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https://www.readbyqxmd.com/read/29149779/increased-genes-expression-levels-of-cytokines-related-to-th17-treg-cells-in-peripheral-blood-mononuclear-cell-correlate-with-clinical-severity-in-copd-and-mustard-gas-exposed-patients
#1
Parisa Farahani, Raheleh Halabian, Ensieh Vahedi, Jafar Salimian
The long lasting inflammation and immune dysregulation is one of the main mechanisms involved in lung complication of veterans exposed to sulfur mustard (SM) gas. Th17/Treg cells have an important role in immunopathogenesis of chronic obstructive pulmonary disease (COPD) and mustard lung disease. In this study, expression of cytokines genes levels related to Th17/Treg cells was determined in peripheral blood mononuclear (PBMC) of mustard lung patients and was compared with COPD patients and healthy controls (HC)...
October 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/29148348/increasing-trends-in-the-use-of-hospital-observation-services-for-older-medicare-advantage-and-privately-insured-patients
#2
Keith D Lind, Claire M Noel-Miller, Lindsey R Sangaralingham, Nilay D Shah, Erik P Hess, Pamela Morin, M Fernanda Bellolio
Policy and financial pressures have driven up use of observation stays for patients in traditional Medicare and the Veterans' Affairs Healthcare System. Using claims data (2004-2014) from OptumLabs™ Data Warehouse, we examined whether people in private Medicare Advantage (MA) and commercial plans experienced similar changes. We found that use of observation increased rapidly for patients in MA plans-even though MA plans were not subject to the same pressures as government-run programs. In contrast, use of observation remained constant for people in commercial plans-except for enrollees 65 and older, for whom it increased somewhat...
July 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148338/comprehensive-support-for-family-caregivers-impact-on-veteran-health-care-utilization-and-costs
#3
Courtney Harold Van Houtven, Valerie A Smith, Karen M Stechuchak, Megan Shepherd-Banigan, Susan Nicole Hastings, Matthew L Maciejewski, Gilbert Darryl Wieland, Maren K Olsen, Katherine E M Miller, Margaret Kabat, Jennifer Henius, Margaret Campbell-Kotler, Eugene Z Oddone
This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how Veterans' use of Veteran Affairs health care and total health care costs changed in 6-month intervals up to 3 years after PCAFC enrollment. The control group was an inverse probability of treatment weighted sample of Veterans whose caregivers applied for, but were not accepted into, PCAFC...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29145834/identification-of-outliers-and-positive-deviants-for-healthcare-improvement-looking-for-high-performers-in-hypoglycemia-safety-in-patients-with-diabetes
#4
Brigid Wilson, Chin-Lin Tseng, Orysya Soroka, Leonard M Pogach, David C Aron
BACKGROUND: The study objectives were to determine: (1) how statistical outliers exhibiting low rates of diabetes overtreatment performed on a reciprocal measure - rates of diabetes undertreatment; and (2) the impact of different criteria on high performing outlier status. METHODS: The design was serial cross-sectional, using yearly Veterans Health Administration (VHA) administrative data (2009-2013). Our primary outcome measure was facility rate of HbA1c overtreatment of diabetes in patients at risk for hypoglycemia...
