scholarly journals Emergency medicine physicians’ knowledge and perceptions of training, education, and resources in eating disorders

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Connie Ma ◽  
Diana Gonzales-Pacheco ◽  
Jean Cerami ◽  
Kathryn E. Coakley
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Eating Disorders ◽  
Local Treatment ◽  
The United States ◽  
Educational Needs ◽  
Medical Complications ◽  
Cross Sectional ◽  
Additional Education ◽  
Previous Training

Abstract Background Feeding and eating disorders present with a variety of medical complications, some of which may be life-threatening. Emergency Medicine (EM) physicians may interact with patients with eating disorders, however, EM physicians’ knowledge and perceptions of resources for treating patients with eating disorders have not been examined. The purpose of this study was to explore previous training/education, perceptions of available resources, and educational needs in treating eating disorders in practicing EM physicians. Methods An investigator-developed survey was used in this cross-sectional pilot study, distributed to EM Residency Program Coordinators in the United States to distribute to EM physicians and residents. The survey assessed EM physicians’ previous training and education in treating and diagnosing eating disorders. The primary outcomes assessed were participants’ previous training/education in eating disorders, knowledge of local resources for patients, and educational needs on a variety of topics related to adult and adolescent eating disorders. Data were described descriptively and SAS 9.4 was used to analyze data. Results Of the 162 participants, just 1.9% completed a rotation on eating disorders during residency. Ninety-three percent were unfamiliar with the American Psychiatric Association’s Practice Guideline for the Treatment of Patients with Eating Disorders; 95% were unfamiliar with the publication, “Emergency Department management of patients with eating disorders” by Trent et al. The majority were not aware of resources for patients with eating disorders including community and online support groups, the National Eating Disorders Association, and local treatment programs. At least 50% agreed additional education on 15 of the 19 topics examined would be useful; 85% agreed to wanting education on the assessment of patients with eating disorders in the Emergency Department. Conclusions Most EM physicians lack training in eating disorders and knowledge of resources available for patients post-Emergency Department discharge. EM physicians agree additional education on a number of topics would be beneficial, particularly assessment of eating disorders in the Emergency Department, medical complications of eating disorders, and hospital admission criteria for those with eating disorders.

scholarly journals Emergency Medicine Physicians’ Knowledge and Perceptions of Training, Education, and Resources in Eating Disorders

2020 ◽  
Author(s):  
Connie Ma ◽  
Diana Gonzales-Pacheco ◽  
Jean Cerami ◽  
Kathryn E Coakley
Keyword(s):  
Emergency Medicine ◽  
Eating Disorders ◽  
Educational Needs ◽  
Cross Sectional Study ◽  
Study Data ◽  
Mental Illnesses ◽  
Post Discharge ◽  
Cross Sectional ◽  
Emergency Department Management ◽  
Previous Training

Abstract Background: Eating disorders, specifically anorexia nervosa, have one of the highest mortality rates of all mental illnesses.(1) Knowledge and perceptions of patients with eating disorders (ED) in the Emergency Medicine (EM) specialty is not explored. EM physicians may be the first or only provider a patient interacts with. The purpose of this study is to explore previous training/education, perceptions of available resources, and educational needs in treating eating disorders in practicing Emergency Medicine (EM) physicians. Methods: A 36-question investigator-developed survey was used in this cross-sectional study. Data were extracted from Opinio for statistical analyses. SAS 9.4 was used to analyze data. The survey assessed EM physicians’ previous training, education, and confidence in treating and diagnosing eating disorders in adults and adolescents. The primary outcomes assessed were participants’ previous training/education in eating disorders, knowledge of resources for patients, and educational needs.Results: Of the 162 participants, just 1.9% completed a rotation on eating disorders during residency. Ninety-three percent were unfamiliar with the American Psychiatric Association’s Practice Guideline for the Treatment of Patients with Eating Disorders; 95% were unfamiliar with the publication, “ED [Emergency Department] management of patients with eating disorders”. At least 50% were unaware of seven of the ten resources for patients with eating disorders examined. At least 50% agreed additional education on 15 of the 19 topics examined would be useful; 85% agreed to education on assessment of patients with eating disorders in the ED.Conclusions: Providing EM physicians with comprehensive education and training and increasing awareness of eating disorder resources could result in identifying more patients with eating disorders to increase treatment post-discharge.

scholarly journals 4256 Association Between Injury Intent and Emergency Department and Hospital Charges for Pediatric Firearm Injuries in the United States

