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Over the last decade, online continuing dental education (CDE) has seen a major transformation in the way it is delivered, marketed, and accessed. The University of Florida College of Dentistry (UFCD) developed and evaluated a web-based CDE format ("Case of the Month") that specifically focused on clinical oral pathology. Over a four-month period, three oral pathology cases were presented monthly (a total of twelve cases overall) using a clinical pathologic conference format including a brief patient history, along with pictures and radiographs needed to make a treatment diagnosis. A differential diagnosis in the form of a question was developed, followed by a detailed description and rationale describing why the option was correct or incorrect. At the conclusion of the case of the month, respondents completed an online survey that ascertained their needs, expectations, attitudes, level of clinical knowledge gained, and experience with the online environment. The primary purpose of this study was to evaluate the expectations and attitudes of these CDE participants. Results suggested that the participants' needs and expectations were generally met: they were able to navigate the website with ease and found the design to be appealing. The biggest disadvantage reported was the inability to communicate with others, including the instructor, while viewing the case, and more respondents would like to have seen some more general/common oral pathology information. [ABSTRACT FROM AUTHOR]

The objective of this longitudinal study was to detect the relationship between the sense of coherence (SOC), which is an adaptive coping response, and depression in informal caregivers of stroke survivors across 2 years. One-hundred-fifteen veterans, who were hospitalized after experiencing an acute stroke, and their informal caregivers were enrolled prior to discharge. Data were collected via face-to-face in-home interviews at 1, 6, 12, 18, and 24 months after discharge. A linear mixed model was fitted to estimate the effects of the time-dependent covariates (SOC) while considering the dependence of outcome measures at repeated times. Based on the linear mixed model, caregivers with a stronger SOC were associated with lower levels of caregiver depression across 2 years following a stroke (p < 0.0001). SOC seems to be an important aspect of a caregiver's capacity to cope after tending to the needs of a stroke patient.

We evaluated a Veterans Health Administration (VHA) care coordination/ home-telehealth (CC/HT) program on the utilization of health care services and health-related quality of life (HRQL) in veterans with diabetes. Administrative records of 445 veterans with diabetes were reviewed to compare health care service utilization in the 1-year period before and 1-year period post-enrollment and also examined self-reported HRQL at enrollment and 1 year later. Multivariate analyses indicated a statistically significant reduction in the proportion of patients who were hospitalized (50% reduction), emergency room use (11% reduction), reduction in the average number of bed days of care (decreased an average of 3.0 days), and improvement in the HRQL role-physical functioning, bodily pain, and social functioning. The results need to be interpreted with caution because we used a single-group study design that may be influenced by regression to the mean. Ideally, future research should use a randomized controlled trial design.

This study compared health-related outcomes, during a 1-year period, for two groups of frail elders-one that received care coordination via distance monitoring (home-telehealth) and one that received no intervention. A case-control design was employed. The home telehealth intervention group was made up of 111 male veterans who were enrolled in a Veterans Health Administration project. The control group consisted of 115 men who were referred from either senior service agencies or hospital rehabilitation programs, but did not receive home-telehealth. Subjects in both groups had primary diagnoses of hypertension, diabetes, respiratory disease, or heart disease. The two groups were similar in terms of age, race, marital status, and independence in instrumental activities of daily living (IADL) at baseline. A paired t-test was used to study the before-after (baseline to 12-month follow-up) improvements in the outcome measures within each group. Regression models were used to compare the outcome improvements between the two groups. Over 1 year, the intervention group improved 2.2 points more in IADL, 14.4 points more in FIM motor scores, and 2.7 points more in FIM cognitive scores than the control group (p < 0.0001). This evidence supports the use of a specific home-telehealth strategy for care coordination to improve functional independence in non-institutionalized veterans with chronic disease. A randomized controlled trial should be employed to confirm these findings.