The Influence of Cost Information on Treatment Choice: A Mixed-Methods Study.

Purpose: To test the null hypothesis that exposure to societal cost information does not affect choice of treatment for carpal tunnel syndrome (CTS).

Methods: We enrolled 304 participants using the Amazon Mechanical Turk platform to complete a survey in which participants were given the choice between carpal tunnel release (CTR) or a less-expensive option (orthosis wear) in a hypothetical mild CTS scenario. Patients were randomized to receive information about the societal cost of CTR (cost cohort) or no cost information (control).

Screen of drug use: Diagnostic accuracy for opioid use disorder.

Aims: Opioid related deaths have more than tripled in recent years. Identifying and referring individuals with opioid use disorder (OUD) to treatment is one of the promising approaches to reduce opioid related deaths. However, using urine toxicology to identify opioid misuse is not reliable.

Cost in Hand Surgery: The Patient Perspective.

Purpose: Rising costs at the patient level have been recognized and shown to directly influence patient decisions. By understanding patient interests in discussing cost, hand surgeons may better prepare themselves and their practices to communicate costs with patients.

Methods: We surveyed 128 patients at an upper extremity surgery clinic at their 2-week postoperative visit.

Drinking Level Versus Drinking Pattern and Cigarette Smoking Among Older Adults.

Background: There is a lack of research on the role of alcohol consumption in cigarette smoking among older adults, and the few studies on alcohol use and smoking with older adults have failed to distinguish between average level and pattern of drinking as predictors of smoking. The main purpose of this study was to examine the independent contributions of average level versus pattern of drinking as predictors of cigarette smoking among older adults. A subsidiary purpose was to examine the link between continued smoking and mortality among older smokers.

Late-Life Drinking Problems: The Predictive Roles of Drinking Level vs. Drinking Pattern.

Objective: Research on late-middle-aged and older adults has focused primarily on average level of alcohol consumption, overlooking variability in underlying drinking patterns. The purpose of the present study was to examine the independent contributions of an episodic heavy pattern of drinking versus a high average level of drinking as prospective predictors of drinking problems.

Method: The sample comprised 1,107 adults ages 55-65 years at baseline.

Why Do People Believe What They Do? A Functionalist Perspective.

Why do people believe what they do? Scholars and laypeople alike tend to answer this question by focusing on the representational functions of beliefs (i.e., representing the world accurately).

Making smart investment decisions in clinical research.

Unlabelled: A recent trial in rheumatoid arthritis found an inexpensive, but infrequently used, combination of therapies is neither inferior nor less safe than an expensive biologic drug. If the trial had been conducted over 10 years ago, arguably 100's of millions of dollars since spent on biologics could have been released to other, more effective treatments. Given the ever increasing number of trials proposed, this commentary uses the trial as an example to challenge payers and research funders to make smarter investments in clinical research to save potential future costs.

Toward cost-effective staffing mixes for Veterans Affairs substance use disorder treatment programs.

Background: In fiscal year (FY) 2008, 133,658 patients were provided services within substance use disorders treatment programs (SUDTPs) in the U.S. Department of Veterans Affairs (VA) health care system.

Arthroscopy for Knee Osteoarthritis Has Not Decreased After a Clinical Trial.

Background: Multiple clinical trials have shown that arthroscopy for knee osteoarthritis is not efficacious. It is unclear how these studies have affected orthopaedic practice in the USA.

Questions/purposes: We questioned whether, in the Veterans Health Administration system, rates of knee arthroscopy in patients with osteoarthritis have changed after publication of the initial clinical trial by Moseley et al.

Genetic Ancestry and Asthma and Rhinitis Occurrence in Hispanic Children: Findings from the Southern California Children's Health Study.

Background: Asthma and rhinitis are common childhood health conditions. Being an understudied and rapidly growing population in the US, Hispanic children have a varying risk for these conditions that may result from sociocultural (including acculturative factors), exposure and genetic diversities. Hispanic populations have varying contributions from European, Amerindian and African ancestries.

The Challenges of Afghanistan and Iraq Veterans' Transition from Military to Civilian Life and Approaches to Reconnection.

Afghanistan and Iraq veterans experienced traumas during deployment, and disrupted connections with friends and family. In this context, it is critical to understand the nature of veterans' transition to civilian life, the challenges navigated, and approaches to reconnection. We investigated these issues in a qualitative study, framed by homecoming theory, that comprised in-depth interviews with 24 veterans.

Drinking Level, Drinking Pattern, and Twenty-Year Total Mortality Among Late-Life Drinkers.

Objective: Research on moderate drinking has focused on the average level of drinking. Recently, however, investigators have begun to consider the role of the pattern of drinking, particularly heavy episodic drinking, in mortality. The present study examined the combined roles of average drinking level (moderate vs.

Pubertal maturation and cortisol level in response to a novel social environment among female adolescents.

Research indicates changes in HPA-axis activity across puberty. The current study extends existing work by evaluating pubertal status and cortisol level in a novel social environment (research laboratory) while controlling for several important biological, behavioral, and psychological variables. Participants were 30 girls (ages 9-16 years) from the United States.