November 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29145788/quality-of-life-following-treatment-for-ptsd-comparison-of-videoconferencing-and-in-person-modalities
#5
Lisa H Glassman, Margaret-Anne Mackintosh, Alexander Talkovsky, Stephanie Y Wells, Kristen H Walter, Induni Wickramasinghe, Leslie A Morland
Introduction Quality of life (QOL) is significantly impaired among individuals with post-traumatic stress disorder (PTSD); however, few treatment outcome studies examine QOL following treatment. Furthermore, the use of videoconferencing to deliver evidence-based treatments for PTSD is increasing dramatically. Although videoconferencing has demonstrated non-inferiority to in-person treatment modalities for improving PTSD symptom severity, no studies to date have directly compared QOL outcomes of an evidence-based intervention delivered via videoconferencing to one delivered in-person...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29145767/addressing-geographic-confounding-through-spatial-propensity-scores-a-study-of-racial-disparities-in-diabetes
#6
Melanie L Davis, Brian Neelon, Paul J Nietert, Kelly J Hunt, Lane F Burgette, Andrew B Lawson, Leonard E Egede
Motivated by a study exploring differences in glycemic control between non-Hispanic black and non-Hispanic white veterans with type 2 diabetes, we aim to address a type of confounding that arises in spatially referenced observational studies. Specifically, we develop a spatial doubly robust propensity score estimator to reduce bias associated with geographic confounding, which occurs when measured or unmeasured confounding factors vary by geographic location, leading to imbalanced group comparisons. We augment the doubly robust estimator with spatial random effects, which are assigned conditionally autoregressive priors to improve inferences by borrowing information across neighboring geographic regions...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29145722/outcomes-of-beating-heart-on-pump-utilizing-a-miniature-bypass-circuit-versus-off-pump-cardiac-bypass-at-a-veterans-affairs-medical-center
#7
Matthew Skancke, Kendal Endicott, Richard Amdur, Michael Greenberg, Gregory Trachiotis
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) helps reduce systemic inflammatory changes by maintaining native pulsatile flow. This analysis evaluates the outcomes of OPCAB at a Veterans Affairs Medical Center (VAMC) and evaluates the use of beating heart on-pump (BHOP) bypass grafting as an empiric therapy for high-risk patients. METHODS: We performed a retrospective analysis of 756 patients who underwent coronary bypass grafting between 2004-2015 at a single VAMC...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29145076/veterans-group-exercise-a-randomized-pilot-trial-of-an-integrative-exercise-program-for-veterans-with-posttraumatic-stress
#8
Lizabeth A Goldstein, Wolf E Mehling, Thomas J Metzler, Beth E Cohen, Deborah E Barnes, Gerard J Choucroun, Aliza Silver, Lisa S Talbot, Shira Maguen, Jennifer A Hlavin, Margaret A Chesney, Thomas C Neylan
BACKGROUND: Posttraumatic stress disorder (PTSD) is prevalent among military veterans and is associated with significant negative health outcomes. However, stigma and other barriers to care prevent many veterans from pursuing traditional mental health treatment. We developed a group-based Integrative Exercise (IE) program combining aerobic and resistance exercise, which is familiar to veterans, with mindfulness-based practices suited to veterans with PTSD. This study aimed to evaluate the effects of IE on PTSD symptom severity and quality of life, as well as assess the feasibility and acceptability of IE...
November 4, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29144886/comparative-effectiveness-of-proactive-tobacco-treatment-among-smokers-with-and-without-chronic-lower-respiratory-disease
#9
Anne C Melzer, Barbara Clothier, Sandra J Japuntich, Siamak Noorbaloochi, Patrick Hammett, Diana J Burgess, Anne M Joseph, Steven S Fu
RATIONALE: Adults with chronic lower respiratory disease (CLRD) differ in their barriers to smoking cessation, but also suffer from tobacco related health concerns, which may motivate quit attempts. Few studies have examined differences in tobacco treatment response between smokers with and without CLRD. OBJECTIVE: We examined the effectiveness of a proactive outreach program for cessation among smokers with and without CLRD. METHODS: Subgroup analysis of the Veterans VICTORY Over Tobacco Study, a pragmatic randomized controlled trial that demonstrated the effectiveness of proactive outreach and the choice of tobacco treatments compared to usual care...
November 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29143411/spontaneous-neural-activity-differences-in-posttraumatic-stress-disorder-a-quantitative-resting-state-meta-analysis-and-fmri-validation
#10
Seth G Disner, Craig A Marquardt, Bryon A Mueller, Philip C Burton, Scott R Sponheim
Identifying the pathophysiology of posttraumatic stress disorder (PTSD) is a critical step toward reducing its debilitating impact. Spontaneous neural activity, measured at rest using various neuroimaging techniques (e.g., regional homogeneity [ReHo], amplitude of low frequency fluctuations [ALFF]), can provide insight about baseline neurobiological factors influencing sensory, cognitive, or behavioral processes associated with PTSD. The present study used activation likelihood estimation (ALE) to conduct the largest-to-date quantitative meta-analysis of spontaneous neural activity in PTSD, including 457 PTSD cases, 292 trauma-exposed controls (TECs), and 293 non-traumatized controls (NTCs) across 22 published studies...
