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Veterans affairs

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https://www.readbyqxmd.com/read/28934258/reports-of-unintended-consequences-of-financial-incentives-to-improve-management-of-hypertension
#1
Sylvia J Hysong, Richard SoRelle, Kristen Broussard Smitham, Laura A Petersen
BACKGROUND: Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT) of financial incentives...
2017: PloS One
https://www.readbyqxmd.com/read/28931486/caring-for-the-veteran-military-and-family-member-nursing-competencies-strategies-for-integrating-content-into-nursing-school-curricula
#2
Libba Reed McMillan, David Crumbley, Julie Freeman, Marilyn Rhodes, Michele Kane, Joy Napper
In the United States, one in every 15 persons is a Veteran (U. S. Department of Veterans Affairs, 2016; U. S. News & World Report, 2017). An estimated 27% of these Veterans receive healthcare through the Veteran's Health Administration (VHA), leaving 73% to seek care in civilian hospitals (Bagalman, 2014). Realistically, most nurses in the United States will care for military members, Veterans or family members in a variety of healthcare systems and settings. Nurse educators are positioned to lead efforts in providing nursing students with the knowledge necessary to provide competent care and serve as advocates for our nation's heroes...
September 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28918830/metformin-has-positive-therapeutic-effects-in-colon-cancer-and-lung-cancer
#3
DeAnna Henderson, Danielle Frieson, Jeffrey Zuber, Solomon S Solomon
BACKGROUND: Metformin (MF), a diabetic drug, has antineoplastic activity as adjuvant therapy for breast cancer and prostate cancer. MF is thought to work via inhibition of mammalian target of rapamycin and activation of p53 and liver kinase B1 via adenosine 5'-monophosphate-activated protein kinase. We investigated survival, recurrences and metastasis in patients with type 2 diabetes mellitus (DM2) along with colorectal cancer (CC) or lung cancer (LC) taking MF using the electronic medical record in Memphis Veterans Affairs Medical Center (colon, n = 202; lung, n = 180)...
September 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28916254/development-of-a-natural-language-processing-engine-to-generate-bladder-cancer-pathology-data-for-health-services-research
#4
Florian R Schroeck, Olga V Patterson, Patrick R Alba, Erik A Pattison, John D Seigne, Scott L DuVall, Douglas J Robertson, Brenda Sirovich, Philip P Goodney
OBJECTIVE: To take a first step towards assembling population based cohorts of bladder cancer patients with longitudinal pathology data, we developed and validated a natural language processing (NLP) engine that abstracts pathology data from full text pathology reports. METHODS: Using 600 bladder pathology reports randomly selected from the Department of Veterans Affairs, we developed and validated an NLP engine to abstract data on histology, invasion (presence versus absence and depth), grade, presence of muscularis propria, and presence of carcinoma in situ...
September 12, 2017: Urology
https://www.readbyqxmd.com/read/28915306/cost-utility-study-of-warfarin-genotyping-in-the-vachs-affiliated-anticoagulation-clinic-of-puerto-rico
#5
Carlos Martes-Martinez, Cristian Méndez-Sepúlveda, Joel Millán-Molina, Matthew French-Kim, Heriberto Marín-Centeno, Giselle C Rivera-Miranda, José J Hernández-Muñoz, Jorge Duconge-Soler
OBJECTIVE: To evaluate the cost-utility of the pharmacogenetic-guided dosing of warfarin (PGx), when compared to the current dosing strategy. METHODS: A Markov model was developed to assess the impact of the genotypingguided warfarin dosing in a hypothetical cohort of patients. The model was based on the percentage of time patients spent within the therapeutic international normalized ratio (INR) range (PTTR). PTTR estimates and genotype distribution were derived from a cohort of patients (n = 206) treated in the Veteran Affairs Caribbean Healthcare System (VACHS) and from results of other research study...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28915156/a-risk-calculator-using-preoperative-opioids-for-prediction-of-total-knee-revision-arthroplasty
#6
Jordan Starr, Irene Rozet, Alon Ben-Ari
OBJECTIVES: Total knee arthroplasty (TKA) is a procedure to improve quality of life. However, some patients require early total knee revision (TKR). Chronic opioid use before TKA is associated with TKR. No risk calculator including opioid use or other risk factors is currently available for predicting TKR. MATERIALS AND METHODS: We retrospectively analyzed medical records of Veterans Affairs patients who underwent TKA from January 1, 2006 to January 1, 2012. Patients were followed until January 1, 2013...
