Comparing total medical costs of surgical treatment versus nonoperative care for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study.

Objectives: To compare the total medical costs associated with operative versus non-operative medical procedures for femoral neck fractures in older adults with Alzheimer's disease (AD).

Methods: This retrospective cohort study examined 4,157 Optum beneficiaries diagnosed with AD who filed an initial claim for femoral neck fracture between January 1, 2012, and December 31, 2017. Generalized linear regression with Gamma log link function was performed to evaluate total medical costs between surgical treatment and non-operative care while controlling for covariates.

Comparing survival rates and mortality in operative versus nonoperative treatment for femoral neck fractures among Alzheimer's disease patients: A retrospective cohort study.

Introduction: Addressing femoral neck fractures resulting from ground-level falls in older adults with Alzheimer's disease (AD) involves a personalized treatment plan. There is considerable ongoing debate concerning the relative advantages and disadvantages of surgical treatment (internal fixation or arthroplasty) vs nonoperative treatment for femoral neck fractures in older persons with AD.

Methods: This retrospective cohort study compared the mortality, hazard ratio, and survival rate between operative and nonoperative treatments, controlling for patients' demographic information and baseline health status.

The silent killer: Previously undetected pulmonary emboli that result in death after discharge.

Introduction: Pulmonary embolism (PE) is a recognized cause of death in hospitalized trauma patients, yet less is known about PE after discharge.

Patients & Methods: All post-discharge, autopsy-demonstrated, fatal PE resulting from trauma within a large US county over six years were analyzed. Counts, percentages, mean values, SD, and IQR were calculated for all variables.

Victimization in Unethical Unlicensed Small Residential Care Homes in the United States: The Case for Whole System Disruption.

In the United States, small residential care homes provide affordable community-based care for disabled older adults. Also called adult foster care homes, residential care facilities, group homes, or board and care homes, small residential care homes are typically private, small businesses operating in single-family dwellings that provide round-the-clock care in a home-like setting in residential neighborhoods. While most states license small residential care homes they also exist, legally and illegally, as unlicensed and unregulated operations.

Geospatial Analysis of Prehospital Triage and Early Potential Preventable Traumatic Deaths.

Severely injured patients often depend on prompt prehospital triage for survival. This study aimed to examine the under-triage of preventable or potentially preventable traumatic deaths. A retrospective review of Harris County, TX, revealed 1848 deaths within 24 hours of injury, with 186 being preventable or potentially preventable (P/PP).

A scoping review of nursing education for firearm safety.

Background: Firearm violence, whether intentional or accidental, affects families worldwide. Nurses often encounter firearm-related injury and death with little knowledge or preparation for dealing with firearm safety issues.

Objectives: The aim was to locate published research on nurse education in firearm safety and examine the preparation of nurses to deal with issues of firearm safety as a deterrent toward decreasing violence.

Exploring the complexity of firearm homicides in Harris County, Texas, from 2009 to 2021: Implications for theory and prevention.

Firearm violence is a major health problem in the United States that clusters asymmetrically across geographic and demographic lines, and the persistence and unequal distribution of firearm violence suggests that novel causal explanations and theoretical frameworks may be warranted to guide preventive strategies. Thus, this study explores the following three hypotheses that are grounded in complex systems theory: 1) trends in firearm homicides risks have shifted heterogeneously in Harris County across endemic degree of risk; 2) firearm homicides clusters have remained resilient in Harris County across the study time period; and 3), the associations between known contextual correlates of firearm homicides and the distribution of firearm homicides risks in Harris County have manifested as nonlinear. Using a retrospective study design (n = 4,397) from January 1, 2009-June 31, 2021, medicolegal death investigation data from the Harris County Institute of Forensic Sciences and estimates of community characteristics from the American Community Survey were analyzed using Joinpoint trend analysis, kernel density geospatial analysis, and proportion tests.

An Analysis of Traumatic and Non-Traumatic Hemopericardium Using Autopsy Data From a County Medical Examiner.

The volume of hemopericardium requiring hemodynamic changes in the trauma patient is not well understood. We performed a study using autopsy data from trauma patients who died with hemopericardium (>20 mL). Of 1848 traumatic deaths, 54 had hemopericardium at autopsy.

Trauma-Informed Approaches to Medicolegal Death Investigation: A Forensic Nursing Perspective.

Forensic nurses engaged in medicolegal death investigations experience trauma-induced responses in responding to, investigating, and documenting sudden unexpected deaths. The trauma of these repeated experiences often results in diminished performance, job dissatisfaction, and burnout. The principles of trauma-informed care are not new but have not been incorporated into death investigation practices.

Barriers to consistent and reliable investigation of sudden unexpected infant death: Perspectives from law enforcement.

Despite persistent efforts to advance infant death investigation, most sudden unexpected infant deaths (SUIDs) remain unexplained. Law enforcement officials contribute to SUID investigations throughout the United States, but their impacts on these investigations have not been adequately examined. In this exploratory study, 26 law enforcement officials were interviewed about their experiences and perspectives with SUID investigations.

Medicolegal death investigator workplace safety hazards: A scoping review of the literature.

