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https://www.readbyqxmd.com/read/28651351/applying-a-theory-driven-framework-to-guide-quality-improvement-efforts-in-nursing-homes-the-lock-model
#1
Whitney L Mills, Camilla B Pimentel, Jennifer A Palmer, A Lynn Snow, Nancy J Wewiorski, Rebecca S Allen, Christine W Hartmann
Purpose of the Study: Implementing quality improvement (QI) programs in nursing homes continues to encounter significant challenges, despite recognized need. QI approaches provide nursing home staff with opportunities to collaborate on developing and testing strategies for improving care delivery. We present a theory-driven and user-friendly adaptable framework and facilitation package to overcome existing challenges and guide QI efforts in nursing homes. Design and development: The framework is grounded in the foundational concepts of strengths-based learning, observation, relationship-based teams, efficiency, and organizational learning...
June 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/28650412/pressure-injury-knowledge-in-critical-care-nurses
#2
Donna M Miller, Lisa Neelon, Kathleen Kish-Smith, Laura Whitney, Christopher J Burant
PURPOSE: The purpose of this study was to identify pressure injury knowledge in critical care nurses related to prevention and staging following multimodal education initiatives. DESIGN: Postintervention descriptive study. SETTING AND SAMPLE: The sample comprised 32 RNs employed in medical intensive care/coronary intensive care or surgical intensive care units. The study setting was a 237-bed Veterans Affairs acute care hospital in the Midwestern United States...
June 21, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28649902/implementation-of-telehealth-is-associated-with-improved-timeliness-to-kidney-transplant-waitlist-evaluation
#3
Rachel C Forbes, Kristy Kummerow Broman, Tommy B Johnson, Diane B Rybacki, Angela E Hannah Gillis, Margarethe Hagemann Williams, David Shaffer, Irene D Feurer, Douglas A Hale
Introduction The United States Department of Veterans Affairs (VA) National Transplant Program has made efforts to improve access by introducing Web-based referrals and telehealth. The aims of this study were to describe the programmatic implementation and evaluate the effectiveness of new technology on the timeliness to kidney transplant evaluation at a VA medical centre. Methods Between 1 January 2009 and 31 May 2016, 835 patients were approved for evaluation. Monthly data were summarized as: number of applications, median days to evaluation, and median percentage of evaluations that occurred within 30 days...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28649309/respiratory-symptoms-among-swedish-soldiers-after-military-service-abroad-association-with-time-spent-in-a-desert-environment
#4
Johannes Saers, Linda Ekerljung, Bertil Forsberg, Christer Janson
Introduction: The aim of this paper was to study whether Swedish soldiers who have served abroad had a higher prevalence of respiratory symptoms than the general population and, if this was the case, also to study whether this was associated with time spent in a desert environment. Methods:The prevalence of respiratory symptoms among 1,080 veterans from Kosovo and Afghanistan was compared with that in almost 27,000 subjects from a general population sample, using propensity score matching and logistic regression...
2017: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28649301/assessment-of-depression-in-veterans-across-missions-a-validity-study-using-rasch-measurement-models
#5
Karen-Inge Karstoft, Anni B S Nielsen, Tine Nielsen
Background: Depression is a common psychopathological outcome following military deployment. Previous studies have reported differing rates of post-deployment depression, indicating that the toll of war differs across missions. However, it is unclear to what degree the varying prevalence is due methodological differences. Studies comparing rates of depression across cohorts using the same methodology and ensuring measurement invariance are rare, leaving us with limited knowledge on the actual depression prevalence variance across missions...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28648681/traumatic-brain-injury-severity-comorbidity-social-support-family-functioning-and-community-reintegration-among-veterans-of-the-afghanistan-and-iraq-wars
#6
Mary Jo Pugh, Alicia A Swan, Kathleen F Carlson, Carlos A Jaramillo, Blessen C Eapen, Christina Dillahunt-Aspillaga, Megan E Amuan, Roxana Delgado, Kimberly McConnell, Erin P Finley, Jordan Grafman
OBJECTIVE: Examine the association between traumatic brain injury (TBI) severity and social, family, community reintegration outcomes as well as return to work status among Post-9/11 veterans in Department of Veterans Affairs (VA) care. DESIGN: Retrospective observational cohort study. SETTING: Mail/online survey fielded to a national sample of veterans. PARTICIPANTS: Among a sample of Post-9/11 veterans with at least 3 years of VA care stratified according to TBI severity and comorbidities, 2023 completed and returned surveys...
June 22, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28648469/long-term-clinical-outcomes-following-radiofrequency-and-microwave-ablation-of-renal-cell-carcinoma-at-a-single-va-medical-center
#7
Salim E Abboud, Tanay Patel, Stephanie Soriano, Joseph Giesler, Nannette Alvarado, Preet Kang
PURPOSE: Microwave ablation (MWA) is a relatively newer treatment modality for treatment of renal cell carcinoma (RCC), and only a few small studies have examined the short- and long-term outcomes for MWA applied to renal tumors. The purpose of this retrospective review is to assess the initial experience including technical short- and long-term success rates of using radiofrequency ablation (RFA) and MWA for RCC at a single Veterans Affairs (VA) medical center. MATERIALS AND METHODS: Tumor characteristics were recorded using the R...
