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Brooks Holliday S, Ayer L, Beckman R, Jaycox LH, Agniel D, Elinoff D, Ramchand R, Hoch E, Wagner L. Do stigma and efficacy mediate the association between training and suicide prevention behavior among Army noncommissioned officers? Suicide Life Threat Behav 2024; 54:195-206. [PMID: 38116706 DOI: 10.1111/sltb.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Rates of suicide in the Active Component of the military have significantly increased since 2010, with particularly high rates among Army service members. One element of the Army's approach to suicide prevention relies on noncommissioned officers (NCOs) as gatekeepers who have regular contact with soldiers. NCOs receive suicide prevention training, but there is limited evidence that such training leads to behavior change. METHODS We surveyed 2468 Army NCOs participating in leadership development courses to determine (a) if training on suicide prevention and soft skills (e.g., active listening) was associated with gatekeeper behavior and use of soft skills; and (b) whether that association was explained by two potential barriers, stigma and perceptions of efficacy. RESULTS Both the number of suicide prevention training topics and soft skills trained were associated with increased gatekeeper behavior; these relationships were explained in part by lower stigma and higher efficacy for use of soft skills. The use of interactive training methods and receiving coaching after training were not associated with stigma or efficacy, though both methods were associated with more frequent use of soft skills. CONCLUSION Results suggest that the content and format of training is important to preparing NCOs to fulfill a gatekeeper role.
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Affiliation(s)
| | - Lynsay Ayer
- RAND Corporation, Santa Monica, California, USA
| | | | | | | | | | | | - Emily Hoch
- RAND Corporation, Santa Monica, California, USA
| | - Lisa Wagner
- RAND Corporation, Santa Monica, California, USA
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McBirney S, Hoch E. Toward a Unified Multiscale Computational Model of the Human Body's Immediate Responses to Blast-Related Trauma: Proceedings and Expert Findings from a U.S. Department of Defense International State-of-the-Science Meeting. Rand Health Q 2023; 10:11. [PMID: 37720077 PMCID: PMC10501818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
The topic of the tenth U.S. Department of Defense International State-of-the-Science Meeting on Blast Injury Research was "Toward a Unified Multiscale Computational Model of the Human Body's Immediate Responses to Blast-Related Trauma." The meeting was held August 16-17, 2022, at the RAND Corporation office in Arlington, Virginia, and more than 60 scientists, clinicians, and military leaders provided scientific overviews, presentations, and posters describing new and emerging science in the field. Before the meeting, a conference planning committee consulted on the literature review and research questions and served as a peer review panel for submitted abstracts. Five leading scientists and clinicians in related fields were invited to serve on an expert panel, lead working groups, and develop overall recommendations. These conference proceedings summarize the meeting and present key findings.
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Ayer L, Holliday S, Beckman R, Jaycox LH, Elinoff D, Ramchand R, Agniel D, Hoch E, Wagner L. Upstream suicide prevention in the U.S. Army: Noncommissioned officers' perspectives. Psychol Serv 2023:2023-86314-001. [PMID: 37384440 DOI: 10.1037/ser0000788] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The goal of this study was to examine the factors associated with Army noncommissioned officer (NCO) experiences, attitudes, and behaviors in their role of identifying potential suicide risk factors in their fellow soldiers. To better understand the perspectives of NCOs, an anonymous survey was administered to 2,468 Army NCOs. Descriptive statistics and linear regressions were conducted to compare subgroups of NCOs. Most (71%) Army NCOs have received many (11 or more) hours of suicide prevention training, but training in soft skills that may be important for the gatekeeper role was less consistently reported. Active Component soldiers reported greater confidence in their intervention skills (Cohen's d = 0.25) and fewer logistical barriers (e.g., time and space to talk) to intervening with at-risk soldiers (Cohen's d = 0.80) compared to Reserve and National Guard soldiers. Formal coursework in mental health areas like psychology or chaplaincy was associated with a greater level of confidence in intervention skills (Cohen's d = 0.23) and in more frequent intervention behavior (Cohen's d = 0.13). Army NCO trainings should be modified to better equip soldiers with the soft skills (e.g., active listening skills and verbally and nonverbally conveying nonjudgment/acceptance and empathy) needed to have effective conversations with soldiers about suicide risk factors and other sensitive topics. Strategies used within mental health education, which appears to be a strength for NCO gatekeepers, could be used to achieve this goal. Reserve and Guard NCOs may need additional supports and tailored trainings to better fit their operational context. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Abstract
BACKGROUND Many states link Medicaid claims with birth certificates or other data, often to inform programs and policies aimed at improving maternal and child health (MCH). OBJECTIVES To develop an up-to-date understanding of the extent of the use of linked Medicaid claims for MCH research by state. RESEARCH DESIGN We completed a structured literature review, developed an inventory of linkage efforts, and facilitated semistructured discussions with representatives from 9 states with established Medicaid claims data linkages to understand the technical details of linkages, experiences creating and maintaining linkages, and barriers or facilitators to establishing linkages. RESULTS We identified 45 peer-reviewed journal articles representing 22 states that used linked Medicaid data to study MCH and 33 states and territories that publicly report on Medicaid data linkages for a total of 39 states with any in-scope linkage. Discussions revealed that linkages often arose from the desire to answer a specific question or evaluate a program but then expanded to other use cases and that most states enable external researchers to access data for analysis. Respondents provided a few examples of where linked birth certificate data were used for health outcomes research. CONCLUSION Additional resources including technical assistance for identifying best practices along with interagency collaboration could overcome barriers and facilitate a coordinated and consolidated approach across states.
