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Veterans affairs

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https://www.readbyqxmd.com/read/28806817/the-effects-of-cannabis-among-adults-with-chronic-pain-and-an-overview-of-general-harms-a-systematic-review
#1
Shannon M Nugent, Benjamin J Morasco, Maya E O'Neil, Michele Freeman, Allison Low, Karli Kondo, Camille Elven, Bernadette Zakher, Makalapua Motu'apuaka, Robin Paynter, Devan Kansagara
Background: Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain. Purpose: To review the benefits of plant-based cannabis preparations for treating chronic pain in adults and the harms of cannabis use in chronic pain and general adult populations. Data Sources: MEDLINE, Cochrane Database of Systematic Reviews, and several other sources from database inception to March 2017. Study Selection: Intervention trials and observational studies, published in English, involving adults using plant-based cannabis preparations that reported pain, quality of life, or adverse effect outcomes...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28806794/benefits-and-harms-of-plant-based-cannabis-for-posttraumatic-stress-disorder-a-systematic-review
#2
Maya E O'Neil, Shannon M Nugent, Benjamin J Morasco, Michele Freeman, Allison Low, Karli Kondo, Bernadette Zakher, Camille Elven, Makalapua Motu'apuaka, Robin Paynter, Devan Kansagara
Background: Cannabis is available from medical dispensaries for treating posttraumatic stress disorder (PTSD) in many states of the union, yet its efficacy in treating PTSD symptoms remains uncertain. Purpose: To identify ongoing studies and review existing evidence regarding the benefits and harms of plant-based cannabis preparations in treating PTSD in adults. Data Sources: MEDLINE, the Cochrane Library, and other sources from database inception to March 2017...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28806372/exploring-rural-disparities-in-medical-diagnoses-among-veterans-with-transgender-related-diagnoses-utilizing-veterans-health-administration-care
#3
Leigh A Bukowski, John Blosnich, Jillian C Shipherd, Michael R Kauth, George R Brown, Adam J Gordon
OBJECTIVES: Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806369/intimate-partner-violence-victimization-and-associated-implications-for-health-and-functioning-among-male-and-female-post-9-11-veterans
#4
Katherine M Iverson, Dawne Vogt, Rachel M Maskin, Brian N Smith
BACKGROUND: There is increased emphasis on identifying patients who experience intimate partner violence (IPV) in Department of Veterans Affairs and other health care settings. A better understanding of IPV's implications for health and functioning is needed among post-911 Veterans, and especially male Veterans, to inform IPV screening and response. OBJECTIVES: To identify past 6-month IPV experienced among partnered post-9/11 Veterans and examine sex-based associations between IPV and health...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806365/associations-between-perceived-race-based-discrimination-and-contraceptive-use-among-women-veterans-in-the-ecuun-study
#5
Serena MacDonald, Leslie R M Hausmann, Florentina E Sileanu, Xinhua Zhao, Maria K Mor, Sonya Borrero
OBJECTIVE: To describe perceived race-based discrimination in Veterans Affairs (VA) health care settings and assess its associations with contraceptive use among a sample of women Veterans. METHODOLOGY: This study used data from a national telephone survey of women Veterans aged 18-44 receiving health care in VA who were at risk of unintended pregnancy. Participants were asked about their perceptions of race-based discrimination while seeking VA health care and about their contraceptive use at last heterosexual intercourse...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28805419/creating-space-for-relationships
#6
Susan L Maataoui, Jodi S Hardwick, Tessa S Lundquist
Sexuality is a key component of personality and behavior, encompassing basic human needs for touch, intimacy, love, affection, and sexual behavior. The design of long-term care facilities makes it almost impossible for a resident to be sexually intimate, to share romantic moments, or to have a meal in a private setting. This case study describes the rationale and process used to establish a private guestroom called the Family Room at Patriots Place, the specialized dementia unit in the Veterans Affairs (VA) Maine Healthcare System Community Living Center (CLC)...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805416/identifying-barriers-to-culture-change-a-qualitative-analysis-of-the-obstacles-to-delivering-resident-centered-care
#7
Ryann L Engle, Denise A Tyler, Katelyn E Gormley, Melissa K Afable, Kimberly Curyto, Omonyêlé L Adjognon, Victoria A Parker, Jennifer L Sullivan
A growing number of healthcare organizations have moved from traditional, institutional nursing home models to ones that emphasize culture change, or resident-centered care (RCC). In 2006, the Department of Veterans Affairs (VA) began implementing a number of changes to VA nursing homes, now called Community Living Centers (CLCs), to provide veterans with a more resident-centered and homelike environment. This study aimed to understand the barriers CLC staff face when delivering RCC. Ten CLCs were included on the basis of their performance levels on RCC and quality of care...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805414/a-culturally-adapted-family-intervention-for-rural-pacific-island-veterans-with-ptsd