September 14, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28914272/a-randomized-controlled-trial-of-a-cpr-decision-support-video-for-patients-admitted-to-the-general-medicine-service
#7
Aimee M Merino, Ryan Greiner, Kristopher Hartwig
BACKGROUND: Patient preferences regarding cardiopulmonary resuscitation (CPR) are important, especially during hospitalization when a patient's health is changing. Yet many patients are not adequately informed or involved in the decision-making process. OBJECTIVE: We examined the effect of an informational video about CPR on hospitalized patients' code status choices. DESIGN: This was a prospective, randomized trial conducted at the Minneapolis Veterans Affairs Health Care System in Minnesota...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913683/an-evidence-map-of-the-women-veterans-health-research-literature-2008-2015
#8
Elisheva R Danan, Erin E Krebs, Kristine Ensrud, Eva Koeller, Roderick MacDonald, Tina Velasquez, Nancy Greer, Timothy J Wilt
BACKGROUND: Women comprise a growing proportion of Veterans seeking care at Veterans Affairs (VA) healthcare facilities. VA initiatives have accelerated changes in services for female Veterans, yet the corresponding literature has not been systematically reviewed since 2008. In 2015, VA Women's Health Services and the VA Women's Health Research Network requested an updated literature review to facilitate policy and research planning. METHODS: The Minneapolis VA Evidence-based Synthesis Program performed a systematic search of research related to female Veterans' health published from 2008 through 2015...
September 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28906129/perceptions-of-u-s-veterans-affairs-and-community-healthcare-providers-regarding-cross-system-care-for-heart-failure
#9
Charlene A Pope, Boyd H Davis, Leticia Wine, Lynne S Nemeth, K Sue Haddock, Tom Hartney, R Neal Axon
Objectives This study explores perceptions of US Veterans Affairs (VA) and non-VA healthcare providers caring for Veterans with heart failure (HF) regarding Veteran knowledge and motivations for dual use, provider roles in recommending and coordinating dual use, systems barriers and facilitators, and suggestions for improving cross-system care. Methods Twenty VA and 11 non-VA providers participated in semi-structured interviews, which were analyzed using parallel qualitative content and discourse analysis. Results VA and non-VA providers described variable HF knowledge and self-management among Veterans, and both groups described the need for improved education addressing medication adherence, self-care, and management of acute symptoms...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28905668/the-impact-of-agent-orange-exposure-on-prognosis-and-management-in-patients-with-chronic-lymphocytic-leukemia-a-national-veteran-affairs-tumor-registry-study
#10
Craig Mescher, David Gilbertson, Nicole M Randall, Gobind Tarchand, Julie Tomaska, Lisa Baumann Kreuziger, Vicki A Morrison
Exposure to Agent Orange (AO) has been associated with the development of chronic lymphocytic leukemia (CLL). We performed a retrospective study of 2052 Vietnam veterans identified in the National VA Tumor Registry to assess the impact of AO exposure on CLL prognosis, treatment and survival. Prognostic factors did not differ based on exposure. Veterans exposed to AO were diagnosed younger (63.2 vs. 70.5 years, p < .0001) and had longer overall survival (median not reached vs. 91 months, p < .001)...
September 14, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28899894/variation-in-management-of-patients-with-obstructive-coronary-artery-disease-insights-from-the-veterans-affairs-clinical-assessment-and-reporting-tool-va-cart-program
#11
Amneet Sandhu, Maggie A Stanislawski, Gary K Grunwald, Kathryn Guinn, Javier Valle, Daniel Matlock, P Michael Ho, Thomas M Maddox, Steven M Bradley
BACKGROUND: Little is known about facility-level variation in the use of revascularization procedures for the management of stable obstructive coronary artery disease. Furthermore, it is unknown if variation in the use of coronary revascularization is associated with use of other cardiovascular procedures. METHODS AND RESULTS: We evaluated all elective coronary angiograms performed in the Veterans Affairs system between September 1, 2007, and December 31, 2011, using the Clinical Assessment and Reporting Tool and identified patients with obstructive coronary artery disease...
September 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28899438/facilitators-and-barriers-to-preparedness-partnerships-a-veterans-affairs-medical-center-perspective
#12
Susan Schmitz, Tamar Wyte-Lake, Aram Dobalian
OBJECTIVE: This study sought to understand facilitators and barriers faced by local US Department of Veterans Affairs Medical Center (VAMC) emergency managers (EMs) when collaborating with non-VA entities. METHODS: Twelve EMs participated in semi-structured interviews lasting 60 to 90 minutes discussing their collaboration with non-VAMC organizations. Sections of the interview transcripts concerning facilitators and barriers to collaboration were coded and analyzed...
September 13, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28899394/a-two-state-comparative-implementation-of-peer-support-intervention-to-link-veterans-to-health-related-services-after-incarceration-a-study-protocol
#13
Molly M Simmons, Benjamin G Fincke, Mari-Lynn Drainoni, Bo Kim, Tom Byrne, David Smelson, Kevin Casey, Marsha L Ellison, Christy Visher, Jessica Blue-Howells, D Keith McInnes
BACKGROUND: Approximately 600,000 persons are released from prison annually in the United States. Relatively few receive sufficient re-entry services and are at risk for unemployment, homelessness, poverty, substance abuse relapse and recidivism. Persons leaving prison who have a mental illness and/or a substance use disorder are particularly challenged. This project aims to create a peer mentor program to extend the reach and effectiveness of reentry services provided by the Department of Veterans' Affairs (VA)...