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Affiliation(s)
| | | | | | | | - Violanda Grigorescu
- Office of the Assistant Secretary for Planning and Evaluation, Washington, DC
| | - Scott Smith
- Office of the Assistant Secretary for Planning and Evaluation, Washington, DC
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Isath A, Ohira S, Hoch E, Frenkel D, Jacobson J, Lanier G, Kai M, Gass A, Levine E. Escalation of Mechanical Circulatory Support in a Patient with an Acute Myocardial Infarction, Cardiogenic Shock and Refractory Ventricular Tachycardia. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Affiliation(s)
- M Schmelz
- Abteilung Experimentelle Schmerzforschung, CBTM, Med. Fakultät Mannheim, Universität Heidelberg, Ludolf-Krehl-Straße 13-17, 68167, Mannheim, Deutschland.
| | - W Häuser
- Medizinisches Versorgungszentrum für Schmerzmedizin und seelische Gesundheit Saarbrücken-St. Johann, Saarbrücken, Deutschland
| | - E Hoch
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Campus Innenstadt, München, Deutschland
| | - F Petzke
- Schmerzmedizin, Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - C Sommer
- Neurologische Klinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
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Shulman E, Kargoli F, Mittell A, Hoch E, DiBiase L, Fisher J, Gross J, Kim S, Ferrick K, Krumerman A. 073_16751-H1 Atrial Fibrillation in Hispanics, Blacks and Whites with Heart Failure. JACC Clin Electrophysiol 2017. [DOI: 10.1016/j.jacep.2017.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Farmer CM, Tanielian T, Fischer SH, Duffy EL, Dellva S, Butcher E, Brown KM, Hoch E. Supporting Veterans in Massachusetts: An Assessment of Needs, Well-Being, and Available Resources. Rand Health Q 2017; 7:9. [PMID: 29057159 PMCID: PMC5644775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Massachusetts is home to approximately 380,000 of the nation's more than 21 million veterans, but there has been little research on the resources available to this population at the state level. There are numerous resources available to veterans and other military-affiliated groups in Massachusetts, but there are still pockets of unmet need in the areas of education, employment, health care, housing, financial, and legal services-particularly for newer veterans and current National Guard/reserve members. Although Massachusetts veterans fare better overall than their peers in other states, they lag behind other Massachusetts residents in terms of health and financial status. Massachusetts veterans and National Guard/reserve members who need support and services face such barriers as a lack of knowledge about how to access services, a lack of awareness about eligibility, and geographic distance from service providers. As the veteran population changes both nationally and in Massachusetts, it will be important for public- and private-sector providers serving Massachusetts veterans and service members to continue addressing unmet needs while ensuring that resources are responsive to shifts in these populations. A better understanding of the unique needs of Massachusetts veterans can help inform investments in initiatives that target these populations and guide efforts to remedy barriers to accessing available support services and other resources.
