<p> In the state of California, about one in six adults suffer from some sort of mental illness and about one in twenty of those suffer from a serious mental illness (SMI). In the County of Los Angeles, about 4.5% of the county&rsquo;s roughly 9.8 million residents suffer from a serious mental illness. Through most of history, mental health care and primary health care have represented two independent systems. The two independent systems have resulted in a double standard of quality of care, accessibility of care, and social stigmas of care. The disconnect leaves mental health care inferior to physical care, where mental illnesses are easily overlooked carrying negative social stigmas with little access. MindLink Coordinators, LLC, a not-for-profit mental health care coordinating organization, looks to bridge a major gap between mental health care and primary health care through care coordination and technology. In conjunction with care coordination, MindLink will provide various services for patients with mental illnesses. MindLink&rsquo;s purpose will start with serving the Los Angeles County area with the hope of eventually serving patients throughout the state of California.</p>

<p> Each year, nearly 70,000 youth in America enter the juvenile justice system and are confined in correctional facilities. Many children younger than 18 years of age are forced to consider these institutions their home as they live out their sentence. A large body of evidence has shown that a majority of these detained adolescents commit crimes due to untreated mental health or from enduring years of constant mental abuse. These issues are often carried over into their sentences and juvenile facilities are not well equipped or properly trained, leaving many behavioral symptoms unattended. Mind Over Matter Telepsychiatry aims to utilize the emerging innovations of telehealth technology to transform mental health service delivery within the juvenile justice system. The mission is to provide accessible, effective, and quality care to vulnerable and often overlooked youth populations in order to prepare them for successful reentry into the community. Mind Over Matter Telepsychiatry&rsquo;s goal is to work alongside juvenile halls located in The Greater Los Angeles area to become the primary provider of behavioral telehealth services. This proposal will provide an in-depth analysis of how Mind Over Matter Telepsychiatry aim to accomplish these objectives.</p>

<p> Diabetes is best described as a disease which affects blood levels and the body cannot regulate or produce enough insulin on its own causing sugar build up in the blood. Diabetes is the seventh leading cause of the death in the United States. Diabetes affects over 29 million Americans, with about 25% of them living with it undiagnosed. Another 86 million people living with pre-diabetes comprise 90% of the population is unaware they are pre-diabetic. Our business, DiaBeaThis Healthcare Clinic, provides health care services to adults 18 years or older who suffer from diabetes or are pre-diabetic. The diabetic services provided for these adults residing in Oceanside, North San Diego County, California. The clinic will provide testing for diabetes, health monitoring, and dietary counseling and will be a source for diabetics to obtain the required medication, supplies, and education needed.</p><p>

<p> The lack of primary care coordination for people with schizophrenia across the continuum of care in a rural Midwest state compromises long-term treatment success. For the purpose of primary care coordination this qualitative study explored perceptions of health care professionals that care for people with schizophrenia regarding expansion of laboratory and/or pharmacy services in the home health care setting. Mental health providers, home health care nurses, pharmacy and laboratory personnel participated in a focus group to identify common themes regarding access to care, care coordination and the utilization of laboratory and/or pharmacy services. A semistructured, open-ended focus group was used to examine the actual experiences of health care practitioners and professionals working with people with schizophrenia in the rural home health care setting. The findings of the focus group demonstrated several common themes. The first theme identified was people with schizophrenia have stigmas about their illness leading to non-compliance and reduced access to care. A second theme identified was the lack of community resources to care for people with schizophrenia. A third theme was the limited knowledge of health care providers to the utilization of home health care in the treatment of people with schizophrenia. The fourth theme was the lack of care coordination, social work and knowledge of the local issues faced by people with schizophrenia. The fifth and final theme was the lack of coordination with laboratory and pharmacy health care specialties. The results of the study may lend interest to more research regarding the utility of expanded home health care services in the care of people with schizophrenia.</p><p>

