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Variable direct cost

Stephanie Agtarap, Adriel Boals, Pamela Holtz, Kenleigh Roden-Foreman, Evan E Rainey, Camilo Ruggero, Ann Marie Warren
BACKGROUND: Depression is a common mental health outcome after traumatic injury, negatively impacting physical outcomes and increasing the cost of care. Research shows that the presence and quality of support is a leading protective factor against depression post-injury; however, research is vague on the directional effects of both factors over the course of recovery. METHODS: 130 patients admitted to a Level I Trauma Center were recruited to a prospective study examining overall outcomes one-year after injury...
October 11, 2016: Journal of Affective Disorders
Leonie Segal, Claire Marsh, Rob Heyes
OBJECTIVES: We explored the real cost of training the workforce in a range of primary health care professions in Australia with a focus on the impact of retention to contribute to the debate on how best to achieve the optimal health workforce mix. METHODS: The cost to train an entry-level health professional across 12 disciplines was derived from university fees, payment for clinical placements and, where relevant, cost of internship, adjusted for student drop-out...
October 6, 2016: Journal of Health Services Research & Policy
Marko Poglitsch, Ashraf H Ahmed, Michael Resl, Andrea Stoller, Dunja Van Oyen, Cornelia Schwager, Claudia Aigner, Oliver Domenig, Michael Krebs, Manuel Haschke, Michael Stowasser
OBJECTIVE: Primary aldosteronism (PA) is form of hypertension characterized by production of aldosterone by the adrenal that is excessive and relatively autonomous of the renin-angiotensin system. Once detected, unilateral PA can be usually cured by surgical removal of the affected adrenal, while bilateral PA can be specifically treated by medications, which antagonize aldosterone action. Clinical guidelines of Endocrine Societies in Europe and the US recommend screening for PA among most hypertensive patients...
September 2016: Journal of Hypertension
Isabelle Cossette, Marie-Ève Gagné, Marie-Christine Ouellet, Philippe Fait, Isabelle Gagnon, Katia Sirois, Sophie Blanchet, Natalie Le Sage, Bradford J McFadyen
OBJECTIVE: To compare gait parameters between children in early adolescence (EA) with and without a mild traumatic brain injury (mTBI) during dual-task walking (DTW). METHODS: Children in EA with mTBI (n = 14; six girls) were compared to those without (n = 13; five girls) while walking in different combinations of obstacle avoidance and cognitive dual-tasks. Gait speed and fluidity and their related dual-task costs (DTC) were analysed along with foot clearance and proximity to the obstacle...
October 14, 2016: Brain Injury: [BI]
Sara C Caddigan, Alaina C Pfenning, Timothy C Sparkes
The acanthocephalan Acanthocephalus dirus is a trophically transmitted parasite that modifies both the physiology and behavior of its intermediate host (isopod) prior to transmission to its definitive host (fish). Infected isopods often contain multiple A. dirus individuals and we examined the relationships between host sharing, body size, energy content, and host modification to determine if host sharing was costly and if these costs could influence the modification of host behavior (mating behavior). Using field-based measures of parasite energy content (glycogen, lipid) and parasite body size (volume), we showed that host sharing was costly in terms of energy content but not in terms of body size...
October 10, 2016: Parasitology Research
Luke R Putnam, Kuojen Tsao, Francesco Morini, Pamela A Lally, Charles C Miller, Kevin P Lally, Matthew T Harting
Importance: Inhaled nitric oxide (iNO) is an expensive, commonly used therapy among patients with congenital diaphragmatic hernia (CDH); however, data to support its ongoing use in this patient population are lacking. Objective: To describe the spectrum of iNO use among patients with CDH and its association with pulmonary hypertension (pHTN) and mortality. Design, Setting, and Participants: A review was conducted of prospectively collected patient data in the Congenital Diaphragmatic Hernia Study Group registry between January 1, 2007, and December 31, 2014, from 70 participating centers in 13 countries...
October 10, 2016: JAMA Pediatrics
Robert J Zalenski, Spencer S Jones, Cheryl Courage, Denise R Waselewsky, Anna S Kostaroff, David Kaufman, Afzal Beemath, John Bronfman, James W Castillo, Hicham Krayem, Anthony Marinelli, Bradley Milner, Maria Teresa Palleschi, Mona Tareen, Sheri Testani, Ayman Soubani, Julie Walch, Judy Wheeler, Sonali Wilborn, Hanna Granovsky, Robert D Welch
CONTEXT: There are few multi-center studies that examine the impact of systematic screening for palliative care and specialty consultation in the ICU. OBJECTIVE: To determine the outcomes of receiving palliative care consultation (PCC) for patients who screened positive on palliative care referral criteria. METHODS: In a prospective quality assurance intervention with a retrospective analysis, the covariate balancing propensity score method was utilized to estimate the conditional probability of receiving a PCC and to balance important covariates...