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Mattke S, Liu H, Hoch E, Mulcahy AW. Avoiding the Tragedy of the Commons in Health Care: Policy Options for Covering High-Cost Cures. Rand Health Q 2017; 6:1. [PMID: 28845339 PMCID: PMC5568155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this article, Mattke and his colleagues discuss the risk that strategic behavior by health insurers could unravel the market for curative therapies for chronic diseases. Because the cost of these cures is front-loaded but the benefits accrue over time, insurers might attempt to delay treatment or avoid patients who require it, in the hope that they might change insurers. The authors discuss policy options to remedy this potential free-rider problem through alignment of incentives at the patient level, coordination among payers, and government intervention. They present a framework to analyze policy options and real-world case studies. While implementing those policy options is far from easy, stakeholders need to collaborate in order to establish equitable mechanisms that fairly distribute the cost and benefits of high-cost cures.
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Havemann-Reinecke U, Hoch E, Preuss UW, Kiefer F, Batra A, Gerlinger G, Hauth I. [On the legalization debate of non-medical cannabis consumption : Position paper of the German Association for Psychiatry, Psychotherapy and Psychosomatics]. Nervenarzt 2016; 88:291-298. [PMID: 27981374 DOI: 10.1007/s00115-016-0248-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Calls are increasing for the legalization of cannabis. Some legal experts, various politicians, political parties and associations are demanding a change in drug policy. The legalization debate is lively and receiving wide coverage in the media. The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) comments on the most important questions from a medical scientific perspective: can cannabis consumption trigger mental illnesses, what consequences would legalization have for the healthcare system and where is more research needed?
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Affiliation(s)
- U Havemann-Reinecke
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Deutschland. .,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland.
| | - E Hoch
- Abt. Psychotherapie & Psychosomatik, Klinik und Poliklinik für Psychiatrie und Psychotherapie, LMU München, München, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - U W Preuss
- Vitos Klinik für Psychiatrie und Psychotherapie Herborn, Herborn, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - F Kiefer
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - A Batra
- Universitätsklinik für Psychiatrie und Psychotherapie, Eberhard-Karls-Universität Tübingen, Tübingen, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - G Gerlinger
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
| | - I Hauth
- Zentrum für Neurologie, Psychiatrie, Psychotherapie und Psychosomatik, Alexianer St. Joseph Krankenhaus, Berlin, Deutschland.,Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), Reinhardtstraße 27 B, 10117, Berlin, Deutschland
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Abstract
The coincidence of tobacco smoking and psychiatric disorders is of great epidemiological and therapeutic importance. Tobacco smoking by people with mental disorders leads to disproportionately high somatic health risks, an adverse clinical course, poorer clinical outcomes and reduced quality of life (QoL). The etiological causes of the high comorbidity between smoking and mental disorders are still unclear: currently, tobacco smoking is discussed as being either the consequence or contributory cause of psychological disorders or both disorders share common antecedents and interactions. Psychiatric patients are motivated to quit and smoking cessation is not generally less effective with smokers with mental disorders than with mentally healthy individuals. Specific smoking cessation programs in the inpatient and outpatient settings are time-consuming and complex but effective. Within the framework of the current S3 guidelines the international evidence has been updated and transformed into treatment guidelines following an elaborate consensus process. Basically the same interventional measures should be used as with mentally healthy individuals; however, smokers with a psychological comorbidity often need more intensive adjuvant psychotherapeutic interventions and often need pharmaceutical support, (bupropion, varenicline and nicotine replacement therapy). Due to the overall unsatisfactory findings the treatment guidelines are partially based on clinical consensus decisions. In this field, a considerable need for research has been determined.
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Affiliation(s)
- S Mühlig
- Institut für Psychologie, Klinische Psychologie und Psychotherapie, Technische Universität Chemnitz, Wilhelm-Raabe-Str. 43, 09107, Chemnitz, Deutschland.