November 15, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/29142937/geographic-variation-and-us-county-characteristics-associated-with-rapid-kidney-function-decline
#11
Benjamin Bowe, Yan Xie, Hong Xian, Min Lian, Ziyad Al-Aly
Introduction: Geographic variation in the prevalence of chronic kidney disease and incidence of end-stage renal disease has been previously reported. However, the geographic epidemiology of rapid estimated glomerular filtration rate (eGFR) decline has not been examined. Methods: We built a longitudinal cohort of 2,107,570 US veterans to characterize the spatial epidemiology of and examine the associations between US county characteristics and rapid eGFR decline...
January 2017: KI Reports
https://www.readbyqxmd.com/read/29142040/use-of-disease-modifying-antirheumatic-drugs-for-inflammatory-arthritis-in-us-veterans-effect-of-specialty-care-and-geographic-distance
#12
Jessica A Walsh, Shaobo Pei, Zachary Burningham, Gopi Penmetsa, Grant W Cannon, Daniel O Clegg, Brian C Sauer
OBJECTIVE: To evaluate the effect of access to and distance from rheumatology care on the use of disease-modifying antirheumatic drugs (DMARD) in US veterans with inflammatory arthritis (IA). METHODS: Provider encounters and DMARD dispensations for IA (rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis) were evaluated in national Veterans Affairs (VA) datasets between January 1, 2015, and December 31, 2015. RESULTS: Among 12,589 veterans with IA, 23...
November 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29140874/hiv-and-age-do-not-synergistically-affect-age-related-t-cell-markers
#13
Shelli Farhadian, Emilie Jalbert, Yanhong Deng, Matthew Bidwell Goetz, Lesley S Park, Amy Justice, Robert Dubrow, Brinda Emu
INTRODUCTION: Despite major progress in controlling HIV disease through anti-retroviral therapy (ART), changes in immune phenotype and function persist in individuals with chronic HIV, raising questions about accelerated aging of the immune system. METHODS: We conducted a cross sectional study (2005-2007) of HIV-infected (n=111) and uninfected (n=114) males from the Veterans Aging Cohort Study. All HIV-infected subjects were on ART with VL<400 copies/mL for at least three years...
November 13, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29140560/negative-posttrauma-cognitions-mediate-the-association-between-morally-injurious-events-and-trauma-related-psychopathology-in-treatment-seeking-veterans
#14
Philip Held, Brian J Klassen, Denise S Zou, Blake S Schroedter, Niranjan S Karnik, Mark H Pollack, Alyson K Zalta
Exposure to potentially morally injurious events has been shown to be associated with posttraumatic stress disorder (PTSD) and depression symptoms in military personnel. Few studies have examined factors that help to explain how potentially morally injurious events may contribute to the development of trauma-related psychopathology. Negative posttrauma cognitions are thought to play a role in the etiology of PTSD and depression following trauma; however, it is unclear whether more global beliefs about the self, others, and world play a role in the development of PTSD and depression due to morally injurious events...
November 15, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/29140225/key-patterns-and-predictors-of-response-to-treatment-for-military-veterans-with-post-traumatic-stress-disorder-a-growth-mixture-modelling-approach
#15
A J Phelps, Z Steel, O Metcalf, N Alkemade, K Kerr, M O'Donnell, J Nursey, J Cooper, A Howard, R Armstrong, D Forbes
BACKGROUND: To determine the patterns and predictors of treatment response trajectories for veterans with post-traumatic stress disorder (PTSD). METHODS: Conditional latent growth mixture modelling was used to identify classes and predictors of class membership. In total, 2686 veterans treated for PTSD between 2002 and 2015 across 14 hospitals in Australia completed the PTSD Checklist at intake, discharge, and 3 and 9 months follow-up. Predictor variables included co-morbid mental health problems, relationship functioning, employment and compensation status...
