1, 2003 to December 5, 2022). Matched propensity scores were used to account for baseline differences.

Association of Age and Sex at Onset With Glenohumeral Osteoarthritis: A Systematic Review and Meta-analysis.

Objective: The aim of the present systematic review is to synthesize existing evidence (qualitative and quantitative) regarding age- and sex-specific differences with glenohumeral osteoarthritis.

Design: The electronic databases PubMed, MEDLINE, and Web of Science were searched up to March 15, 2023. Articles reporting on the association of risk factors (age and sex) with glenohumeral osteoarthritis were considered.

Factors Associated with the Decision to Complete Bariatric Metabolic Surgery among a Racially and Ethnically Diverse Sample of Adults: A Classification and Regression Tree Analysis.

Background: Less than 50% of eligible candidates who are referred complete Bariatric Metabolic Surgery (BMS). The factors influencing the decision to complete BMS, particularly how these factors vary across different racial and ethnic groups, remain largely unexplored.

Methods: This prospective cohort study included adult patients referred to a bariatric surgeon or obesity medicine program between July 2019-September 2022.

The Use of Electronic Health Record Data to Identify Variation in Referral, Consent, and Engagement in a Pediatric Intervention for Overweight and Obesity: A Cross-Sectional Study.

Clinical weight management programs face low participation. The authors assessed whether using electronic health record (EHR) data can identify variation in referral, consent, and engagement in a pediatric overweight and obesity (OW/OB) intervention. Using Epic EHR data collected between August 2020 and April 2021, sociodemographic and clinical diagnostic data (ie, [ICD] codes from visit and problem list [PL]) were analyzed to determine their association with referral, consent, and engagement in an OW/OB intervention.

Family-based pediatric weight management interventions in US primary care settings targeting children ages 6-12 years old: A systematic review guided by the RE-AIM framework.

Obesity is a pandemic that disproportionately affects children from vulnerable populations in the USA. Current treatment approaches in primary care settings in the USA have been reported to be insufficient at managing pediatric obesity, primarily due to implementation challenges for healthcare systems and barriers for families. While the literature has examined the efficacy of pediatric obesity interventions focused on internal validity, it lacks sufficient reporting and analysis of external validity necessary for successful translation to primary care settings.

Differences in Use of Clinical Decision Support Tools and Implementation of Aspirin, Blood Pressure Control, Cholesterol Management, and Smoking Cessation Quality Metrics in Small Practices by Race and Sex.

Importance: Practice-level evidence is needed to clarify the value of population-based clinical decision support (CDS) tools in reducing racial and sex disparities in cardiovascular care.

Objective: To evaluate the association between CDS tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices.

Design, Setting, And Participants: This cross-sectional study used practice-level data from the Agency for Healthcare Research and Quality-funded EvidenceNOW initiative.

Variability in the Transition of Care to Poststroke Rehabilitation During the First Wave of COVID-19.

Objective: The aim of the study is to evaluate transitions of acute stroke and inpatient rehabilitation facility care during the first wave of COVID-19.

Design: This is a retrospective observational study (3 comprehensive stroke centers with hospital-based inpatient rehabilitation facilities) between January 1, 2019, and May 31, 2019 (acute stroke = 584, inpatient rehabilitation facility = 210) and January 1, 2020, and May 31, 2020 (acute stroke = 534, inpatient rehabilitation facility = 186). Acute stroke characteristics included stroke type, demographics, and medical comorbidities.

Effect of inpatient rehabilitation facility care on ninety day modified Rankin score in ischemic stroke patients.

Objective: To determine Inpatient Rehabilitation Facility (IRF) treatment effect on modified Rankin Scale (mRS) scores at 90 days in acute ischemic stroke (AIS) patients.

Materials And Methods: This prospective cross-sectional study included 738 AIS patients admitted 1/1/2018-12/31/2020 to a Comprehensive Stroke Center with a Stroke Rehabilitation program. We compared outcomes for patients who went directly home versus went to IRF at hospital discharge: (1) acute care length of stay (LOS), (2) National Institutes of Health Stroke Scale (NIHSS) score, (3) mRS score at hospital discharge and 90 days, (4) the proportion of mRS scores ≤ 2 from hospital discharge to 90 days.

Longitudinal depression screening of frontline critical care nurses during the COVID-19 pandemic: A mixed-methods study.

Purpose: To evaluate the severity and longitudinal trends of depression in critical care nurses caring for patients with COVID-19 in the US during a global pandemic.

Methods: The study employed longitudinal mixed methods. Using the Patient Health Questionnaire (PHQ-9), nurses were sent electronic surveys at baseline, 1 month, and between 3 and 6 months to measure the severity and trends of depression during the prevaccination stage of the COVID-19 pandemic.

Efficacy of a Primary Care eHealth Obesity Treatment Pilot Intervention Developed for Vulnerable Pediatric Patients.

Challenges to treat excess weight in primary care settings include time constraints during encounters and barriers to multiple visits for patient families, especially those from vulnerable backgrounds. Dynamo Kids! (DK), a bilingual (English/Spanish) e-health intervention, was created to address these system-level challenges. This pilot study assessed the effect of DK use on parent-reported healthy habits and child BMI.

Precise Estimation for the Age of Initiation of Tobacco Use Among U.S. Youth: Finding from the Population Assessment of Tobacco and Health (PATH) Study, 2013-2017.

Context: Youth tobacco use remains a prominent United States public health issue with a high economic and health burden.

Method: We pooled never and ever users at youth's first wave of PATH participation (waves 1-3) to estimate age of initiation for hookah, e-cigarettes, cigarettes, traditional cigars, cigarillos, and smokeless tobacco prospectively (waves 2-4). Age of initiation of each tobacco product was estimated using weighted interval-censored survival analyses.

Relationship between teacher fidelity to an early childhood obesity prevention program and the Child care center nutrition and physical activity environment.

Background: Child care centers (CCC) can be strategic settings to establish healthy lifestyle behaviors through obesity prevention programs. Fidelity to the implementation of such programs is a vital evaluation component, but is often not measured. This study assessed CCC teacher fidelity to the implementation of "Healthy Caregivers, Healthy Children (HC2)", a CCC-based obesity prevention intervention.

Prevalence of polypharmacy and associated adverse outcomes and risk factors among children with asthma in the USA: a cross-sectional study.

Objective: To estimate the prevalence of polypharmacy, identify risk factors and examine related adverse outcomes in the US children with asthma.

Design, Setting And Participants: This population-based, cross-sectional study included 1776 children with asthma from the 2011-2020 National Health and Nutrition Examination Surveys.

Exposures: Polypharmacy is defined as taking ≥2 medications concurrently for ≥1 day over the past 30 days.

Incidence of and predictors for serious opioid-related adverse drug events.

Purpose: To determine the incidence of and predictors for serious opioid-related adverse drug events (ORADEs) in postoperative inpatients.

Methods: A retrospective cohort study design of serious ORADEs in surgical inpatients between 2015 and 2017, who were abstracted from the electronic health record, in an 800-bed academic medical health center.

Results: A total of 27,942 surgery patients met the inclusion criteria.