| | - S Andreas
- Lungenfachklinik Immenhausen, Pneumologische Lehrklinik der Universitätsmedizin Göttingen, Immenhausen, Deutschland
| | - A Batra
- Lungenfachklinik Immenhausen, Pneumologische Lehrklinik der Universitätsmedizin Göttingen, Immenhausen, Deutschland
| | - K U Petersen
- Allgemeine Psychiatrie und Psychotherapie mit Poliklinik, Universitätsklinikum Tübingen, Eberhard Karis Universität Tübingen, Tübingen, Deutschland
| | - E Hoch
- Abteilung Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Mannheim, Deutschland
| | - T Rüther
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
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Fremont A, Weissman JS, Hoch E, Elliott MN. When Race/Ethnicity Data Are Lacking: Using Advanced Indirect Estimation Methods to Measure Disparities. Rand Health Q 2016; 6:16. [PMID: 28083444 PMCID: PMC5158280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A key aim of U.S. health care reforms is to ensure equitable care while improving quality for all Americans. Limited race/ethnicity data in health care records hamper efforts to meet this goal. Despite improvements in access and quality, gaps persist, particularly among persons belonging to racial/ethnic minority and low-income groups. This study describes the use of indirect estimation methods to produce probabilistic estimates of racial/ethnic populations to monitor health care utilization and improvement. One method described, called Bayesian Indirect Surname Geocoding, uses a person's Census surname and the racial/ethnic composition of their neighborhood to produce a set of probabilities that a given person belongs to one of a set of mutually exclusive racial/ethnic groups. Advances in methods for estimating race/ethnicity are enabling health plans and other health care organizations to overcome a long-standing barrier to routine monitoring and actions to reduce disparities in care. Though these new estimation methods are promising, practical knowledge and guidance on how to most effectively apply newly available race/ethnicity data to address disparities can be greatly extended.
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Gresenz CR, Hoch E, Eibner C, Rudin RS, Mattke S. Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges. Rand Health Q 2016; 5:4. [PMID: 28083414 PMCID: PMC5158219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.
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Kreuter M, Nowak D, Rüther T, Hoch E, Thomasius R, Vogelberg C, Brockstedt M, Hellmann A, Gohlke H, Jany B, Loddenkemper R. [Cannabis--Position Paper of the German Respiratory Society (DGP)]. Pneumologie 2016; 70:87-97. [PMID: 26935046 DOI: 10.1055/s-0042-100040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In this position paper, the adverse health effects of cannabis are reviewed based on the existing scientific literature; in addition possible symptom-relieving effects on some diseases are depicted. In Germany, cannabis is the most widely used illicit drug. Approximately 600,000 adult persons show abusive or addictive cannabis consumption. In 12 to 17 year old adolescents, cannabis use increased from 2011 to 2014 from 2.8 to 6.4%, and the frequency of regular use from 0.2 to 1.5%. Currently, handling of cannabinoids is much debated in politics as well as in general public. Health aspects have to be incorporated into this debate. Besides analysing mental and neurological side effects, this position paper will mainly focus on the influences on the bronchopulmonary and cardiovascular system. There is strong evidence for the induction of chronic bronchitis. Allergic reactions including asthma are known, too. Associations with other diseases like pulmonary emphysema, lung cancer and pneumonia are not sufficiently proven, however cannot be excluded either. In connection with the use of cannabis cardiovascular events such as coronary syndromes, peripheral vascular diseases and cerebral complications have been noted. Often, the evidence is insufficient due to various reasons; most notably, the overlapping effects of tobacco and cannabis use can frequently not be separated adequately. Empirically, early beginning, high-dosed, long-lasting and regular cannabis consumption increase the risk of various psychological and physical impairments and negatively affect age-based development. Concerns therefore relate especially to children and adolescents. There is only little scientific evidence for medical benefits through cannabis as a remedy; systematic research of good quality, in particular prospective, randomised, placebo-controlled double-blinded studies are rare. The medical societies signing this position paper conclude that cannabis consumption is linked to adverse health effects which have to be taken into consideration in the debate about the social attitude towards cannabinoids. The societies agree that many aspects regarding health effects of cannabis are still uncertain and need clarification, preferably through research provided by controlled studies.
