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https://www.readbyqxmd.com/read/29346587/are-root-cause-analyses-recommendations-effective-and-sustainable-an-observational-study
#1
Peter D Hibbert, Matthew J W Thomas, Anita Deakin, William B Runciman, Jeffrey Braithwaite, Stephanie Lomax, Jonathan Prescott, Glenda Gorrie, Amy Szczygielski, Tanja Surwald, Catherine Fraser
Objective: To assess the strength of root cause analysis (RCA) recommendations and their perceived levels of effectiveness and sustainability. Design: All RCAs related to sentinel events (SEs) undertaken between the years 2010 and 2015 in the public health system in Victoria, Australia were analysed. The type and strength of each recommendation in the RCA reports were coded by an expert patient safety classifier using the US Department of Veteran Affairs type and strength criteria...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29345997/trends-in-health-insurance-and-type-among-military-veterans-united-states-2000-2016
#2
Carla E Zelaya, Colleen N Nugent
OBJECTIVES: To describe long-term national trends in health insurance coverage among US veterans from 2000 to 2016 in the context of recent health care reform. METHODS: We used 2000 to 2016 National Health Interview Survey data on veterans aged 18 to 64 years to examine trends in insurance coverage and uninsurance by year, income, and state Medicaid expansion status. We also explored the current proportions of veterans with each type of insurance by age group. RESULTS: The percentage of veterans with private insurance decreased from 70...
January 18, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29345864/naltrexone-and-disulfiram-treatment-response-in-veterans-with-alcohol-dependence-and-co-occurring-problem-gambling-features
#3
Jon E Grant, Marc N Potenza, Shane W Kraus, Ismene L Petrakis
BACKGROUND: Disordered gambling behavior frequently co-occurs with alcohol dependence and other psychiatric conditions. Using data from a previously published trial, we conducted secondary analyses to examine the influence of problem-gambling features on treatment outcome for alcohol dependence or co-occurring psychopathology assessed via DSM-IV criteria. METHODS: Two hundred fifty-four patients with alcohol dependence and co-occurring psychiatric disorders were treated for 12 weeks in an outpatient medication study conducted at 3 Veterans Administration outpatient clinics from October 1998 to March 2002...
November 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29345407/hepatitis-c-eradication-with-daa-and-risk-of-liver-cancer-recurrence-the-debate-unrests
#4
Massimo Colombo, Vincenzo Boccaccio
The advent of user friendly and highly successful oral regimens based on direct antiviral agents (DAA), has made a cure of hepatitis C possible in more than 95% of treated patients, including those who were considered difficult to cure with interferon, a vast category including patients with advanced liver disease and those who had a hepatocellular carcinoma (HCC) successfully eradicated by resection or local ablation1 . Despite low rates of treatment uptake and response to therapy with interferon, such hard to treat patients were able to gain significant health benefits, like halting of progression towards liver failure and prevention of second primary tumours, once replication of the hepatitis C virus (HCV) was permanently shut down2,3 ...
January 18, 2018: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29344631/a-brief-exposure-based-treatment-vs-cognitive-processing-therapy-for-posttraumatic-stress-disorder-a-randomized-noninferiority-clinical-trial
#5
Denise M Sloan, Brian P Marx, Daniel J Lee, Patricia A Resick
Importance: Written exposure therapy (WET), a 5-session intervention, has been shown to efficaciously treat posttraumatic stress disorder (PTSD). However, this treatment has not yet been directly compared with a first-line PTSD treatment such as cognitive processing therapy (CPT). Objective: To determine if WET is noninferior to CPT in patients with PTSD. Design, Setting, and Participants: In this randomized clinical trial conducted at a Veterans Affairs medical facility between February 28, 2013, and November 6, 2016, 126 veteran and nonveteran adults were randomized to either WET or CPT...
January 17, 2018: JAMA Psychiatry
https://www.readbyqxmd.com/read/29344616/ensuring-timely-access-to-quality-care-for-us-veterans
#6
Jennifer Daley
No abstract text is available yet for this article.
January 17, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29343088/creating-and-testing-regulatory-focus-messages-to-enhance-medication-adherence
#7
Ashley O'Connor, Amy Ladebue, Jamie Peterson, Ryan Davis, Susan Jung Grant, Marina McCreight, Anne Lambert-Kerzner
Objectives Strategies were explored to improve patient adherence to cardioprotective medications by borrowing from a motivational framework used in psychology, regulatory focus theory. The current study is part of a larger randomized control trial and was aimed at understanding what written educational messages, based on patients' regulatory focus tendency, resonated with each individual as a potential reminder to take medications. This study was also aimed at understanding why messages resonated with the patients...
