Corticosteroid Dosing and Glucose Levels in COPD Patients Are Not Associated with Increased Readmissions.

Introduction: Hospital admissions and readmissions for chronic obstructive pulmonary disease (COPD) exacerbations are associated with increased mortality and higher cost. The management of exacerbations with a shortened course of systemic corticosteroids has similar efficacy as compared to longer steroid courses, but actual overall steroid dose given is still variable. The outcomes associated with steroid side effects, such as hyperglycemia, need further evaluation.

Postdischarge Correlates of Health Literacy Among Medicaid Inpatients.

Health literacy may represent a target for intervention to improve hospital transitions. This study analyzed the association of health literacy with postdischarge utilization among Medicaid patients treated in an integrated health care system. Discharged inpatients covered by Medicaid (N = 112) participated in this observational study set in a single 600-bed hospital in a private, nonprofit, integrated health care system in the southwestern United States.

A Model Program of Community-Based Supports for Older Adults at Risk of Nursing Facility Placement.

Transitioning an older adult into a nursing facility is a major life event for older adults (care recipients, CRs) and their family caregivers (CGs). This article describes the implementation of a community living program and presents findings on important health and well-being indicators. One hundred ninety-one participants aged 60 and older not eligible for or currently enrolled in Medicaid and meeting four risk domains (functional, health, cognitive/emotional, informal support system) were enrolled for the 10-month program.

Cost-effectiveness of the chronic disease self-management program: implications for community-based organizations.

Chronic conditions are the leading cause of growing healthcare spending, disability, and death in the U.S. In the wake of national health reform, policy makers and healthcare professionals are becoming increasingly concerned in containing healthcare costs while improving quality of patient care.

Feasibility of "Standardized Clinician" Methodology for Patient Training on Hospital-to-Home Transitions.

Introduction: Patient engagement in health care is increasingly recognized as essential for promoting the health of individuals and populations. This study pilot tested the standardized clinician (SC) methodology, a novel adaptation of standardized patient methodology, for teaching patient engagement skills for the complex health care situation of transitioning from a hospital back to home.

Methods: Sixty-seven participants at heightened risk for hospitalization were randomly assigned to either simulation exposure-only or full-intervention group.

The association between office-based provider visits and emergency department utilization among Medicaid beneficiaries.

The purpose of our study was to describe the relationship between office-based provider visits and emergency department (ED) utilization by adult Medicaid beneficiaries. Data were extracted from the publicly-available Medical Expenditure Panel Survey, a nationally representative sample of the civilian non-institutionalized population in the United States. The sample included 1,497 respondents who had full year Medicaid coverage in 2009.

Retrospective cohort study of medication adherence and risk for 30-day hospital readmission in a Medicare Cost Plan.

Purpose: Reducing hospital readmissions requires deploying appropriate interventions to groups at highest risk for readmission. Long-term medication adherence may indicate one's ability to manage recovery and chronic illness after discharge. If so, medication adherence also may be a predictor of hospital readmission.

Barriers to health care among Bell County residents with health insurance medical aid.

Barriers to high-quality health care are associated with negative consequences, not only for the uninsured but also for persons with adequate health insurance or medical aid. Understanding barriers encountered by community residents can improve the outcomes of community interventions designed to address unmet health care needs. The Bell County Needs Assessment was conducted to understand the needs of residents in Bell County, Texas.

Designing iCanFit: A Mobile-Enabled Web Application to Promote Physical Activity for Older Cancer Survivors.

Background: Most older cancer survivors (OCS) do not engage in regular physical activity (PA) despite well-known health benefits. With the increased use of mobile technologies among older adults, mobile tools may be an effective method to deliver PA promotion programs for OCS.

Objective: To document the process of designing an OCS-friendly mobile-enabled Web application of PA promotion program.

Multisite qualitative study of primary care physicians' and midlevel providers' self-reported practices and perceptions about maintaining cognitive health.

Introduction: To facilitate national efforts to maintain cognitive health through public health practice, the Healthy Brain Initiative recommended examining diverse groups to identify stakeholder perspectives on cognitive health. In response, the Healthy Aging Research Network (HAN), funded by the Centers for Disease Control and Prevention (CDC), coordinated projects to document the perspectives of older adults, caregivers of people with dementia, and primary care providers (PCPs) on maintaining cognitive health. Our objective was to describe PCPs' perceptions and practices regarding cognitive health.

