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https://www.readbyqxmd.com/read/28319582/trends-in-the-purchase-of-surgical-care-in-the-community-by-the-veterans-health-administration-va
#1
Amy K Rosen, William O'Brien, Qi Chen, Michael Shwartz, Kamal F M Itani, William Gunnar
BACKGROUND: The 2014 implementation of the Veterans Choice Program increased opportunities for Veterans to receive care in the community. Although surgical care is a Veterans Health Administration (VA) priority, little is known about the types of surgeries provided in the VA versus those referred to community care (CC), and whether Veterans are increasing their use of surgical care through CC with these additional opportunities. OBJECTIVES: To examine national trends across VA facilities in the frequencies and types of surgeries provided in the VA and through CC, and explore the association between facilities' purchase of care with rurality and surgical complexity designation...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28318053/statins-decrease-the-risk-of-decompensation-in-hbv-and-hcv-related-cirrhosis-a-population-based-study
#2
Fu-Ming Chang, Yen-Po Wang, Hui-Chu Lang, Chia-Fen Tsai, Ming-Chih Hou, Fa-Yauh Lee, Ching-Liang Lu
BACKGROUND & AIM: Statin decreased the risk of decompensation and mortality in veteran patients with cirrhosis due to hepatitis C virus (HCV). Whether this beneficial effect can be extended to cirrhosis in general population or cirrhosis with other causes, such as hepatitis B virus (HBV) infection and alcohol, remains unknown. Statin also decreased the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV and HCV infection. It is unclear whether the effect can be observed in patients already with cirrhosis...
March 20, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28317097/engagement-in-advance-care-planning-and-surrogates-knowledge-of-patients-treatment-goals
#3
Terri R Fried, Maria Zenoni, Lynne Iannone, John O'Leary, Brenda T Fenton
OBJECTIVES: A key objective of advance care planning (ACP) is improving surrogates' knowledge of patients' treatment goals. Little is known about whether ACP outside of a trial accomplishes this. The objective was to examine patient and surrogate reports of ACP engagement and associations with surrogate knowledge of goals. DESIGN: Cohort study SETTING: Primary care in a Veterans Affairs Medical Center. PARTICIPANTS: 350 community-dwelling veterans age ≥55 years and the individual they would choose to make medical decisions on their behalf, interviewed separately...
March 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28314434/acceptability-of-medication-and-nonmedication-treatment-for-insomnia-among-female-veterans-effects-of-age-insomnia-severity-and-psychiatric-symptoms
#4
Najwa C Culver, Yeonsu Song, Sarah Kate McGowan, Constance H Fung, Michael N Mitchell, Juan Carlos Rodriguez, Joseph M Dzierzewski, Karen R Josephson, Stella Jouldjian, Donna L Washington, Elizabeth M Yano, C Amanda Schweizer, Cathy A Alessi, Jennifer L Martin
PURPOSE: Female veterans are at high risk for sleep problems, and there is a need to provide effective treatment for this population who experience insomnia. This study's primary goal was to compare the acceptability of medication versus nonmedication treatments for insomnia among female veterans. In addition, we examined the role of patient age, severity of sleep disturbance, and psychiatric symptoms on acceptability of each treatment approach and on the differences in acceptability between these approaches...
