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Study design prognostic study, Level III. Objective (1) To determine the incidence and demographics of idiopathic scoliosis (IS) in a large cohort of children in a Southern California integrated healthcare system, (and 2) identify the demographic or clinical factors associated with the greatest risk of IS. Summary of background data Although many authors have reported on the incidence and prevalence of IS in children, there have been few incidence studies in the United States on large, self-contained populations. Methods A retrospective chart analysis was done on diagnosed cases of IS within our integrated healthcare system in patients under age 18 years during the entire 2013 calendar year. Patient demographics were recorded and the incidence of idiopathic scoliosis was determined. Odds ratios(OR) for having IS and for having more severe initial curve magnitudes based on demographics were determined using logistic regression models. Results IS Incidence was 3.9, 28.6, and 393 per 100,000, respectively, for the infantile, juvenile, and adolescent group. The female incidence was more than twice that of males in all age groups. Multivariate logistic regression analysis showed Asians and non-Hispanic Whites had the highest OR of IS (OR 1.54 and 1.32 with 95% confidence interval (CI) 1.33-1.79 and 1.19-1.47). Whites, Blacks, and mixed-race patients had a significantly higher initial curve magnitude than Hispanics; females also had a significantly greater initial curve magnitude than boys (18.1 versus 16.7°). Underweight patients had a 50% increased OR of IS vs normal weight (95% CI 1.16-1.94) with a progressively decreased OR of IS as weight increased. Conclusions Our study of a large integrated healthcare system sheds light on the incidence of IS and the odds ratios based on weight, sex and ethnicity/race. The overall incidence was lower overall than previously thought.Level of Evidence: 3.

This quality improvement (QI) project analyzed the impact of RN-led medication teaching on readmissions of adult patients discharged from a Midwest psychiatric veterans' hospital. Data on patient participation in the initiative, outpatient medication adherence, and annual 30-day readmission rates were gathered from electronic medical records (EMR) and patient discharge logs from years 2017 and 2018. Forty-three percent of RNs engaged in the initiative. Percentages of patients, who received medication teaching throughout the year, ranged from 27% to 40%. However, self-reported medication adherence following discharge was much higher (73-85%). The RN-led medication teaching initiative did not impact recidivism, and low staff participation was reflected by the downtrend in numbers of patients who received medication teaching throughout the year. Compared to previous years, annual recidivism increased. Fifty-three percent of recidivist patients who received medication teaching reported complete outpatient medication adherence prior to readmission, possibly indicating it is not a significant factor in preventing readmissions or, alternatively, that patients tend to over-report adherence. A small group of patients (19%) accounted for the majority of readmissions annually (70%). This group appears to be most at risk for continued recidivism. Future attempts to improve unit recidivism might benefit from aligning interventional strategies to the common risk factors of chronic recidivists.

Objective Traditional scoliosis braces are typically crafted from customized casts or molds made of the patient's trunk. More recently, computer aided design/computer aided manufacture (CAD/CAM) and other computer technology has been introduced in order to try to eliminate this close physical contact and minimize the variability of orthotists' skills. The purpose of the present study is to report on the preliminary experience with the Los Angeles braceTM, a new CAD/CAM brace.

The use of Electronic Health Records (EHRs) has been widely advocated to transform health-care delivery by improving quality, safety, and efficiency. Compared to a paper-based system, EHRs offer better access to clinical data and facilitate order entry and decision support. However, the benefits provided by EHRs do not eliminate the need to assess how such systems alter clinician time utilization. A major barrier to EHR use has been the concern that the EHR will take longer to use than paper-based systems. Few studies have addressed this issue in specialty clinic settings. We performed a time-motion study to evaluate how oncologists' time utilization differed before and after EHR implementation.

This final technical report is written to document the results of current contractural efforts for AIPERS. With this documentation the feasibility of developing an operational automated exercise system is realized with two subsystems. In particular, the report includes a summary of system and software performance improvements, and suggested future goals. Also included as Appendix A is the AIPERS/SSB functional description. (Author)

Methods A survey was sent to a random sample of 1,400 patients obtained from the AAOL newsletter database of 4,500 patients. The 20 question survey assessed patient demographics, perceived value of treatment, medication use, health and utilization ratings, compliance, school/work attendance, hospitalizations and unplanned physician visits and health related measures such as energy, sleep, and emotional well-being. Data was analyzed using SPSS by the research team.