Dissemination of a Care Collaboration Project.

A core project team was able to identify essential implementation components for a successful dual-care program aimed at improving communication and collaboration with non-VA health care providers.

Associations between childbirth and women veterans' VA and non-VA Hospitalizations for major diagnostic categories.

Women Veterans enrolled in Veterans Affairs (VA) health care almost always use non-VA hospitals for childbirth, making it more likely they will use non-VA hospitals for other needs, as well. We compared VA and non-VA hospitalizations obtained by VA enrollees in seven states from 2004 through 2007 to determine whether women aged 18 to 44 were more likely to use VA or non-VA care for diagnoses in certain major categories, and how this use differed between women who did or did not have any pregnancy/childbirth admissions during the 4 years. We found that women were hospitalized much more in non-VA than in VA hospitals, though they were relatively more likely to use VA hospitals for mental illness, digestive system diseases, and neoplasms than other diagnoses.

Use and Quality of Care at a VA Outreach Clinic in Northern Maine.

Objective: To assess use and quality of care at a new 1-day-per-week Veterans Administration Outreach Clinic in remote northern Maine.

Methods: Veterans Administration electronic medical records were abstracted to compare outreach clinic patients seen in its first year to patients seen at the nearest outpatient treatment sites, a small-staff, full-time VA clinic 81 miles away and a community-based outpatient clinic 55 miles away. Chart abstractions (N = 1251) yielded counts of visits, patients newly enrolled in VA care, patients transferring to the outreach clinic, and patients who had and maintained a local non-VA primary care physician, as well as multiple quality of care performance measures using standard VA criteria.

Rural veteran access to healthcare services: investigating the role of information and communication technologies in overcoming spatial barriers.

This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented.

theta, beta But not alpha-band EEG connectivity has implications for dual task performance in Parkinson's disease.

People with Parkinson's disease (PD) have difficulty performing dual tasks or simultaneous movements, even if the same movements can be easily performed individually. This has particular significance clinically, as for example falling injuries may occur if care is not taken to perform tasks one at a time. We investigated whether this difficultyx results from impaired dopamine-modulated connectivity.

A novel segmentation, mutual information network framework for EEG analysis of motor tasks.

Background: Monitoring the functional connectivity between brain regions is becoming increasingly important in elucidating brain functionality in normal and disease states. Current methods of detecting networks in the recorded electroencephalogram (EEG) such as correlation and coherence are limited by the fact that they assume stationarity of the relationship between channels, and rely on linear dependencies. In contrast to diseases of the brain cortex (e.

Changing adolescent health behaviors: the healthy teens counseling approach.

Background: Brief motivational interventions that have been provided in addition to routine primary care have changed adolescent health behaviors. Whether health screening and motivational-interviewing-based counseling provided by clinicians during routine care can change behaviors is unknown.

Methods: Healthy Teens was a primary care, office-system intervention to support efficient, patient-centered counseling at well visits.

Spectral clustering of fMRI data within regions of interest: clarification of L-dopa effects in Parkinson's disease.

Identifying active regions of the brain that are task-related is important in fMRI study. Current methods of determining functional Regions of Interest (ROIs) are unsatisfactory because they either reduce the effect size or bias the statistical results. We propose a spectral clustering method for assessing those voxels within an ROI that are suitable for further task-activation analysis.

Sustainable impact of a primary care depression intervention.

Background: Re-Engineering Systems for Primary Care Treatment of Depression (RESPECT-D) sought to improve patient outcomes by disseminating the 3-component model of depression management. The purpose of this study was to determine whether an integrated model of depression management continued to be used by primary care clinicians after the end of a randomized controlled trial (RCT).

Methods: A descriptive evaluation was conducted at 2 time points.

Concordance between the PHQ-9 and the HSCL-20 in depressed primary care patients.

Background: Two instruments commonly used in primary care research to measure depressive severity are the Patient Health Questionnaire-9 (PHQ-9) and the Hopkins Symptom Checklist-20 (HSCL-20). However, there is little information regarding the relationship between clinical information derived from these scales. The present study investigates the psychometric properties of the PHQ-9 and HSCL-20, determines the degree of instrument concordance, and describes the factor structure of the HSCL-20.

Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial.

Objective: To test the effectiveness of an evidence based model for management of depression in primary care with support from quality improvement resources.

Design: Cluster randomised controlled trial.

Setting: Five healthcare organisations in the United States and 60 affiliated practices.