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Veterans affairs

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https://www.readbyqxmd.com/read/28211937/patterns-of-computed-tomography-surveillance-in-survivors-of-colorectal-cancer-at-veterans-health-administration-facilities
#1
Amikar Sehdev, Eric A Sherer, Siu L Hui, Jingwei Wu, David A Haggstrom
BACKGROUND: Annual computed tomography (CT) scans are a component of the current standard of care for the posttreatment surveillance of survivors of colorectal cancer (CRC) after curative-intent resection. The authors conducted a retrospective study with the primary aim of assessing patient, physician, and organizational characteristics associated with the receipt of CT surveillance among veterans. METHODS: The Department of Veterans Affairs Central Cancer Registry was used to identify patients diagnosed with AJCC collaborative stage I to III CRC between 2001 and 2009...
February 17, 2017: Cancer
https://www.readbyqxmd.com/read/28206801/burden-and-mental-health-among-caregivers-of-veterans-with-traumatic-brain-injury-polytrauma
#2
Joan M Griffin, Minji K Lee, Lauren R Bangerter, Courtney Harold Van Houtven, Greta Friedemann-Sánchez, Sean M Phelan, Kathleen F Carlson, Laura A Meis
Veterans who survive multiple traumatic injuries, including traumatic brain injuries (TBI), must often rely on family caregivers for ongoing care and support with reintegration. Understanding factors associated with caregiving that help or harm caregivers' health is critical for identifying appropriate and effective interventions that support caregiver health and promote the provision of quality care to veterans. This study utilized cross-sectional data from the Family and Caregiver Experiences Study, a survey of 564 caregivers caring for veterans who served after September 11, 2001, survived TBI/polytrauma during service, and received inpatient rehabilitation care in a Veterans Affairs Polytrauma Rehabilitation Center...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28206800/perspectives-of-veterans-with-mild-traumatic-brain-injury-on-community-reintegration-making-sense-of-unplanned-separation-from-service
#3
Alexander V Libin, Manon Maitland Schladen, Ellen Danford, Samantha Cichon, Dwan Bruner, Joel Scholten, Maria Llorente, Slavomir Zapata, Alexander W Dromerick, Marc R Blackman, Kathryn M Magruder
For veterans separated from the military as a result of acquired mild traumatic brain injury (mTBI), the transition from a military identity to a civilian one is complicated by health, cognitive, and psychosocial factors. We conducted in-depth interviews with 8 veterans with mTBI to understand how they perceived the experience of departure from the military, rehabilitation services provided at a Department of Veterans Affairs (VA) Polytrauma Network Site, and reentry into civilian life. Two distinct patterns of thinking about community reintegration emerged...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28206798/facilitating-reintegration-for-military-service-personnel-veterans-and-their-families-an-introduction-to-the-special-issue
#4
Christine A Elnitsky, Ryan P Kilmer
As service members return from active duty and, in some cases, exit the military, they face a process of reintegration (also referred to as community reintegration) as they seek to resume participation in their life roles as civilians. Facilitating this dynamic process of reintegration for service members, veterans, and their families-including outlining potential strategies for supporting this return to civilian life and its demands, roles, and responsibilities-is the focus of this Special Issue. Reintegration has been framed as a national priority (U...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28204876/continuous-positive-airway-pressure-adherence-in-patients-with-obstructive-sleep-apnea-symptomatic-bph
#5
Ramesh V V S Metta, Awais Zaka, Vincent C Lee, M Jeffery Mador
Purpose To determine the short-term and long-term adherence rates with continuous positive airway pressure (CPAP) therapy in sleep apnea patients with benign prostatic hyperplasia (BPH) compared to matched controls. Methods A case-control retrospective analysis was performed in a veterans affairs hospital. All symptomatic patients with BPH (n = 107) ever started on CPAP therapy between 2006 and 2012 were compared with controls matched for severity of sleep apnea (AHI). Adherence measures were obtained at the third and twelfth month visits...
February 16, 2017: Lung
https://www.readbyqxmd.com/read/28203055/resident-surgeon-efficiency-in-femtosecond-laser-assisted-cataract-surgery
#6
Andrew C Pittner, Brian R Sullivan
PURPOSE: Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification. PATIENTS AND METHODS: A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28202428/patient-use-of-electronic-prescription-refill-and-secure-messaging-and-its-association-with-undetectable-hiv-viral-load-a-retrospective-cohort-study
#7
D Keith McInnes, Stephanie L Shimada, Amanda M Midboe, Kim M Nazi, Shibei Zhao, Justina Wu, Casey M Garvey, Thomas K Houston
BACKGROUND: Electronic personal health records (PHRs) can support patient self-management of chronic conditions. Managing human immunodeficiency virus (HIV) viral load, through taking antiretroviral therapy (ART) is crucial to long term survival of persons with HIV. Many persons with HIV have difficulty adhering to their ART over long periods of time. PHRs contribute to chronic disease self-care and may help persons with HIV remain adherent to ART. Proportionally veterans with HIV are among the most active users of the US Department of Veterans Affairs (VA) PHR, called My HealtheVet...