#8
Julia M Whealin, Athena C Yoneda, Dawna Nelson, Todd S Hilmes, Michelle M Kawasaki, Oscar H Yan
The Veterans Affairs mission to provide equitable, accessible, and patient-centered care necessitates that culturally appropriate interventions are available when cultural differences may jeopardize engagement in care. However, within the VA, wounded warriors residing in rural areas in the Pacific Islands have been offered interventions that were developed and tested using largely urban mainland populations. The objectives of this article were to (a) document the cultural adaptation of a cognitive-behavioral clinical intervention for use by rural Pacific Island veterans, and (b) report feasibility data for the intervention...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805412/factors-impacting-rural-pacific-island-veterans-access-to-care-a-qualitative-examination
#9
Julia M Whealin, Dawna Nelson, Michelle M Kawasaki, Michael A Mahoney
Pacific Island veterans suffer from greater severity of posttraumatic stress disorder (PTSD) compared with Caucasian veterans but face substantial barriers to mental health care. However, the factors that may dissuade or facilitate veterans in the Pacific Islands from seeking mental health care are not known. The main aim of this study was to identify how internal and external factors interact to impact wounded warriors' access to and use of mental health services. Veterans residing in 5 rural Pacific Island locations were mailed recruitment materials...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805411/rural-american-indian-and-alaska-native-veterans-telemental-health-a-model-of-culturally-centered-care
#10
Cynthia W Goss, W J Buck Richardson, Nancy Dailey, Byron Bair, Herbert Nagamoto, Spero M Manson, Jay H Shore
American Indian and Alaska Native (AI/AN) veterans living in rural areas have unique health care needs and face numerous barriers to accessing health care services. Among these needs is a disproportionate prevalence of posttraumatic stress disorder and other mental illnesses. Since 2001, 14 rural communities have partnered with the U.S. Department of Veterans Affairs and the Centers for American Indian and Alaska Native Health at the University of Colorado Anschutz Medical Campus to extend telemental health clinics to American Indian veterans...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805357/schedule-for-rating-disabilities-dental-and-oral-conditions-final-rule
#11
(no author information available yet)
This document amends the Department of Veterans Affairs (VA) Schedule for Rating Disabilities by revising the portion of the schedule that addresses dental and oral conditions. The effect of this action is to ensure that the rating schedule uses current medical terminology and to provide detailed and updated criteria for evaluation of dental and oral conditions for disability rating purposes.
August 3, 2017: Federal Register
https://www.readbyqxmd.com/read/28805309/safety-of-herpes-zoster-vaccination-among-inflammatory-bowel-disease-patients-being-treated-with-anti-tnf-medications
#12
N Khan, Y Shah, C Trivedi, J D Lewis
BACKGROUND: The risk of herpes zoster (HZ) is elevated in inflammatory bowel disease (IBD) patients treated with anti-TNF medications. While it is optimal to give herpes zoster vaccine prior to initiation of therapy clinical circumstances may not always allow this. AIM: To determine the safety of giving herpes zoster vaccine while patients are on anti-TNF therapy. METHODS: We conducted a retrospective cohort study involving IBD patients who were followed in the Veterans Affairs (VA) healthcare system between 2001 and 2016...
August 14, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#13
Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton
OBJECTIVES: To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN: Randomized clinical trial. SETTING: Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS: Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128)...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28803927/clinical-implications-of-the-limited-relationship-of-voltage-criteria-for-electrocardiogram-left-ventricular-hypertrophy-to-cardiovascular-mortality
#14
Le Dung Ha, Ayman Elbadawi, Victor F Froelicher
BACKGROUND: Numerous methods have been proposed for diagnosing left ventricular hypertrophy using the electrocardiogram. They have limited sensitivity for recognizing pathological hypertrophy at least in part due to their inability to distinguish pathological from physiological hypertrophy. Our objective is to compare the major electrocardiogram - left ventricular hypertrophy criteria using cardiovascular mortality as a surrogate for pathological hypertrophy. METHODS: This study was a retrospective analysis of 16,253 Veterans less than 56 years of age seen at a large Veteran's Affairs Medical Center from 1987 to 1999 and followed a median of 17...
