Incremental dementia-related expenditures in a medicaid population.

Objectives: With the growing number of older adults, understanding expenditures associated with treating medical conditions that are more prevalent among older adults is increasingly important. The objectives of this research were to estimate incremental medical encounters and incremental Medicaid expenditures associated with dementia among Indiana Medicaid recipients 40 years or older in 2004.

Methods: A retrospective cohort design analyzing Indiana Medicaid administrative claims files was used.

An examination of preactivity and postactivity flexibility practices of National Collegiate Athletic Association Division I tennis coaches.

The purpose of this study was to determine if National Collegiate Athletic Association (NCAA) Division I men's tennis programs are in compliance with suggested current preactivity and postactivity stretching protocols. Questionnaires were sent to NCAA Division I men's tennis programs in the USA. Seventy-six coaches (73 men and 3 women) participated in the study.

Logistics modelling: improving resource management and public information strategies in Florida.

One of the most time-sensitive and logistically-challenging emergency response operations today is to provide mass prophylaxis to every man, woman and child in a community within 48 hours of a bioterrorism attack. To meet this challenge, federal, state and local public health departments in the USA have joined forces to develop, test and execute large-scale bioterrorism response plans. This preparedness and response effort is funded through the US Centers for Disease Control and Prevention's Cities Readiness Initiative, a programme dedicated to providing oral antibiotics to an entire population within 48 hours of a weaponised inhalation anthrax attack.

Calcium, dairy products, and energy balance in overweight adolescents: a controlled trial.

Background: Dairy product and calcium consumption have been associated with modifying body fat and body weight in children and adults.

Objective: In overweight adolescent boys and girls, we aimed to determine the effect of the doubling of habitual calcium intake to the recommended intake from dairy or calcium carbonate on energy balance and purported mechanisms including fecal fat excretion, macronutrient use, and parathyroid hormone suppression.

Design: Twenty-five girls with a mean (±SD) BMI (in kg/m(2)) of 33 ± 5 and 17 boys with a BMI of 28 ± 5, aged 12-15 y, participated in two 3-wk controlled feeding sessions that used a crossover design in random order as a summer research camp.

The impact of a revised EQ-5D population scoring on preference-based utility scores in an inflammatory arthritis cohort.

Background And Objective: It is well established that there are problems with the EQ-5D. This is due to the original scoring methods used and how negative time trade-off (TTO) values were treated. A revised scoring method has been published.

Diagnostic testing, treatment, cost of care, and survival among registered and non-registered patients with myelodysplastic syndromes.

Considering current reliance on cancer registry data, we sought to assess the potential for bias in myelodysplastic syndrome (MDS) registration using SEER-Medicare data 2001-2005. Using a validated claims-based algorithm, we identified and compared registered and non-registered MDS patients, and found that median cumulative survival was 18 and 28 months, 74% and 64% used erythropoiesis-stimulating agents (ESAs), and average 6-month health care cost was $24,249 and $21,750, respectively. While most non-registered MDS patients showed resource utilization and survival characteristics consistent with lower-risk MDS, a subset was registered as acute myeloid leukemia (7.

Deriving a preference-based measure for cancer using the EORTC QLQ-C30.

Objective: The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) is one of the most commonly used measures in cancer care but in its current form cannot be used in economic evaluation because it does not incorporate preferences. We address this gap by estimating a preference-based measure for cancer from the EORTC QLQ-C30.

Methods: Factor analysis, Rasch analysis, and other psychometric analyses were undertaken on a clinical trial dataset of 655 patients with multiple myeloma to derive a health state classification system amenable to valuation.

Revisiting United States valuation of EQ-5D states.

In the original US valuation study of EQ-5D states, all worse-than-dead time trade-off responses (26% of the sample) were divided by 39 to increase the QALY estimates. This transformation has no theoretical justification and motivates this re-examination. Using the publically available dataset, we compared three alternative random utility models: instant (IRUM), angular (ARUM), and episodic (ERUM) models.