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Affiliation(s)
- M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg
| | - D Nowak
- Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München
| | - T Rüther
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Campus Innenstadt, München
| | - E Hoch
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Campus Innenstadt, München
| | - R Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, Universitätsklinikum Hamburg-Eppendorf
| | - C Vogelberg
- Klinik u. Poliklinik f. Kinder- u. Jugendmedizin, Abteilung Kinderpneumologie/Allergologie, Universitätsklinikum Carl Gustav Carus, Dresden
| | - M Brockstedt
- Gesundheitsamt Berlin-Mitte, Berufsverband für Kinder- und Jugendärzte
| | - A Hellmann
- Zentrum für Pneumologie und Onkologie am Diako Augsburg, Bundesverband der Pneumologen, Schlaf- und Beatmungsmediziner
| | - H Gohlke
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, Innere Medizin & Pneumologie, Missionsärztliche Klinik, Würzburg
| | - B Jany
- Deutsche Gesellschaft für Kardiologie und Deutsche Herzstiftung
| | - R Loddenkemper
- Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, Berlin
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Abstract
BACKGROUND From 2010 until 2015 two interdisciplinary evidence-based guidelines were developed to summarize the current knowledge regarding screening, diagnostics and treatment of alcohol and tobacco-related disorders. METHODS Both guidelines were prepared under the auspices of the German Society for Psychiatry, Psychotherapy and Psychosomatics (Deutsche Gesellschaft für Psychiatrie, Psychotherapie, Psychosomatik und Nervenheilkunde, DGPPN) and the German Society for Addiction Research and Therapy (Deutsche Gesellschaft für Suchtforschung und -therapie, DG-Sucht). To meet the methodological criteria for the highest quality guidelines (S3 criteria) as defined by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF) the following criteria were realized: (1) a systematic search, selection and appraisal of the international literature, (2) a structured process to reach consensus and (3) inclusion of all relevant representatives of future guideline users. RESULTS More than 60 clinical experts and researchers analyzed the scientific literature. In total 41 international and national guidelines (23 for alcohol and 18 for tobacco) were used. Moreover, 83 systematic Cochrane reviews (alcohol 28, tobacco 55) and 5863 articles (alcohol 2213, tobacco 3650) were analyzed. A total of 7 expert groups formulated 174 recommendations for the screening, diagnosis and treatment of alcohol-related disorders. Six expert groups created 81 recommendations for the screening, diagnosis and treatment of tobacco-related disorders. Approximately 50 scientific associations, professional organizations, patient and family initiatives, as well as representatives of the healthcare system formed a consensus group. In seven 1 and 2-day conferences, all clinical recommendations were discussed and approved by this group. Both guidelines will be revised on a regular basis to guarantee that the clinical recommendations are kept up to date. CONCLUSIONS Both systematically developed, evidence-based treatment guidelines are comprehensive instruments to provide orientation and assist the decision-making process for physicians, psychologists and other therapists as well as patients and their families in the diagnosis and treatment of alcohol and tobacco use related disorders.
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Affiliation(s)
- E Hoch
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J 5, 68159, Mannheim, Deutschland.,Abt. Psychotherapie und Psychosomatik, Klinik und Poliklinik für Psychiatrie und Psychotherapie der LMU München, München, Deutschland
| | - K Petersen
- Sektion Suchtforschung und Suchttherapie, Klinik für Psychiatrie und Psychotherapie, Universitätsklinik Tübingen, Tübingen, Deutschland
| | - I Kopp
- AWMF-Institut für Medizinisches Wissensmanagement, Philipps-Universität, Marburg, Deutschland
| | - A Batra
- Sektion Suchtforschung und Suchttherapie, Klinik für Psychiatrie und Psychotherapie, Universitätsklinik Tübingen, Tübingen, Deutschland
| | - K Mann
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J 5, 68159, Mannheim, Deutschland.
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Vogt I, Hoch E, Thomasius R, Winkler K. Frauen und Alkoholabhängigkeit: Aktueller Forschungsstand zur Effektivität psychotherapeutischer Behandlungen als Grundlagen für Behandlungsempfehlungen. Suchttherapie 2015. [DOI: 10.1055/s-0034-1396795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- I. Vogt
- Institut für Suchtforschung, Frankfurt
| | - E. Hoch
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit, Mannheim
| | - R. Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), UKE Hamburg
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Hoch E, Petersen K, Batra A, Mann K. Messbare Qualitätsverbesserung in der Praxis?! Entwicklung von sektorenübergreifenden Qualitätsindikatoren aus der S3-Leitlinie Alkohol. Suchttherapie 2015. [DOI: 10.1055/s-0035-1557569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Friedberg MW, Chen PG, White C, Jung O, Raaen L, Hirshman S, Hoch E, Stevens C, Ginsburg PB, Casalino LP, Tutty M, Vargo C, Lipinski L. Effects of Health Care Payment Models on Physician Practice in the United States. Rand Health Q 2015; 5:8. [PMID: 28083361 PMCID: PMC5158241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The project reported here, sponsored by the American Medical Association (AMA), aimed to describe the effects that alternative health care payment models (i.e., models other than fee-for-service payment) have on physicians and physician practices in the United States. These payment models included capitation, episode-based and bundled payment, shared savings, pay for performance, and retainer-based practice. Accountable care organizations and medical homes, which are two recently expanding practice and organizational models that frequently participate in one or more of these alternative payment models, were also included. Project findings are intended to help guide efforts by the AMA and other stakeholders to make improvements to current and future alternative payment programs and help physician practices succeed in these new payment models-i.e., to help practices simultaneously improve patient care, preserve or enhance physician professional satisfaction, satisfy multiple external stakeholders, and maintain economic viability as businesses. The article provides both findings and recommendations.