May 17, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28646388/skin-conductance-reactivity-to-standardized-virtual-reality-combat-scenes-in-veterans-with-ptsd
#8
Mascha van 't Wout, Christopher M Spofford, William S Unger, Elizabeth B Sevin, M Tracie Shea
Interest in virtual reality (VR) as a clinical tool to augment posttraumatic stress (PTSD) treatment has grown substantially in recent years due to advances in VR technology. Moreover, its potential assisted use in the PTSD diagnostic process has been recognized. In this study we examined physiological responding, skin conductance, to a standardized presentation of non-personalized combat-related VR events (e.g. encountering enemy fire; explosions) as compared to non-combat classroom VR events in 19 Veterans with and 24 Veterans without combat-related PTSD who had been deployed to Iraq and Afghanistan...
June 23, 2017: Applied Psychophysiology and Biofeedback
https://www.readbyqxmd.com/read/28645572/longitudinal-associations-between-mental-health-conditions-and-overactive-bladder-in-women-veterans
#9
Catherine S Bradley, Ingrid E Nygaard, Stephen L Hillis, James C Torner, Anne G Sadler
BACKGROUND: One in five recently deployed U.S. women veterans report overactive bladder symptoms. Mental health conditions such as depression and anxiety commonly co-occur in women with overactive bladder, but temporal relationships between these outcomes have not been well-studied, and the mechanism behind this association is unknown. The Women Veterans Urinary Health Study, a nationwide longitudinal study in recently deployed women veterans, was designed to better understand relationships between overactive bladder and mental health conditions...
June 20, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28645207/development-and-validation-of-an-electronic-medical-record-emr-based-computed-phenotype-of-hiv-1-infection
#10
Devon W Paul, Nigel B Neely, Meredith Clement, Isaretta Riley, Mashael Al-Hegelan, Matthew Phelan, Monica Kraft, David M Murdoch, Joseph Lucas, John Bartlett, Mehri McKellar, Loretta G Que
Background: Electronic medical record (EMR) computed algorithms allow investigators to screen thousands of patient records to identify specific disease cases. No computed algorithms have been developed to detect all cases of human immunodeficiency virus (HIV) infection using administrative, laboratory, and clinical documentation data outside of the Veterans Health Administration. We developed novel EMR-based algorithms for HIV detection and validated them in a cohort of subjects in the Duke University Health System (DUHS)...
June 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28642197/risk-of-hepatocellular-cancer-in-hcv-patients-treated-with-direct-acting-antiviral-agents
#11
Fasiha Kanwal, Jennifer Kramer, Steven M Asch, Maneerat Chayanupatkul, Yumei Cao, Hashem B El-Serag
BACKGROUND AND AIMS: The risk of hepatocellular cancer (HCC) after sustained virological response (SVR) with direct acting antivirals (DAA) is unclear. Our aim was to examine the risk and determinants of HCC in patients cured with DAA. METHODS: We conducted a retrospective cohort study of HCV patients who were treated with DAA in any of the 129 Veterans Health Administration hospitals between 1/1/2015 and 12/31/2015. We calculated the annual incidence rates for HCC by SVR...
June 19, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28641996/impact-of-paliperidone-palmitate-versus-oral-atypical-antipsychotics-on-health-care-resource-use-and-costs-in-veterans-with-schizophrenia-and-comorbid-substance-abuse
#12
Patrick Lefebvre, Erik Muser, Kruti Joshi, Maral DerSarkissian, Rachel H Bhak, Mei Sheng Duh, Brian Shiner, Yinong Young-Xu
PURPOSE: Almost half of all patients diagnosed with schizophrenia have a history of substance abuse (SA). However, data on treatment of schizophrenia with paliperidone palmitate (PP) among patients with comorbid SA are limited. The objective of this study was to compare all-cause and SA-related health care resource utilization and costs in veterans with schizophrenia and co-occurring SA who were treated with PP versus oral atypical antipsychotics (OAAs). METHODS: Veterans Health Administration electronic health record data were used to conduct a retrospective longitudinal study in veterans with schizophrenia who initiated PP or OAA between January 1, 2010 and June 30, 2016, had ≥12 months of enrollment before treatment initiation (baseline), were diagnosed with SA, and had ≥1 Global Assessment of Functioning score during baseline...