Incidence of the myelodysplastic syndromes using a novel claims-based algorithm: high number of uncaptured cases by cancer registries.

The myelodysplastic syndromes (MDSs) are hematologically diverse hematopoietic stem cell malignancies primarily affecting older individuals. The incidence of MDS in the United States is estimated at 3.3 per 100 000; however, evidence suggests underreporting of MDS to centralized cancer registries.

Outcomes of dental hygiene baccalaureate degree education in Canada.

There is little published literature about the outcomes of dental hygiene baccalaureate degree education, particularly in Canada. Since there are various dental hygiene entry-to-practice educational models in Canada, exploring baccalaureate dental hygiene education is becoming an increasingly important subject. The purpose of this study was to explore the personal outcomes and dental hygiene practice outcomes of dental hygiene degree-completion education in Canada from the perspectives of diploma dental hygienists who have continued their education to the bachelor's degree level.

Incident use and outcomes associated with potentially inappropriate medication use in older adults.

Background: Most studies of potentially inappropriate medication (PIM) use among older adults have focused on prevalence rather than incidence.

Objectives: The goals of this study were to determine the 1-year incidence of PIM use among elderly Indiana Medicaid residents of nursing homes and to examine associations between incident PIM use and hospitalization and mortality.

Methods: A retrospective analysis was conducted using Indiana Medicaid enrollment and administrative claims files.

A discourse on dental hygiene education in Canada.

Over the past decade, the discourse on dental hygiene education has gained momentum in Canada. This review provides insights into the evolution of dental hygiene education in Canada, briefly exploring the history and professional influences for diploma and baccalaureate education within the profession. The profession in Canada has yet to implement a national standardized entry-to-practice educational model, but the recent development of national educational competencies may prove to be a promising beginning.

Modeling correlated healthcare costs.

Accurate estimation and prediction of healthcare costs play crucial roles in decisions made by healthcare agencies on policy and resource allocation. Development of a cost model allows these decision-makers the opportunity to investigate the impact of different policies and/or allocations of resources. With increased subject-specific information, longitudinal studies and the breakdown of total costs into categories comes the need for healthcare cost models to account for correlation.

Digital gene expression analysis of gastrointestinal helminth resistance in Scottish blackface lambs.

Digital gene expression (DGE) analysis offers a route to gene discovery which by-passes the need to develop bespoke arrays for nonmodel species, and is therefore a potentially valuable tool for molecular ecologists. Scottish blackface sheep, which vary in resistance to the common abomasal parasitic nematode Teladorsagia circumcincta, were trickle-infected with L3 larvae over 3 months to mimic the natural progression of infection. DGE was performed on abomasal lymph node tissue after the resolution of infection in resistant animals.

Likelihood Analysis of Multivariate Probit Models Using a Parameter Expanded MCEM Algorithm.

Multivariate binary data arise in a variety of settings. In this paper, we propose a practical and efficient computational framework for maximum likelihood estimation of multivariate probit regression models. This approach uses the Monte Carlo EM (MCEM) algorithm, with parameter expansion to complete the M-step, to avoid the direct evaluation of the intractable multivariate normal orthant probabilities.

Proceedings of the Modeling Evidence in HPV Pre-Conference Workshop in Malmö, Sweden, May 9-10, 2009.

Background: Prominent published and active human papillomavirus (HPV) modelers from around the world were invited to participate in the inaugural Modeling Evidence in HPV (MEHPV) Pre-Conference Workshop on May 9-10, 2009, in Malmö, Sweden. The workshop took place directly before the 25th International Papillomavirus Conference.

Objectives: The aim of the workshop was to develop an international network of investigators engaged in HPV modeling and to facilitate open discussion about the structure and parameterization of models, as well as other methodologic concerns.

Toward a more universal approach in health valuation.