2020 ◽  
Vol 4 (s1) ◽  
pp. 124-124
Author(s):  
Diana Marie Bongiorno ◽  
Gia M. Badolato ◽  
Meleah D. Boyle ◽  
Jon S. Vernick ◽  
Joseph F. Levy ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
The United States ◽  
Hospital Charges ◽  
Unintentional Injuries ◽  
Severe Injuries ◽  
Cross Sectional ◽  
Emergency Department Care ◽  
Sample Mean ◽  
Firearm Injury

OBJECTIVES/GOALS: In 2016, more than 3,100 children died, and an estimated 17,000 children had non-fatal injuries, from firearms in the United States. In this study, we used hospital charges as a proxy for medical resource utilization, and compared differences in charges by intent of firearm injury among children. METHODS/STUDY POPULATION: In this cross-sectional study of the 2016 Nationwide Emergency Department Sample, we identified firearm injury cases among children aged 19 years or younger using ICD-10-CM external cause of morbidity codes. Injury intent was characterized as unintentional, assault, self-inflicted, undetermined, or due to legal intervention. We included patients treated and released from the emergency department (ED) or admitted alive to the hospital, and excluded those who were transferred or died in the ED. We used linear regressions with survey weighting to compare differences in mean healthcare charges by firearm injury intent, with and without adjustment for ED disposition. RESULTS/ANTICIPATED RESULTS: Among 12,469 cases in the weighted sample, mean age was 16.5 years, a majority were male (88.2%) and Medicaid-insured (57.8%), and 64% were discharged from the ED and 36% admitted. Injuries were 49.0% unintentional, 45.1% assault-related, and 1.8% self-inflicted. Compared to children with self-inflicted injuries (charges $115,224), children with assault-related injuries (charges $55,052; p<0.007) and unintentional injuries (charges $38,643; p<0.001) had lower mean charges per visit. Differences in charges were no longer significant after adjusting for ED disposition, as 85.8% of self-inflicted injuries were admitted, compared to 46.5% of assault-related and 24.3% of unintentional injuries. DISCUSSION/SIGNIFICANCE OF IMPACT: Although the majority of pediatric firearm-related injuries resulting in emergency department care are unintentional or assault-related, self-inflicted injuries result in greater per visit hospital charges, attributable to higher hospitalization rates, and likely due to more severe injuries.

scholarly journals P078: Handover education in Canadian adult and pediatric emergency medicine residencies: a national survey and needs assessment

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S104-S105
Author(s):  
P. Lee ◽  
I. Rigby ◽  
S.J. McPherson
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Patient Care ◽  
Pediatric Emergency ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Period ◽  
Hand Off ◽  
Pediatric Inpatient ◽  
Didactic Lecture

Introduction: Emergency department handover is a high-risk period for patient safety. A recent study showed a decreased rate of preventable adverse events and errors after implementation of a resident hand-off bundle on pediatric inpatient wards. In a 2013 survey by the Canadian Associations of Internes and Residents, only 11% of residents in any discipline stated they received a formal teaching session on handover. Recently, the CanMEDS 2015 Physician Competency Framework has added safe and skillful transfer of patient care as a new proficiency within the collaborator role. We hypothesize that significant variation exists in the current delivery and evaluation of handover education in Canadian EM residencies. Methods: We conducted a descriptive, cross-sectional survey of Canadian residents enrolled in the three main training streams of Emergency Medicine (FRCP CCFP-EM, PEM). The primary outcome was to determine which educational modalities are used to teach and assess handover proficiency. Secondarily, we described current sign-over practices and perceived competency at patient handover. Results: 130 residents completed the survey (73% FRCP, 19% CCFP-EM, 8% PEM). 6% of residents were aware of handover proficiency objectives within their curriculum, while 15% acknowledged formal evaluation in this area. 98% of respondents were taught handover by observation of staff or residents on shift, while 55% had direct teaching on the job. Less than 10% of respondents received formal sessions in didactic lecture, small group or simulation formats. Evaluation of handover skills occurred primarily by on shift observation (100% of respondents), while 3% of residents had received assessment through simulation. Local centre handover practices were variable; less than half of residents used mnemonic tools, written or electronic adjuncts. Conclusion: Canadian EM residents receive variable and sparse formal training and assessment on emergency department handover. The majority of training occurs by on shift observation and few trainees receive instruction on objective tools or explicit patient care standards. There exists potential for further development of standardized objectives, utilization of other educational modalities and formal assessments to better prepare residents to conduct safer patient handoffs.

