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Journal of General Internal Medicine

By Nirav Shah and Jason Wang

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Policy Brief

Mucio Kit Delgado, Ginde AA, Pallin DJ, Camargo CA
Academic Emergency Medicine, 2010

Objectives: Emergency departments (EDs) are increasingly proposed as high-yield venues for providing preventive health education to a population at risk for unhealthy behaviors and unmet primary care needs. This study sought to determine the preferred health education topics and teaching modality among ED patients and visitors.

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Journal Article

Kimerling R, Street AE, Pavao J, Mark W. Smith, Cronkite RC, Holmes TJ, Frayne SM
American Journal of Public Health, 2010

We examined military-related sexual trauma among deployed Operation Enduring Freedom and Operation Iraqi Freedom veterans. Of 125 729 veterans who received Veterans Health Administration primary care or mental health services, 15.1% of the women and 0.7% of the men reported military sexual trauma when screened. Military sexual trauma was associated with increased odds of a mental disorder diagnosis, including posttraumatic stress disorder, other anxiety disorders, depression, and substance use disorders.

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Journal Article

Lee CI, Tsai EB, Sigal BM, Sylvia Plevritis, Alan Garber, Rubin G
American Journal of Roentgenology, 2010

OBJECTIVE. The purpose of this study was to evaluate the prevalence of incidental extracardiac findings on coronary CT, to determine the associated downstream resource utilization, and to estimate additional costs per patient related to the associated diagnostic workup.

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Journal Article

Grant Miller
Economic Journal, 2010

There has been considerable debate in the last decade about whether or not family planning programmes in developing countries reduce fertility or improve socio-economic outcomes. This article provides new evidence by studying the expansion of one of the world's oldest and largest family planning organisations - Profamilia of Colombia. It finds that family planning explains less than 10% of Colombia's fertility decline during its demographic transition.

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Journal Article

Samanez-Larkin, GR, Wagner, AD, Knutson, B
Soc Cogn Affect Neurosci, 2010
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Journal Article

Victor Fuchs
Journal of the American Medical Association, 2010

Health care expenditures in the United States have been increasing much more rapidly than the rest of the economy over the past 30 years. The average gap, 2.8% per annum, results in health care's share of the economy doubling every 26 years.1 Why does this matter? Would it matter if expenditures for personal computers were increasing 2.8% per annum more rapidly than the rest of the economy?

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Journal Article

Jennifer Schneider, Newberry SJ, Riedl MA, Dena M. Bravata, Maglione M, Suttorp MJ, Vandana Sundaram, Paige NM, Towfigh A, Hulley BJ, Shekelle PG
Journal of the American Medical Association, 2010

Context There is heightened interest in food allergies but no clear consensus exists regarding the prevalence or most effective diagnostic and management approaches to food allergies.

Objective To perform a systematic review of the available evidence on the prevalence, diagnosis, management, and prevention of food allergies.

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Journal Article

V Yank, V Tuohy, AC Logan, Dena M. Bravata, K Staudenmayer, Vandana Sundaram, D McMahon, CD Stave, JL Zehnder, I Olkin, Kathryn M. McDonald, Douglas K. Owens, Randall Stafford Randall Stafford
Comparative Effectiveness, 2010

This report evaluates the level of evidence currently available to support the effectiveness and safety of using recombinant activated coagulation factor VII (rFVIIa) for clinical indications not approved by the U. S. Food and Drug Administration (FDA). rFVIIa is approved for a variety of uses in hemophilia patients who have developed antibody inhibitors that compromise the use of standard factor replacement. Use of this costly biologic product has expanded beyond these hemophilia-related indications to encompass a range of off-label uses, most of which are in-hospital uses.

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Journal Article

Patel CJ, Jay Bhattacharya, Butte AJ
PLoS One, 2010

BACKGROUND: Type 2 Diabetes (T2D) and other chronic diseases are caused by a complex combination of many genetic and environmental factors. Few methods are available to comprehensively associate specific physical environmental factors with disease. We conducted a pilot Environmental-Wide Association Study (EWAS), in which epidemiological data are comprehensively and systematically interpreted in a manner analogous to a Genome Wide Association Study (GWAS).

