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Improved rainwater erosion toughness for enzymatically activated carbonate precipitation with regard to airborne debris handle.
OBJECTIVES From 2011 to 2015, psychiatric emergency department visits among youth in the United States increased 28% and psychiatric visits made up 10% of all pediatric emergency department (ED) visits. Previous research has focused on adolescent mental health, with little characterization of children 10 years of age and younger with mental health complaints. The primary objective of this study was to describe these children who presented to a pediatric ED for mental health complaints in terms of demographics and psychosocial factors. METHODS One researcher reviewed medical records of children 10 years and younger who presented to the Children's of Alabama ED between January 1, 2016 and May 31, 2016 with a mental health-related chief complaint. Patient data were then categorized based on demographic information, characteristics of the ED visit, and medical and social history. Descriptive analyses were run using SAS version 9.4. RESULTS In total, 222 patients 10 years and younger were seen between January 1 anheir school (OR -1.12, P less then 0.01). CONCLUSIONS The pediatric ED sees a significant number of children ages 10 years and younger for mental health-related complaints. Nearly half of these children were admitted for psychiatric care. Several factors were found to predict admission, which reflect psychosocial influences. These psychosocial factors are important targets for intervention both in the ED and in the community.OBJECTIVES To define the magnitude of buprenorphine presence in the urine drug screens of pregnant women and to assess the presence of illicit buprenorphine use versus the presence of prescribed buprenorphine use. METHODS Initial prenatal drug screen results for all pregnant patients in our practice for a 1-year period were analyzed and tabulated. RESULTS Buprenorphine was found in the urine drug screens of 16% of pregnant patients. The presence of buprenorphine was by far the highest for any substance associated with neonatal abstinence syndrome (NAS). We estimate that the exposure to buprenorphine of approximately one-third of individuals in our population is associated with illicit buprenorphine use. CONCLUSIONS The high rate of NAS in our region is primarily associated with both illicit and prescribed buprenorphine rather than other substances. Buprenorphine usage at the time that prenatal care is initiated, rather than opiate use at the onset of prenatal care, is the underlying factor that must be addressed if our region is to successfully combat our high rates of NAS.OBJECTIVES Personal health behavior can influence the academic development of healthcare students. This study was designed to evaluate the personal health behavior, including sleep time, of healthcare students at a large health sciences center. METHODS An anonymous online survey based on standardized questionnaires about sleep, insomnia, depression, alcohol use, and exercise was sent to all of the healthcare students (including medical, nursing, pharmacy, graduate biomedical science, and allied health students) in the Texas Tech University Health Sciences Center graduate education programs in Lubbock. RESULTS In total, 412 students replied to this survey. Their mean sleep duration during the weekday was 7.5 ± 1.2 hours; 16.5% were short sleepers (15 days during the last month. Many students were either moderately or severely bothered by "the lack of energy" because of poor sleep, and 56.6% of students rated their sleep as either fair or poor. Approximately 35% of students had drinking patterns that qualified as hazardous drinking, 6.3% of students smoked, and 23% of students did not do even mild exercise during the week. Eighty-nine percent of students reported stress in their life, including family stress, job stress, financial stress, legal stress, and other stress. KWA0711 Thirty-five percent of students considered their health as either poor or fair. Approximately 50% of students did not expect any change in their situation during the next 3 to 6 months. CONCLUSIONS Although most healthcare students report adequate sleep times, more than half of them rate their sleep as fair or poor. In addition, some have poor health habits, including excessive alcohol use. Health science centers should introduce programs to promote healthy behaviors and reduce stress in healthcare students.OBJECTIVE To determine the amount of variation in numbers and types of medications requiring prior authorization (PA) by insurance plan and type. METHODS Most health insurance companies require PA for medications to ensure safe and effective use and contain costs. We generated 4 lists of medications that required PA during 2017 for commercial, marketplace, Medicaid, and Medicare plans. We aggregated medications according to the generic medication name equivalent using codes and medication names. We compared these medications to assess how many of the medications required PA by 1, 2, 3, or all 4 of the insurance plans. We counted all prescription orders written for a patient age 18 years or older with health plan insurance during 2017 for any of the medications that appeared on the health plan's PA lists by querying the electronic health record. RESULTS PA was required for 600 unique medications in 2017 across the 4 plans. Of 691,457 prescription orders written for 114,159 members, 31,631 (5%) were written for 1 of the 600 medications that required PA by at least 1 insurance plan. There were 12,540 medication orders (written for 6,642 members) that potentially required PA. The marketplace plan required PA for the greatest number of medications (440), followed by the Medicare (272), commercial (271), and Medicaid (72) plans. The most commonly prescribed classes of medications for which PA was required by at least 1 plan were antihyperlipidemics (22% of orders potentially requiring PA), narcotic analgesics (13%), hypnotics (12%), antidiabetic medications (9%), and antidepressants (9%). For only 25% of medications (151 of 600) was PA required by at least 3 plans, and for only 5% (32 of 600) was PA required by all 4 insurance types. CONCLUSION Medications requiring PA can differ within a single health insurance company, but this variation may be unavoidable due to external factors. © American Society of Health-System Pharmacists 2020. All rights reserved. For permissions, please e-mail [email protected].
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