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Veterans affairs

J T Nelson, A A Swan, B Swiger, M Packer, M J Pugh
Hearing loss is the second most common disability awarded by the U.S. Department of Veterans Affairs (VA) to former members of the U.S. uniformed services. Hearing readiness and conservation practices differ among the four largest uniformed military services (Air Force, Army, Marine Corps, and Navy). Utilizing a data set consisting of all hearing loss claims submitted to the VA from fiscal years 2003-2013, we examined characteristics of veterans submitting claims within one year of separation from military service...
October 18, 2016: Hearing Research
Juliet Shih, Heather Leutwyler, Christine Ritchie, Steven M Paul, Jon D Levine, Bruce Cooper, Fay Wright, Yvette P Conley, Christine Miaskowski
PURPOSE: Between 14 and 85 % of patients report noticeable changes in cognitive function during chemotherapy (CTX). The purposes of this study were to determine which demographic, clinical, and symptom characteristics were associated with inter-individual variability in initial levels of attentional function as well as with changes in the trajectories of attentional function in a sample of oncology patients who received two cycles of CTX. METHODS: Oncology outpatients (n = 1329) were recruited from two comprehensive cancer centers, one veteran's affairs hospital, and four community-based oncology programs...
October 20, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Aoife O'Donovan, Ashkan J Ahmadian, Thomas C Neylan, Mark A Pacult, Donald Edmondson, Beth E Cohen
[OBJECTIVE]: Elevated inflammation has been repeatedly observed in posttraumatic stress disorder (PTSD), and it may drive the development of both psychiatric symptoms and physical comorbidities. However, it is not clear if elevated inflammation is a feature of both remitted and current PTSD, and little is known about relationships between specific clusters of PTSD symptoms and inflammation. Exaggerated threat sensitivity, as indexed by threat reactivity and avoidance of perceived threats, may be particularly closely associated with inflammation...
October 17, 2016: Brain, Behavior, and Immunity
Lisa M James, Brian E Engdahl, Arthur C Leuthold, Apostolos P Georgopoulos
BACKGROUND: We recently reported that six alleles from class II genes of the Human Leukocyte Antigen (HLA) confer protection from Gulf War Illness (GWI) (Georgopoulos et al., 2015). The most significant effect is exerted on Neurological-Cognitive-Mood (NCM), Pain, and Fatigue symptoms, such that higher number of copies of the protective alleles are associated with lower symptom severity. Here we tested the hypothesis that this effect is exerted by modulating the strength of neural synchronicity...
October 14, 2016: EBioMedicine
Linda Resnik, Sarah Ekerholm, Erin E Johnson, Marsha L Ellison, Thomas P O'Toole
OBJECTIVE: Veterans Affairs (VA) is expanding peer support. Research is limited on Veterans' perspective on benefits from peer services. We describe homeless Veteran perceptions of value and examine characteristics associated with benefit. METHOD: From a sample of Veterans in a multisite randomized control trial, we studied addition of peers in VA Primary Care and homeless-oriented primary care clinics. We used qualitative methods to study the perceptions of peer services among a subsample of homeless Veterans...
October 20, 2016: Journal of Clinical Psychology
Nabeel Khan, Dhruvan Patel, Yash Shah, Yu-Xiao Yang
BACKGROUND: Iron deficiency anemia (IDA) is an often unrecognized and undertreated complication of ulcerative colitis (UC). We conducted the first nationwide study in the United States to evaluate the prevalence of testing for iron deficiency (ID) in anemic UC patients and determine the frequency of treatment with iron supplementation in patients with IDA. METHODS: Nationwide cohort of patients with newly diagnosed UC in the Veterans Affairs health care system was identified...
October 18, 2016: Inflammatory Bowel Diseases
Swati Lederer, Michael J Fischer, Howard S Gordon, Anuradha Wadhwa, Subhash Popli, Elisa J Gordon
BACKGROUND: Patients with chronic kidney disease (CKD) commonly have unmet information needs. Greater patient participation in healthcare discussions can address these needs and improve health outcomes. We developed a patient-centered question prompt sheet (QPS) to engage CKD patients in healthcare conversations. METHODS: We conducted a two phase, mixed-methods, cross-sectional study involving semi-structured telephone interviews. Patients with an estimated glomerular filtration rate (eGFR) <60 ml/min/1...
October 19, 2016: BMC Nephrology
Stephen Duquette, Ryan Kuster, Tyler Evans, William Wooden, Imtiaz Munshi, Adam Cohen, Sunil S Tholpady
No abstract text is available yet for this article.
October 19, 2016: JAMA Surgery
Nirav Patel, Justine Pierson, Timothy Lee, Bruce Mast, Bernard T Lee, Irene Estores, Dhruv Singhal
BACKGROUND: Integrative medicine (IM) is currently used by 40% of Americans. Our objective is to examine the prevalence and perception of IM utilization in patients being evaluated for elective plastic surgery. METHODS: In July 2014, 402 consecutive patients presenting to plastic surgery clinics at the University of Florida, Veterans Affairs (VA), and Private Practices in Gainesville, Florida were requested to complete a survey regarding utilization of and attitudes towards IM...