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Journal Article

Sarah (Sally) M. Horwitz, Caspary G, Storfer-Isser A, Singh M, Fremont W, Golzari M, Stein RE
Academic Pediactrics, 2010

OBJECTIVE: The aim of this study was to investigate training in developmental and behavioral pediatrics (DBP) for graduating residents, their competencies in diagnosing and treating child mental health (MH) problems, and whether the amount of DBP training and/or perceived competencies are associated with perceived responsibility for treating 3 MH problems.

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Policy Brief

Steinman MA, Mary Goldstein
Joint Commission Journal on Quality and Patient Safety, 2010

Background: Many patients with hypertension have legitimate reasons to forego standard blood pressure targets yet are nonetheless included in performance measurement systems. An approach to performance measurement incorporating clinical reasoning was developed to determine which patients to include in a performance measure.

Design: A 10-member multispecialty advisory panel refined a taxonomy of situations in which the balance of benefits and harms of anti-hypertensive treatment does not clearly favor tight blood pressure control (< 140/90 mm Hg).

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Journal Article

Laurence Baker, David Hopkins
International Journal for Quality in Health Care, 2010

OBJECTIVE: Some argue that health plans have minimal impacts on quality of care and that quality data collection should focus only on physician organizations. We investigate the relative impact of physician organizations and health plans on quality measures.

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Journal Article

Gillian D. Sanders, Anaya HD, Asch S, Hoang T, Golden JF, Bayoumi AM, Douglas Owens
Journal of General Internal Medicine, 2010

BACKGROUND: The CDC recommends routine voluntary HIV testing of all patients 13-64 years of age. Despite this recommendation, HIV testing rates are low even among those at identifiable risk, and many patients do not return to receive their results. OBJECTIVE: To examine the costs and benefits of strategies to improve HIV testing and receipt of results. DESIGN: Cost-effectiveness analysis based on a Markov model. Acceptance of testing, return rates, and related costs were derived from a randomized trial of 251 patients; long-term costs and health outcomes were derived from the literature.

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Journal Article

Crystal Smith-Spangler, Jessie L. Juusola, Eva A. Enns, Douglas Owens, Alan Garber
Annals of Internal Medicine, 2010

Background: Sodium consumption raises blood pressure, increasing the risk for heart attack and stroke. Several countries, including the United States, are considering strategies to decrease population sodium intake.

Objective: To assess the cost-effectiveness of 2 population strategies to reduce sodium intake: government collaboration with food manufacturers to voluntarily cut sodium in processed foods, modeled on the United Kingdom experience, and a sodium tax.

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Journal Article

Jodie Trafton, Susana B. Martins, Michel M, Lewis E, Wang D, Combs A, Scates N, Tu S, Mary Goldstein
Pain Medicine, 2010

Abstract Objective. To develop and evaluate a clinical decision support system (CDSS) named Assessment and Treatment in Healthcare: Evidenced-Based Automation (ATHENA)-Opioid Therapy, which encourages safe and effective use of opioid therapy for chronic, noncancer pain. Design. CDSS development and iterative evaluation using the analysis, design, development, implementation, and evaluation process including simulation-based and in-clinic assessments of usability for providers followed by targeted system revisions. Results.

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Journal Article

Joseph A. Mikels, Lockenhoff CE, Maglio SJ, Laura L. Carstensen, Mary K. Goldstein, Alan M. Garber
Journal of Experimental Psychology Applied, 2010

Research on aging has indicated that whereas deliberative cognitive processes decline with age, emotional processes are relatively spared. To examine the implications of these divergent trajectories in the context of health care choices, we investigated whether instructional manipulations emphasizing a focus on feelings or details would have differential effects on decision quality among younger and older adults. We presented 60 younger and 60 older adults with health care choices that required them to hold in mind and consider multiple pieces of information.