In the United States, medicolegal death investigation practices and policies pertaining to sudden unexpected deaths are mandated by state government. Practices vary across states, which contributes to inconsistency in job prerequisites and training. In preparation for a study focused on occupational safety and health of medicolegal death investigators in their on-scene and follow-up activities, a scoping review was conducted to document known occupational safety risks and health-related conditions associated with death investigation.

Identifying gaps and improving investigation of fatal elder abuse and/or neglect.

Death investigator and autopsy reports for decedents 65 years and older within a major metropolitan area over a five-year period were assessed for the possibility of elder abuse and/or neglect. The study consisted of two stages. A simple two-question screening criteria was used to determine whether the decedent was (1) dependent on another for at least one activity of daily living and (2) had a presence of at least one indicator of abuse and/or neglect.

Forensic Nursing Research: The Basics Explained.

As a growing profession, forensic nursing requires research to establish best practice guidelines leading to evidence-based practice. In addition, forensic nursing quality improvement projects are necessary to evaluate and improve practices and policies. The purpose of this article is to provide step-by-step guidelines on research and quality improvement projects to encourage all forensic nurses to actively contribute to and utilize research in practice.

Fatal and Nonfatal Injury Patterns of Stranded Motorists.

Because nonfatal and fatal incidents for stranded motorists are not separated from vehicular accidents, little data are available on incident characteristics. To close this gap, data fields were inserted into databases at a medical examiner's office and two trauma centers to collect injury-related information. Forensic nurses and pathologists aided in forming a collaboration among the agencies involved and supported data collection efforts.

Nursing Care for Extracorporeal Membrane Oxygenation in the Trauma Patient.

Trauma patients that survive the immediate threat of death are at risk for potentially life-threatening complications such as acute respiratory distress syndrome and multisystem organ failure. Extracorporeal membrane oxygenation (ECMO) use in trauma patients has largely been controversial for concerns of inducing major hemorrhage with the use of systemic anticoagulation to prevent thrombus development while connected to the ECMO circuit. There is limited data available for specific guidelines for optimal management of the trauma population; however, recent studies suggest comparable outcomes to those of nontrauma patients treated with ECMO.

When falls become fatal-Clinical care sequence.

Objectives: This study encompassed fall-related deaths, including those who died prior to medical care, that were admitted to multiple healthcare institutions, regardless of whether they died at home, in long-term care, or in hospice. The common element was that all deaths resulted directly or indirectly from injuries sustained during a fall, regardless of the temporal relationship. This comprehensive approach provides an unusual illustration of the clinical sequence of fall-related deaths.

Nurses and Medicolegal Death Investigation.

Forensic nurses currently serve in medicolegal death investigation settings nationwide, yet registered nurses seldom recognize death investigation as a career option. The purpose of this article is to describe medicolegal death investigation in the United States and the roles nurses can achieve, depending upon state and agency job requirements. Duties and qualifications for job positions, whether filled by election, appointment, or staff hiring, are described to provide examples of nurses' roles within the medicolegal death investigation setting and to present career options.

Quality Assurance Through Standard Operating Procedures Development and Deviation: A Medicolegal Death Investigation Systems Response to the COVID-19 Pandemic.

Standard operating procedures drive everyday practice within any organization, including those within a forensic setting. In the event of unusual circumstances, organizations must respond rapidly to address the impact on operations while ensuring that the quality and safety outcomes of routine services are not affected. This case study illustrates how standard operating procedures can be newly developed or modified, and rapidly deployed and quickly revised, to address unusual circumstances.

Message Appeals on an Instagram Account Promoting Seat Belt Use That Attract Adolescents and Young Adults: Elaboration-Likelihood Perspective Study.

Background: Adolescents and young adults demonstrate the highest rate of unrestrained motor vehicle fatalities, making the promotion of seat belt restraint a priority for public health practitioners. Because social media use among adolescents and young adults has proliferated in recent years, it is critical to explore how to use this tool to promote seat belt use among this population. Social media posts can contain various types of information within each post and this information can be communicated using different modalities.

Characteristics of Trauma Mortality in Patients with Aortic Injury in Harris County, Texas.

Background: The National Academies of Science have issued a call for zero preventable trauma deaths. The mortality characteristics in all patients with aortic injury are not well described.

Methods: All prehospital and hospital medical examiner records for deaths occurring in Harris County, Texas in 2014 were retrospectively reviewed, and patients with traumatic aortic injury were selected.

Bleeding to death in a big city: An analysis of all trauma deaths from hemorrhage in a metropolitan area during 1 year.

Background: Hemorrhage is the most common cause of potentially preventable trauma deaths, but no studies have focused on all civilian traumatic deaths from hemorrhage, so we describe a year of these deaths from a large county to identify opportunities for preventing hemorrhagic deaths.

Methods: All trauma-related deaths in Harris County, Texas, in 2014 underwent examination by the medical examiner; patients were excluded if hemorrhage was not their primary reason for death. Deaths were then categorized as preventable/potentially preventable hemorrhage (PPH) or nonpreventable hemorrhage.