Patient Use of Cardiovascular Devices and Apps: Are We Getting Our Money's Worth?

The evolution of technology makes it likely that a large number of people will invest in and use health-related mobile applications and wearable devices. Yet the question remains: Do these technology-based interventions modify health behavior and improve health…and are we getting our money's worth? The vast majority of studies concerning health-related apps and wearable devices have small sample sizes and short time spans of 6 months or less, so it is not clear if these durations were determined by lack of consistent use over time. Furthermore, many of the most popular applications have not been subjected to randomized trials.

Reducing the Cost of Medicaid: A Multistate Simulation.

According to some estimates, the United States wastes as much as 30% of health care dollars. Some of that waste can be mitigated by reducing certain costs associated with Medicaid. We chose 5 areas of savings applicable to Medicaid: (1) modification of physician payment models to reduce unnecessary care, (2) development of a medication adherence program for patients dually eligible for Medicaid and Medicare support ("dual eligibles"), (3) improvement in unnecessary admissions and readmissions for dual eligibles, (4) reduction in emergency department visits among children in Medicaid and dual-eligible beneficiaries, and (5) improvement in adoption of end-of-life advance directives.

First point-spread function and x-ray phase-contrast imaging results with an 88-mm diameter single crystal.

In this study, we report initial demonstrations of the use of single crystals in indirect x-ray imaging with a benchtop implementation of propagation-based x-ray phase-contrast imaging. Based on single Gaussian peak fits to the x-ray images, we observed a four times smaller system point-spread function (PSF) with the 50-µm thick single crystal scintillators than with the reference polycrystalline phosphor/scintillator. Fiber-optic plate depth-of-focus and Al reflective-coating aspects are also elucidated.

Effect of Grand-Aides Nurse Extenders on Readmissions and Emergency Department Visits in Medicare Patients With Heart Failure.

Numerous procedures have been tested to reduce hospital readmissions with varying success. The objective of this study was to evaluate all-cause readmissions and emergency department (ED) visits 30 days and 6 months after discharge with Grand-Aides (GAs): nurse extenders making frequent home visits under video direction by a nurse supervisor. Medicare patients with primary diagnosis of heart failure at the University of Virginia discharged January 1, 2013 to January 1, 2015 were included.