September 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28899303/philosophical-clarity-and-justifying-the-scope-of-advanced-practice-nursing
#14
Pamela G Reed
The United States (US) Department of Veterans Affairs proposed a policy change for nursing practice that would grant full practice authority to advanced practice registered nurses (APRNs) nationwide. In this article, the author briefly explains this proposed policy and explores the relevance and implications of bringing philosophy into policy debates and discussions about the nature and scope of practice.
January 2017: Nursing Science Quarterly
https://www.readbyqxmd.com/read/28899261/nursing-home-referral-within-the-veterans-health-administration-practice-variation-by-payment-source-and-facility-type
#15
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Veterans enrolled within the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) may receive nursing home (NH) care in VHA-operated Community Living Centers (CLCs), State Veterans Homes (SVHs), or community NHs, which may or may not be under contract with the VHA. This study examined VHA staff perceptions of how Veterans' eligibility for VA and other payment impacts NH referrals within VA Medical Centers (VAMCs). Thirty-five semistructured interviews were performed with discharge planning and contracting staff from 12 VAMCs from around the country...
January 1, 2017: Research on Aging
https://www.readbyqxmd.com/read/28899221/predictors-of-prolongation-in-radiation-treatment-time-in-a-veteran-population-treated-with-chemoradiation-for-oropharyngeal-cancer
#16
Andrew M Vahabzadeh-Hagh, Jean-Claude M Rwigema, Vishad Nabili, Marilene B Wang, William C Lorentz
BACKGROUND: Prolonged radiation treatment time (RTT) is associated with worse tumor control. Here we identify and determine the implications of factors that predict treatment prolongation in Veterans Affairs (VA) patients undergoing chemoradiation. METHODS: Chart review from July 2000 to October 2013. 81 patients with advanced stage oropharyngeal cancer treated with chemoradiation. RESULTS: Twenty-nine patients (35.8%) had RTT prolonged by ≥10 days...
September 12, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28892409/changes-in-the-delivery-of-veterans-affairs-cancer-care-ensuring-delivery-of-coordinated-quality-cancer-care-in-a-time-of-uncertainty
#17
Leah L Zullig, Karen M Goldstein, Hayden B Bosworth
No abstract text is available yet for this article.
September 11, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28891777/hypnosis-for-smoking-relapse-prevention-a-randomized-trial
#18
Timothy P Carmody, Carol L Duncan, Sharon N Solkowitz, Joy Huggins, Joel A Simon
The purpose of this study was to determine whether hypnosis would be more effective than standard behavioral counseling in helping smokers to remain abstinent. A total of 140 current smokers were enrolled in a randomized controlled smoking cessation trial at an urban Veterans Affairs medical center. Participants (n = 102) who were able to quit for at least 3 days received either a hypnosis or behavioral relapse prevention intervention. Both relapse prevention interventions consisted of two 60 min face-to-face sessions and four 20 min follow-up phone calls (two phone calls per week)...
October 2017: American Journal of Clinical Hypnosis
https://www.readbyqxmd.com/read/28891153/a-randomized-trial-of-off-site-collaborative-care-for-depression-in-chronic-hepatitis-c-virus
#19
Fasiha Kanwal, Jeffrey M Pyne, Shahriar Tavakoli-Tabasi, Susan Nicholson, Brian Dieckgraefe, Erma Storay, Matthew Bidwell Goetz, Jennifer R Kramer, Donna Smith, Shubhada Sansgiry, Aylin Tansel, Allen L Gifford, Steven M Asch
OBJECTIVE: To test the effectiveness of a collaborative depression care model in improving depression and hepatitis C virus (HCV) care. DATA SOURCES/STUDY SETTING: Hepatitis C virus clinic patients who screened positive for depression at four Veterans Affairs Hospitals. STUDY DESIGN: We compared off-site depression collaborative care (delivered by depression care manager, pharmacist, and psychiatrist) with usual care in a randomized trial...
September 11, 2017: Health Services Research
https://www.readbyqxmd.com/read/28887168/hcv-eradication-induced-by-direct-acting-antiviral-agents-reduces-the-risk-of-hepatocellular-carcinoma
#20
George N Ioannou, Pamela K Green, Kristin Berry
BACKGROUND AND AIMS: It is unclear whether direct-acting antiviral (DAA) treatment-induced sustained virologic response (SVR) reduces the risk of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV) infection. We aimed to determine the impact of DAA-induced SVR on HCC risk. METHODS: We identified 62,354 patients who initiated antiviral treatment in the Veterans Affairs (VA) national healthcare system from 1/1/1999 to 12/31/2015, including 35,871 (58%) interferon-only regimens, 4535 (7...
September 5, 2017: Journal of Hepatology
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