November 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/28306156/posttraumatic-stress-disorder-antipsychotic-use-and-risk-of-dementia-in-veterans
#5
Elizabeth E Roughead, Nicole L Pratt, Lisa M Kalisch Ellett, Emmae N Ramsay, John D Barratt, Philip Morris, Graeme Killer
OBJECTIVES: To examine the risk of dementia associated with posttraumatic stress disorder (PTSD) and the contribution of antipsychotic use to this risk. DESIGN: Retrospective cohort study SETTING: Australia. Administrative claims data from the Australian Government Department of Veterans' Affairs were used. PARTICIPANTS: Male Vietnam veterans aged 55 to 65 at baseline (2001-02) with no preexisting dementia diagnosis (N = 15,612). MEASUREMENTS: The association between PTSD and dementia was assessed over 12 years of follow-up...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28303444/outcomes-of-a-therapeutic-fly-fishing-program-for-veterans-with-combat-related-disabilities-a-community-based-rehabilitation-initiative
#6
Jessie L Bennett, Jennifer A Piatt, Marieke Van Puymbroeck
The purpose of this study was to examine the outcomes of a therapeutic fly-fishing program for veterans with combat-related disabilities. A total of 40 veterans participated in the 4-day therapeutic fly-fishing program and this study. The outcomes examined included reducing symptoms of posttraumatic stress (PTS), depression, perceived stress, functional impairment (i.e., work, relationships, physical, and everyday life), increasing self-determination, and leisure satisfaction. Each research participant completed pretest, posttest, and 3-month follow-up questionnaires...
March 16, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28302595/behavioral-indicators-on-a-mobile-sensing-platform-predict-clinically-validated-psychiatric-symptoms-of-mood-and-anxiety-disorders
#7
Skyler Place, Danielle Blanch-Hartigan, Channah Rubin, Cristina Gorrostieta, Caroline Mead, John Kane, Brian P Marx, Joshua Feast, Thilo Deckersbach, Alex Sandy Pentland, Andrew Nierenberg, Ali Azarbayejani
BACKGROUND: There is a critical need for real-time tracking of behavioral indicators of mental disorders. Mobile sensing platforms that objectively and noninvasively collect, store, and analyze behavioral indicators have not yet been clinically validated or scalable. OBJECTIVE: The aim of our study was to report on models of clinical symptoms for post-traumatic stress disorder (PTSD) and depression derived from a scalable mobile sensing platform. METHODS: A total of 73 participants (67% [49/73] male, 48% [35/73] non-Hispanic white, 33% [24/73] veteran status) who reported at least one symptom of PTSD or depression completed a 12-week field trial...
March 16, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28302109/interaction-of-cd14-haplotypes-and-soluble-cd14-on-pulmonary-function-in-agricultural-workers
#8
Tricia D LeVan, Lynette M Smith, Art J Heires, Ted R Mikuls, Jane L Meza, Lisa A Weissenburger-Moser, Debra J Romberger
BACKGROUND: Agricultural environments are contaminated with organic dusts containing bacterial components. Chronic inhalation of organic dusts is implicated in respiratory diseases. CD14 is a critical receptor for gram-negative lipopolysaccharide; however, its association with respiratory disease among agricultural workers is unknown. The objective of this study was to determine if serum soluble CD14 (sCD14) levels are associated with lung function among agricultural workers and if this association is modified by genetic variants in CD14...
March 16, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28301173/psychotherapy-practices-for-veterans-with-ptsd-among-community-based-providers-in-texas
#9
Erin P Finley, Polly H Noël, Shuko Lee, Elizabeth Haro, Hector Garcia, Craig Rosen, Nancy Bernardy, Mary Jo Pugh, Jacqueline A Pugh
Significant changes in national health policy, like the Veterans Choice Act, have created growing opportunities for veterans to receive care outside of the Veterans Administration (VA), yet little is known about the attitudes and practices in PTSD care of community providers, particularly their use of evidence-based psychotherapies (EBPs). The authors assessed psychotherapy practices of community providers serving veterans with PTSD in Texas. They surveyed Texas mental health providers regarding their patient population, practice setting, and posttraumatic stress disorder (PTSD)-related screening, assessment, and treatment practices...
March 16, 2017: Psychological Services
https://www.readbyqxmd.com/read/28301070/substance-use-disorders-and-the-risk-of-suicide-mortality-among-men-and-women-in-the-us-veterans-health-administration
#10
Kipling M Bohnert, Mark A Ilgen, Samantha Louzon, John F McCarthy, Ira R Katz
BACKGROUND AND AIMS: Limited information is available regarding links between specific substance use disorders (SUDs) and suicide mortality; however, the preliminary evidence that is available suggests that suicide risk associated with SUDs may differ for men and women. This study aimed to estimate associations between SUDs and suicide for men and women receiving Veterans Health Administration (VHA) care. DESIGN: A cohort study using national administrative health records...