October 5, 2016: Journal of Pain and Symptom Management
Laura Sordo, Rui Santos, Joao Reis, Alona Shulika, Joao Silva
Most ocean acidification (OA) experimental systems rely on pH as an indirect way to control CO2. However, accurate pH measurements are difficult to obtain and shifts in temperature and/or salinity alter the relationship between pH and pCO2. Here we describe a system in which the target pCO2 is controlled via direct analysis of pCO2 in seawater. This direct type of control accommodates potential temperature and salinity shifts, as the target variable is directly measured instead of being estimated. Water in a header tank is permanently re-circulated through an air-water equilibrator...
2016: PeerJ
Gina Nicholson, Shravanthi R Gandra, Ronald J Halbert, Akshara Richhariya, Robert J Nordyke
OBJECTIVE: Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events. METHODS: MEDLINE database was searched electronically for English language studies published during 2007-2012, with cost estimates for CV events of interest - unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization...
2016: ClinicoEconomics and Outcomes Research: CEOR
Georgia Miskell, Jennifer Salmond, David E Williams
Low-cost sensors offer the possibility of gathering high temporal and spatial resolution crowd-sourced data-sets that have the potential to revolutionize the ways in which we understand individual and population exposure to air pollution. However, one of the challenges associated with crowd-sourced data ('citizen science'), often from low-cost sensors, is that citizens may use sites strongly affected by local conditions, limiting the wider significance of the data. This paper examines results from a low-cost network measuring ground-level ozone to evaluate the impact of siting on data quality...
September 29, 2016: Science of the Total Environment
April N Kapu, Carmel A McComiskey, Lacey Buckler, Jennifer Derkazarian, Tammy Goda, Maria A Lofgren, Colleen K McIlvennan, Julie Raaum, Patricia M Selig, Corinna Sicoutris, Barbara Todd, Vicki Turner, Elizabeth Card, Nancy Wells
OBJECTIVE: This study examines data collected from a survey of advanced practice providers' (APPs') perceptions of reasonable versus actual APP-to-patient ratios and other factors that affect workload burden in both inpatient and outpatient clinical settings. BACKGROUND: Advanced practice providers provide accessible, cost-effective, and quality care in a growing number of specialty practices across multiple patient care settings. They are caring for higher volumes of patients and assuming more responsibilities while continuing to navigate highly complex healthcare systems...
October 2016: Journal of Nursing Administration
Seema R Khurana, Alexandria G Beranger, Elizabeth R Felix
OBJECTIVE: This study investigates the direct comparison of energy cost, efficiency, and effort between an ankle-foot orthosis (AFO) and a functional electrical stimulation (FES) device for foot drop in ambulatory patients with multiple sclerosis. DESIGN: Twenty adults (32-74 years old; 55% female) with a diagnosis of multiple sclerosis resulting in foot drop participated in a crossover, counterbalanced preliminary study. Each participant was tested on different days, with each session consisting of a separate walk trial per prosthetic device...
September 26, 2016: American Journal of Physical Medicine & Rehabilitation
Nita Khandelwal, David Benkeser, Norma B Coe, Ruth A Engelberg, J Randall Curtis
RATIONALE: In the intensive care unit (ICU), complex decision-making by clinicians and families requires good communication to ensure care is consistent with patients' values and goals. OBJECTIVES: Assess the economic feasibility of staffing ICUs with a communication facilitator. METHODS: Data from a randomized trial of an "ICU communication facilitator" linked to hospital financial records; eligible patients (n=135) were admitted to the ICU at a single hospital with predicted mortality ≥30% and a surrogate decision maker...
September 27, 2016: Annals of the American Thoracic Society
David E Cade, Ari S Friedlaender, John Calambokidis, Jeremy A Goldbogen
Rorqual whales exhibit an extreme lunge filter-feeding strategy characterized by acceleration to high speed and engulfment of a large volume of prey-laden water [1-4]. Although tagging studies have quantified the kinematics of lunge feeding, the timing of engulfment relative to body acceleration has been modeled conflictingly because it could never be directly measured [5-7]. The temporal coordination of these processes has a major impact on the hydrodynamics and energetics of this high-cost feeding strategy [5-9]...
