6 research outputs found

    Teen Distracted Reality an Interactive Virtual Education (D.R.I.V.E.): Experience and Impact on Teenage Drivers

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    Introduction: In 2013, 2,163 teens in the United States ages 16–19 were killed and 243,243 were treated in emergency departments for injuries from motor vehicle crashes. distracted driving (i.e. texting, loud music, or phone conversations) and impaired driving (driving under the influence) play a role in these motor vehicle crashes. Prevention efforts aimed at high-risk teenager driving behavior may encourage safe driving habits. Methods: The Teen D.R.I.V.E. program is a mobile driving simulator that provides teenagers with distracted and impaired driving scenarios. We administered anonymous surveys from April 2015-April 2016 to obtain demographic data and evaluate the program’s impact on their driving behavior. We retrospectively analyzed survey responses using univariate and multivariate statistical analysis. Results: A total of 1374 participants in the survey, however, 50 did not respond to the driving experience portion of the survey. Most participants (70%) were between 16-17 years of age years old and 51% were males. A majority (76%) of respondents had driving experience (26% permit, and 46% license) or had attended a driver’s education course (67%). After experiencing the simulation respondents felt that the consequences of driving distracted (53%) and driving impaired (61%) were worse than previously expected. In addition, participants said that they would never drive distracted (70%) or drive impaired (90%). A majority of participants (72%) feel that simulation is the most effective way to teach driving related topics. Conclusion: Teen D.R.I.V.E. offers a valuable experience to teenagers, teaching them about the dangers of driving distracted and impaired. Participants are likely to never drive impaired compared or distracted. Most teenagers feel simulation teaches these driving lessons most effectively

    Are Goods for Guns Good for the Community? An Update of a Community Gun Buyback Program

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    BACKGROUND: Gun violence remains a leading cause of death in the United States. Community gun buyback programs provide an opportunity to dispose of extraneous firearms. The purpose of this study was to understand the demographics, motivation, child access to firearms and household mental illness of buyback participants in hopes of improving the program\u27s effectiveness. METHODS: A 2015 Injury Free Coalition for Kids gun buyback program which collaborated with local police departments was studied. We administered a 23-item questionnaire survey to gun buyback participants assessing demographic characteristics, motivation for relinquishing firearms, child firearm accessibility, and mental illness/domestic violence history. RESULTS: A total of 186 individuals from Central/Western Massachusetts turned in 339 weapons. Participants received between 25and25 and 75 in gift cards dependent on what type of gun was turned in, with an average cost of $41/gun. A total of 109 participants (59%) completed the survey. Respondents were mostly white (99%), male (90%) and first-time participants in the program (85.2%). Among survey respondents, 54% turned in firearms for safety reasons . Respondents reported no longer needing/wanting their weapons (47%) and approximately one in eight participants were concerned the firearm(s) were accessible to children. Most respondents (87%) felt the program encouraged neighborhood awareness of firearm safety. Three out of every five participants reported that guns still remained in their homes, additionally; 21% where children could potentially access them and 14% with a history of mental illness/suicide/domestic violence in the home. CONCLUSIONS: Gun buybacks can provide a low-cost means of removing unwanted firearms from the community. Most participants felt their homes were safer after turning in the firearm(s). In homes still possessing guns, emphasis on secure gun storage should continue increasing the safety of children and families. The results of this survey also provided new insights into the association between mental illness/suicide and gun ownership. LEVEL OF EVIDENCE: Level III, Prognostic and Epidemiological

    Patients’ Perspectives, Experiences, and Concerns With Perianal Fistulae:Insights From Online Targeted-Disease Forums

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    Background: Perianal fistulae can undermine physical, emotional, and social well-being in patients with Crohn’s disease and are challenging to manage. Social media offers a rich opportunity to gain an in-depth understanding of the impact of perianal fistulae on patients’ daily lives outside of controlled environments. In this study, we conducted social media analytics to examine patients’ experiences with perianal fistulae and assessed the impact of perianal fistulae on patients’ behavior and overall well-being. Methods: We used a mixed-method approach to examine 119 986 publicly available posts collected from 10 Crohn’s disease forums in the United States between January 01, 2010 and January 01, 2020. Discussions related to Crohn’s perianal fistulae were retrieved. We randomly selected 700 posts and qualitatively analyzed them using an inductive thematic approach. We then applied a latent Dirichlet allocation probabilistic topic model to explore themes in an unsupervised manner on the collection of 119 986 posts. Results: In the qualitative analysis, 5 major themes were identified: (1) burden of perianal fistula; (2) challenges associated with treatment; (3) online information seeking and sharing; (4) patient experiences with treatments; and (5) patients’ apprehension about treatments. In the quantitative analysis, the percentages of posts related to the major themes were (1) 20%, (2) 29%, (3) 66%, and (4) 28%, while the topic model did not identify theme 5. Conclusions: Social media reveals a dynamic range of themes governing patients’ perspectives and experiences with Crohn’s perianal fistulae. In addition to the biopsychosocial burden, patients frequently express dissatisfaction with current treatments and often struggle to navigate among available management options.</p

