This article discusses the evaluation of secondary care in the area of health surveillance. This was a descriptive and normative/evaluative study. Performance analysis drew on secondary data, based on a historical series of dental procedures conducted at the specialized dental clinics implemented in Brazil and recorded by the Outpatient Information System of the Unified National Health System (SIA/SUS) in 2007, as well as primary data from site visits to the clinics, based on questionnaires completed by clinic staff. Performance of the clinics was poor in most regions of the country, and the North of Brazil had the lowest percentage of specialty services implemented. The indicator "Performance of Secondary Care in Oral Health" was 64.4%. The type 3 specialty clinics showed better results in terms of performance and achievement of targets. The study showed the need to review the legal framework for implementing specialized dental clinics by adjusting the criteria and norms, as well as definition of new standards for achievement of goals in the evaluation and monitoring of these services.
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http://dx.doi.org/10.1590/s0102-311x2012001300009 | DOI Listing |
JAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
JAMA Netw Open
January 2025
Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (IMHAY), Santiago, Chile.
Importance: Mental health stigma is a considerable barrier to help-seeking among young people.
Objective: To systematically review and meta-analyze randomized clinical trials (RCTs) of interventions aimed at reducing mental health stigma in young people.
Data Sources: Comprehensive searches were conducted in the CENTRAL, CINAHL, Embase, PubMed, and PsycINFO databases from inception to February 27, 2024.
JAMA Netw Open
January 2025
Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.
Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.
Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.
Crit Care Explor
January 2025
All authors: Department of Pharmacy, Brigham and Women's Hospital, Boston, MA.
Importance: Recent studies have found an association between COVID-19 infection and deeper sedation in mechanically ventilated patients, raising concerns about the impact of the COVID-19 pandemic on pain, agitation, and delirium (PAD) management practices overall.
Objectives: This study aimed to assess differences in PAD management in patients without COVID-19 infection in pre- and peri-COVID-19 pandemic timeframes.
Design, Setting, And Participants: This was a single-center, retrospective, pre-/post-cohort analysis of mechanically ventilated adult patients without COVID-19 infection admitted to an ICU in Boston, MA.
Pain Ther
January 2025
Robert Wood Johnson University Hospital/Rutgers Medical School, New Brunswick, NJ, USA.
Introduction: Many interventional strategies are commonly used to treat chronic low back pain (CLBP), though few are specifically intended to target the distinct underlying pathomechanisms causing low back pain. Restorative neurostimulation has been suggested as a specific treatment for mechanical CLBP resulting from multifidus dysfunction. In this randomized controlled trial, we report outcomes from a cohort of patients with CLBP associated with multifidus dysfunction treated with restorative neurostimulation compared to those randomized to a control group receiving optimal medical management (OMM) over 1 year.
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