Archive

Archive for the ‘health and health care’ Category

The Economic Burden of Adults With Major Depressive Disorder in the United States (2005 and 2010)

April 1, 2015 Comments off

The Economic Burden of Adults With Major Depressive Disorder in the United States (2005 and 2010)
Source: Journal of Clinical Psychiatry

Background:
The economic burden of depression in the United States—including major depressive disorder (MDD), bipolar disorder, and dysthymia—was estimated at $83.1 billion in 2000. We update these findings using recent data, focusing on MDD alone and accounting for comorbid physical and psychiatric disorders.

Method:
Using national survey (DSM-IV criteria) and administrative claims data (ICD-9 codes), we estimate the incremental economic burden of individuals with MDD as well as the share of these costs attributable to MDD, with attention to any changes that occurred between 2005 and 2010.

Results:
The incremental economic burden of individuals with MDD increased by 21.5% (from $173.2 billion to $210.5 billion, inflation-adjusted dollars). The composition of these costs remained stable, with approximately 45% attributable to direct costs, 5% to suicide-related costs, and 50% to workplace costs. Only 38% of the total costs were due to MDD itself as opposed to comorbid conditions.

Conclusions:
Comorbid conditions account for the largest portion of the growing economic burden of MDD. Future research should analyze further these comorbidities as well as the relative importance of factors contributing to that growing burden. These include population growth, increase in MDD prevalence, increase in treatment cost per individual with MDD, changes in employment and treatment rates, as well as changes in the composition and quality of MDD treatment services.

Influence of music and its genres on respiratory rate and pupil diameter variations in cats under general anaesthesia: contribution to promoting patient safety

April 1, 2015 Comments off

Influence of music and its genres on respiratory rate and pupil diameter variations in cats under general anaesthesia: contribution to promoting patient safety(PDF)
Source: Journal of Feline Medicine and Surgery

Objectives
The aims of the study were to recognise if there is any auditory sensory stimuli processing in cats under general anaesthesia, and to evaluate changes in respiratory rate (RR) and pupillary diameter (PD) in anaesthetised patients exposed to different music genres, while relating this to the depth of anaesthesia.

Methods
A sample of 12 cats submitted for elective ovariohysterectomy were exposed to 2 min excerpts of three different music genres (classical [CM], pop [PM] and heavy metal [HM]) at three points during surgery (T1 = coeliotomy; T2 = ligature placement and transection of the ovarian pedicle; T3 = ligature placement and transection of the uterine body). A multiparametric medical monitor was used to measure the RR, and a digital calliper was used for PD measurement. Music was delivered through headphones, which fully covered the patient’s ears. P values <0.05 were considered to be statistically significant.

Results
Statistically significant differences between stimuli conditions for all surgical points were obtained for RR (T1, P = 0.03; T2, P = 0.00; and T3, P = 0.00) and for PD (T1, P = 0.03; T2, P = 0.04; and T3, P = 0.00). Most individuals exhibited lower values for RR and PD when exposed to CM, intermediate values to PM and higher values to HM.

Conclusions and relevance
The results suggest that cats under general anaesthesia are likely to perform auditory sensory stimuli processing. The exposure to music induces RR and PD variations modulated by the genre of music and is associated with autonomic nervous system activity. The use of music in the surgical theatre may contribute to allowing a reduced anaesthetic dose, minimising undesirable side effects and thus promoting patient safety.

How Much Will It Cost? How Americans Use Prices in Health Care

April 1, 2015 Comments off

How Much Will It Cost? How Americans Use Prices in Health Care
Source: Public Agenda

As Americans shoulder more health care costs, Public Agenda research suggests that many are hungry for more and better price information. However, some obstacles remain to increasing the number of Americans who compare prices before getting care. This research was supported by the Robert Wood Johnson Foundation and findings are based on a nationally representative survey of 2,010 adults conducted in 2014, along with focus groups and follow-up interviews.

Study shows electronic cigarette vapors contain toxins and have the potential to be a public health concern

April 1, 2015 Comments off

Study shows electronic cigarette vapors contain toxins and have the potential to be a public health concern
Source: RTI International

On the heels of the Federal Drug Administration’s (FDA) second public workshop to explore the public health considerations associated with e-cigarettes, nonprofit research organization RTI International released a new research paper “Exhaled Electronic Cigarette Emissions: What’s Your Secondhand Exposure?,” which explores the composition of e-cigarette vapor and the potential health impacts of secondhand exposure.

The study finds e-cigarette emissions contain enough nicotine, and numerous other chemicals to cause concern. A non-user may be exposed to secondhand aerosol particles similar in size to tobacco smoke and diesel engine smoke. Meanwhile, e-cigarettes are a rapidly growing business with annual sales doubling yearly to $1 billion in 2013, and a current lack of regulation that has allowed for a surge in marketing.

Because e-cigarette products are not yet regulated, the chemicals and devices involved vary widely, as may the potential health impacts. Many factors — including the specific device used — influence the chemical makeup and toxicity of e-cigarette emissions. The full scope of health impacts of e-cigarette smoke, as well as secondhand exposure’s impacts on children, is still unknown.

