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https://www.readbyqxmd.com/read/28641862/perioperative-beta-blockers-and-statins-for-noncardiac-surgery-patients-with-coronary-stents
#1
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/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#2
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
#3
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
#4
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
#5
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/28634198/the-effect-of-sustained-virological-response-on-the-risk-of-extrahepatic-manifestations-of-hepatitis-c-virus-infection
#6
Parag Mahale, Eric A Engels, Ruosha Li, Harrys A Torres, Lu-Yu Hwang, Eric L Brown, Jennifer R Kramer
BACKGROUND AND AIM: Chronic HCV infection is associated with several extrahepatic manifestations (EHMs). Data on the effect of sustained virological response (SVR) on the risk of EHMs are limited. METHODS: We conducted a retrospective cohort study using data of patients from the US Veterans Affairs HCV Clinical Case Registry who had a positive HCV RNA test (10/1999-08/2009). Patients receiving interferon-based antiviral therapy (AVT) were identified. SVR was defined as negative HCV RNA at least 12 weeks after end of AVT...
June 20, 2017: Gut
https://www.readbyqxmd.com/read/28633678/variation-in-empiric-coverage-versus-detection-of-methicillin-resistant-staphylococcus-aureus-and-pseudomonas-aeruginosa-in-hospitalizations-for-community-onset-pneumonia-across-128-us-veterans-affairs-medical-centers
#7
Barbara E Jones, Kevin Antoine Brown, Makoto M Jones, Benedikt D Huttner, Tom Greene, Brian C Sauer, Karl Madaras-Kelly, Michael A Rubin, Matthew Bidwell Goetz, Matthew H Samore
OBJECTIVE To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia. DESIGN Cross-sectional study. SETTING A total of 128 hospitals in the Veterans Affairs health system. PARTICIPANTS Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010. METHODS We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28632542/creation-and-execution-of-a-novel-anesthesia-perioperative-care-service-at-a-veterans-affairs-hospital
#8
Bret D Alvis, Adam B King, Pratik P Pandharipande, Liza M Weavind, Katelin Avila, Philip J Leisy, Muhammad Ajmal, Michael McHugh, Kirk A Keegan, David A Baker, Ann Walia, Christopher G Hughes
Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways. These are well-described methods that have shown to improve perioperative outcomes. An established perioperative surgical home model can help implementation, efficiency, and adherence to enhanced recovery after surgery pathways...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632462/examining-changes-in-negative-mood-regulation-expectancies-ptsd-depression-and-substance-use-following-integrated-cognitive-behavioral-therapy
#9
Emma Y Siegel, Moira Haller, Ruifeng Cui, Ryan S Trim, Susan R Tate, Sonya B Norman
BACKGROUND: The comorbidity of depression, posttraumatic stress disorder (PTSD), and substance use disorder (SUD) is common among veterans. Some research indicates that poor expectancies for negative mood regulation (NMR) may be associated with depression, trauma symptoms, and substance abuse. However, little is known about whether NMR expectancies can be changed through psychotherapy and if so, whether changes in NMR expectancies are related to changes in depression, PTSD, and SUD. METHODS: Therefore, this study examined 1) whether negative mood regulation (NMR) expectancies correlate with depression, PTSD, and SUD symptoms, 2) whether NMR expectancies improve after group integrated cognitive behavioral therapy (ICBT) and 3) whether these changes were associated with improvements in depression, PTSD, and SUD symptoms in a sample of 123 veterans (89% male, 64% non-Hispanic Caucasian) recruited from a Department of Veteran Affairs (VA) Healthcare System...
