Depression and the Likelihood of Hospital Admission from the Emergency Department among Older Patients with HIV.

OBJECTIVE: The objective was to determine if depression was associated with an increased likelihood of hospital admission following an emergency department (ED) visit among older patients diagnosed with HIV. METHODS: We performed secondary analysis of data from the Nationwide Emergency Department Sample (NEDS) in the United States using multivariable Poisson regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). We included adults aged 50 years and older, diagnosed with HIV using International Classification of Diseases, 9th revision (ICD-9-CM) codes. We controlled for demographic characteristics, hospital characteristics, and comorbid conditions in the analysis. RESULTS: In the final multivariable model, there was a 45% increase in the likelihood of hospital admission following an ED visit among older patients with HIV diagnosed with depression compared with those not diagnosed with depression (PR = 1.45, 95% CI = 1.39-1.52). CONCLUSIONS: Depression was associated with hospital admission among adults aged 50 and over.

Mobile Access to Clinical Information at the Point of Care.

OBJECTIVES: Using library subscriptions and accessible on handheld devices, this study sought to promote authoritative health information apps, and evidence-based point-of-care resources. METHODS: Three cohorts of internal medicine residents were issued iPads at the beginning of their second year, and were trained to skillfully access resources from the digital library. Pre- and post-intervention surveys were respectively administered at the beginning of the second year and end of the third year of training. The residents' computer experience and computer knowledge was assessed. Additionally, before and after formal introduction to iPads, perceptions on the use of computers to access clinical information were assessed. Survey responses were compared using two sample methods and summarized through descriptive statistics. RESULTS: Sixty-eight residents completed the pre-survey questionnaires and 45 completed the post-surveys. There were significant improvements in the residents' level of computer experience, and familiarity with medical apps. Furthermore, there was increased knowledge obtained in accessing clinical information through electronic medical records. Residents positively perceived the potential effects of computers and electronic medical records in medicine. CONCLUSION: Study findings suggested that health science libraries can be instrumental in providing search skills to health professionals, especially residents in training. Participants showed appreciation of iPads and library support that facilitated successful completion of their related tasks. Replicating this study with a larger sample derived from multiple sites is recommended for future studies. Participation of mid-level healthcare professionals, such as Physician Assistants and Nurse Practitioners is suggested.