By polling individual responses to hypothetical scenarios, valuation studies estimate population preferences toward health on a quality-adjusted life year (QALY) scale. The scenarios typically involve trade-offs in time (time trade-off (TTO)), risk (standard gamble (SG)), or number of persons affected (person trade-off (PTO)). This paper revisits the QALY assumptions and provides a coherent health econometric approach that unites TTO, SG, and PTO techniques under a common estimator.

Participation of older patients with prostate cancer in Medicare eligible trials.

Purpose: On June 7, 2000 President Clinton issued an executive memorandum directing Medicare payment for routine patient care in qualifying clinical trials. We estimated the proportion of older patients with prostate cancer who were examined as part of a qualifying clinical trial, and the association between participation and patient characteristics.

Materials And Methods: We performed an observational study using the Surveillance, Epidemiology and End Results Medicare database to determine participation in qualifying clinical trials in a sample of 37,216 men 66 years old or older who were enrolled in Medicare and diagnosed with prostate cancer between September 2000 and December 2002.

Endorectal pull-through for Hirschsprung's disease-a multicenter, long-term comparison of results: transanal vs transabdominal approach.

Purpose: Previous studies have reported decreased continence in patients undergoing transanal endorectal pull-through (TERP) for Hirschsprung's disease compared to the older transabdominal approach (TAA). To address this, we examined long-term stooling outcomes in a large, multicenter cohort of patients undergoing either TERP or TAA.

Methods: Data were collected from 5 large pediatric institutions.

Williams syndrome in an adult.

We report a case of a diagnosis of Williams syndrome in a 57-year-old male referred for cardiac surgery with a presumptive diagnosis of aortic valvular stenosis and ascending aortic aneurysm, supravalvular stenosis being first suspected during surgery. Williams syndrome was subsequently confirmed via genetics testing. In patients presenting with an ascending aortic aneurysm, developmental delay, and with poorly visualized coronary arteries during angiography, the diagnosis of supravalvular aortic stenosis or Williams syndrome should be considered.

Examination of the physical and psychosocial determinants of health behaviour in 4-5-year-old children with congenital cardiac disease.

Objectives: To assess the general health and activity levels of 4- and 5-year-old children after intervention for congenital cardiac disease.

Methods: Health behaviour outcomes were assessed in 91 children who had surgery or catheter intervention for congenital cardiac disease. The children were classified into four groups according to severity.

Effects of short-term celecoxib treatment in patients with invasive transitional cell carcinoma of the urinary bladder.

High-grade invasive transitional cell carcinoma (InvTCC) kills >14,000 people yearly in the United States, and better therapy is needed. Cyclooxygenase-2 (Cox-2) is overexpressed in bladder cancer. Cox inhibitors have caused remission of InvTCC in animal studies, and cancer regression was associated with doubling of the apoptotic index in the tumor.

Characterizing the space of interatomic distance distribution functions consistent with solution scattering data.

Scattering of neutrons and X-rays from molecules in solution offers alternative approaches to the study of a wide range of macromolecular structures in their solution state without crystallization. We study one part of the problem of elucidating three-dimensional structure from solution scattering data, determining the distribution of interatomic distances, P(r), where r is the distance between two atoms in the protein molecule. This problem is known to be ill-conditioned: for a single observed diffraction pattern, there may be many consistent distance distribution functions, and there is a risk of overfitting the observed scattering data.

Prevalence of cancer visits by physician specialty, 1997-2006.

Understanding the prevalence of cancer-related visits by physician specialty may help target educational and quality improvement initiatives. Using the 1997-2006 National Ambulatory Medical Care Survey, adult ambulatory visits (N = 161,278) were classified by cancer diagnosis and patients' characteristics and compared with physician specialty. The prevalence of cancer visits within each specialty varied from 0% to 62%.

Post-eccentric exercise blunted hGH response.

The purpose of the present study was to test if a previous acute concentric exercise bout blunts hGH response after an eccentric exercise bout. Nine healthy untrained male university students (25.4+/-0.