June 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28629990/employment-stability-in-veterans-and-service-members-with-traumatic-brain-injury-a-va-traumatic-brain-injury-model-systems-study
#10
Christina Dillahunt-Aspillaga, Mary Jo Pugh, Bridget A Cotner, Marc A Silva, Adam Haskin, Xinyu Tang, Marie E Saylors, Risa Nakase-Richardson
OBJECTIVE: To examine incidence and predictors of employment stability in Veterans and Military Service Members (V/SM) with traumatic brain injury (TBI) who return to work. DESIGN: Prospective observational cohort study. SETTING: Four Department of Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRCs). PARTICIPANTS: 110 V/SM with mild (26%), moderate (22%), or severe (52%) TBI enrolled in the VA PRC TBI Model Systems database within 2 years of injury who were discharged between January 2009 and June 2015...
June 16, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28625448/the-effect-of-race-on-postsurgical-ambulatory-medical-follow-up-among-united-states-veterans
#11
Robert B Schonberger, Feng Dai, Cynthia Brandt, Matthew M Burg
STUDY OBJECTIVE: To investigate the association between self-identified black or African American race and the presence of ambulatory internal medicine follow-up in the year after surgery. Our hypothesis was that among US Veterans who presented for surgery, black or African American race would be associated with a decreased likelihood to receive ambulatory internal medicine follow-up in the year after surgery. DESIGN: Retrospective observational. SETTING: All US Veterans Affairs hospitals...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28623628/does-patient-preference-measurement-in-decision-aids-improve-decisional-conflict-a-randomized-trial-in-men-with-prostate-cancer
#12
Joseph D Shirk, Catherine M Crespi, Josemanuel D Saucedo, Sylvia Lambrechts, Ely Dahan, Robert Kaplan, Christopher Saigal
BACKGROUND: Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement. OBJECTIVES: We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting...
June 16, 2017: Patient
https://www.readbyqxmd.com/read/28622572/differential-predictive-value-of-ptsd-symptom-clusters-for-mental-health-care-among-iraq-and-afghanistan-veterans-following-ptsd-diagnosis
#13
Noelle B Smith, Jack Tsai, Robert H Pietrzak, Joan M Cook, Rani Hoff, Ilan Harpaz-Rotem
OBJECTIVES: Veterans from the recent conflicts in Iraq and Afghanistan are being diagnosed with posttraumatic stress disorder (PTSD) at high rates. This study examined characteristics associated with mental health service utilization, specifically psychotherapy, through the Department of Veterans Affairs (VA), in a large cohort of Iraq and Afghanistan veterans newly diagnosed with PTSD. METHOD: This study utilized national VA administrative data from Iraq and Afghanistan veterans following an initial diagnosis of PTSD and completed a self-report measure of PTSD symptoms between Fiscal Years 2008-2012 (N=52,456; 91...
June 13, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28618875/implementation-of-guideline-based-therapy-for-chronic-obstructive-pulmonary-disease-differences-between-men-and-women-veterans
#14
Seppo T Rinne, A Rani Elwy, Chuan-Fen Liu, Renda Soylemez Wiener, Lisa Thayer, Alexandra Gerity, Lori A Bastian
Chronic obstructive pulmonary disease (COPD) is common among both men and women, and guidelines recommend the same therapy for both sexes. While previous studies have identified gender differences in other chronic disease management, few studies have examined how implementation of COPD guidelines differs between men and women. We performed a cross-sectional study of veterans admitted to Veterans Affairs (VA) hospitals for COPD during October 1, 2008, to September 30, 2011. We collected information on baseline COPD medications during the 6 months prior to hospitalization and categorized therapies as "appropriate" or "inappropriate" based on current guidelines...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28617159/ambulatory-care-coordination-issues-with-dual-use-veteran-organ-transplant-recipients
#15
Stephanie A Thrall, Leonard E Egede, David J Taber
The previous literature indicates that patients receiving ongoing care in both Veterans Affairs (VA) and non-VA setting (dual care) may have reduced health outcomes. The objective of this study was to assess the impact of dual care provided to a veteran solid organ transplant population. This was a retrospective cohort study of stable solid organ transplant recipients receiving care at both a Veterans Affairs Medical Center and transplant center. Forty-six veteran organ transplant recipients met inclusion criteria...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28614184/coordinating-care-across-health-care-systems-for-veterans-with-gynecologic-malignancies-a-qualitative-analysis
