A5023664343- Emergency and Acute Care Studies
- Trauma and Emergency Care Studies
- Cardiac Arrest and Resuscitation
- Asthma and respiratory diseases
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Disaster Response and Management
- Injury Epidemiology and Prevention
- Child and Adolescent Health
- Neonatal Respiratory Health Research
- Healthcare Policy and Management
- Health, Environment, Cognitive Aging
- Machine Learning in Healthcare
- Traumatic Brain Injury and Neurovascular Disturbances
- Climate Change and Health Impacts
- Inhalation and Respiratory Drug Delivery
- Air Quality and Health Impacts
- Pharmaceutical studies and practices
- Healthcare cost, quality, practices
- Hospital Admissions and Outcomes
- Esophageal and GI Pathology
- Healthcare Operations and Scheduling Optimization
- Colorectal Cancer Screening and Detection
- School Health and Nursing Education
- Health Policy Implementation Science
- Trauma Management and Diagnosis
Florida College
2017-2025
University of Florida
2017-2025
Ta Solutions (China)
2024
Jacksonville University
2019-2023
Yale University
2023
Baylor College of Medicine
2023
University of Colorado Denver
2023
Center for Children
2023
Medical College of Wisconsin
2023
The University of Texas Rio Grande Valley
2023
Background: The delivery of emergency medical services (EMS) is a resource-intensive process, and prior studies suggest that EMS utilization in children may vary by socioeconomic status. Child Opportunity Index (COI) provides multidimensional measure neighborhood-level resources conditions affect the health children. We evaluated measures acuity among COI.Methods: performed cross-sectional study using encounters for patients less than 18 years age from 10,067 agencies 47 US states...
Abstract Background The ongoing opioid epidemic in the United States has reinforced need to provide multimodal and non-opioid pain management interventions. PAMI-ED ALT program employed a multifaceted approach Emergency Department (ED) developing electronic health record (EHR) order panels discharge panels, as well educating patients, clinicians, ED staff on alternatives, including non-pharmacologic primary objective of this analysis was compare changes analgesic administrations prescribing...
Abstract Background Prior studies on the association between asthma and cancer show inconsistent results. This study aimed to generate additional evidence cancer, both overall, by type, in United States. Method We conducted a retrospective cohort using 2012–2020 electronic health records claims data OneFlorida+ clinical research network. Our population included of adult patients with ( n = 90,021) matching without 270,063). built Cox proportional hazards models examine diagnosis subsequent...
Children have differing utilization of emergency medical services (EMS) by socioeconomic status. We evaluated differences in prehospital care among children the Child Opportunity Index (COI), agreement between a child's COI at scene and home, in-hospital outcomes for COI.
Introduction: Asthma exacerbations are a common cause of pediatric Emergency Medical Services (EMS) encounters. Accordingly, prehospital management asthma has been designated an EMS research priority. However, accurate identification from the record is nuanced and difficult due to heterogeneity symptoms, especially in children. Therefore, this study's objective was develop prehospital-specific computable phenotype (CP) that could accurately identify encounters for exacerbations.
Background Social determinants of health (SDOH) influence access to care and are associated with inequities in patient outcomes, yet few studies have explored SDOH among pediatric EMS patients. The objective this study was examine the presence clinician free text notes quantify association transport decisions.Methods This a retrospective analysis primary 9-1-1 responses for patients ages 0–17 years from 2019 ESO Data Collaborative research dataset. We excluded cardiac arrests law enforcement...
Aim: This study describes the demographic, socioeconomic, and tumor-specific characteristics of patients who refuse breast cancer surgery. Materials Methods: is a retrospective from 2004-2015 captured by National Cancer Data Base. Demographic, predictors were compared between refused surgery versus those agreed to surgery, using bivariate multivariate models. Results: A total 2,445,870 met inclusion criteria. On analysis, black Asian had higher odds refusing surgical treatment whites...
Objectives: Pediatric behavioral health disorders and related emergency department visits are increasing, but effects on medical services (EMS) unknown. This study's objective was to describe the statewide epidemiology of pediatric health-related EMS encounters in Florida, including mental substance use. Methods: analysis is a retrospective study from Florida's Tracking Reporting Systems Database 2011 2016. Demographic, clinical, EMS, geographic characteristics described. We also compared...