February 15, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28198662/changes-in-bacterial-epidemiology-and-antibiotic-resistance-among-veterans-with-spinal-cord-injury-disorder-over-the-past-9-years
#8
Margaret A Fitzpatrick, Katie J Suda, Nasia Safdar, Stephen P Burns, Makoto M Jones, Linda Poggensee, Swetha Ramanathan, Charlesnika T Evans
OBJECTIVE: Patients with spinal cord injury and disorder (SCI/D) have an increased risk of infection with multidrug-resistant (MDR) bacteria. We described bacterial epidemiology and resistance in patients with SCI/D at Veterans Affairs Medical Centers (VAMCs) for the past 9 years. DESIGN: Retrospective cohort Setting: One hundred thirty VAMCs. PARTICIPANTS: Veterans with SCI/D and bacterial cultures with antibiotic susceptibility testing performed between 1/1/2005-12/31/2013...
February 15, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28197620/measuring-practicing-clinicians-information-literacy-an-exploratory-analysis-in-the-context-of-panel-management
#9
Brian E Dixon, Katherine Barboza, Ashley E Jensen, Katelyn J Bennett, Scott E Sherman, Mark D Schwartz
BACKGROUND: As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES: This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans' Affairs (VA) medical center. METHODS: Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention...
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28195958/rehospitalization-in-the-first-year-following-veteran-and-service-member-tbi-a-va-tbi-model-systems-study
#10
Johanna Tran, Flora Hammond, Kristen Dams-OʼConnor, Xinyu Tang, Blessen Eapen, Marissa McCarthy, Risa Nakase-Richardson
OBJECTIVE: To determine the incidence and causes of rehospitalization following military or Veteran traumatic brain injury (TBI). SETTING: Department of Veterans Affairs (VA) Veterans Health Administration Polytrauma Rehabilitation Centers (VHA PRCs). PARTICIPANTS: Consecutive sample of VHA TBI Model System participants (N = 401). DESIGN: Prospective observational cohort study. MAIN MEASURES: Number and type of rehospitalizations in first year post-TBI...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28195877/direct-acting-antivirals-are-effective-for-chronic-hepatitis-c-treatment-in-elderly-patients-a-real-world-study-of-17%C3%A2-487-patients
#11
Feng Su, Lauren A Beste, Pamela K Green, Kristin Berry, George N Ioannou
BACKGROUND: The mean age of patients with chronic hepatitis C virus (HCV) infection in the USA has been increasing. Despite the increasing proportion of HCV-infected elderly patients, this group is under-represented in clinical trials of HCV treatment. AIM: We aimed to describe the real-world effectiveness of direct-acting antivirals (DAAs) among elderly patients. PATIENTS AND METHODS: We retrospectively identified 17 487 HCV-infected patients who were started on treatment with sofosbuvir, ledipasvir/sofosbuvir, or paritaprevir/ombitasvir/ritonavir/dasabuvir-based regimens in the Veterans Affairs Healthcare System between 1 January 2014 and 30 June 2015...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28195682/access-to-palliative-care-services-during-the-terminal-hospital-episode-reduces-intervention-rates-and-hospital-costs-a-database-study-of-19707-elderly-patients-dying-in-hospital-2011-2015
#12
Anthony W Ireland
BACKGROUND: The burden of healthcare costs for persons approaching death is of increasing concern. This study examines cost savings associated with access to palliative care (PC) during the hospital episode ending in death for a large sample of elderly patients. METHODS: A retrospective cohort study of administrative data for Department of Veterans' Affairs clients identified patient demographics, hospital characteristics, utilisation data and component costs for the hospital terminal episode for patients aged ≥ 70 years who died in hospital between July 2011 and June 2015...
February 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28193660/antimicrobial-resistance-of-escherichia-coli-urinary-isolates-in-the-veterans-affairs-healthcare-system
#13
Haley J Morrill, Jacob B Morton, Aisling R Caffrey, Lan Jiang, David Dosa, Leonard A Mermel, Kerry L LaPlante
We reviewed almost 300,000 clinical E. coli urine isolates (2009-2013) from 127 facilities to assess antibiotic resistance among Veterans Affairs healthcare system patients using Clinical Laboratory Standards Institute and Centers for Disease Control and Prevention National Healthcare Safety Network definitions/guidance. Resistance to fluoroquinolones and trimethoprim/sulfamethoxazole approached 30%. Resistance to nitrofurantoin, anti-pseudomonal penicillin/beta-lactamase inhibitors, and carbapenems remained less than 10%...
