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https://www.readbyqxmd.com/read/27909877/association-between-mental-health-staffing-level-and-primary-care-mental-health-integration-level-on-provision-of-depression-care-in-veteran-s-affairs-medical-facilities
#1
Denise C Cooper, Christian D Helfrich, Stephen M Thielke, Ranak B Trivedi, Karin M Nelson, Gayle E Reiber, Evercita C Eugenio, Kristine Beaver, Julie Nugent-Carney, Vincent S Fan
We examined the association of mental health staffing and the utilization of primary care/mental health integration (PCMHI) with facility-level variations in adequacy of psychotherapy and antidepressants received by Veterans with new, recurrent, and chronic depression. Greater likelihood of adequate psychotherapy was associated with increased (1) PCMHI utilization by recurrent depression patients (AOR 1.02; 95% CI 1.00, 1.03); and (2) staffing for recurrent (AOR 1.03; 95% CI 1.01, 1.06) and chronic (AOR 1.02; 95% CI 1...
December 1, 2016: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/27909492/a-comparison-between-dabigatran-and-warfarin-on-time-to-elective-cardioversion
#2
Amanda N Basto PharmD, Nathan P Fewel PharmD, Rajiv Gupta Md, Eileen M Stock PhD, Mia Ta PharmD
OBJECTIVE: To evaluate the use of dabigatran versus warfarin on time to elective direct current cardioversion (DCCV). METHODOLOGY: This retrospective observational study was conducted at a single Veterans Affairs hospital in the Southwestern region of the U.S. Patients with atrial fibrillation or atrial flutter who were initiated on either warfarin or dabigatran prior to DCCV were reviewed. The time to cardioversion was compared between warfarin and dabigatran, as well as costs of therapy, rescheduling rates, and adverse events...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27907919/the-impact-of-health-care-appointment-non-adherence-on-graft-outcomes-in-kidney-transplantation
#3
David J Taber, James N Fleming, Cory E Fominaya, Mulugeta Gebregziabher, Kelly J Hunt, Titte R Srinivas, Prabhakar K Baliga, John W McGillicuddy, Leonard E Egede
BACKGROUND: Non-adherence to medication is a well-studied and known cause of late allograft loss, but it is difficult to measure and prospectively monitor. The aim of this study was to assess if appointment non-adherence was correlated with medication non-adherence and a predictor of graft outcomes. METHODS: This was a longitudinal cohort study that used the National United States Renal Data System and veterans affairs health records data with time-to-event analyses conducted to assess the impact on graft and patient survival...
December 2, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27906862/correlational-study-of-diabetic-retinopathy-and-hearing-loss
#4
Caroline Ooley, Weon Jun, Kim Le, Allen Kim, Nathan Rock, Molly Cardenal, Rebecca Kline, Drew Aldrich, John Hayes
PURPOSE: Our research goal was to complete a retrospective chart review to determine if there is a correlation between the level of diabetic retinopathy and diabetic neurosensory hearing loss. METHODS: A retrospective analysis of 175 Department of Veterans Affairs Computerized Patient Record System charts was completed at the VA Portland Health Care System. Subjects were classified by degree of diabetic retinopathy as follows: no diabetic retinopathy (n = 80), mild nonproliferative diabetic retinopathy (n = 51), moderate nonproliferative diabetic retinopathy (n = 25), and combined severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy (PDR) (n = 17)...
November 30, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#5
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27902814/trends-in-surgical-treatment-of-breast-cancer-in-the-veterans-affairs-system
#6
Tyler A Evans, Stephen Duquette, Tahereh Soleimani, Luisa F Christensen, Imtiaz Munshi, Adam Cohen, Sunil S Tholpady
No abstract text is available yet for this article.
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27901559/extension-of-the-presumptive-period-for-compensation-for-gulf-war-veterans-interim-final-rule
#7
(no author information available yet)
The Department of Veterans Affairs (VA) is issuing this interim final rule to amend its adjudication regulations regarding compensation for disabilities resulting from undiagnosed illnesses suffered by veterans who served in the Persian Gulf War. This amendment is necessary to extend the presumptive period for qualifying chronic disabilities resulting from undiagnosed illnesses that must become manifest to a compensable degree in order that entitlement for compensation be established. The intended effect of this amendment is to provide consistency in VA adjudication policy and preserve certain rights afforded to Persian Gulf War veterans and ensure fairness for current and future Persian Gulf War veterans...