    Application of Mitomycin C after dilation of an anastomotic stricture in a newborn with necrotizing enterocolitis

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    Necrotizing enterocolitis (NEC) is a common life-threatening condition in premature infants. Bacterial translocation, localized inflammation and subsequent perforation often require surgery for source control and definitive treatment. Small and large intestinal strictures may result from either creation of a surgical anastomosis or the disease process itself. Current methods to treat strictures include, balloon dilation and surgical resection with or without anastomosis. We report the diagnosis and surgical management of a premature infant treated for NEC, who developed an anastomotic stricture and was successfully treated with topical Mitomycin C after balloon stricturoplasty

    Understanding the role of the primary care physician in the management of patients with Crohn’s perianal fistulas

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    To understand the role of primary care physicians (PCPs) in the recognition, diagnosis, and management of Crohn’s perianal fistulas (CPF) and their referral patterns and treatment expectations. This survey-based study was conducted between September 2020 and October 2020. US-based PCPs managing at least one patient with Crohn’s disease per week were included. Participants were presented with two case vignettes relevant to primary care practice; Case Vignette 1 comprised three parts and focused on initial CPF presentation and progression to partial response; Case Vignette 2 focused on recurrent CPF. Survey questions elicited the physician’s clinical approach to each case. Data were presented as descriptive statistics. Overall, 151 PCPs (median 23 years in practice) who saw about three patients per month with new/existing CPF responded. For Case Vignette 1, upon identification of a fistulous tract, 89% of respondents would refer the patient, mostly to a colorectal surgeon or gastroenterologist. Most PCPs (69%) would begin the patient on medication; 46% would conduct a diagnostic/imaging study. Treatment expectations after referral varied: 55% of respondents believed surgeons would place a seton or use one prior to surgery; 23% expected medical management only; 23% were unsure. Case Vignette 2 revealed that 98% of PCPs preferred to be involved in patient care after referral; however, only 49% were. Of these, 76% considered reinforcing patient treatment adherence as their primary role. While 80% of PCPs were at least moderately satisfied with communication and care coordination with multidisciplinary teams, 52% considered lack of access to specialists as at least a moderate barrier to multidisciplinary team management. PCPs want more involvement in multidisciplinary management of patients with CPF. Continuing education providing PCPs with up-to-date information on diagnostic modalities, treatment options, early diagnosis, the role of PCPs within a multidisciplinary team, and effective initial CPF care is required. What were the study’s aims? To understand how primary care physicians recognize, treat, and monitor patients with Crohn’s disease-related perianal fistulas (small tunnels between the bowel and skin near the anus). How was the study done? US-based primary care physicians, including internists, were included if they had experience in treating patients with Crohn’s disease. Descriptions of the history and symptoms of two hypothetical patients were provided: one patient who may have Crohn’s perianal fistulas and another patient whose Crohn’s perianal fistulas had returned after being treated. After reading these descriptions, the physicians completed a questionnaire designed to show how they would help each patient. What did the study find out? Not all physicians treat patients with Crohn’s perianal fistulas in the same way in terms of diagnostic tests and medical treatments, although most said they would refer them to a specialist if a fistula was identified. Many wanted to be involved in patient care after referral to a specialist but only half were. Of those, most thought their main role was to ensure patients followed the treatments given by specialists. More than half of primary care physicians thought a lack of access to specialists could be a barrier to care. How does this impact care? The physicians surveyed want more involvement in multidisciplinary teams who look after patients with Crohn’s perianal fistulas. To do this, they need more education about the diagnosis and treatment of Crohn’s perianal fistulas, and clarity around their role within multidisciplinary teams who manage these patients.</p

    And the survey said.... evaluating rationale for participation in gun buybacks as a tool to encourage higher yields

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    BACKGROUND: Gun buyback programs represent one arm of a multipronged approach to raise awareness and education about gun safety. METHODS: The city of Worcester, MA has conducted an annual gun buyback at the Police Department Headquarters since 2002. We analyzed survey responses from a voluntary, 18-question, face-to-face structured interview from December 2009 to June 2015 using descriptive statistics to determine participant demographics and motivations for participation. RESULTS: A total of 943 guns were collected, and 273 individuals completed surveys. The majority of participants were white males older than 55years (42.4%). Participants represented 61 zip codes across Worcester County, with 68% having prior gun safety training and 61% with weapons remaining in the home (27% of which children could potentially access). The top reasons for turning in guns were no longer needed (48%) and fear of children accessing the gun (14%). About 1 in 3 respondents knew someone injured/killed by gun violence. Almost all (96%) respondents claimed the program raised community awareness of firearm risk. CONCLUSION: The Worcester Goods for Guns Buyback has collected more than 900 guns between 2009 and 2015. The buyback removes unwanted guns from homes and raises community awareness about firearm safety
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