22 research outputs found
Student Voices: Engaging Diverse Learners through Shared Learning
A student panel discussion and reflection on revising an assignment from a simulation to an experiential learning activity will be presented. Student facilitators represent several majors and levels of undergraduate experiences which also allows modeling for roots of interprofessional collaboration. Students as teaching partners increases awareness of diversity and disability culture on the EKU campus
The structure of a "xylan" from kenaf (Hibiscus cannabinus)
"April, 1987.""Portions of the work were used by LD and EB as partial fulfillment of the requirements for the Master of Science degree at the Institute of Paper Chemistry.""This paper has been submitted for consideration for publication in Cellulose Chemistry and Technology.
IN-CORE INSTRUMENTATION DEVELOPMENT, FIRST TOPICAL REPORT, TASK II, PHASE I- -TELEMETERING
being developed, which will make it possible to transmit information from 100 or more in-core sensors through a single pressure vessel penetration. The development of a multiplexing subsystem for use within the reactor pressure vessel is being carried out. The most promising methods of multiplexing investigated are electromechanical commutation and electroric frequency division. (M.C.G.
USE OF INSTRUMENTED FUEL ASSEMBLIES FOR THE CORE THERMAL--HYDRAULIC ANALYSIS. GARIGLIANO DEVELOPMENT PROGRAM.
VA Healthcare Costs of a Collaborative Intervention for Chronic Pain in Primary Care
Background: Chronic pain is costly to individuals and the healthcare system, and is often undertreated. Collaborative care models show promise for improving treatment of patients with chronic pain. The objectives of this article are to report the incremental benefit and incremental health services costs of a collaborative intervention for chronic pain from a veterans affairs (VA) healthcare perspective.
Methods: Data on VA treatment costs incurred by participants were obtained from the VA\u27s Decision Support System for all utilization except certain intervention activities which were tracked in a separate database. Outcome data were from a cluster-randomized trial of a collaborative intervention for chronic pain among 401 primary care patients at a VA medical center. Intervention group participants received assessments and care management; stepped-care components were offered to patients requiring more specialized care. The main outcome measure was pain disability-free days (PDFDs), calculated from Roland-Morris Disability Questionnaire scores.
Results: Participants in the intervention group experienced an average of 16 additional PDFDs over the 12-month follow-up window as compared with usual care participants; this came at an adjusted incremental cost of $364 per PDFD for a typical participant. Important predictors of costs were baseline medical comorbidities, depression severity, and prior year\u27s treatment costs.
Conclusion: This collaborative intervention resulted in more pain disability-free days and was more expensive than usual care. Further research is necessary to identify if the intervention is more cost-effective for some patient subgroups and to learn whether pain improvements and higher costs persist after the intervention has ended
Sex Differences in the Medical Care of VA Patients with Chronic Non-Cancer Pain
Objective
Despite a growing number of women seeking medical care in the veterans affairs (VA) system, little is known about the characteristics of their chronic pain or the pain care they receive. This study sought to determine if sex differences are present in the medical care veterans received for chronic pain.
Design
Retrospective cohort study using VA administrative data.
Subjects
The subjects were 17,583 veteran patients with moderate to severe chronic non-cancer pain treated in the Pacific Northwest during 2008.
Methods
Multivariate logistic regression assessed for sex differences in primary care utilization, prescription of chronic opioid therapy, visits to emergency departments for a pain-related diagnosis, and physical therapy referral.
Results
Compared with male veterans, female veterans were more often diagnosed with two or more pain conditions, and had more of the following pain-related diagnoses: fibromyalgia, low back pain, inflammatory bowel disease, migraine headache, neck or joint pain, and arthritis. After adjustment for demographic characteristics, pain diagnoses, mental health diagnoses, substance use disorders, and medical comorbidity, women had lower odds of being prescribed chronic opioid therapy (adjusted OR [AOR] 0.67, 95% CI 0.58–0.78), greater odds of visiting an emergency department for a pain-related complaint (AOR 1.40, 95% CI 1.18–1.65), and greater odds of receiving physical therapy (AOR 1.19, 95% CI 1.05–1.33). Primary care utilization was not significantly different between sexes.
Conclusions
Sex differences are present in the care female veterans receive for chronic pain. Further research is necessary to understand the etiology of the observed differences and their associations with clinical outcomes