CRS — Health Care for Veterans: Traumatic Brain Injury (March 9, 2015)

March 31, 2015 Comments off

Health Care for Veterans: Traumatic Brain Injury (PDF)
Source: Congressional Research Service (via Homeland Security Digital Library)

In recent years, Congress, the Department of Defense (DOD), and the Department of Veterans Affairs (VA) have increased attention to traumatic brain injury (TBI), which is known as a “signature wound” of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Although the early stages of TBI treatment may occur within the military health care system (if the injury occurs during military service), this report focuses on the VA health care system. In FY2015, VA spending for TBI is estimated to be $234 million. The VA projects the 10-year (FY2016–FY2025) costs of TBI to be $2.2 billion (including $0.5 billion for OEF/OIF veterans).

The type of treatment needed depends on the severity of the injury. Most cases of mild TBI— representing the majority of injuries—resolve without medical attention. Moderate or severe TBI requires immediate treatment. In the case of servicemembers, treatment begins at the site of the event and continues at a military treatment facility. Once stabilized, servicemembers may remain at a military treatment facility or be sent to VA medical facilities.

An explanation and analysis of how world religions formulate their ethical decisions on withdrawing treatment and determining death

March 31, 2015 Comments off

An explanation and analysis of how world religions formulate their ethical decisions on withdrawing treatment and determining death
Source: Philosophy, Ethics, and Humanities in Medicine

Introduction
This paper explores definitions of death from the perspectives of several world and indigenous religions, with practical application for health care providers in relation to end of life decisions and organ and tissue donation after death. It provides background material on several traditions and explains how different religions derive their conclusions for end of life decisions from the ethical guidelines they proffer.

Methods
Research took several forms beginning with a review of books and articles written by ethicists and observers of Bön, Buddhism, Christianity, Hinduism, Indigenous Traditions, Islam, Judaism, Shinto and Taoism. It then examined sources to which these authors referred in footnotes and bibliographies. In addition, material was gathered through searches of data bases in religious studies, general humanities, social sciences and medicine along with web-based key word searches for current policies in various traditions.

Results
Religious traditions provide their adherents with explanations for the meaning and purpose of life and include ethical analysis for the situations in which their followers find themselves. This paper aims to increase cultural competency in practitioners by demonstrating the reasoning process religions use to determine what they believe to be the correct decision in the face of death.

Conclusion
Patterns emerge in the comparative study of religious perspectives on death. Western traditions show their rootedness in Judaism in their understanding of the human individual as a finite, singular creation. Although the many branches of Western religions do not agree on precisely how to determine death, they are all able to locate a moment of death in the body. In Eastern traditions personhood is not defined in physical terms. From prescribing the location of death, to resisting medical intervention and definitions of death, Eastern religions, in their many forms, incorporate the beliefs and practices that preceded them. Adding to the complexity for these traditions is the idea that death is a process that continues after the body has met most empirical criteria for determining death. For Hinduism and Buddhism, the cessation of heart, brain and lung function is the beginning of the process of dying—not the end.

Audit of VA’s Drug-Free Workplace Program

March 31, 2015 Comments off

Audit of VA’s Drug-Free Workplace Program
Source: U.S. Department of Veterans Affairs, Office of Inspector General

We conducted this audit to assess how effectively VA’s Drug-Free Workplace Program identifies and addresses illegal drug use among VA employees. VA needs to improve management of its Drug-Free Workplace Program. VA selected about 3 of every 10 applicants for pre employment drug testing before hiring these individuals into Testing Designated Positions (TDPs) in fiscal year (FY) 2013. We estimate that of the nearly 22,600 individuals VA reported hiring into TDPs in FY 2013, about 15,800 were hired without a pre-employment drug test. VA facilities tested about 68 percent of the 3,420 employees selected for random drug testing in FY 2013. We identified at least 19,100 employees in TDPs who were not subject to the possibility of monthly random drug testing.

In addition, VA erroneously designated as many as 13,200 employees in non-TDPs for drug testing in FY 2014. Further, only 17 (33 percent) of the 51 employees who tested positive for drugs as a result of reasonable suspicion of on-the-job drug use or after a workplace accident or injury were referred to VA’s Employee Assistance Program.

These issues occurred because VA does not support that all tentative selectees for TDPs need to be drug tested before being hired. VA also does not effectively monitor local facility compliance with random employee drug testing requirements. Furthermore, VA lacks adequate oversight to ensure the accuracy of drug testing data and that consistent personnel actions are taken when employees test positive for drugs. As a result, VA has little assurance that this program is performing as intended to identify and eliminate illegal drug use in its workforce.

Since VA’s workforce is expected to grow significantly with the passage of the Veterans Access, Choice, and Accountability Act of 2014, VA needs to take actions to address weaknesses in its Drug-Free Workplace Program immediately. We recommended the Deputy Assistant Secretary for Human Resources Management implement processes to ensure full compliance with VA’s pre-employment applicant drug testing and random employee drug testing requirements, and improve program integrity by ensuring the accurate coding of employees in TDPs.

The Acting Deputy Assistant Secretary for Human Resources Management concurred with our recommendations and provided an acceptable action plan. We will follow up on the implementation of the corrective actions.

Follow

Get every new post delivered to your Inbox.

Join 1,022 other followers