Background— Influenza infection has been associated with increased risk of adverse cardiac and cerebral vascular outcomes. Oseltamivir, a treatment for influenza, shown to decrease the severity an influenza episode, but few data exist regarding its potentially protective effect against recurrent outcomes among patients history disease. Methods Results— Electronic healthcare service pharmacy records 37 482 TRICARE beneficiaries, aged 18 older, coded cardiovascular (CV) disease subsequent...

Abstract: Background : National rates of cesarean birth continue a three decade‐long escalation, despite widespread recognition that reduction in the use procedure is continuing appropriate public health goal, as evidenced by Healthy People 2010 targets. Nonclinical factors associated with delivery include maternal age, race, socioeconomic status, and insurance coverage. This study compared trends for U.S. Department Defense healthcare beneficiary population from 1996 to 2002 those observed...

Aims: To develop and deliver a new model of prescribing (NMOP) pilot with physiotherapists in Northern Ireland Health Social Care. Methods: Baseline end-point audits medicines, process maps patient journeys clinical pathways, stakeholder feedback sessions surveys. Findings: Audit showed an increase the delivery prescriptions using NMOP mechanisms reduction other for prescription, removing need GP to action. Prescribing was evidence based there number steps time taken all pathways. Patients...

Introduction General opioid prescribing has decreased in response to practice guidelines and policy changes, but information on recent practices initial is needed support interventions reduce the risk of long-term prescription use. Methods This cross-sectional study examined Military Health System data between 1 October 2015 30 September 2021 explore prescriptions among providers serving 1.66 million US service members. We compared characteristics a subgroup (n=372 960) receiving an within...

Article The association between oseltamivir use and adverse neuropsychiatric outcomes among TRICARE beneficiaries, ages 1 through 21 years diagnosed with influenza was published on March 1, 2009 in the journal International Journal of Adolescent Medicine Health (volume 21, issue 1).

Abstract: Background : A previous study of the United States Department Defense healthcare beneficiaries reported elevated cesarean delivery rates for black and Asian women relative to white that were independent maternal socioeconomic status. This finding suggests other factors may explain rates. The purpose this was examine prevalence specific chronic diseases identified as risk complications during pregnancy, labor, delivery, explore strength each disease predict a outcome . Methods...

Background: Chronic low-back pain (LBP) is a frequent cause of work absence and disability, frequently associated with long-term use opioids. Objective: To describe military readiness-related outcomes at follow-up in soldiers LBP grouped by the type early treatment received for their LBP. Treatment groups were based on receipt opioid or tramadol prescription nonpharmacologic modalities (NPT). Design, Subjects, Measures: A retrospective longitudinal analysis U.S. new episodes persisting more...

The simultaneous use of multiple prescription medications has been associated with an increased risk adverse drug events and other drug-related complications, especially in the elderly.To quantify prevalence among a sample Department Defense (DoD) health care beneficiaries, aged 65 years older, who used their TRICARE (military services) benefit to obtain medication.Outpatient pharmacy fill records were analyzed for 10% random 1.27 million beneficiaries older obtained 1 or more 90-day period...

The U.S. Department of Defense (DoD) health care benefit (TRICARE) provides 9.2 million active-duty and retired uniformed services personnel their family members with access to a comprehensive pharmacy low out-of-pocket costs. DoD's Uniform Formulary is available worldwide at 3 points service (military pharmacies, contracted mail order, community [network non-network] pharmacies). Community military order accounted for 64%, 23%, 13%, respectively, $6.5 billion total drug expenditures during...

A computer-based anatomy program, Virtual Canine Anatomy: The Head, was incorporated into a first-year veterinary dissection laboratory two years ago to address challenges inherent in the traditional pedagogical approach. program uses specimen photographs, QuickTime Reality, and interactive features help students study dissection, osteology, radiology of canine head. Photographs each phase are displayed along with instructions. Students can click on anatomical structures photograph highlight...

To assess whether significant variations in observed cesarean rates U.S. military hospitals may be attributed to differences clinical case mix.Hospital discharge records for births 2002 were grouped into mutually exclusive strata calculate predicted subgroups defined by maternal race, health plan, hospital location, delivery volume, teaching status, and neonatal intensive care unit (NICU) status. The 95% confidence interval (CI) around each standardized ratio (SR) of the...