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Journal Article

Jeremy Goldhaber-Fiebert, Stout NK, Goldie SJ
Value Health, 2010

Objectives: Model-based cost-effectiveness analyses support decision-making. To augment model credibility, evaluation via comparison to independent, empirical studies is recommended. Methods: We developed a structured reporting format for model evaluation and conducted a structured literature review to characterize current model evaluation recommendations and practices. As an illustration, we applied the reporting format to evaluate a microsimulation of human papillomavirus and cervical cancer.

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Journal Article

Crystal Smith-Spangler, Juusola JL, Enns EA, Douglas Owens, Alan Garber
Annals of Internal Medicine, 2010

Background: Sodium consumption raises blood pressure, increasing the risk for heart attack and stroke. Several countries, including the United States, are considering strategies to decrease population sodium intake.

Objective: To assess the cost-effectiveness of 2 population strategies to reduce sodium intake: government collaboration with food manufacturers to voluntarily cut sodium in processed foods, modeled on the United Kingdom experience, and a sodium tax.

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Journal Article

Sarah (Sally) M. Horwitz, chamberlain P, Landsverk J, Mullican C
Administration and Policy in Mental Health, 2010

Any comprehensive approach to children's mental health should consider services systems such as Child Welfare that provide services to children with high rates of emotional and behavioral disorders. This paper will review what is known about efficacious parent-focused interventions that can improve the lives of children in Child Welfare and explore possible reasons why such interventions are rarely used by Child Welfare agencies. Data from a pilot study suggest key features for increasing the implementation of efficacious practices to improve children's mental health.

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Journal Article

Lynne C. Huffman, Brat GA, Lisa Chamberlain, Paul Wise
Academic Pediatrics, 2010

OBJECTIVE: The aim of this review was to evaluate the impact of managed care on publicly insured children with special health care needs (CSHCN).

METHODS: We conducted a review of the extant literature. Using a formal computerized search, with search terms reflecting 7 specific outcome categories, we summarized study findings and study quality.

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Journal Article

Daniella Perlroth, Glass RJ, Davey VJ, Cannon D, Alan M. Garber, Douglas K. Owens
Clinical Infectious Diseases, 2010

BACKGROUND: The optimal community-level approach to control pandemic influenza is unknown. METHODS: We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization.

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Journal Article

Colleen D. Acosta, Mucio Kit Delgado, Michael A. Gisondi, Amritha Raghunathan, Peter A. D’Souza, Gregory Gilbert, David A. Spain, Patrice Christensen, N. Ewen Wang
Academic Emergency Medicine, 2010

Background: Since California lacks a statewide trauma system, there are no uniform interfacility pediatric trauma transfer guidelines across local emergency medical services (EMS) agencies in California. This may result in delays in obtaining optimal care for injured children.

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Journal Article

The MacArthur Foundation Research Network on an Aging Society, John (Jack) Rowe, Laura Carstensen
Contexts, 2010

In "Facts and Fictions About an Aging America" (Contexts, Fall 2009), our research group unpacked a series of widely held, inter-related misconceptions about our aging population and outlined the broad societal implications of the realities. With the realities articulated and myths exposed, we can start to explore how policy-makers can effectively invest across the life course to create a successful aging society. We call for a new approach to aging—one that involves not only new policies, but also new ways to think about aging in America.

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Journal Article

Kurella Tamura M, Mary Goldstein, Perez-Stable EJ
Nephrology, Dialysis, Transplant, 2010

BACKGROUND AND OBJECTIVES: Rates of dialysis withdrawal are higher among the elderly and lower among Blacks, yet it is unknown whether preferences for withdrawal and engagement in advance care planning also vary by age and race or ethnicity. DESIGN, SETTING, PARTICIPANTS AND METHODS: We recruited 61 participants from two dialysis clinics to complete questionnaires regarding dialysis withdrawal preferences in five different health states.

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