Little is known about emergency medical services' (EMS') management of pediatric asthma. This study's objective was to describe the demographic, clinical, and geographic characteristics current EMS' asthma in state with fourth-largest population.This a retrospective observational study EMS patients ages 2 18 years an exacerbation from 2011 2016. Patients Florida's Tracking Reporting System were included if their chief complaint indicated respiratory distress, they received at least 1...
Prehospital research and evidence-based guidelines (EBGs) have grown in recent decades, yet there is still a paucity of prehospital implementation research. While studies revealed EMS agency leadership perspectives on implementation, the important opinions frontline clinicians regarding to be explored systematic approach. The objective this study was measure preferences for process EBG whether current practices align with those preferences.
Objectives: Pediatric specialty care is increasingly regionalized. It unknown how regionalization affects emergency medical services (EMS) providers' destination decisions for non-trauma pediatric patients. We sought to characterize the rates of bypass closest facility, and facilities' levels in three diverse EMS agencies. Methods: This a one-year retrospective study patients less than 18 years age transported by agencies (Baltimore City, Prince George's County, Queen Anne's County) 2016. A...
Introduction: Deciding where to transport a patient is key decision made by emergency medical services (EMS), particularly for children because pediatric hospital resources are regionalized. Since evidence-based guidelines destinations being developed, the purpose of this study was use large statewide EMS database describe current patterns providers' destination decisions patients.Methods: This retrospective transports from 2011-2016 in Tracking and Reporting System (EMSTARS), Florida's...
Prehospital evidence-based guidelines (EBGs) are developed to optimize clinical outcomes for emergency medical services (EMS) patients. However, widespread implementation of EBGs is often inconsistent. Therefore, this study aimed assess the baseline knowledge and practices EMS leaders related EBG implementation.
Pediatric asthma exacerbations are a common cause of emergency medical services (EMS) encounters. Bronchodilators and systemic corticosteroids mainstays exacerbation therapy, yet data on the efficacy EMS administration mixed. This study's objective was to assess association between pediatric patients hospital admission rates based severity transport intervals.
Abstract Aims and Objectives The aims of this project were to (a) determine barriers current handover transport process, (b) develop a new protocol process for team‐to‐team handover, (c) evaluate staff satisfaction with the process. Background critically ill patients from paediatric emergency department intensive care unit is period vulnerability associated adverse events. Design A mixed‐methods study using quasi‐experimental design qualitative approach. Methods Focus groups conducted...
Objective: Few areas of prehospital care are supported by evidence-based guidelines (EBGs). We aimed to identify gaps in clinical and operational EBGs prioritize future EBG development research funding. Methods: Using modified Delphi methodology, we sought consensus among experts development. Five rounds surveys were administered between October 2019 February 2020. Round 1 asked participants list the top three that should be prioritized for guideline Based on responses, 3 reviewers performed...
To determine the relationship between Numeric Rating Scale (NRS) and Defense Veterans Pain (DVPRS) as pain intensity measures, we compared scores to sociodemographic treatment data in patients revisiting emergency department (ED).
Prior studies examining prehospital characteristics related to return of spontaneous circulation (ROSC) in pediatric out-of-hospital cardiac arrest (OHCA) are limited structured data. Natural language processing (NLP) could identify new factors from unstructured data using free-text narratives. The purpose this study was use NLP examine EMS clinician narratives for associated with ROSC OHCA.This a retrospective analysis patients ages 0-17 OHCA 2019 the ESO Data Collaborative. We performed an...
Respiratory distress accounts for approximately 14% of all pediatric emergency medical services (EMS) encounters, with asthma being the most common diagnosis. In department (ED), early administration systemic corticosteroids decreases hospital admission and speeds resolution symptoms. For children treated by EMS, there is an opportunity earlier corticosteroid administration. Most EMS agencies carry intravenous (IV) corticosteroids; yet given challenges low rates IV placement, oral (OCS) are...
It is prudent to take a unified approach exploring how contextual social determinants of health (SDoH) relate COVID-19 occurrence and outcomes. Poor geographically represented data small number SDoH examined in most previous research studies have left knowledge gap the relationships between In this study, we linked 199 factors covering 11 domains built environments with electronic records (EHRs) from large clinical network (CRN) National Patient-Centered Clinical Research Network (PCORnet)...