Association of asthma with osteopenia, osteoporosis, osteomalacia, and fractures

2020 ◽  
Vol 41 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Mohammed S. Shaheen ◽  
Jonathan I. Silverberg
Keyword(s):  
Emergency Department ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pathologic Fractures ◽  
Ed Visits ◽  
National Emergency ◽  
The Relationship

Background: Previous studies that examined the relationship between asthma, osteoporosis, and pathologic fractures found conflicting results. Objective: To determine whether asthma is associated with osteopenia, osteoporosis, osteomalacia, and fractures in U.S. adults. Methods: A cross-sectional study of 198,102,435 children and adults, including 10,129,307 with asthma, from the 2006‐2012 National Emergency Department Sample, which includes a representative 20% sample of emergency department (ED) visits throughout the United States. Results: ED visits of patients with versus without asthma were associated with higher odds of osteopenia (7 of 7 years: multivariable logistic regression of all years pooled; adjusted odds ratio [aOR] 1.45 [95% confidence interval {CI}, 1.41‐1.50]), osteoporosis (7 of 7 years: aOR 1.85 [95% CI, 1.82‐1.88]), osteomalacia (7 of 7 years: aOR 2.00 [95% CI, 1.61‐2.49]), and pathologic fractures (7 of 7 years: OR 1.24 [95% CI, 1.20‐1.27]). Patients with asthma and with long-term glucocorticoid use had higher odds of osteoporosis, osteopenia, osteomalacia, and fractures compared with patients with asthma and without long-term glucocorticoid use. Patients with asthma and with fractures incurred significantly more inpatient admissions, and higher costs of ED and inpatient care. Conclusion: ED visits with asthma were associated with osteopenia, osteoporosis, osteomalacia, and pathologic fractures.

scholarly journals Diagnosis of Eating Disorders Among College Students: A Comparison of Military and Civilian Students

2021 ◽  
Author(s):  
Sarah E Falvey ◽  
Samantha L Hahn ◽  
Olivia S Anderson ◽  
Sarah K Lipson ◽  
Kendrin R Sonneville
Keyword(s):  
College Students ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Univariate Analysis ◽  
The United States ◽  
P Value ◽  
Cross Sectional ◽  
Eating Disorder Symptoms ◽  
Chi Square Analysis ◽  
The Military

ABSTRACT Introduction Eating disorders are often under-detected, which poses a serious threat to the health of individuals with eating disorder symptoms. There is evidence to suggest that the military represents a subpopulation that may be susceptible to high prevalence of eating disorders and vulnerable to their underdiagnosis. Underreporting of eating disorder symptoms in the military could lead to this underdiagnosis of individuals with eating disorder symptoms. The purpose of this study was to examine the association between military affiliation and eating disorder symptoms among college students and the likelihood of eating disorder diagnosis among those with eating disorder symptoms using a large, diverse college-aged sample of both military-involved and civilian students. Materials and Methods Participants for this study were from the 2015-2016, 2016-2017, and 2017-2018 Healthy Minds Study (HMS). Healthy Minds Study is a large, cross-sectional cohort study of both undergraduate and graduate students from universities and colleges across the United States and Canada. The Healthy Minds Study survey questions include assessment of demographic information, military status, self-reported eating disorder symptoms using the SCOFF questionnaire, and self-reported eating disorder diagnosis. Univariate analysis, chi-square analysis, and logistic regression with an unadjusted and covariate adjusted model were used to examine the association between eating disorder symptoms and military affiliation. These analyses were also used to examine the association between eating disorder diagnosis among those with eating disorder symptoms and military affiliation. All analyses were conducted using SPSS. Results The prevalence of eating disorder symptoms was high among both the civilian (20.4%) and military-involved (14.4%) students. Among females, there was a significantly higher (P value = .041) prevalence of eating disorder symptoms among civilian college students (24.7%) compared to military-involved students (21.3%). Among those with eating disorder symptoms, the prevalence of diagnosis was low in both military and civilian students. Specifically, the prevalence of diagnosis was significantly lower (P value = .032) among military-involved college students (10.8%) compared to civilian college students (16.4%). Differences in sociodemographic characteristics (e.g., gender, race/ethnicity, and age) among military-involved and civilian college students appear to explain this association. Conclusions The underdiagnosis of eating disorders is far too common, and this represents a threat to the health of military and civilian populations alike. Underdiagnosis of eating disorders within military environments may be due to underreporting, particularly among men and racial/ethnic minority groups.

