Neuropsychological Symptoms and Functional Capacity in Older Adults with Chronic Pain.

The impact of chronic pain on neuropsychological functioning of older adults is under-studied. The present study examined the relationship between chronic pain, depression, anxiety, cognition, and functional capacity in community-dwelling older adults (ages 60-89) who completed an outpatient neuropsychological evaluation ( = 452). Psychometrically sound and validated measures were used to assess depression (Geriatric Depression Scale [GDS]), anxiety (Beck Anxiety Inventory [BAI]), cognitive functioning (the Mini Mental Status Exam [MMSE] and the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]), and functional capacity (Texas Functional Living Scale [TFLS] and Instrumental Activities of Daily Living Questionnaire [IADL]).

Labelling of mental illness in a paediatric emergency department and its implications for stigma reduction education.

Introduction: Stigmatizing attitudes and behaviours towards patients with mental illness have negative consequences on their health. Despite research regarding educational and social contact-based interventions to reduce stigma, there are limitations to the success of these interventions for individuals with deeply held stigmatizing beliefs. Our study sought to better understand the process of implicit mental illness stigma in the setting of a paediatric emergency department to inform the design of future educational interventions.

Dual-System Use and Intermediate Health Outcomes among Veterans Enrolled in Medicare Advantage Plans.

Objective: The concurrent use of multiple health care systems may duplicate or fragment care. We assessed the characteristics of veterans who were dually enrolled in both the Veterans Affairs (VA) health care system and a Medicare Advantage (MA) plan, and compared intermediate quality outcomes among those exclusively receiving care in the VA with those receiving care in both systems.

Data Sources/study Setting: VA and MA quality and administrative data from 2008 to 2009.

Predictors of high-risk prescribing among elderly Medicare Advantage beneficiaries.

Objectives: To examine patient, community, and insurance plan predictors of high-risk prescribing in the elderly Medicare Advantage population.

Study Design: Cohort study.

Methods: Using a sample of 203 Medicare Advantage plans from the 2006-2008 Health Outcomes Survey, we compared patient, community, and insurance plan characteristics of 77,247 respondents with and without new Medicare Part D claims for high-risk medications from June 2006 to May 2007.

Meaning of death: an exploration of perception of elderly in a Bangladeshi village.

The aim of this qualitative study was to explore the perceptions of meaning of death among the elderly in a Bangladeshi community, and to understand how the meaning of death affects one's overall well-being. Understandings of death were explored through the explanations respondents provided on the journey of the soul during lifetime and the afterlife, concepts of body-soul duality, and perceived "good" and "bad" deaths. The relationship to well-being was expressed in terms of longevity, anxiety/acceptance of death, and preferred circumstances for death.

Underreporting high-risk prescribing among Medicare Advantage plans: a cross-sectional analysis.

Background: Although Medicare Advantage plans are required to report clinical performance using Healthcare Effectiveness Data and Information Set (HEDIS) quality indicators, the accuracy of plan-reported performance rates is unknown.

Objective: To compare calculated and reported rates of high-risk prescribing among Medicare Advantage plans.

Design: Cross-sectional comparison.

Fitness memberships and favorable selection in Medicare Advantage plans.

Background: Because Medicare Advantage plans must pay for covered services, they may design insurance benefits to appeal to healthier beneficiaries.

Methods: We identified 11 Medicare Advantage plans that offered new fitness-membership benefits in 2004 or 2005 and matched these plans to 11 Medicare Advantage control plans that did not offer coverage for fitness memberships. Using a difference-in-differences approach, we compared the self-reported health status of persons who enrolled after the fitness benefit was added to the plan with the self-reported health status of persons entering the same plan before the fitness benefit was offered.