Many diabetic total joint arthroplasty candidates are unable to achieve a preoperative hemoglobin A1c goal of 7% or less.

Background: Patients with poorly controlled diabetes have an elevated risk of complications and death following total joint arthroplasty. Some centers set a threshold hemoglobin A1c (HbA1c) value above which surgery is delayed pending better glycemic control. The purpose of this study was to examine how many diabetic patients scheduled for primary total joint arthroplasty underwent a delay because of an HbA1c value of >7.

Al-Anon family groups' newcomers and members: Concerns about the drinkers in their lives.

Background And Objectives: Despite Al-Anon's widespread availability and use, knowledge is lacking about the drinkers in attendees' lives. We filled this gap by describing and comparing Al-Anon newcomers' and members' reports about their "main drinker" (main person prompting initial attendance).

Methods: Al-Anon's World Service Office mailed a random sample of groups, yielding completed surveys from newcomers (N = 362) and stable members (N = 265).

Component alignment during total knee arthroplasty with use of standard or custom instrumentation: a randomized clinical trial using computed tomography for postoperative alignment measurement.

Background: Patient-specific femoral and tibial cutting blocks produced with use of data from preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans have been employed recently to optimize component alignment in total knee arthroplasty. We report the results of a randomized controlled trial in which CT scans were used to compare postoperative component alignment between patients treated with custom instruments and those managed with traditional instruments.

Methods: The in-hospital data and early clinical outcomes, including Knee Society scores, were determined in a randomized clinical trial of forty-seven patients who had undergone a total of forty-eight primary total knee arthroplasties with patient-specific instruments (twenty-two knees) or standard instruments (twenty-six knees).

Prospective associations among approach coping, alcohol misuse and psychiatric symptoms among veterans receiving a brief alcohol intervention.

Brief alcohol interventions (BAIs) target alcohol consumption and may exert secondary benefits including reduced depression and posttraumatic stress disorder (PTSD) symptoms among non-veteran and veteran populations. This study examined whether approach coping, alcohol misuse, and an interaction of these two factors prior to the administration of a BAI (i.e.

Protective mechanisms and prevention of violence and aggression in veterans.

Although a subset of Iraq and Afghanistan Veterans show aggression toward others after they return home from military service, little is known about protective mechanisms that could be bolstered to prevent violence. A national longitudinal survey was conducted between 2009 and 2011 using a random sample of veterans who served in Operation Iraqi Freedom or Operation Enduring Freedom. One thousand and ninety veterans, from 50 states representing all military branches, completed 2 waves of data collection, 1 year apart (retention rate = 79%).

Five-year trends in women veterans' use of VA maternity benefits, 2008-2012.

Background: An increasing number of young women veterans are returning from war and military service and are seeking reproductive health care from the Veterans Health Administration (VHA). Many of these women seek maternity benefits from the VHA, and yet little is known regarding the number of women veterans utilizing VHA maternity benefits nor the characteristics of pregnant veterans using these benefits. In May 2010, VHA maternity benefits were expanded to include 7 days of infant care, which may serve to entice more women to use VHA maternity benefits.

Cannabis use expectancies mediate the relation between depressive symptoms and cannabis use among cannabis-dependent veterans.

Objectives: The current study examined the cross-sectional associations between depressive symptoms and cannabis use, and the mediating role of positive and negative expectancies of cannabis use.

Methods: Participants (n = 100) were cannabis-dependent veterans recruited as part of a larger self-guided cannabis quit study. Baseline (prequit) data were used.

The comorbidity of sleep apnea and mood, anxiety, and substance use disorders among obese military veterans within the Veterans Health Administration.

Objectives: To determine the relations between obstructive sleep apnea (OSA) diagnosis, the likelihood of being diagnosed with a psychological condition, among obese veterans, after accounting for severity of obesity and the correlated nature of patients within facility. We hypothesized that (1) individuals with a diagnosis of OSA would be more likely to receive a diagnosis of a (a) mood disorder and (b) anxiety disorder, but not (c) substance use disorder.

Design: Cross-sectional retrospective database review of outpatient medical records between October 2009 and September 2010, conducted across all 140 Veterans Health Administration (VHA) facilities.

Implementation and evaluation of an incentivized Internet-mediated walking program for obese adults.

In response to rising health care costs associated with obesity rates, some health care insurers are adopting incentivized technology-enhanced wellness programs. The purpose of this study is to evaluate the large-scale implementation of an incentivized Internet-mediated walking program for obese adults and to examine program acceptance, adherence, and impact. A mixed-methods evaluation was conducted to investigate program implementation, acceptance, and adherence rates, and physical activity rates among program participants.

Al-Anon family groups: newcomers and members.

Objective: Empirical knowledge is lacking about Al-Anon Family Groups (Al-Anon), the most widely used form of help by people concerned about another's drinking, partly because conducting research on 12-step groups is challenging. Our purpose was to describe a new method of obtaining survey data from 12-step group attendees and to examine influences on initial Al-Anon attendance and attendees' recent life contexts and functioning.

Method: Al-Anon's World Service Office sent a mailing to a random sample of groups, which subsequently yielded surveys from newcomers (n = 359) and stable members (n = 264).