Effectiveness of Caregiver Interventions on Patient Outcomes in Adults With Dementia or Alzheimer's Disease: A Systematic Review.

We conducted a systematic review to evaluate whether caregiver-involved interventions improve patient outcomes among adults with dementia or Alzheimer's disease. We identified and summarized data from randomized controlled trials enrolling adults with dementia or Alzheimer's disease by searching MEDLINE, PsycINFO, and other sources. Patient outcomes included global quality of life, physical and cognitive functioning, depression/anxiety, symptom control and management, and health care utilization.

Clinical Utility of the Japan-Chronic Total Occlusion Score in Coronary Chronic Total Occlusion Interventions: Results from a Multicenter Registry.

Background: The performance of the Japan-chronic total occlusion (J-CTO) score in predicting success and efficiency of CTO percutaneous coronary intervention has received limited study.

Methods And Results: We examined the records of 650 consecutive patients who underwent CTO percutaneous coronary intervention between 2011 and 2014 at 6 experienced centers in the United States. Six hundred and fifty-seven lesions were classified as easy (J-CTO=0), intermediate (J-CTO=1), difficult (J-CTO=2), and very difficult (J-CTO≥3).

DSM-5 personality traits discriminate between posttraumatic stress disorder and control groups.

The relevance of personality traits to the study of psychopathology has long been recognized, particularly in terms of understanding patterns of comorbidity. In fact, a multidimensional personality trait model reflecting five higher-order personality dimensions-negative affect, detachment, antagonism, disinhibition, and psychoticism-is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and represented in the Personality Inventory for DSM-5 (PID-5). However, evaluation of these dimensions and underlying personality facets within clinical samples has been limited.

Impact of different privacy conditions and incentives on survey response rate, participant representativeness, and disclosure of sensitive information: a randomized controlled trial.

Background: Anonymous survey methods appear to promote greater disclosure of sensitive or stigmatizing information compared to non-anonymous methods. Higher disclosure rates have traditionally been interpreted as being more accurate than lower rates. We examined the impact of 3 increasingly private mailed survey conditions-ranging from potentially identifiable to completely anonymous-on survey response and on respondents' representativeness of the underlying sampling frame, completeness in answering sensitive survey items, and disclosure of sensitive information.

Use of isosorbide dinitrate and hydralazine in African-Americans with heart failure 9 years after the African-American Heart Failure Trial.

The 2013 American College of Cardiology Foundation/American Heart Association guidelines recommend combined isosorbide dinitrate (ISDN) and hydralazine to reduce mortality and morbidity for African-Americans with symptomatic heart failure (HF) and reduced ejection fraction, currently receiving optimal medical therapy (class I, level A). Nitrates can alleviate HF symptoms, but continuous use is limited by tolerance. Hydralazine may mitigate nitrate tolerance, and the ISDN-hydralazine combination in the Vasodilators in Heart Failure Trial (V-HeFT) I improved survival and exercise tolerance in men with dilated cardiomyopathy or HF with reduced ejection fraction, most notably in self-identified black participants.

The effect of cognitive load and patient race on physicians' decisions to prescribe opioids for chronic low back pain: a randomized trial.

Objective: To test the hypothesis that racial biases in opioid prescribing would be more likely under high levels of cognitive load, defined as the amount of mental activity imposed on working memory, which may come from environmental factors such as stressful conditions, chaotic workplace, staffing insufficiency, and competing demands, one's own psychological or physiological state, as well as from demands inherent in the task at hand.

Design: Two (patient race: White vs Black) by two (cognitive load: low vs high) between-subjects factorial design.

Setting And Participants: Ninety-eight primary care physicians from the Veterans Affairs Healthcare System.

Nutrition management of amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease with high risk of malnutrition. Symptoms of dysphagia, depression, cognitive impairment, difficulty with self-feeding and meal preparation, hypermetabolism, anxiety, respiratory insufficiency, and fatigue with meals increase the risk of malnutrition. Malnutrition negatively affects prognosis and quality of life, making early and frequent nutrition assessment and intervention essential.

Pronouns and progress: a psychoanalytic primer.