November 15, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/29139308/the-impact-of-deployment-and-traumatic-brain-injury-on-the-health-and-behavior-of-children-of-us-military-service-members-and-veterans
#16
Tracey A Brickell, Louis M French, Sara M Lippa, Rael T Lange
This study examined the impact of service member/veteran (SMV) combat deployment and traumatic brain injury (TBI) on the health and behavior of his or her children. Participants were 104 female spouse caregivers of US SMVs who had sustained a mild, severe, or penetrating TBI. Participants completed the Children's Health and Behavior Questionnaire (CHBQ; r = .758 to .881) that evaluates school grades, behavior, medical health, emotional health, and social participation: (a) prior to the first combat deployment, (b) in the month prior to the TBI, (c) within 2 years after the TBI, and (d) 2 or more years after the TBI...
November 1, 2017: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/29139114/operation-family-caregiver-problem-solving-training-for-military-caregivers-in-a-community-setting
#17
Leisa R Easom, Ke Wang, Renee H Moore, Heqiong Wang, Laura Bauer
OBJECTIVE: This study, conducted over a 2-year period at 9 sites, describes the outcomes of an evidence-based support program, Operation Family Caregiver, to gain an understanding of how a tailored, problem-solving training could assist military caregivers, who provide care and assistance to those injured, ill, or disabled as a result of war. METHOD: A pre-post research design was employed to examine caregiver burden, depression, health complaints, satisfaction with life, children's anxiety, and problem solving among a convenience sample of caregivers of 128 military service members and veterans...
November 15, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/29138051/sarcopenia-in-peripheral-arterial-disease-prevalence-and-impact-on-functional-status
#18
Odessa Addison, Steven J Prior, Rishi Kundi, Monica C Serra, Leslie I Katzel, Andrew W Gardner, Alice S Ryan
OBJECTIVES: To determine the prevalence of sarcopenia in older men with peripheral arterial disease (PAD) and to compare to a subset of the group to age, race, sex, and body mass index (BMI)-matched non-PAD control counterparts. We also sought to compare the functional status of those with PAD with and without sarcopenia. DESIGN: Cohort study. SETTING: A Veterans Affairs medical center. PARTICIPANTS: Sedentary, community dwelling men age 50+ years with a confirmed diagnosis of PAD (N=108; 44% black; BMI 27...
November 11, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29137891/human-leukocyte-antigen-hla-and-gulf-war-illness-gwi-hla-drb1-13-02-spares-subcortical-atrophy-in-gulf-war-veterans
#19
Lisa M James, Peka Christova, Brian E Engdahl, Scott M Lewis, Adam F Carpenter, Apostolos P Georgopoulos
BACKGROUND: Gulf War Illness (GWI) is a multisystem disorder that has affected a substantial number of veterans who served in the 1990-91 Gulf War. The brain is prominently affected, as manifested by the presence of neurological, cognitive and mood symptoms. We reported previously on the protective role of six Human Leukocyte Antigen (HLA) alleles in GWI (Georgopoulos et al., 2016) and their association with regional brain function (James et al., 2016). More recently, we reported on the presence of subcortical brain atrophy in GWI (Christova et al...
November 9, 2017: EBioMedicine
https://www.readbyqxmd.com/read/29135855/factors-associated-with-the-implementation-of-a-nurse-staffing-directive
#20
Ann M Annis, Claire H Robinson, Nicholas Yankey, Sarah L Krein, Sonia A Duffy, Beth Taylor, Anne Sales
BACKGROUND: In 2010, the Veterans Health Administration issued a Staffing Methodology (SM) Directive to provide a standardized, data-driven method for determining appropriate inpatient nurse staffing. OBJECTIVE: We aimed to describe experiences and factors related to SM implementation. METHODS: We administered a Web-based survey to chief nurse executives to obtain their implementation experiences. Structural, process, and outcome factors and barriers associated with self-reported implementation success were identified...
December 2017: Journal of Nursing Administration
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