Self-reported physical and mental health of older adults: the roles of caregiving and resources.

Objectives: This study examined factors associated with self-reported physical and mental health, focusing on caregiving status and the availability of social supports and financial resources.

Methods: Two bivariate analyses were performed to examine the sociodemographic characteristics as well as perceived health outcomes among caregiving and non-caregiving participants. Two-equation probit models were used to determine independent predictors of self-reported physical and mental health, using data from 1071 community-based adults (≥ 60 years).

Programmatic influences on outcomes of an evidence-based fall prevention program for older adults: a translational assessment.

Investigating the implementation and dissemination of evidence-based health-promotion programs to reach large numbers of diverse older adults is needed. The purpose of this study is to examine relationships between class size and session attendance and assess differences in intervention outcomes based on these community-based fall prevention program characteristics. Pre-post data were analyzed from 2,056 falls prevention program participants.

Correlates of family health history discussions between college students and physicians: does family cancer history make a difference?

Effective communication between young adults and their healthcare providers can contribute to early detection of risk for developing cancer and establishment of lifelong habits for engagement in healthcare and health promotion behaviors. Our objectives were to examine factors influencing family health history discussions between college students and physicians and factors associated with perceptions about who is responsible for initiating such discussions. Data from an internet-based study of 632 college students were analyzed.

Utilization of screening mammography among middle-aged and older women.

Aims: This study examines patterns of screening mammogram use, investigating the relationship of screening with demographic, health status, and healthcare factors.

Methods: Data from 1242 women aged ?41 were obtained from a random sample of mailed surveys to community households in an eight-county region in Central Texas in 2010. The dependent variable was the timing of the participants' most recent screening mammography (in the past 12 months, between 1 and 2 years, or >2 years).

Survey respondents planning to have screening colonoscopy report unique barriers.

Tailoring colorectal cancer screening interventions to address the needs of individuals for whom screening is recommended requires accurate identification of the barriers experienced by each targeted group. The primary purpose of this survey study was to test differences in the barriers to undergoing screening colonoscopy reported by men and women. In addition, we were interested in differences in barriers reported by 1) 50-year-olds versus those age 51 to 80 years, 2) persons reporting readiness for colonoscopy versus those not reporting readiness, and 3) persons who had had a primary care encounter in the preceding 12 months versus those who had not.

Primary care providers' sources and preferences for cognitive health information in the United States.

In most countries, physicians and other health-care providers play key roles in promoting health. Accumulating scientific evidence suggests that providers may soon want to include cognitive health among the areas they promote. Cognitive health is the maintenance of cognitive abilities that enable social connectedness, foster a sense of purpose, promote independent living, allow recovery from illness or injury and promote effective coping with functional deficits.

Making the Most of Your Healthcare intervention for older adults with multiple chronic illnesses.

Objective: This study tested the efficacy of a patient engagement intervention for older adults with multiple chronic illnesses.

Methods: Seventy-nine participants were randomly assigned to receive the intervention (Intervention Group), contacts on a different topic (Safety Group), or Usual Care. The Intervention and Safety Groups attended a 2-h workshop and participated in phone calls; one before and one after a naturally-occurring medical encounter.

Acute variation in cognitive function in hemodialysis patients: a cohort study with repeated measures.

Background: Although cognitive function in hemodialysis patients is believed to be best 24 hours after the dialysis session, the extent of variation during the dialysis cycle is unknown.

Study Design: Cohort study with repeated measures.

Setting & Participants: Hemodialysis centers; patients aged 55 years or older.

Structured practice: a memory intervention for persons with dementia.

This study assessed the feasibility of Structured Practice, a memory intervention format for persons with dementia that requires little or no expertise on the part of a trainer. Fourteen residents of assisted-living facilities practiced a 7-digit telephone number and engaged in guided social interaction with a trainer during several sessions. Free and cued recalls were assessed 5 minutes after each session and at least 1 day after each session.

A comparison of spaced retrieval to other schedules of practice for people with dementia.

Spaced retrieval training uses a schedule of practice trials distributed according to a learner's performance. The authors compared spaced retrieval to four alternative schedules of practice to determine whether it is more effective than other schedules for people with dementia. Participants practiced (a) pill names or (b) nonverbal sequences.