Psychoanalytic psychotherapists have the role responsibility to hover evenly over everything that is said--and not said--in the analytic situation. Pronouns may be worthy of special attention. Just as children demonstrate a predictable course in the acquisition and mastery of pronouns, it may be that the analytic patient also shows a predictable sequence in the deployment of pronouns over the course of a successful treatment.

Cost-effectiveness and socio-economic aspects of childhood influenza vaccination.

Children have high rates of healthcare utilization due to influenza. In addition, children also transmit influenza to others in their households and the community. The costs of influenza in children include the direct medical care costs from increased outpatient visits and hospitalizations, and also indirect costs due to productivity losses especially for their parents and due to transmission of the virus to others.

Knowledge and attitudes about personalized mental health genomics: narratives from individuals coping with serious mental illness.

The present qualitative study examined the personal accounts, elicited via semi-structured interview, of nine United States military veterans with serious mental illness to describe their knowledge, attitudes, and beliefs about psychiatric genetics, genetic testing and counseling for mental illness. The aim of the research was to elucidate issues from the perspective of adults with mental illness that may inform the education and training of mental health providers on basic genetic counseling. Findings suggest that participants had some basic knowledge about genetics, were interested in psychiatric genetic testing, and had an awareness of both positive and negative aspects of genetic test results.

Race disparities in U.S. nephrology fellowship training.

Background And Objectives: Renal disease disproportionately affects African-American patients. Trust has been implicated as an important factor in patient outcomes. Higher levels of trust and better interpersonal care have been reported when race of patient and physician are concordant.

Presence and correlates of racial disparities in adherence to colorectal cancer screening guidelines.

Objectives: We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS).

Methods: The sample included 328 Black and 1827 White patients age 50-75 from 24 VA medical facilities who responded to a mailed survey with phone follow-up (response rate: 73% for Blacks and 89% for Whites). CRCS adherence and race were obtained through surveys and supplemented with administrative data.

Variation in estimates of limited health literacy by assessment instruments and non-response bias.

Objectives: This paper compares estimates of poor health literacy using two widely used assessment tools and assesses the effect of non-response on these estimates.

Study Design And Setting: A total of 4,868 veterans receiving care at four VA medical facilities between 2004 and 2005 were stratified by age and facility and randomly selected for recruitment. Interviewers collected demographic information and conducted assessments of health literacy (both REALM and S-TOFHLA) from 1,796 participants.

Families of patients with polytrauma: Understanding the evidence and charting a new research agenda.

Although research shows that caring for a family member with chronic disease or disability can cause significant distress for caregivers, it also shows that families that function well and adequately support patients can improve the quality of life and health outcomes for their ill or disabled family member. Currently, little knowledge exists about how families function and cope after a loved one has sustained polytrauma, the multiple traumatic injuries that often include traumatic brain injury (TBI). We summarize the polytrauma and TBI research about family needs during rehabilitation and recovery, describe current efforts to improve family-centered care, and detail approaches for understanding family resilience and the long-term consequences of injuries on families.

The effect of perceived racial discrimination on bodily pain among older African American men.

Objectives: We examined the extent to which experiences of racial discrimination are associated with bodily pain reported by African American men.

Methods: The study sample consisted of 393 African American male veterans who responded to a national survey of patients aged 50-75 who received care from the Veterans Health Administration (VHA). Veterans were surveyed by mail, with a telephone follow-up.

Biologics for rheumatoid arthritis: an overview of Cochrane reviews.

Background: The biologic disease-modifying anti-rheumatic drugs (DMARDs) are very effective in treating rheumatoid arthritis (RA), however there is a lack of head-to-head comparison studies.

Objectives: To compare the efficacy and safety of abatacept, adalimumab, anakinra, etanercept, infliximab, and rituximab in patients with RA.

Methods: This 'Overview of Reviews' was done by including all Cochrane Reviews on Biologics for RA available in The Cochrane Library.

Understanding primary care physicians' treatment of chronic low back pain: the role of physician and practice factors.