August 10, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28803840/development-and-validation-of-risk-equations-for-complications-of-type-2-diabetes-recode-using-individual-participant-data-from-randomised-trials
#15
Sanjay Basu, Jeremy B Sussman, Seth A Berkowitz, Rodney A Hayward, John S Yudkin
BACKGROUND: In view of substantial mis-estimation of risks of diabetes complications using existing equations, we sought to develop updated Risk Equations for Complications Of type 2 Diabetes (RECODe). METHODS: To develop and validate these risk equations, we used data from the Action to Control Cardiovascular Risk in Diabetes study (ACCORD, n=9635; 2001-09) and validated the equations for microvascular events using data from the Diabetes Prevention Program Outcomes Study (DPPOS, n=1018; 1996-2001), and for cardiovascular events using data from the Action for Health in Diabetes (Look AHEAD, n=4760; 2001-12)...
August 10, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28801938/factors-in-variability-of-serial-gabapentin-concentrations-in-elderly-patients-with-epilepsy
#16
Jeannine M Conway, Lynn E Eberly, Joseph F Collins, Flavia M Macias, R Eugene Ramsay, Ilo E Leppik, Angela K Birnbaum
OBJECTIVES: To characterize and quantify the variability of serial gabapentin concentrations in elderly patients with epilepsy. METHODS: This study included 83 patients (age ≥60 years) from an 18-center, randomized, double-blind, double dummy, parallel study from the Veterans Affairs Cooperative 428 Study. All patients were taking 1500 mg/day of gabapentin. Within-person coefficient of variation (CV) in gabapentin concentrations, measured weekly to bimonthly for up to 52 weeks, then quarterly, was computed...
August 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28797024/cha2ds2-vasc-score-warfarin-use-and-risk-for-thromboembolic-events-among-hiv-infected-persons-with-atrial-fibrillation
#17
Katherine Hsin-Yu Chau, Rebecca Scherzer, Carl Grunfeld, Priscilla Ying Hsue, Michael G Shlipak
BACKGROUND: The prevalence of atrial fibrillation in the HIV-infected population is growing, but the ability of the CHA2DS2-VASc score to predict thromboembolic (TE) risk is unknown in this population. SETTING: Within the Veterans Affairs HIV Clinical Case Registry, 914 patients had an atrial fibrillation diagnosis between 1997 and 2011 and no previous TE events. METHODS: We compared TE incidence by CHA2DS2-VASc scores and stratified by warfarin use...
September 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28795831/problem-solving-therapy-for-suicide-prevention-in-veterans-with-moderate-to-severe-traumatic-brain-injury
#18
Sean M Barnes, Lindsey L Monteith, Georgia R Gerard, Adam S Hoffberg, Beeta Y Homaifar, Lisa A Brenner
OBJECTIVE: Develop and test the acceptability and feasibility of Problem-Solving Therapy for Suicide Prevention (PST-SP), a group intervention aimed at improving problem solving and preventing suicide, among Veterans with hopelessness and moderate-to-severe traumatic brain injury (TBI). RESEARCH METHOD: Following treatment development, 16 U.S. Veterans with moderate-to-severe TBI and a Beck Hopelessness Scale score ≥4 participated in an acceptability and feasibility pilot study of PST-SP at a Veterans Affairs Medical Center...
August 10, 2017: Rehabilitation Psychology
https://www.readbyqxmd.com/read/28782374/addressing-the-challenges-of-palliative-care-for-homeless-veterans
#19
Evelyn Hutt, Karen Albright, Hannah Dischinger, Mary Weber, Jacqueline Jones, Thomas P O'Toole
BACKGROUND: Veterans who nearing the end of life (EOL) in unstable housing are not adequately served by current palliative care or homeless programs. METHODS: Multidisciplinary focus groups, interviews with community and Veterans Affairs (VA) leaders and with 29 homeless veterans were conducted in five cities. A forum of national palliative and homelessness care leaders (n=5) and representatives from each focus group (n=10), then convened. The forum used Nominal Group Process to suggest improvements in EOL care for veterans without homes...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28772293/speech-language-pathologists-use-of-intelligibility-measures-in-adults-with-dysarthria
#20
Naomi Gurevich, Sydney L Scamihorn
Purpose: Speech-language pathologists (SLPs) who work with adults with dysarthria were surveyed to investigate trends of clinical practice for assessing speech intelligibility. Method: Two hundred ninety-six SLPs responded to an online survey October 22-November 30, 2015. Results: Findings showed that 35% of SLPs lacked access to any standardized assessments of intelligibility, with 66% of these implicating cost as the main reason. Work settings played a role, as all SLPs working in Veterans Affairs hospitals and 97% of SLPs working in university or research clinics reported access to at least one formal assessment...
August 3, 2017: American Journal of Speech-language Pathology
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