October 17, 2016: Federal Register
https://www.readbyqxmd.com/read/27900751/-reflection-on-the-differences-and-similarities-of-mental-health-care-in-virginia-and-taiwan-geography-history-culture-and-nurse-practitioners
#8
Chueh-Fen Lu, Ching-Chuan Tung, Linda Ely
Sponsored by the pilot overseas internships project of the Ministry of Education, Taiwan, the authors and ten undergraduate students from Taiwan visited several mental health facilities in Virginia for one month. These facilities included the Catawba State Hospital, Salem Veteran Affairs Medical Center, Carilion Saint Albans Behavioral Health (New River Valley Medical Center), Warm Hearth Village, Adult & Child Family Counseling private outpatient clinic, the Free Clinic of the New River Valley, New Life Clubhouse, and Self-Government Program for Assertive Community Treatment...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27898996/calcium-pyrophosphate-deposition-disease-and-associated-medical-co-morbidities-a-national-cross-sectional-study-of-us-veterans
#9
Crystal Kleiber Balderrama, Ann K Rosenthal, Daniel Lans, Jasvinder A Singh, Christie M Bartels
OBJECTIVE: Calcium pyrophosphate crystal deposition disease (CPDD) is a common cause of acute and chronic arthritis, yet there are few large epidemiologic studies of CPDD. We sought to characterize CPDD in the national Veterans Affairs (VA) population. METHODS: Patients with International Classification of Diseases, ninth revision (ICD-9) codes for CPDD seen at any VA medical center from 2010 through 2014 were matched by age and gender with control patients without CPDD, using data from the Department of Veterans Affairs Corporate Data Warehouse...
November 29, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27898166/neither-10-nor-14-day-sequential-treatment-is-better-than-standard-triple-therapy-for-helicobacter-pylori-eradication
#10
Emanuel Warrington, Orlando López-Román, Rafael Tirado Montijo, Rafael Urbina, Marcia Cruz-Correa, Doris H Toro
OBJECTIVE: Helicobacter pylori is a bacterial pathogen associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa associated lymphoid tissue lymphoma. Current treatment guidelines support a 7- to 14-day, triple-drug protocol consisting of a proton-pump inhibitor (PPI), clarithromycin, and either amoxicillin or an imidazole. The initial eradication rates for this regimen were 80 to 90%. Nevertheless its effectiveness has declined as the antibiotic resistance to clarithromycin and metronidazole has emerged...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27898159/interagency-partnership-to-deliver-veteran-directed-home-and-community-based-services-interviews-with-aging-and-disability-network-agency-personnel-regarding-their-experience-with-partner-department-of-veterans-affairs-medical-centers
#11
Kali S Thomas, Susan M Allen
Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed...
2016: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/27898153/postconcussive-symptom-overreporting-in-iraq-afghanistan-veterans-with-mild-traumatic-brain-injury
#12
Sarah M Jurick, Elizabeth W Twamley, Laura D Crocker, Chelsea C Hays, Henry J Orff, Shahrokh Golshan, Amy J Jak
A comprehensive evaluation, including the assessment of neurobehavioral symptoms, has been instituted at the Department of Veterans Affairs (VA) healthcare system to address the large number of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans returning with mild traumatic brain injuries (mTBIs). The Validity-10 is measure of symptom overreporting embedded within the Neurobehavioral Symptom Inventory, a component of the comprehensive evaluation that assesses postconcussive symptom severity...
2016: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/27894058/a-non-inferiority-trial-of-prolonged-exposure-for-posttraumatic-stress-disorder-in-person-versus-home-based-telehealth
#13
Ron Acierno, Rebecca Knapp, Peter Tuerk, Amanda K Gilmore, Carl Lejuez, Kenneth Ruggiero, Wendy Muzzy, Leonard Egede, Melba A Hernandez-Tejada, Edna B Foa
This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up...
November 22, 2016: Behaviour Research and Therapy
https://www.readbyqxmd.com/read/27893045/association-of-3-different-antihypertensive-medications-with-hip-and-pelvic-fracture-risk-in-older-adults-secondary-analysis-of-a-randomized-clinical-trial
#14
Rachel Puttnam, Barry R Davis, Sara L Pressel, Paul K Whelton, William C Cushman, Gail T Louis, Karen L Margolis, Suzanne Oparil, Jeffrey Williamson, Alokananda Ghosh, Paula T Einhorn, Joshua I Barzilay
Importance: On the basis of observational studies, the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Data from randomized clinical trials are lacking. Objective: To examine whether the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Design, Setting, and Participants: Using Veterans Affairs and Medicare claims data, this study examined hip and pelvic fracture hospitalizations in Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial participants randomized to first-step therapy with a thiazide-type diuretic (chlorthalidone), a calcium channel blocker (amlodipine besylate), or an angiotensin-converting enzyme inhibitor (lisinopril)...