March 16, 2017: Addiction
https://www.readbyqxmd.com/read/28299413/apolipoprotein-e-the-resilience-gene
#11
Lisa M James, Brian E Engdahl, Apostolos P Georgopoulos
The apolipoprotein E (apoE) gene has been implicated in various conditions, most notably Alzheimer's disease and coronary artery disease. A predisposing role of the apoE4 isoform and a protective role of apoE2 isoform in those diseases have been documented. Here we investigated the role of apoE in resilience to trauma. Three hundred and forty-three US veterans were genotyped for apoE and were assessed for their lifetime trauma exposure (trauma score, T) and severity of posttraumatic stress disorder symptoms (PCL)...
March 15, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28298332/impact-of-lifelong-exercise-training-on-endothelial-ischemia-reperfusion-and-ischemic-preconditioning-in-humans
#12
Martijn F H Maessen, Anke Ccm van Mil, Yaïra Straathof, Niels P Riksen, Gerard A P J M Rongen, Maria T E Hopman, Thijs M H Eijsvogels, Dick H J Thijssen
Reperfusion is essential for ischemic tissue survival, but causes additional damage to the endothelium (i.e. ischemia-reperfusion [IR] injury). Ischemic preconditioning (IPC) refers to short repetitive episodes of ischemia that can protect against IR. However, IPC efficacy attenuates with older age. Whether physical inactivity contributes to the attenuated efficacy of IPC to protect against IR injury in older humans is unclear. We tested the hypotheses that lifelong exercise training relates to 1) attenuated endothelial IR and 2) maintained IPC efficacy that protects veteran athletes against endothelial IR...
March 15, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28295524/the-impact-of-cannabis-use-disorder-on-suicidal-and-nonsuicidal-self-injury-in-iraq-afghanistan-era-veterans-with-and-without-mental-health-disorders
#13
Nathan A Kimbrel, Eric C Meyer, Bryann B DeBeer, Suzy B Gulliver, Sandra B Morissette
The objective of this study was to assess the association between cannabis use disorder (CUD) and self-injury among veterans. As expected, after adjusting for sex, age, sexual orientation, combat exposure, traumatic life events, traumatic brain injury, posttraumatic stress disorder, depression, alcohol use disorder, and noncannabis drug use disorder, CUD was significantly associated with both suicidal (OR = 3.10, p = .045) and nonsuicidal (OR = 5.12, p = .009) self-injury. CUD was the only variable significantly associated with self-injury in all three models examined...
March 13, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28295416/validating-harmful-alcohol-use-as-a-phenotype-for-genetic-discovery-using-phosphatidylethanol-and-a-polymorphism-in-adh1b
#14
Amy C Justice, Kathleen A McGinnis, Jan Tate, Ke Xu, William C Becker, Hongyu Zhao, Joel Gelernter, Henry R Kranzler
BACKGROUND: Although alcohol risk is heritable, few genetic risk variants have been identified. Longitudinal (EHR) data offer a largely untapped source of phenotypic information for genetic studies, but EHR-derived phenotypes for harmful alcohol exposure have yet to be validated. Using a variant of known effect, we used electronic health record (EHR) data to develop and validate a phenotype for harmful alcohol exposure that can be used to identify unknown genetic variants in large samples...
March 11, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28295142/creation-of-an-interprofessional-teledementia-clinic-for-rural-veterans-preliminary-data
#15
Becky B Powers, Marcia C Homer, Natalia Morone, Natali Edmonds, Michelle I Rossi
The teledementia clinic is a new model of care that expands the reach of specialized geriatric and dementia care using clinical video telehealth (CVT) to rural veterans, who frequently lack access to specialty care. The clinic is a Veterans Affairs (VA) Geriatric Research, Education, and Clinical Center clinical demonstration project. It is located in the Pittsburgh VA Healthcare System tertiary referral hospital and serves veterans in affiliated rural community-based outpatient clinics (CBOCs). Rural CBOC primary care providers refer clinic patients, or referral is according to previous cognitive impairment diagnosis in a VAPHS geriatric clinic...
