A Decade of Diabetes Hospitalizations: Meaningful Information for Community-Based Health Services Administrators for Identifying and Assessing Risk

The American Diabetes Association has established that the largest contributor of expenditures related to the cost of care for diabetes is inpatient hospital care. Research has shown that when multiple hospitalizations have been examined, patients diagnosed with diabetes have higher same year readmission rates. Medicare-enrolled patients with coronary artery disease and diabetes who participated in a diabetes management intervention that included self-care behavior instructions and nurse management had fewer emergency room visits and hospitalizations for diabetes related care. In the US, an aging population and expected changes in the ethnic composition prompts an alert to actively address the need for prevention, early detection, reduction of associated complications experienced, and exploration of a cure of the chronic condition of diabetes. This study’s purpose was two-fold: to examine the variability in hospitalization rates of diabetes by geographical location and age groups from 2000-2011 to examine any statistically significant relationships. The study further proposes the exploration of low-cost technology mechanisms to reduce diabetes related hospitalizations through the use of mHealth. Practical interventions using mHealth technologies are feasible solutions to addressing virtual prevention efforts and improving the outcomes of care among patients diagnosed with diabetes

Recommendations for Exploring the Impact of the Opioid Epidemic: A Proposed Management Framework

It is imperative to prepare Business School Health Services Administration (HSAD) graduates with management tools to assess patient need and reduce barriers to care alongside clinicians. HSAD programs require interprofessional learning activities to shape competency and skill in community needs assessment. This HSAD program works collaboratively across the University community and with external partners to offer such an experience. Integrating this concept into the curriculum encourages graduates as early careerists to implement services and resources for patient need. Understanding that problems exists is a precursor to an economic valuation of such prevalent conditions as the dynamic opioid epidemic

Addressing Adversities in Caring for Mental Health in Rural Settings: A Conversation with Rural Mental Healthcare Practice Co-founder Dr. Taryn S. Van Gilder-Pierce

Due to lack of mental healthcare facilities in rural areas, the population often resorts to private practice practitioners to address their need for mental health services. Dr. Taryn S. Van Gilder-Pierce and her husband, Dr. William D. Pierce founded their private practice in Yankton, SD in 2001. She has more than 25 years of training and experience treating individuals, married couples, families, and groups in rural South Dakota. The interview delves into the challenges faced by early career professionals in building a practice in remote areas and extends into the room for expansion within the field of rural mental health provision of services

Risk Factors of Fall-Related Emergency Department Visits by Fall Location of Older Adults in the US

Introduction: Prior evidence indicates that predictors of older adult falls vary by indoor-outdoor location of the falls. While a subset of United States’ studies reports this finding using primary data from a single geographic area, other secondary analyses of falls across the country do not distinguish between the two fall locations. Consequently, evidence at the national level on risk factors specific to indoor vs outdoor falls is lacking. Methods: Using the 2017 Nationwide Emergency Department Sample (NEDS) data, we conducted a multivariable analysis of fall-related emergency department (ED) visits disaggregated by indoor vs outdoor fall locations of adults 65 years and older (N = 6,720,937) in the US. Results: Results are compatible with findings from previous primary studies. While women (relative risk [RR] = 1.43, 95% confidence interval [CI], 1.42-1.44) were more likely to report indoor falls, men were more likely to present with an outdoor fall. Visits for indoor falls were highest among those 85 years and older (RR = 2.35, 95% CI, 2.33-2.37) with outdoor fall visits highest among those 84 years and younger. Additionally, the probabilities associated with an indoor fall in the presence of chronic conditions were consistently much higher when compared to an outdoor fall. We also found that residence in metropolitan areas increased the likelihood of an indoor elderly fall compared to higher outdoor fall visits from seniors in non-core rural areas, but both indoor and outdoor fall visits were higher among older adults in higher income ZIP codes. Conclusion: Our findings highlight the contrasting risk profile for elderly ED patients who report indoor vs outdoor falls when compared to the elderly reporting no falls. In conjunction, we highlight implications from three perspectives: a population health standpoint for EDs working with their primary care and community care colleagues; an ED administrative vantage point; and from an individual emergency clinician’s point of view

Exploring Occupational Therapy Student and Entry-Level Practitioner Perceptions of Mental Health Accommodations

Mental health concerns are prevalent among occupational therapy graduate students and entry-level practitioners entering the workforce. Prior research has highlighted that the rise in mental health concerns and the high-achieving nature of occupational therapy students impacts their success in the classroom and the clinic. While formal and informal mental health accommodations are beneficial, obtaining and implementing such accommodations has been cited as a challenging process plagued with negative stigma. This study aimed to understand the perceived effectiveness of common academic and work-related mental health accommodations for meeting the role demands that occupational therapy students and practitioners encounter in the classroom, during fieldwork and capstone, and in entry-level practice. Data were gathered from 218 occupational therapy students and entry-level practitioners who completed an electronic survey, including checklists and Likert scale items. Results include the prevalence of mental health concerns, the use of formal and informal mental health accommodations, and the perceived effectiveness of mental health accommodations in meeting the role demands of occupational therapy students and entry-level practitioners. Participants reported that the commonly prescribed mental health accommodations effectively met role demands in academic and work settings. Qualitative responses to the survey provided a deeper understanding of these perceptions and the barriers students encountered when attaining or implementing such accommodations in the classroom and clinical settings. Implications for occupational therapy education address the prevalence of mental health concerns and the barriers occupational therapy students face when attaining and implementing mental health accommodations

Novel Interventions for HIV Self-Management in African American Women: A Systematic Review of mHealth Interventions

The purpose of this systematic review was to assess the quality of interventions using mobile health (mHealth) technology being developed for and trialed with HIV-infected African American (AA) women. We aimed to assess rigor and to ascertain if these interventions have been expanded to include the broad domain of self-management. After an extensive search using the PRISMA approach and reviewing 450 records (411 published studies and 39 ongoing trials atclinicaltrials.gov), we found little completed research that tested mHealth HIV self-management interventions for AA women. Atclinicaltrials.gov, we found several mHealth HIV intervention studies designed for women in general, forecasting a promising future. However, most studies were exploratory in nature and focused on a single narrow outcome, such as medication adherence. Given that cultural adaptation is the key to successfully implementing any effective self-management intervention, culturally relevant, gender-specific mHealth interventions focusing on HIV-infected AA women are warranted for the future