November 21, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27893030/development-and-initial-validation-of-the-risk-analysis-index-for-measuring-frailty-in-surgical-populations
#15
Daniel E Hall, Shipra Arya, Kendra K Schmid, Casey Blaser, Mark A Carlson, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason Johanning
Importance: Growing consensus suggests that frailty-associated risks should inform shared surgical decision making. However, it is not clear how best to screen for frailty in preoperative surgical populations. Objective: To develop and validate the Risk Analysis Index (RAI), a 14-item instrument used to measure surgical frailty. It can be calculated prospectively (RAI-C), using a clinical questionnaire, or retrospectively (RAI-A), using variables from the surgical quality improvement databases (Veterans Affairs or American College of Surgeons National Surgical Quality Improvement Projects)...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27891527/the-multimorbidity-index-a-tool-for-assessing-the-prognosis-of-patients-from-their-history-of-illness
#16
Farrokh Alemi, Cari R Levy, Raya E Kheirbek
BACKGROUND: The Multimorbidity (MM) Index predicts the prognosis of patients from their diagnostic history. In contrast to existing approaches with broad diagnostic categories, it treats each diagnosis as a separate independent variable using individual International Classification of Disease, Revision 9 (ICD-9) codes. OBJECTIVE: This paper describes the MM Index, reviews the published data on its accuracy, and provides procedures for implementing the Index within electronic health record (EHR) systems...
2016: EGEMS
https://www.readbyqxmd.com/read/27882837/determining-multiple-sclerosis-phenotype-from-electronic-medical-records
#17
Richard E Nelson, Jorie Butler, Joanne LaFleur, Kristin Knippenberg, Aaron W C Kamauu, Scott L DuVall
BACKGROUND: Multiple sclerosis (MS), a central nervous system disease in which nerve signals are disrupted by scarring and demyelination, is classified into phenotypes depending on the patterns of cognitive or physical impairment progression: relapsing-remitting MS (RRMS), primary-progressive MS (PPMS), secondary-progressive MS (SPMS), or progressive-relapsing MS (PRMS). The phenotype is important in managing the disease and determining appropriate treatment. The ICD-9-CM code 340.0 is uninformative about MS phenotype, which increases the difficulty of studying the effects of phenotype on disease...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27881692/monitoring-of-urate-lowering-therapy-among-us-veterans-following-the-2012-american-college-of-rheumatology-guidelines-for-management-of-gout
#18
Jonathan C Hughes, Jessica L Wallace, Candace L Bryant, Brent E Salvig, T Neal Fourakre, William J Stone
BACKGROUND: With the prevalence of and hospitalizations for gout increasing, optimizing care for patients with gout is imperative. The 2012 American College of Rheumatology gout guidelines emphasize that timely monitoring is key to achieving serum urate (SUA) goals. Few studies have examined this metric following the 2012 update, and to our knowledge, none have examined a veteran population. OBJECTIVE: To evaluate adherence to urate-lowering therapy (ULT) monitoring guidelines in a veteran population...
November 22, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27880088/lectio-divina-a-preliminary-evaluation-of-a-chaplaincy-program
#19
Marek S Kopacz, Mary S Adams, Robert F Searle
This participant outcome evaluation serves as a preliminary investigation into the effects of lectio divina, a chaplaincy service representing a form of focused Scripture reading. A sample of n = 19 patients who participated in this service at a Department of Veterans Affairs Medical Center in upstate New York was screened at baseline and 30-days follow-up using the Duke University Religion Index, Berg Spiritual Injury Scale, and a screening question for thoughts of harming self or others. These measures were used to assess the intended outcomes of enhanced religiosity, ameliorated spiritual injury, and decreased thoughts of violence...
November 23, 2016: Journal of Health Care Chaplaincy
https://www.readbyqxmd.com/read/27880003/association-of-multimorbidity-with-mortality-and-healthcare-utilization-in-chronic-kidney-disease
#20
C Barrett Bowling, Laura Plantinga, Lawrence S Phillips, William McClellan, Katharina Echt, Neale Chumbler, Gerald McGwin, Ann Vandenberg, Richard M Allman, Theodore M Johnson
OBJECTIVES: Chronic kidney disease (CKD) almost universally occurs in individuals with other medical problems. However, few studies have described CKD-related multimorbidity using a framework that identifies chronic conditions as concordant (having overlap in treatment goals) versus discordant (having opposing treatment recommendations) and unrelated (having no overlap, but contributing to complexity via different resource requirements). DESIGN: Retrospective cohort...
November 23, 2016: Journal of the American Geriatrics Society
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