BACKGROUND: A recent study showed low adherence to the published treatment guidelines for axial spondyloarthritis (axSpA) / ankylosing spondylitis (AS). The aim of this study was to determine barriers to guideline adoption that are specific to axSpA / AS. METHODS: A systematic literature review was conducted to learn which general barriers to guideline adoption have been proposed in the literature. A second systematic literature review was conducted to identify strategies to increase response rates in the deployment of electronic surveys. A survey was developed based on the findings from the literature, aimed to interrogate the perspective of rheumatologists on barriers within their practice. A focus group was conducted to gain insight from experts in the field. RESULTS: The SLR identified 22 primary research articles on barriers to guideline adherence in axSpA / AS, almost all of which focused on drug therapy or physical therapy / exercise. Only 1 of the 22 studies was conducted in the US. The SLR on survey deployment methods identified 52 articles, 40 of which included sufficient information to calculate response rates. The mean response rate for online surveys distributed to rheumatologists was 0.33 with no statistically significant differences between surveys that contacted physicians once, twice or three or more times. From the literature, a framework was synthesized that captures relevant barriers to guideline adherence in 5 categories: guideline factors, health professional factors, patient factors, practice setting factors and societal factors. A survey was drafted, with questions targeting each of the five categories included in the framework. Suggestions from the experts participating in the focus group resulted in a revised survey consisting of 33 questions. Additionally, the focus group proposed ideas for survey dissemination, including strong support for the utilization of social media in addition to email invitations. CONCLUSION: The literature on barriers to guideline adherence in axSpA / AS is limited, in particular in the domains of disease activity monitoring, osteoporosis screening / monitoring, and other non-pharmacologic therapies. Only a single US study on barriers to guideline adherence in axSpA / AS was identified, indicating the need for more research in this field. The focus group provided firsthand perspective, allowing for modification of the survey to capture the most informative data. The focus group also provided insight into survey dissemination methods and ideas to maximize participation. The SLR on electronic survey deployment suggests an expected response rate of 0.33 for surveys administered to rheumatologists via email.

Bias and stereotypes around race, gender, sexuality, and class have been concepts that have and continue to plague medicine. Whether conscious or not, physicians have demonstrated bias when prescribing opioids to Black, Indigenous, and people of color (BIPOC) populations. These patients deserve proper pain control. In 2021, the CDC stated 75,673 people died in the United States from opioid overdose. Because of this, the medical community has an obligation to treat every patient equally and fairly regardless of their skin color or background. With the nature of pain as it is, there exists no clinical, objective measurement of pain. Currently, vulnerable populations, such as individuals with obstacles to self-advocacy, are being left to suffer through pain crises. Additional oversight and inclusion of healthcare equity is needed to combat this unethical gap in patient care. There are numerous ways to create pain management equity, in terms of conversations around pain along with the proper distribution of pain medication, especially opiates. The way to do this is through conversation and discussions around systemic racism and implicit bias. These can take the form of rounds or group discussions within a healthcare setting. There are many ways to combat this bias, but among the first should be discussion. / Urban Bioethics

No description available.

Individuals with heart failure (HF) are often readmitted within 30 days of discharge from the hospital. Telehealth has been developed to help manage HF during this critical period. However, association of telehealth with improved HF outcomes is still unclear. There is a need to identify the patients who benefit most from telehealth and explore factors that work in conjunction with telehealth to improve HF outcomes. Therefore the purpose of this study was to explore the patient characteristic factors that impact health status and healthcare utilization outcomes of patients with HF who use telehealth in a homecare setting. A descriptive, correlational study design using retrospective chart review was employed. The sample comprised Medicare patients admitted to a New England homecare agency, with HF as a diagnosis and had used telehealth from 2008 to 2010. OASIS and electronic documentation at the homecare agency served as data sources. Descriptive statistics, logistic and multiple regression analysis were used to analyze association of patient demographic, psychosocial status, and disease characteristics with HF outcomes of patients on telehealth. The sample size was 403, of whom 70% were over 75 years of age, 55% were female, and 94% were Caucasian. Number of nursing contacts ranged 1 to 26 with a median value of 10. There were 118 (29.3%) all-cause readmissions, 76 cardiac-related hospitalizations (18.9%), 17 cases with mortality (4.2%) and 52 (12.7%) abrupt terminations of telehealth. For patients with HF on telehealth, patient characteristics such as: anxiety, high number of medications, acute cardiac events, musculoskeletal, psychiatric and anemia type of co-morbidity were associated with high nursing utilization patterns; dyspnea, high number of medications, obesity, ACEI/ARB and beta-blockers were associated with hospitalizations; and renal, psychiatric and cancer type of co-morbidities and female gender were associated with unplanned termination of telehealth. Abrupt termination of telehealth was also found to be correlated with hospitalizations. The findings of this study contribute to our understanding of healthcare utilization by patients with heart failure on telehealth.

Approximately 78–87% of high school students are involved in an extracurricular activity, with nearly 57% of those students involved in a sport/sports team program (Caldarella et. al, 2019). High school male wrestling has been identified to be one of the leading sports in which student-athletes will experience mental health issues related to depression, anxiety, stress, disordered eating, rapid weight loss, eating disorders, aggression, and more (Sarkar & Fletcher, 2014). Occupational therapy practitioners (OTPs) are limited in school systems, where their role is related solely to students’ academic attainment and achievement, yet education is only one of four occupations experienced within the secondary school setting. OTPs are trained in both physical and psychosocial rehabilitation. This presents potential for the profession to be integrated within school-based athletic programming to provide mental health and wellness services for adolescent male wrestlers. The purpose of this project is to determine if active presence and facilitation of mental health services by OTPs within athletics would enhance a student athlete’s sport performance and promote their holistic health and wellness for long-lasting health care management.

No description available.