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Introduction: Sexual assault is a public health problem that affects many Americans and has multiple long-lasting effects on victims. Medical evaluation after sexual assault frequently occurs in the emergency department, and documentation of the visit plays a significant role in decisions regarding prosecution and outcomes of legal cases against perpetrators. The American College of Emergency Physicians recommends coding such visits as sexual assault rather than adding modifiers such as “alleged.”Methods: This study reviews factors associated with coding of visits as sexual assault compared to suspected sexual assault using the 2016 Nationwide Emergency Department Sample.Results: Younger age, female gender, a larger number of procedure codes, urban hospital location, and lack of concurrent alcohol use are associated with coding for confirmed sexual assault.Conclusion: Implications of this coding are discussed.

In the traditional clinical research model, patients are typically involved only as participants. However, there has been a shift in recent years highlighting the value and contributions that patients bring as members of the research team, across the clinical research lifecycle. It is becoming increasingly evident that to develop research that is both meaningful to people who have the targeted condition and is feasible, there are important benefits of involving patients in the planning, conduct, and dissemination of research from its earliest stages. In fact, research funders and regulatory agencies are now explicitly encouraging, and sometimes requiring, that patients are engaged as partners in research. Although this approach has become commonplace in some fields of clinical research, it remains the exception in clinical pain research. As such, the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials convened a meeting with patient partners and international representatives from academia, patient advocacy groups, government regulatory agencies, research funding organizations, academic journals, and the biopharmaceutical industry to develop consensus recommendations for advancing patient engagement in all stages of clinical pain research in an effective and purposeful manner. This article summarizes the results of this meeting and offers considerations for meaningful and authentic engagement of patient partners in clinical pain research, including recommendations for representation, timing, continuous engagement, measurement, reporting, and research dissemination. [ABSTRACT FROM AUTHOR]

Background Persistent postsurgical pain (PPSP) is a common complication that impacts quality of life, often necessitating long-term opioid treatment. Certain neurocognitive factors, including reduced performance on cognitive flexibility tasks, are associated with increased risk of PPSP. We examine the perceptions of surgical patients and clinicians with regard to perioperative pain management activities and needs; patient acceptance and use of a perioperative neurocognitive training intervention; and implementation feasibility. Methods We conducted both individual and focus group interviews with patients undergoing thoracic surgery and clinicians in an academic medical center. The Consolidated Framework for Intervention Research guided the development of interview questions related to the adoption and implementation of a neurocognitive intervention to mitigate PPSP. A thematic analysis was used to analyze the responses. Results Forty patients and 15 clinicians participated. Interviews revealed that there is minimal discussion between clinicians and patients about PPSP. Most participants were receptive to a neurocognitive intervention to prevent PPSP, if evidence demonstrating its effectiveness were available. Potential barriers to neurocognitive training program adoption included fatigue, cognitive overload, lack of familiarity with the technology used for delivering the intervention, and immediate postoperative pain and stress. Implementation facilitators would include patient education about the intervention, incentives for its use, and daily reminders. Conclusion The study identified several guiding principles for addressing patients' and clinicians' barriers to effectively implementing a neurocognitive training intervention to mitigate PPSP after surgery. To ensure the sustainability of neurocognitive interventions for preventing PPSP, such interventions would need to be adapted to meet patients' and clinicians' needs within the perioperative context. [ABSTRACT FROM AUTHOR]

Physical child abuse continues to be a serious public health issue in the United States. This study expands on previous research by exploring trends in physical child abuse diagnoses among children admitted to emergency departments (EDs) across the United States. The analysis aimed to explicate the association between physical child abuse and both sociodemographic and behavioral health covariates to better inform and identify risk factors associated with ED admissions for abuse. The study also explicated differences between confirmed and suspected physical child abuse cases. The study utilized a nationally representative sample of hospital-owned EDs that included 319,676,625 ED admissions between 2006 and 2017 for children under 18-years-old. The analysis included a trend analysis, bivariate descriptive statistics, and multivariate logistic regression models were employed. Children with a physical child abuse diagnosis were less likely to be from higher income communities (a OR = 0.61, 95% CI [0.53, 0.71]), less likely to be female (a OR = 0.93, 95% CI [0.90, 0.96]), and more likely to be uninsured (a OR = 1.65, 95% CI [1.48, 1.84]). Children with attention-deficit hyperactivity disorder (a OR = 1.36, 95% CI [1.14, 1.62]) and a conduct disorder (a OR = 1.28, 95% CI [1.04, 1.58]) were more likely to have a physical abuse diagnosis. The sex-stratified analyses found that the higher rates of physical abuse among children with attention-deficit hyperactivity disorder were driven by the male subsample, while higher rates of abuse for those with conduct disorders were the result of the female subsample. A supplemental analysis of suspected versus confirmed physical child abuse for the fourth quarter of 2015 through 2017 also revealed sociodemographic and behavioral health differences. This study supports the need to consider sociodemographic and behavioral risk factors associated with physical child abuse to inform treatment and potential reoccurrence of abuse. [ABSTRACT FROM AUTHOR]