June 19, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28641886/genome-wide-expression-in-veterans-with-schizophrenia-further-validates-the-immune-hypothesis-for-schizophrenia
#13
Gabriel R Fries, Dimitre H Dimitrov, Shuko Lee, Nicole Braida, Jesse Yantis, Craig Honaker, Joe Cuellar, Consuelo Walss-Bass
This study aimed to test whether a dysregulation of gene expression may be the underlying cause of previously reported elevated levels of inflammatory cytokines in veterans with schizophrenia. We performed a genome-wide expression analysis in peripheral blood mononuclear cells from veterans with schizophrenia and controls, and our results show that 167 genes and putative loci were differently expressed between groups. These genes were enriched primarily for pathways related to inflammatory mechanisms and formed networks related to cell death and survival, immune cell trafficking, among others, which is in line with previous reports and further validates the inflammatory hypothesis of schizophrenia...
June 19, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28641862/perioperative-beta-blockers-and-statins-for-noncardiac-surgery-patients-with-coronary-stents
#14
Joshua S Richman, Laura A Graham, Aerin DeRussy, Thomas M Maddox, Kamal M F Itani, Mary T Hawn
IMPORTANCE: Recent publications report that perioperative initiation of statin therapy is associated with improved outcomes particularly among patients with increased cardiac risk. However, findings on associations with beta blocker (BB) initiation are mixed. OBJECTIVE: This study examines associations between perioperative statin and BB use in a national sample of patients with cardiac stents. DESIGN: Retrospective cohort study. SETTING: VA Medical Centers nationwide...
May 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28641586/access-education-and-policy-awareness-predictors-of-influenza-vaccine-acceptance-among-vha-healthcare-workers
#15
Jennifer Lipkowitz Eaton, David C Mohr, Kathleen M McPhaul, Richard A Kaslow, Richard A Martinello
OBJECTIVE To identify predictors of influenza vaccine acceptance among VHA healthcare workers (HCWs), with emphasis on modifiable factors related to promotion campaigns. DESIGN Survey. SETTING National single-payer healthcare system with 140 hospitals and 321,000 HCWs. PARTICIPANTS National voluntary sample of HCWs in the Veterans Health Administration (VHA) system. METHODS We invited a random sample of 5% of all VHA HCWs to participate. An 18-item intranet-based survey inquired about occupation, vaccination status, employer policy, and local campaign efforts...
June 23, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#16
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28639465/an-innovative-approach-to-addressing-the-hiv-care-continuum-implementation-of-a-clinical-pharmacy-resident-in-a-veterans-affairs-hiv-specialty-clinic
#17
Autumn Bagwell, M Shawn McFarland, Todd Hulgan
PURPOSE: Engagement of patients in the HIV care continuum and adherence to antiretroviral therapy (ART) continue to limit successful viral suppression. Innovative practices to improve this continuum and ameliorate potential physician shortages are needed. The objective of this evaluation was to determine the clinical benefits of incorporating pharmacy resident involvement on a multidisciplinary team in caring for patients with HIV. METHODS: A single-center pre-post cohort pilot evaluation was conducted at the Tennessee Valley Healthcare Systems VA Medical Center...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28637450/health-care-use-and-costs-at-the-end-of-life-a-comparison-of-elderly-australian-decedents-with-and-without-a-cancer-history
#18
Rebecca Reeve, Preeyaporn Srasuebkul, Julia M Langton, Marion Haas, Rosalie Viney, Sallie-Anne Pearson
BACKGROUND: There is limited population-level research on end-of-life care in Australia that considers health care use and costs across hospital and community sectors. The aim of this study was to quantify health care use and costs in the last 6 months of life in a cohort of elderly Australian decedents and to examine the factors associated with end-of-life resource use and costs. METHODS: A retrospective cohort study using routinely collected health data from Australian Government Department of Veterans' Affairs clients...
June 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28636829/analysis-of-minimally-invasive-esophagectomy-at-a-single-veterans-affairs-medical-center
#19
Matthew D Skancke, Robert A Grossman, Gustavo Marino, Fredrick J Brody, Gregory D Trachiotis
BACKGROUND: To date, there are no published studies focusing on the benefits of minimally invasive esophagectomy (MIE) versus open esophagectomy at a Veterans Affairs Medical Center (VAMC). Our primary outcome was the incidence of esophageal malignancy in the veteran population and the postoperative morbidity following traditional and MIE for malignancy. DESIGN: Retrospective analysis of the incidence of esophageal malignancy at a Veteran Integrated Service Network (VISN) 5 VAMC reported to the VAMC Esophageal Tumor Registry between 2003 and 2016 and outcomes of the veterans who received esophagectomy for malignancy...
June 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28636486/spirituality-religion-and-suicidality-among-veterans-a-qualitative-study
#20
Jaimie Lusk, Steven K Dobscha, Marek Kopacz, Mary Frances Ritchie, Sarah Ono
OBJECTIVES: This qualitative study explores the relationship between Veterans' spirituality/religion and suicide ideation and attempts. METHODS: Qualitative semi-structured interviews were conducted with 30 Veterans who either endorsed chronic suicidal ideation or had made suicide attempt(s). Interviews explored the bi-directional relationship between spirituality/religion (e.g., beliefs, practices and experiences), and suicide ideation and behaviors. Interviews were analyzed using thematic analysis...
June 21, 2017: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
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