Background: An increasing number of Operation Iraqi Freedom/Operation Enduring Freedom veterans experience chronic pain. Despite treatment guidelines, there is wide variation in physicians' approaches to pain treatment, and many physicians are unsure of the best treatment approach. Research has examined factors associated with opioid prescribing, but there is little information on physician characteristics that predict patterns of clinical responses to pain.

Are gender differences in colorectal cancer screening rates due to differences in self-reporting?

Objective: Studies have found that women are less likely than men to undergo colorectal cancer (CRC) screening. While one source of these disparities may be gender differences in barriers and facilitators to screening, another may be differences in reporting bias.

Method: In this study of 345 male and female veterans, conducted in 2006 in Minneapolis, MN, we examined CRC screening adherence rates by gender using medical records and self-report and assessed whether any differences were due to reporting bias.

Developing a polytrauma rehabilitation center: a pioneer experience in building, staffing, and training.

The military operations in Iraq and Afghanistan have resulted in patterns of injury not commonly seen in previous conflicts. Improvised explosive devices are the primary weapon, and exposure to blast is the most common mechanism of injury. Blasts can result in polytrauma injury, in which multiple body systems, including the head and brain, are injured.

Randomized trial showed requesting medical records with a survey produced a more representative sample than requesting separately.

Objectives: The objective of the study was to compare the effect of two approaches to requesting medical records on survey response rates, sample representativeness, and the quality of self-reported screening.

Study Design And Setting: Eight hundred ninety veterans aged 50-75 years from the Minneapolis VA Medical Center were randomly assigned to (1) records request included with a colorectal cancer screening survey ("with-survey" group) or (2) request in a separate mailing following a completed survey ("after-survey" group). Analyses compared response rates, the proportion and characteristics of patients providing records, and the validity of self-reported screening, by group.

Gout is associated with more comorbidities, poorer health-related quality of life and higher healthcare utilisation in US veterans.

Objective: To better understand the impact of gout on functional status, health-related quality of life (HRQoL), mortality and healthcare utilisation in US veterans.

Methods: All veterans seen in Veterans Integrated Service Network-13 from 1 October 1996 to 31 March 1998 received mailed surveys asking about demographic characteristics; performance of activities of daily living and HRQoL by Short Form-36 (SF-36) for Veterans. Administrative data included demographics; inpatient/outpatient healthcare utilisation; ICD-9 codes for gout, medical comorbidities and arthritis excluding gout-"arthritic comorbidity" and 1-year mortality.

Effect of health-related quality of life on women and men's Veterans Affairs (VA) health care utilization and mortality.

Introduction: Although women will account for almost 11% of veterans by 2040, we know little about their health and functioning, particularly compared to men.

Objective: To compare women and men veterans' health-related quality of life (HRQOL) and VA health care utilization and to see if previously described associations between HRQOL, subsequent VA health care utilization, and mortality in male veterans would generalize to women veterans.

Methods: Prospective cohort study of all veterans who received medical care from an Upper Midwest Veterans Affairs facility between 10/1/96 and 3/31/98 and returned a mailed questionnaire.

Quality of care for gout in the US needs improvement.

Objective: To examine evidence-based quality indicators (QIs) in US veterans with gout diagnosis, and to examine the effect of demographics, heath care utilization/access, comorbid conditions, or physican characteristics as predictors of quality of gout care.

Methods: Using the Minneapolis Veterans Affairs electronic medical record system, we identified a cohort of veterans receiving medication to treat gout between January 1, 1999 and December 31, 2003, and evaluated 3 recently published evidence-based QIs for gout management: QI 1 = allopurinol dose <300 mg in gout patients with renal insufficiency, QI 2 = uric acid check within 6 months of starting a new allopurinol prescription, and QI 3 = complete blood count and creatine kinase check every 6 months for gout patients receiving prolonged colchicine therapy. We calculated the proportion of patients whose therapy adhered to each QI and to all applicable indicators (overall physician adherence).

Gender differences in colorectal cancer screening barriers and information needs.

Context: Several prior studies have found that women are less likely to be screened for colorectal cancer (CRC) than men. While the source of this screening differential is unknown, recent studies suggest gender differences in barriers to screening might explain the disparity.

Objective: This formative study was designed to explore CRC screening barriers, attitudes and preferences by gender.