Articles: health.
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The concept of attention can provide insight into the needs of clinicians and how health systems design can impact patient care quality and medical errors. ⋯ None.
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A previously healthy 55-year-old male patient presented repeatedly to the emergency department with severe episodic periumbilical abdominal pain. After an extensive diagnostic work-up and subsequent clinical deterioration, appendiceal diverticulitis was diagnosed. We identified a correlation of white blood cell counts and possibly faecal calprotectin with the clinical presentation. We suggest that appendiceal diverticulitis should be considered in middle-aged patients with recurrent episodes of abdominal pain that correlate with laboratory markers of inflammation.
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Comparative Study
Electronic Health Records versus Survey Small Area Estimates for Public Health Surveillance.
Electronic health records (EHRs) are increasingly being leveraged for public health surveillance. EHR-based small area estimates (SAEs) are often validated by comparison to survey data such as the Behavioral Risk Factor Surveillance System (BRFSS). However, survey and EHR-based SAEs are expected to differ. In this cross-sectional study, SAEs were generated using MDPHnet, a distributed EHR-based surveillance network, for all Massachusetts municipalities and zip code tabulation areas (ZCTAs), compared to BRFSS PLACES SAEs, and reasons for differences explored. ⋯ EHR-based SAEs tended to be higher than BRFSS and more variable. Possible explanations include detection of undiagnosed cases and over-classification using EHR data, and under-reporting within BRFSS. Both EHR and survey-based surveillance have strengths and limitations that should inform their preferred uses in public health surveillance.
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Low socioeconomic status has been linked to increased mortality. However, the impacts of poverty, alone or combined with health behaviors, on mortality and life expectancy have not been adequately investigated. ⋯ Poverty is strongly associated with increased risk of death, but the risks could be modestly abated by a healthier lifestyle. These findings call for a comprehensive strategy for enhancing a healthy lifestyle and improving income equality to reduce death risks, particularly among those experiencing health disparities due to poverty.
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The primary objective of the study was to assess the factors that influenced the increased failure rate among first-year Indian medical students who appeared for the Maharashtra University of Health Science (MUHS) summative university examination, having experienced the competency-based medical education (CBME) curriculum for the first time amid the coronavirus disease (COVID-19) pandemic. ⋯ The total failure rate of 27% in the MUHS examination was mainly attributed to interplay between the student's mental health, lack of devices or Internet, and the changed assessment part of the CBME curriculum. Surprisingly, lecture frequencies, teaching patterns, and study resources did not influence the failure rate. These results can be used to formulate interventions that will help to improve academic performance and mental health students and thus help them adapt to the new curriculum.