Issue - Southern Medical Association

Invited Commentary

Commentary on “Factors Associated with Emergency Department Visits in Asthma Exacerbation”

Although the more regular use of inhaled corticosteroids (ICS) in patients with moderate to severe asthma has led to a reduction in admission rates for exacerbations,1 rates of emergency department (ED) visits remain unacceptably and inexplicably high.2 Previous work has shown that nonwhite race, low socioeconomic status, and greater asthma…

Perspectives

Moving Away from Fee-for-Service: Implications for Medication Adherence

As part of the Patient Protection and Affordable Care Act (PL 111–148), the US Congress has required that the Centers for Medicare & Medicaid Services implement pay-for- performance programs in which reimbursement will be tied to patients’ treatment outcomes. Pay-for-performance models are an attempt at controlling healthcare costs while concurrently…

Perspectives

Don’t Order a Test Just Because You Can

Community-acquired pneumonia (CAP) is a clinical diagnosis based on typical features, including fever, cough with sputum production, and pleuritic chest pain, supported by physical examination findings of lung consolidation, laboratory evidence of leukocytosis or bandemia, and new infiltrates on chest imaging.1 Urinary antigen tests for Legionella pneumophila serotype 1 and…

Original Article

Effectiveness of an Urban Emergency Department Call-Back System in the Successful Linkage to Treatment of Sexually Transmitted Infections

Objectives: There is a high incidence of asymptomatic sexually transmitted infections (STIs) in emergency department (ED) patients. There is no historical indication, physical examination finding, or rapidly available laboratory testing specific for detecting STIs in women. This study was conducted to describe the performance of an ED call-back system for…

Original Article

Impact of Trainees on Length of Stay in the Emergency Department at an Academic Medical Center

Objectives: Emergency department (ED) overcrowding remains a growing concern despite continued efforts by hospitals to improve efficiency while also maintaining quality of care and medical education. The purpose of this study was to examine whether the total number of trainees rotating in the ED affects length of stay (LOS). Methods:…

Invited Commentary

Commentary on “Impact of Trainees on Length of Stay in the Emergency Department at an Academic Medical Center”

Like many other components of the US healthcare system, emergency departments (EDs) are struggling to deal with the major clinical and nonclinical challenges of our current healthcare environment. Strong and growing clinical demands of patients and referring sources often are matching or exceeding ED capabilities and capacities. Additional imperatives are…

Original Article

Assessment of Appropriate Antibiotic Prescribing for Urinary Tract Infections in an Internal Medicine Clinic

Objectives: Urinary tract infections (UTIs) are one of the most common infections encountered in ambulatory care and inpatient settings. Although these infections are common, not all patients are prescribed an appropriate antibiotic or duration of therapy. The primary objective of this analysis was to evaluate the appropriateness of antibiotic selection…

Original Article

Factors Associated with Emergency Department Visits in Asthma Exacerbation

Objectives: Despite quality improvement initiatives to prevent asthma-related emergency department (ED) visits, rates have not declined. We sought to determine factors associated with ED visits in an underserved population. Methods: We performed a case–control analysis of asthma patients at three ambulatory care centers serving low-income populations. Cases consisted of asthmatic…

Invited Commentary

Commentary on “Effectiveness of an Urban Emergency Department Call-Back System in the Successful Linkage to Treatment of Sexually Transmitted Infections”

In this issue of the Southern Medical Journal, Lolar and colleagues studied an emergency department (ED) setting with a policy that all patients with symptoms of sexually transmitted infections (STIs) are treated.1 Asymptomatic patients who were tested and not treated in the ED were entered into a call-back system by…

Original Article

Factors Associated with Local Public Health Agency Participation in Obesity Prevention in Southern States

Objectives: Obesity rates in the southern US states are higher than in other states. Historically, large-scale community-based interventions in the United States have not proven successful. With local public health agencies (LPHAs) tasked with prevention, their role in obesity prevention is important, yet little research exists regarding what predicts the…

Original Article

Lawyer Mothers: Infant-Feeding Intentions and Behavior

Objectives: Maternal employment postpartum can have a powerful influence over infant-feeding behaviors. The objective of this cross-sectional online survey was to explore the infant-feeding intentions and behaviors of a convenience sample of lawyer mothers. We compared our findings with those for physician mothers. Methods: Lawyers participated in an anonymous online…

Original Article

Pediatric Staphylococcus aureus Infections: Impact of Methicillin Resistance at a Canadian Center

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) causes a wide spectrum of potentially serious infections in children. This study describes the evolving experience with S. aureus infections at a Canadian tertiary pediatric care center serving a wide geographic area. Design: In this two-component study, a retrospective review of infection control databases for…

Original Article

Utilization of 2013 BRFSS Physical Activity Data for State Cancer Control Plan Objectives: Alabama Data

Objectives: All comprehensive US cancer control plans mention physical activity and implement physical activity promotion objectives as part of these cancer plans. The purpose of this investigation was to describe the physical activities reported by Alabama adults in the 2013 Behavioral Risk Factor Surveillance System (BFRSS) and to compare these…

Original Article

Insurance Status Effects on Stage of Diagnosis and Surgical Options Used in the Treatment of Breast Cancer

Objectives: Insurance status has the potential to play a significant role in an individual’s health care by affecting the time of diagnosis and the treatment options used. Our study reviewed insurance status as a determinant of the time of a breast cancer diagnosis as well as the surgical treatment options…