January 1, 2018: Chronic Illness
https://www.readbyqxmd.com/read/29342320/association-of-pre-esrd-serum-calcium-with-post-esrd-mortality-among-incident-esrd-patients-a-cohort-study
#8
Yoshitsugu Obi, Christina Park, Melissa Soohoo, Keiichi Sumida, Takayuki Hamano, Connie M Rhee, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Elani Streja
Albumin-corrected serum calcium (cSCa) decline at late stages of chronic kidney disease and rise after dialysis initiation. While hypercalcemia is associated with higher mortality in end-stage renal disease (ESRD), there are scarce data on the impact of pre-ESRD cSCa on post-ESRD mortality. Therefore, we used a large national cohort of 21,826 US veterans with incident ESRD who transitioned to dialysis in all US Department of Veterans Affairs healthcare facilities over 2009-2014 to examine the associations with all-cause and cause-specific post-ESRD mortality of (1) cSCa concentrations averaged over the last six months and (2) its rate of decline during the last 12 months before dialysis initiation...
January 17, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29341172/statin-use-and-the-risk-of-cardiovascular-implantable-electronic-device-infection-a-cohort-study-in-a-veteran-population
#9
Talal Alzahrani, Angelike P Liappis, Larry M Baddour, Pamela E Karasik
BACKGROUND: The rate of cardiovascular implantable electronic device infection (CIEDI) has increased, despite the use of perioperative antibiotics at the time of device placement or revision. This is due, in part, to the presence of multiple comorbid conditions in an elderly population, in general, who require CIED. Statins may have an antibacterial effect, although there is currently no evidence that the likelihood of CIEDI has been impacted by statin use. METHODS: A retrospective cohort study was performed to assess whether statins are associated with a reduced risk of CIEDI...
January 17, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29339013/the-use-of-telemental-health-to-meet-the-mental-health-needs-of-women-using-department-of-veterans-affairs-services
#10
Jessica L Moreau, Kristina M Cordasco, Alexander S Young, Sabine M Oishi, Danielle E Rose, Ismelda Canelo, Elizabeth M Yano, Sally G Haskell, Alison B Hamilton
BACKGROUND: Women veterans are a growing segment of Department of Veterans Affairs (VA) users with distinct mental health needs and well-documented barriers to care. Telemental health holds much promise for reducing barriers to mental health care. We assessed VA stakeholders' perceptions of telemental health's appropriateness and potential to address the mental health needs of women veteran VA users. METHODS: We conducted semistructured qualitative interviews with 40 key leadership and clinical stakeholders at VA medical centers and associated outpatient clinics...
January 12, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29339012/patient-rated-access-to-needed-care-patient-centered-medical-home-principles-intertwined
#11
Julian Brunner, Emmeline Chuang, Donna L Washington, Danielle E Rose, Catherine Chanfreau-Coffinier, Jill E Darling, Ismelda A Canelo, Elizabeth M Yano
BACKGROUND: Primary care teams can facilitate access to care by helping patients to determine whether and when care is needed, and coordinating care across multiple clinicians and settings. Appointment availability metrics may or may not capture these contributions, but patients' own ratings of their access to care provide an important alternative view of access that may be more closely related to these key functions of care teams. PROCEDURES: We used a 2015 telephone survey of 1,395 women veterans to examine associations between key care team functions and patient-rated access to needed care...
January 12, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29338320/effect-of-a-group-medical-clinic-for-veterans-with-diabetes-on-body-mass-index
#12
Adva Eisenberg, Matthew J Crowley, Cynthia Coffman, David Edelman
Objective To assess the impact of a group medical clinic designed for patient with type 2 diabetes mellitus and hypertension on body mass index. Methods Using data from a randomized trial of 239 veterans with type 2 diabetes mellitus, we performed a secondary analysis using analysis of covariance mixed models to explore the effect of a 12-month group medical clinic intervention on change in body mass index vs. usual care. In an exploratory subgroup analysis, we compared change in body mass index between treatment arms stratified by whether patients had >0...
January 1, 2018: Chronic Illness
https://www.readbyqxmd.com/read/29337762/tinnitus-and-auditory-perception-after-a-history-of-noise-exposure-relationship-to-auditory-brainstem-response-measures
#13
Naomi F Bramhall, Dawn Konrad-Martin, Garnett P McMillan
OBJECTIVES: To determine whether auditory brainstem response (ABR) wave I amplitude is associated with measures of auditory perception in young people with normal distortion product otoacoustic emissions (DPOAEs) and varying levels of noise exposure history. DESIGN: Tinnitus, loudness tolerance, and speech perception ability were measured in 31 young military Veterans and 43 non-Veterans (19 to 35 years of age) with normal pure-tone thresholds and DPOAEs. Speech perception was evaluated in quiet using Northwestern University Auditory Test (NU-6) word lists and in background noise using the words in noise (WIN) test...