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Borchers K, Weber A, Hirth T, Tovar GTM, Hoch E. Inkjet-Bioprinting von künstlichem Gelenkknorpel: Biotintenentwicklung und Methodenetablierung. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Schäfer M, Bonnet U, Herrmann D, Hoch E, Schröder W, Reymann G, Veltrup C, Wessel B, Wieczorek A, Wodarz N. Von den Spielarten klinischer Praxis zur Evidenz – Pharmakologische Strategien im Alkoholentzug. Suchttherapie 2012. [DOI: 10.1055/s-0032-1330977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hoch E, Noack R, Henker J, Pixa A, Höfler M, Behrendt S, Bühringer G, Wittchen HU. Efficacy of a targeted cognitive-behavioral treatment program for cannabis use disorders (CANDIS). Eur Neuropsychopharmacol 2012; 22:267-80. [PMID: 21865014 DOI: 10.1016/j.euroneuro.2011.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 06/09/2011] [Accepted: 07/22/2011] [Indexed: 10/17/2022]
Abstract
AIMS To examine the efficacy, 3- and 6-month follow-up effects of a psychological treatment for older adolescents and adults with DSM-IV cannabis use disorders. The program was tailored to the needs of this patient population. EXPERIMENTAL PROCEDURES A randomized controlled clinical trial of 122 patients aged 16 to 44 years with DSM-IV cannabis dependence as the main substance use diagnosis was conducted. Patients were randomly assigned to either Active Treatment (AT, n = 90) or a Delayed Treatment Control group (DTC, n = 32). Treatment consisted of 10 sessions of therapy, detailed in a strictly enforced manual. Assessments were conducted at baseline, during each therapy session, at post treatment and at follow-up assessments at 3 and 6 months. RESULTS The treatment retention rate was 88%. Abstinence was achieved in 49% of AT patients and in 13% of those in DTC (p < 0.001; intend-to-treat (ITT) analysis). Further, AT patients improved significantly (p < = 0.001) in the frequency of cannabis use per week, addiction severity, number of disability days, and overall level of psychopathology. Program effects were maintained over a 3-month- (abstinence rate: 51%) and 6-month follow-up (45%) period. CONCLUSION The treatment program is effective in obtaining abstinence as well as reducing cannabis use and improves the associated social and mental health burden.
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Affiliation(s)
- E Hoch
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Strasse 46,D-01187 Dresden, Germany
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Conde M, Craven JD, Immel T, Hoch E, Stenbaek-Nielsen H, Hallinan T, Smith RW, Olson J, Sun W, Frank LA, Sigwarth J. Assimilated observations of thermospheric winds, the aurora, and ionospheric currents over Alaska. ACTA ACUST UNITED AC 2001. [DOI: 10.1029/2000ja000135] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Simon R, Hoch E, Holz A. The German monitoring and reporting system for the treatment of substance-related problems: a national system on the basis of aggregated data. Eur Addict Res 1999; 5:167-72. [PMID: 10705182 DOI: 10.1159/000018989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The German treatment monitoring and reporting system EBIS for out-patient centres treating clients with substance-related problems and disorders was set up in 1980. A parallel system for in-patient treatment was added in 1993 under the name of SEDOS. Together they are based nation-wide on more than 600 specialised treatment centres which collect diagnosis- and treatment-related data as well as information on socio-economic and family background. As part of the data relate to the end of treatment, also evaluative elements are included. In EBIS and SEDOS, aggregated data are the basis of the national and regional statistics produced, which offers a very high level of data protection for the clients treated. The revision of the national system implementing the Treatment Demand Indicator Protocol as the European Monitoring Centre for Drugs and Drug Addiction standard has already been started.
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Affiliation(s)
- R Simon
- IFT Institut für Therapieforschung, München, Deutschland.
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