#16
Jessica L Zuchowski, Joya G Chrystal, Alison B Hamilton, Elizabeth W Patton, Laurie C Zephyrin, Elizabeth M Yano, Kristina M Cordasco
BACKGROUND: Veterans concurrently using both Veterans Affairs (VA) and community providers and facilities have increased coordination needs related to bridging their care across health care settings. Women Veterans commonly require a combination of VA and community care if they have women-specific specialty care needs, such as gynecologic malignancies. OBJECTIVES: We assessed VA women's health providers' and administrators' perceptions of coordination challenges for Veterans' gynecologic cancer care, and potential approaches for addressing these challenges...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28609724/diagnostic-accuracy-of-a-two-item-drug-abuse-screening-test-dast-2
#17
Quyen Q Tiet, Yani E Leyva, Rudolf H Moos, Brandy Smith
OBJECTIVE: Drug use is prevalent and costly to society, but individuals with drug use disorders (DUDs) are under-diagnosed and under-treated, particularly in primary care (PC) settings. Drug screening instruments have been developed to identify patients with DUDs and facilitate treatment. The Drug Abuse Screening Test (DAST) is one of the most well-known drug screening instruments. However, similar to many such instruments, it is too long for routine use in busy PC settings. This study developed and validated a briefer and more practical DAST for busy PC settings...
June 8, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28609600/who-do-australian-general-practitioners-refer-to-physiotherapy
#18
Sarah Dennis, Ian Watts, Ying Pan, Helena Britt
BACKGROUND: Physiotherapy plays an important role in the health of many Australians. The aims of this study were to assess changes in the rate of general practitioner (GP) referral to physiotherapists in Australia from 1998 to 2014, and to determine patient characteristics associated with increased likelihood of such referral. METHODS: Secondary analysis was undertaken of data from the Bettering the Evaluation and Care of Health program using weighted encounter data years 1998-99 to 2014-15 inclusive...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28608413/use-of-veterans-affairs-and-medicaid-services-for-dually-enrolled-veterans
#19
Jean Yoon, Megan E Vanneman, Sharon K Dally, Amal N Trivedi, Ciaran S Phibbs
OBJECTIVES: To examine how dual coverage for nonelderly, low-income veterans by Veterans Affairs (VA) and Medicaid affects their demand for care. DATA SOURCES: Veterans Affairs utilization data and Medicaid Analytic Extract Files. STUDY DESIGN: A retrospective, longitudinal study of VA users prior to and following enrollment in Medicaid 2006-2010. DATA COLLECTION/EXTRACTION METHODS: Veterans Affairs reliance, or proportion of care provided by VA, was estimated with beta-binomial models, adjusting for patient and state Medicaid program factors...
June 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28605268/va-staff-perceptions-of-the-role-of-the-extended-care-referral-process-in-home-and-community-based-services-versus-nursing-home-use-post-hospital-discharge
#20
Edward Alan Miller, Orna Intrator, Emily Gadbois, Stefanie Gidmark, James L Rudolph
Little is known about how the extended care referral process-its structure and participants-influences Veterans' use of home and community-based services (HCBS) over nursing home care within the Veterans Health Administration (VHA). This study thus characterizes the extended care referral process within the VHA and its impact on HCBS versus nursing home use at hospital discharge. Data derive from 35 semi-structured interviews at 12 Veterans Affairs Medical Centers (VAMCs). Findings indicate that the referral process is characterized by a commitment by care teams to consider HCBS if possible, varied practice depending on the clinician that most heavily influences care team recommendations, and care team emphasis on respecting Veteran/family preferences even when they are contrary to care team recommendations...
June 12, 2017: Home Health Care Services Quarterly
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