January 15, 2018: Ear and Hearing
https://www.readbyqxmd.com/read/29337486/improving-risk-stratification-among-veterans-diagnosed-with-prostate-cancer-impact-of-the-17-gene-prostate-score-assay
#14
Julie A Lynch, Megan P Rothney, Raoul R Salup, Cesar E Ercole, Sharad C Mathur, David A Duchene, Joseph W Basler, Javier Hernandez, Michael A Liss, Michael P Porter, Jonathan L Wright, Michael C Risk, Mark Garzotto, Olga Efimova, Laurie Barrett, Brygida Berse, Michael J Kemeter, Phillip G Febbo, Atreya Dash
BACKGROUND: Active surveillance (AS) has been widely implemented within Veterans Affairs' medical centers (VAMCs) as a standard of care for low-risk prostate cancer (PCa). Patient characteristics such as age, race, and Agent Orange (AO) exposure may influence advisability of AS in veterans. The 17-gene assay may improve risk stratification and management selection. OBJECTIVES: To compare management strategies for PCa at 6 VAMCs before and after introduction of the Oncotype DX Genomic Prostate Score (GPS) assay...
January 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29336277/evaluation-of-hypoglycemia-and-potential-risk-factors-in-a-veterans-affairs-community-living-center
#15
Marissa L Ostroff, Kristin Aloi, William Bryan, Jason Moss, Lindsay Garris, Richard Sloane, Jennie Hewitt, Carrie Thomas, Janine Bailey
OBJECTIVES: To describe hypoglycemic events in a Veterans Affairs (VA) community living center (CLC) population and to determine predictive risk factors associated with hypoglycemia. DESIGN: Retrospective, exploratory, observational chart review. SETTING: Tertiary-care VA Healthcare System CLC. PATIENTS: Residents residing in a VA CLC with at least one active order for insulin between June 1, 2009, and June 30, 2013, were evaluated over a 90-day study period...
January 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29335663/improving-mental-health-treatment-utilization-in-military-veterans-examining-the-effects-of-perceived-need-for-care-and-social-support
#16
Robert Graziano, Eric B Elbogen
Objective: Many veterans with mental health problems do not adequately utilize needed care. Research has focused on identifying barriers to mental health care in veterans. Method: The current study adds to existing literature by examining whether perceived need for treatment and social support affect treatment utilization in a national longitudinal survey of Iraq and Afghanistan veterans (n = 1090). Results: The Health Beliefs Model (HBM) postulates that a key reason why patients fail to obtain needed care is their belief "it's up to me to handle my own problems...
September 2017: Military Psychology
https://www.readbyqxmd.com/read/29335238/automating-quality-measures-for-heart-failure-using-natural-language-processing-a-descriptive-study-in-the-department-of-veterans-affairs
#17
Jennifer Hornung Garvin, Youngjun Kim, Glenn Temple Gobbel, Michael E Matheny, Andrew Redd, Bruce E Bray, Paul Heidenreich, Dan Bolton, Julia Heavirland, Natalie Kelly, Ruth Reeves, Megha Kalsy, Mary Kane Goldstein, Stephane M Meystre
BACKGROUND: We developed an accurate, stakeholder-informed, automated, natural language processing (NLP) system to measure the quality of heart failure (HF) inpatient care, and explored the potential for adoption of this system within an integrated health care system. OBJECTIVE: To accurately automate a United States Department of Veterans Affairs (VA) quality measure for inpatients with HF. METHODS: We automated the HF quality measure Congestive Heart Failure Inpatient Measure 19 (CHI19) that identifies whether a given patient has left ventricular ejection fraction (LVEF) <40%, and if so, whether an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker was prescribed at discharge if there were no contraindications...
January 15, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29334971/the-titanium-elastic-nail-serves-as-an-alternative-treatment-for-adult-proximal-radial-shaft-fractures-a-cohort-study
#18
Ying-Cheng Huang, Jenn-Huei Renn, Yih-Wen Tarng
BACKGROUND: To investigate whether closed reduction and internal fixation (CRIF) with titanium elastic nails (TENs) is a viable alternative treatment in proximal radial fractures. METHODS: In Kaohsiung Veterans General Hospital, from November 2013 to April 2015, five adult male patients with forearm injuries (average age 43 years; range 35-64 years) were treated for proximal radial shaft fractures. CRIF with TENs for radial shaft fractures was performed in these five patients...
January 15, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29334874/a-comparison-of-collaborative-care-outcomes-in-two-health-care-systems-va-clinics-and-federally-qualified-health-centers
#19
Kathleen M Grubbs, John C Fortney, Jeffrey Pyne, Dinesh Mittal, John Ray, Teresa J Hudson
OBJECTIVE: Collaborative care for depression results in symptom reduction when compared with usual care. No studies have systematically compared collaborative care outcomes between veterans treated at Veterans Affairs (VA) clinics and civilians treated at publicly funded federally qualified health centers (FQHCs) after controlling for demographic and clinical characteristics. METHODS: Data from two randomized controlled trials that used a similar collaborative care intervention for depression were combined to conduct post hoc analyses (N=759)...
January 16, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29334642/examining-the-latent-structure-mechanisms-for-comorbid-posttraumatic-stress-disorder-and-major-depressive-disorder
#20
Margo C Hurlocker, Desirae N Vidaurri, Lisa-Ann J Cuccurullo, Kelly Maieritsch, C Laurel Franklin
BACKGROUND: Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD...
January 8, 2018: Journal of Affective Disorders
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