Emergency department (ED) visits related to opioid use disorder (OUD) have increased nearly twofold over the last decade. Treatment with buprenorphine has been demonstrated decrease opioid-related overdose deaths. In this study, we aimed better understand ED clinicians' attitudes toward initiation of treatment in ED.We performed a mixed-methods study consisting survey 174 clinicians (attending physicians, residents, and physician assistants) semi-structured interviews 17 attending emergency...

Abstract G uatemala's rural indigenous population suffers from one of the highest rates chronic child malnutrition (stunting) in world. Successfully addressing stunting requires defining barriers to and opportunities for new behaviour‐change initiatives. We undertook a mixed‐methods assessment feeding practices food purchasing behaviours around infants young children aged 6–36 months two uatemalan communities. found that most caregivers were aware only acute forms they greatly underestimated...

Abstract Background Research to date has detailed numerous challenges in emergency department (ED) communication with persons living dementia (PLWD) and their caregivers. However, little is known about experiences of individuals belonging minoritized racial ethnic groups, who are disproportionately impacted by less likely be included research. Methods We conducted semi‐structured interviews 29 caregivers PLWD from two urban academic hospital EDs distinct patient populations. The first site...

Disrespectful and abusive maternity care is a common pervasive problem that disproportionately impacts marginalized women. By making mothers less likely to agree facility-based delivery, it contributes the unacceptably high rates of maternal mortality in low- middle-income countries. Few programmatic approaches have been proposed address disrespectful care. Care navigation was pioneered by field oncology improve health outcomes vulnerable populations promote patient autonomy providing...

Background With the rapid increase in telehealth use during COVID-19 pandemic, concerns have been raised about potential for exacerbating existing healthcare disparities marginalized populations. While eliminating barriers such as transportation and time constraints, may introduce related to technology access. little known patient experience accessing this study seeks understand facilitators well interventions that address them. Methods We conducted qualitative interviews with parents of...

Abstract Objective To characterize the national distribution of COVID‐19 hospital and emergency department visitor restriction policies across United States, focusing on patients with cognitive or physical impairment receiving end‐of‐life care. Methods Cross‐sectional study exceptions, using a nationally representative random sample EDs hospitals during first wave pandemic, by trained investigators standardized instrument. Results Of 352 studied, 326 (93%) had hospital‐wide policy 164 (47%)...

Diversity, equity, and inclusion (DEI) leadership roles have grown in academic emergency medicine (EM). We sought to elucidate specific pathways DEI among current leaders EM. From March May 2023, we conducted semistructured, qualitative interviews with EM across 5 US regions investigate their leadership. Participants were recruited via email using Accreditation Council for Graduate Medical Education-accredited residency websites the Academy Diversity Inclusion After recording transcribing...

Recent scholarship has revealed racial disparities in emergency department (ED) physical restraint use agitation management. We implemented an interdisciplinary educational program that integrates discussions about the role of bias with workplace violence (WPV) prevention strategies to increase awareness implicit and comfort verbal de-escalation among ED staff. In partnership hospital security at a large urban academic medical center, we developed 1-hour online WPV prerequisite course...

Objective Given the aging population and growing burden of frailty, we conducted this scoping review to describe available literature regarding use impact frailty assessment tools in care emergency department (ED) patients older than 60 years. Methods A search was made using Covidence system various terms. Inclusion criteria comprised peer-reviewed focusing on screening used for a geriatric (60+ years age) presenting EDs. An additional PubMed, EBSCO, CINAHL articles published last 5 toward...

Abstract Introduction Delirium affects 15% of older adults presenting to emergency departments (EDs) but is detected in only one‐third cases. Evidence‐based guidelines for ED delirium screening exist, are underutilized. Frontline staff perceptions about and time resource constraints known barriers uptake. Early adopters can offer valuable lessons successful implementation. Methods We conducted semi‐structured interviews with clinician‐administrators leading initiatives from 20 EDs the United...

In Guatemala, diabetes is an emerging public health concern. Guatemala has one of the largest indigenous populations in Latin America, and this population frequently does not access formal care system. Therefore, knowledge about emergence limited.Interview participants (n=23) were recruited from a convenience sample adults with type 2 at rural clinic Guatemala. A structured interview was used to assess its complications; diabetes-related treatment; dietary lifestyle changes; family social...

Purpose Cervical cancer is an important cause of mortality in low- and middle-income countries. Although screening technologies continue to improve, systems care remain fragmented. It better understand factors that affect use services loss follow-up along the continuum. Methods We conducted a mixed-methods study cytology-based program rural Guatemala. A retrospective electronic chart review was performed on data from all patients 2013 2014. analyzed progression through calculated...

Racism impacts patient care and clinical training in emergency medicine (EM), but dedicated racism is not required graduate medical education. We designed an innovative health equity retreat to teach EM residents about forms of skills for responding racial inequities environments. The three-hour occurred during the residency didactic conference maximize resident participation. prioritized facilitated reflection on residents' own experiences race order emphasize these concepts' relevance all...

Abstract Background Evaluating older adults with cognitive dysfunction in emergency departments (EDs) requires obtaining collateral information from sources other than the patient. Understanding challenges clinicians face can inform development of interventions to improve geriatric care and, more specifically, detection ED delirium. The objective was understand clinicians' experiences on dysfunction, both before and during COVID‐19 pandemic. Methods From February May 2021, we conducted...

<h3>ABSTRACT</h3> <h3>Background:</h3> Like many other low- and middle-income countries, Guatemala has adopted visual inspection with acetic acid (VIA) as a low-resource alternative to the Pap smear for cervical cancer screening. Nongovernmental organizations (NGOs) introduced VIA in 2004, growing number of NGOs, working both independently collaboration Guatemalan Ministry Health, employ prevention programs today. While much research describes efficacy feasibility Latin America, little is...

The country of Guatemala has one the highest rates chronic child malnutrition in world, which primarily affects rural, indigenous Maya population. In this study we explore apparent paradox endemic food insecurity and coexisting communities alongside a predominance agricultural land holdings production. A mixed methods design explored availability access rural community, as compared to nearby urban community. Structured surveys both open-air markets corner stores examined price, quality,...

Chronic kidney disease (CKD) is increasing worldwide, and the majority of CKD burden in low- middle-income countries (LMICs). However, there wide variability global access to care therapies such as dialysis transplantation. The challenges health professionals experience while providing LMICs have not been well described. goal this study elicit professionals' perceptions a resource-constrained environment, strategies for dealing with resource limitations, suggestions improving...

Guatemala has one of the highest rates child stunting in world; indigenous Maya population, who constitute a majority, are disproportionately affected comparison to general population. Nevertheless, research on social dynamics malnutrition communities is lacking. To address this deficiency, we present here an ethnographic study caregivers' experiences two rural towns, supplemented by quantitative data collection both sites. Our documents ways which normalized total experience for and...

Access to low-cost essential generic medicines is a critical health policy goal in low-and-middle income countries (LMICs). Guatemala an LMIC where there both limited availability and affordability of these medications. However, attitudes physicians pharmacy staff regarding generics, especially generics for non-communicable diseases (NCDs), have not been fully explored Guatemala.Semi-structured interviews with 30 12 several highland towns were conducted. Interview questions related...

Indigenous populations worldwide endure disparities in access to biomedical health care. This article suggests that institutional bureaucracy is an important and underexamined barrier care for indigenous Maya people Guatemala. Based on interviews, participant observation, seven years of experience with a non-governmental organization's patient advocacy program, we examine how institutions' administrative systems impede patients' abilities obtain specialty medical treatments. Particularly,...