March 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28294318/impact-of-killing-in-war-a-randomized-controlled-pilot-trial
#16
Shira Maguen, Kristine Burkman, Erin Madden, Julie Dinh, Jeane Bosch, Jessica Keyser, Martha Schmitz, Thomas C Neylan
OBJECTIVE: The purpose of this pilot study was to test the effectiveness of Impact of Killing (IOK), a novel, cognitive-behavioral treatment (CBT) aimed at reducing mental health symptoms and functional impairment. METHOD: Participants were 33 combat Veterans with a posttraumatic stress disorder (PTSD) diagnosis who had completed trauma-focused psychotherapy and reported distress regarding killing or feeling responsible for the deaths of others in war. Veterans were randomized to either IOK treatment or a 6-week waitlist condition, after which Veterans could receive IOK...
March 10, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28294310/longitudinal-analysis-of-quality-of-diabetes-care-and-relational-climate-in-primary-care
#17
Marina Soley-Bori, Justin K Benzer, James F Burgess
OBJECTIVE: To assess the influence of relational climate on quality of diabetes care. DATA SOURCES/STUDY SETTING: The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA administrative datasets. STUDY DESIGN: Multilevel panel data (2008-2012) with patients nested into clinics. DATA COLLECTION/EXTRACTION METHODS: Diabetic patients were identified using ICD-9 codes and assigned to the clinic with the highest frequency of primary care visits...
March 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28294195/nightmares-as-predictors-of-suicide-an-extension-study-including-war-veterans
#18
Nils Sandman, Katja Valli, Erkki Kronholm, Erkki Vartiainen, Tiina Laatikainen, Tiina Paunio
Nightmares are intensive dreams with negative emotional tone. Frequent nightmares can pose a serious clinical problem and in 2001, Tanskanen et al. found that nightmares increase the risk of suicide. However, the dataset used by these authors included war veterans in whom nightmare frequency - and possibly also suicide risk - is elevated. Therefore, re-examination of the association between nightmares and suicide in these data is warranted. We investigated the relationship between nightmares and suicide both in the general population and war veterans in Finnish National FINRISK Study from the years 1972 to 2012, a dataset overlapping with the one used in the study by Tanskanen et al...
March 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28293778/evaluating-the-quality-of-rural-intensive-case-management-services-using-administrative-data-an-exploratory-study
#19
Somaia Mohamed
Assertive Community Treatment (ACT) for people with severe mental illness is an effective approach that is increasingly implemented in rural areas. Low-cost methods of evaluating fidelity to program models are needed to assure services are delivered as intended. In 2007, the Veterans Health Administration implemented an ACT-like Mental Health Intensive Case Management (ACT/ICM) program for SMI veterans in rural areas. This study demonstrates the use of administrative data, reflecting patient characteristics and intensity of service delivery, to characterize services delivered by these programs, to compare them to general mental health programs at the same VA medical centers, and to each other...
March 15, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28293767/gambling-in-a-national-u-s-veteran-population-prevalence-socio-demographics-and-psychiatric-comorbidities
#20
Elina A Stefanovics, Marc N Potenza, Robert H Pietrzak
This study aimed to examine associations between gambling level and clinically relevant measures, including psychiatric disorders and suicidality, in a nationally representative sample of U.S. veterans. Data on 3157 U.S. veterans were analyzed from the National Health and Resilience in Veterans Study. Chi square tests and analyses of variance were used to assess associations between gambling level, and demographic, military, and personality characteristics. Multinomial logistic regressions using stepwise selection were used to identify independent correlates of recreational gambling and at-risk/problem gambling (ARPG)...
March 14, 2017: Journal of Gambling Studies
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