Department of Defense (DoD) health care planners want to stimulate a voluntary migration prescription fills from military and community pharmacies its mail-order pharmacy, lower-cost dispensing option for the department. Beneficiary cost share 90-day supply generic/ brand medication is $0/$0 at pharmacies, $3/$9 DoD $9/$27 network pharmacies.To examine pharmacy use patterns among beneficiary population age 65 years or older, traditionally heaviest users TRICARE DOD drug benefit, identify...

Like many payers, the Department of Defense (DoD) has limited ability to work directly with prescribers ensure appropriate medication use. Many older beneficiaries are prescribed multiple maintenance medications, placing them at higher risk for adverse drug interactions, contraindicated use, and other polypharmacy-related problems. Medication reviews may mitigate these risks, but optimal venue therapy management is unclear.To (a) determine if will respond a mailed request from DoD pursue...

"Severe hyponatraemia associated with pre-eclampsia." Journal of Obstetrics and Gynaecology, 29(2), pp. 143–144

Innovative reforms in medical education will require instructional tools to support these changes and give students more flexibility where how they learn. At Colorado State University, the software program Virtual Canine Anatomy (VCA) was developed assist student learning both inside outside anatomical laboratory. The includes interactive photographs of dissected canine cadavers, dissection instructions with accompanying videos diagrams, radiographs, three-dimensional models. There is a need...

Objectives: To calculate the annual rate of psychiatric evacuation U.S. Service members out Iraq and Afghanistan identify risk factors for evacuation. Methods: Descriptive regression analyses were performed using deployment records evacuated from January 2004 through September 2010 with a diagnosis, 20% random sample all other deployers (N = 364,047). Results: A total 5,887 psychiatrically evacuated, 3,951 (67%) which on first deployment. The increased 72.9 per 100,000 in to 196.9 2010....

Anatomy faculty with cadaver-based laboratory courses were presented a significant challenge in March 2020 to create equivalent learning experiences without cadaveric access. The undergraduate domestic animal anatomy course at the Colorado State University was halfway into 16-week semester when COVID-19 lockdown orders and transition remote instruction began. new curriculum critically evaluated using student surveys outcome data. Most students (92.5%) agreed that online success; however, who...

During public health emergencies, the Military Health System experiences challenges similar to those across U.S. and private systems. This study explored how 1 such event, 2009/2010 influenza (H1N1) pandemic, impacted care utilization associated costs in System.Data from Data Repository were used examine diagnoses, claims data, dates of services with respect military or civilian during 2004-2009/2010 seasons. Comparison analysis was conducted through two-tailed t-tests regression...

Abstract: Background : In response to rising cesarean rates, it is reasonable for health care organizations look a managed model as means of controlling further rate increases. However, little conclusive evidence exists support this solution. We undertook study the Department Defense beneficiary population assess impact enrollment in TRICARE Prime, Department's plan, on delivery rates . Methods Pooled hospital discharge records from 1999–2002 live, singleton births were analyzed calculate...

inhibitor (PPI) esomeprazole in the third copayment tier on TRICARE formulary July 17, 2005. The change to nonpreferred status for included a $13 increase (from $9.00 $22.00) either 30-day supply purchased from community pharmacy or 90-day mail-order and $0 if obtained military but with prior authorization (PA) requirement. was designed encourage use of PPIs other than purchases.To quantify changes (a) beneficiary utilization relative (b) settings used filling prescriptions following...

The Department of Defense (DoD) Military Health System (MHS) embodies decades health care practice that has evolved in scope and complexity to meet the demands for quality which its beneficiaries are entitled. War, Base Realignment Closure (BRAC), other dynamic forces require ongoing review revision policy military hospitals as well expanded network civilian providers who our nation’s soldiers, sailors, airmen, marines their families. result been an incrementally constructed assurance (QA)...

Abstract Purpose To evaluate the use of lipid‐lowering treatment (LLT) among patients at risk for cardiovascular disease (CVD) in US Military Health System (MHS). Methods The study examined healthcare service and prescription records beneficiaries ≥18 years calendar 2002, 2004, 2006. Patients were categorized based on (CV) risk, with exposure to LLT defined as one or more prescriptions medication. Logistic regression models estimated odds 2004 2006 relative 2002 after adjustment age, gender,...

This study examined the changes in self-reported health status of Department Defense care beneficiaries associated with September 11th terrorist attacks. Responses to a single-item, general measure from pre- and post-September 11 quarterly survey events for calendar year 2001 were analyzed compare unfavorable response rates before after Increases following attacks reported by total population 39 44 subgroups examined. Statistically significant increases active duty personnel dependents...