A Cross-sectional Study of Emergency Department Boarding Practices in the United States

2014 ◽  
Vol 21 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Stephen R. Pitts ◽  
Frances L. Vaughns ◽  
Marc A. Gautreau ◽  
Matthew W. Cogdell ◽  
Zachary Meisel
Keyword(s):  
United States ◽  
Emergency Department ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Trends in Emergency Department Visits and Charges for Gout in the United States between 2006 and 2012

2016 ◽  
Vol 43 (8) ◽  
pp. 1589-1592 ◽  
Author(s):  
Sadao Jinno ◽  
Kohei Hasegawa ◽  
Tuhina Neogi ◽  
Tadahiro Goto ◽  
Maureen Dubreuil
Keyword(s):  
United States ◽  
Emergency Department ◽  
Temporal Trends ◽  
The United States ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Ed Visits ◽  
Sectional Analysis

Objective.To examine temporal trends in the rate of gout emergency department (ED) visits and charges in the United States between 2006 and 2012.Methods.A serial cross-sectional analysis of the Nationwide Emergency Department Sample.Results.The rate of ED visits for gout in adults overall increased from 75.0 to 85.4 per 100,000 persons over the study period (14% increase, p < 0.001), and increased 29% for those aged 45–54 years. Nationwide ED charges increased from $156 million to $281 million (80% increase, p < 0.001).Conclusion.Between 2006 and 2012, the rate of gout ED visits increased among US adults, most notably in those aged 45–54 years.

Rapid Assessment of Psychological and Epidemiological Correlates of COVID-19 Concern, Financial Strain, and Health-Related Behavior Change in a Large Online Sample

2020 ◽  
Author(s):  
Benjamin W Nelson ◽  
Adam Khan Pettitt ◽  
Jessica Flannery ◽  
Nicholas B. Allen
Keyword(s):  
Depressive Symptoms ◽  
Rapid Assessment ◽  
Epidemiological Data ◽  
The United States ◽  
Financial Strain ◽  
Medical Complications ◽  
Cross Sectional ◽  
Loss Of Life ◽  
Global Pandemic ◽  
Health Related

COVID-19 emerged in November 2019 leading to a global pandemic that has not only resulted in widespread medical complications and loss of life, but has also impacted global economies and transformed daily life. The current rapid response study in a convenience online sample quickly recruited 2,065 participants across the United States, Canada, and Europe in late March and early April 2020. Cross-sectional findings indicated elevated anxiety and depressive symptoms compared to historical norms, which were associated with COVID-19 concern more strongly than epidemiological data signifying objective risk. Employment loss was associated with greater depressive symptoms and COVID-19 concern, and depressive symptoms and COVID-19 concern were significantly associated with more stringent self-quarantine behavior. The rapid collection of data during the early phase of this pandemic is limited by under-representation of non-Caucasians and middle age and older adults. Nevertheless, these findings have implications for interventions to slow the spread of COVID-19 inflection.

scholarly journals Increase in emergency department visits related to cannabis reported using syndromic surveillance system

2019 ◽  
Vol 29 (4) ◽  
pp. 621-625 ◽  
Author(s):  
G N Noel ◽  
A M Maghoo ◽  
F F Franke ◽  
G V Viudes ◽  
P M Minodier
Keyword(s):  
Emergency Department ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Syndromic Surveillance System ◽  
Icd 10

Abstract Background Cannabis is illegal in France but, as in many countries, legalization is under debate. In the United States, an increase of emergency department (ED) visits related to cannabis exposure (CE) in infants and adults was reported. In France, a retrospective observational study also suggested an increase of CE in children under 6 years old. This study only included toddlers and the data sources used did not allow repeated analysis for monitoring. Methods Our study aimed to evaluate the trend in visits for CE in ED in patients younger than 27 years old in Southern France. A cross-sectional study using the Electronic Emergency Department Abstracts (EEDA) included in the national Syndromic Surveillance System. CE visits were defined using International Classification of Disease (ICD-10). Results From 2009 to 2014, 16 EDs consistently reported EEDA with <5% missing diagnosis code. Seven hundred and ninety seven patients were admitted for CE including 49 (4.1%) children under 8 years old. From 2009–11 to 2012–14, the rate of CE visits increased significantly across all age groups. The highest increase was in the 8–14 years old (+144%; 1.85–4.51, P < 0.001) and was also significant in children under 8 (0.53–1.06; P = 0.02). Among children under 8, hospitalization rate (75.5% vs. 16.8%; P < 0.001) and intensive care unit admissions (4.1% vs. 0.1%; P < 0.001) were higher compared with patients older than 8 years. Conclusion These trends occurred despite cannabis remaining illegal. EEDA could be useful for monitoring CE in EDs.

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