October 10, 2016: Current Biology: CB
Catia Balducci, David C Green, Paola Romagnoli, Mattia Perilli, Christer Johansson, Pavlos Panteliadis, Angelo Cecinato
This study reports the first investigation of atmospheric illicit drug concentrations in Northern Europe using measurements of cocaine and cannabinoids in Amsterdam, London and Stockholm. Further, these measurements were compared to those made in Rome to explore the geographical and inter-city variability. Co-located measurements of atmospheric particulate mass and PAHs were used to help describe and interpret the illicit drug measurements with respect to atmospheric dispersion. Cocaine concentrations ranged from 0...
September 21, 2016: Environment International
Alessandra Buja, Anna Maria Saieva, Angela Vinelli, Rosaria Manola Cacco, Ketty Ottolitri, Elisa De Battisti, Claudio Dario, Vincenzo Baldo
BACKGROUND: Reporting adverse events (AE) with a bearing on patient safety is fundamentally important to the identification and mitigation of potential clinical risks. OBJECTIVE: The aim of this study was to analyze the AE reporting systems adopted at a university hospital for the purpose of enhancing the learning potential afforded by these systems. RESEARCH DESIGN: Retrospective cohort study METHODS: Data were collected from different information flows (reports of incidents and falls, patients' claims and complaints, and cases of hospital-acquired infection [HAI]) at an university hospital...
September 17, 2016: International Journal of Risk & Safety in Medicine
George N Guild, Robert P Runner, Gina M Castilleja, Melissa J Smith, CatPhuong L Vu
BACKGROUND: Allogeneic blood transfusions have inherent risk and direct cost in total hip arthroplasty. Anterior total hip arthroplasty has grown in popularity with increased utilization. This approach may offer an enhanced recovery but has been associated with increased blood loss. Several technologies have been developed including the Canady Hybrid Plasma Scalpel (CHPS) and Aquamantys Bipolar Sealer (BS) to decrease blood loss. METHODS: Two hundred forty-four consecutive patients undergoing anterior supine intermuscular total hip arthroplasty were separated by intraoperative cautery device (CHPS vs BS)...
August 10, 2016: Journal of Arthroplasty
Julajak Limsrivilai, Ryan W Stidham, Shail M Govani, Akbar K Waljee, Wen Huang, Peter D R Higgins
BACKGROUND & AIMS: A subset of patients with inflammatory bowel diseases (IBD) have continuously active inflammation, leading to a high number of complications and high direct healthcare costs (diagnostic tests, medications, and surgeries) and indirect costs (reduced employment and productivity and fewer opportunities for activities). Identifying these high-risk patients and providing effective interventions could produce better outcomes and reduce costs. We used prior year data to create IBD risk models to predict IBD-related hospitalizations, emergency department visits, and high treatment charges (>$30,000/year) in the subsequent year...
September 16, 2016: Clinical Gastroenterology and Hepatology
Kimberly C Dreison, Lauren Luther, Kelsey A Bonfils, Michael T Sliter, John H McGrew, Michelle P Salyers
Burnout is prevalent among mental health providers and is associated with significant employee, consumer, and organizational costs. Over the past 35 years, numerous intervention studies have been conducted but have yet to be reviewed and synthesized using a quantitative approach. To fill this gap, we performed a meta-analysis on the effectiveness of burnout interventions for mental health workers. We completed a systematic literature search of burnout intervention studies that spanned more than 3 decades (1980 to 2015)...
September 19, 2016: Journal of Occupational Health Psychology
Marko Poglitsch, Ashraf H Ahmed, Michael Resl, Andrea Stoller, Dunja Van Oyen, Cornelia Schwager, Claudia Aigner, Oliver Domenig, Michael Krebs, Manuel Haschke, Michael Stowasser
OBJECTIVE: Primary aldosteronism (PA) is form of hypertension characterized by production of aldosterone by the adrenal that is excessive and relatively autonomous of the renin-angiotensin system. Once detected, unilateral PA can be usually cured by surgical removal of the affected adrenal, while bilateral PA can be specifically treated by medications, which antagonize aldosterone action. Clinical guidelines of Endocrine Societies in Europe and the US recommend screening for PA among most hypertensive patients...
September 2016: Journal of Hypertension
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