February 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28192622/the-safety-and-efficacy-of-baclofen-to-reduce-alcohol-use-in-veterans-with-chronic-hepatitis-c-a-randomized-clinical-trial
#14
Peter Hauser, Bret Fuller, Samuel B Ho, Paul Thuras, Shira Kern, Eric Dieperink
BACKGROUND AND AIMS: Alcohol use disorders (AUDs) are common among people with chronic hepatitis C (HCV) and accelerate the development of fibrosis and cirrhosis caused by HCV. Baclofen, a gamma-aminobutyric acid (GABA) beta-receptor agonist, differs from medications for AUDs currently approved by the United States (US) Federal Drug Administration (FDA) as it is metabolized primarily through the kidneys. The primary outcome of this study was to compare baclofen with a placebo in the percentage of days abstinent from alcohol...
February 13, 2017: Addiction
https://www.readbyqxmd.com/read/28190690/changes-in-veteran-tobacco-use-identified-in-electronic-medical-records
#15
Paul G Barnett, Adam Chow, Nicole E Flores, Scott E Sherman, Sonia A Duffy
INTRODUCTION: Electronic medical records represent a new source of longitudinal data on tobacco use. METHODS: Electronic medical records of the U.S. Department of Veterans Affairs were extracted to find patients' tobacco use status in 2009 and at another assessment 12-24 months later. Records from the year prior to the first assessment were used to determine patient demographics and comorbidities. These data were analyzed in 2015. RESULTS: An annual quit rate of 12...
February 9, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28187513/collaboration-to-accelerate-proteogenomics-cancer-care-the-department-of-veterans-affairs-department-of-defense-and-the-national-cancer-institute-s-applied-proteogenomics-organizational-and-learning-apollo-network
#16
L D Fiore, H Rodriguez, C D Shriver
The ability to interrogate cancer at the proteogenomic level has the potential to transform oncology care from trial-and-error treatment strategies based on the anatomy and genomic profiling of tumors to one that is precisely based on the tumor's molecular profile. The next step in the evolution of precision oncology is developing proteogenomic approaches that make no exclusive assumptions a priori as to the molecular level of the patient's disease. The DoD, VA, and NCI responded to the Cancer Moonshot initiative by linking each agency's unique capabilities in clinical and basic science, computing, and high-throughput sequencing...
February 10, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28187101/how-nurse-gender-influences-patient-priority-assignments-in-us-emergency-departments
#17
Jacob Miguel Vigil, Patrick Coulombe, Joe Alcock, Sarah See Stith, Eric Kruger, Sara Cichowski
The goals of this study were to compare whether emergency department (ED) patients' pain intensity (PI) is measured differently by male and female nurses and to determine whether PI, heart rate (HR), and respiratory rate (RR) were used to prioritize patient urgency differently by male and female nurses. The associations between patients' PI|HR|RR and the Emergency Severity Index (ESI) scores they were assigned by attending nurses were analyzed using a national database of electronic medical records of US Veterans Affairs ED patients from 2008 to 2012...
March 2017: Pain
https://www.readbyqxmd.com/read/28185483/genital-nerve-stimulation-is-tolerable-and-effective-for-bladder-inhibition-in-sensate-individuals-with-incomplete-sci
#18
Steven W Brose, Dennis J Bourbeau, Kenneth J Gustafson
BACKGROUND: Neurogenic detrusor overactivity after spinal cord injury (SCI) causes urinary incontinence and reduces bladder capacity. Surface electrical genital nerve stimulation (GNS) acutely inhibits reflex bladder contractions. The stimulation amplitude selected for GNS is typically twice the amplitude that is required to evoke the pudendal-anal reflex. There is concern about the ability of persons with sensation to comfortably tolerate effective levels of GNS. The objective of this work is to determine if persons with incomplete SCI are able to tolerate acute GNS for bladder inhibition...
February 10, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28185477/measuring-pain-phenomena-after-spinal-cord-injury-development-and-psychometric-properties-of-the-sci-qol-pain-interference-and-pain-behavior-assessment-tools
#19
Matthew L Cohen, Pamela A Kisala, Trevor A Dyson-Hudson, David S Tulsky
OBJECTIVE: To develop modern patient-reported outcome measures that assess pain interference and pain behavior after spinal cord injury (SCI). DESIGN: Grounded-theory based qualitative item development; large-scale item calibration field-testing; confirmatory factor analyses; graded response model item response theory analyses; statistical linking techniques to transform scores to the Patient Reported Outcome Measurement Information System (PROMIS) metric. SETTING: Five SCI Model Systems centers and one Department of Veterans Affairs medical center in the United States...
February 10, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28183346/study-protocol-improving-the-transition-of-care-from-a-non-network-hospital-back-to-the-patient-s-medical-home
#20
Roman A Ayele, Emily Lawrence, Marina McCreight, Kelty Fehling, Jamie Peterson, Russell E Glasgow, Borsika A Rabin, Robert Burke, Catherine Battaglia
BACKGROUND: The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that bridges the gap and improves the current transition of care process within the Eastern Colorado Health Care System (ECHCS)...
February 10, 2017: BMC Health Services Research
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