October 17, 2016: Annals of Plastic Surgery
Marianne H Gillam, Nicole L Pratt, Maria C S Inacio, Elizabeth E Roughead, Sepehr Shakib, Stephen J Nicholls, Stephen E Graves
Background and purpose - It is unclear whether metal particles and ions produced by mechanical wear and corrosion of hip prostheses with metal-on-metal (MoM) bearings have systemic adverse effects on health. We compared the risk of heart failure in patients with conventional MoM total hip arthroplasty (THA) and in those with metal-on-polyethylene (MoP) THA. Patients and methods - We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs health claims database on patients who received conventional THA for osteoarthritis between 2004 and 2012...
October 19, 2016: Acta Orthopaedica
Christine Anne Ganzer
: A review of recent research and its relevance for nurses in all settings. ABSTRACT: The last two decades have seen increasing numbers of women entering all branches of the U.S. armed forces. Now that women in the military are no longer prohibited from holding direct combat positions, they are often exposed to traumatic events that place them at higher risk for mental health conditions. Nurses working within the Veterans Affairs (VA) system and those working in non-VA settings are likely to encounter female veterans...
October 13, 2016: American Journal of Nursing
Peter Kokkinos, Narayan Puneet, Tsimploulis Apostolos, Doumas Michael, Pittaras Andreas, Faselis Charles, Myers Jonathan
OBJECTIVE: Hypertension is one of the most common risk factors for congestive heart failure (CHF). Evidence suggests that increased fitness may attenuate the risk for CHF in the general population. However, the association between fitness and CHF incidence in hypertensive patients has not been assessed. DESIGN AND METHOD: A total of 8,725 hypertensive men (mean age 60 ± 10) from Washington DC and Palo Alto Veterans Affairs Medical Centers underwent routine exercise tolerance testing...
September 2016: Journal of Hypertension
Apostolos Tsimploulis, Michael Doumas, Andreas Pittaras, Charles Faselis, Jonathan Myers, Peter Kokkinos
OBJECTIVE: Chronological aging in healthy subjects is associated with declines in muscle mass, strength, endurance, and aerobic fitness. Older individuals respond favorably to exercise, suggesting that physical inactivity plays an important role in age-related dysfunctions. Conversely, physical activity and improved exercise capacity is associated with lower mortality risk in hypertensive individuals. However, the impact of increased exercise capacity in older hypertensive individuals has not been investigated extensively...
September 2016: Journal of Hypertension
Nora T Oliver, Christine M Hartman, Jennifer R Kramer, Elizabeth Y Chiao
INTRODUCTION: Chronic HIV/hepatitis C virus (HCV) coinfection carries increased risk of cirrhosis, hepatocellular carcinoma, and death. Due to anti-inflammatory properties, 3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) inhibitors (statins) may be useful adjunctive therapy to reduce liver disease progression. METHODS: Clinical information was extracted from the Veterans Affairs HIV and HCV Clinical Case Registries (1999-2010). HIV-related variables included combination antiretroviral therapy era of diagnosis, CD4 cell count, and percentage time with undetectable HIV viral load...
October 23, 2016: AIDS
Stephen Metraux, Dan Treglia, Thomas P O'Toole
We examined migration patterns among 113,400 homeless veterans, focusing on the prevalence and the basic geographic patterns of this migration. Data were for all veterans who initiated use of Veterans Affairs homeless services in 2011 or 2012; and we followed them using Veterans Affairs administrative records for up to 2 years following this initial contact. Results showed that 15.3% of the veterans migrated across regions while homeless. Those who were homeless for longer periods were more likely to migrate, and migration, were it to occur, was most likely earlier on in veterans' homelessness episodes...
October 2016: Military Medicine
Shahbaz R Arain, Julie K Freed, Jutta Novalija, Paul S Pagel, Thomas J Ebert
OBJECTIVE: The mechanism of perioperative hypotension in patients taking an angiotensin-receptor blocker up to the time of surgery remains unclear. This study tested the hypothesis that short-term angiotensin-receptor blocker treatment attenuated the sympathetic and vascular responses to autonomic stimuli in volunteers undergoing anesthesia. DESIGN: Randomized, crossover, blinded, pilot design. SETTING: Zablocki Veterans Affairs Medical Center, Milwaukee, WI...
August 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Nancy J Carballo, Cathy A Alessi, Jennifer L Martin, Michael N Mitchell, Ron D Hays, Nananda Col, Emily S Patterson, Stella Jouldjian, Karen Josephson, Constance H Fung
PURPOSE: Obstructive sleep apnea is a prevalent sleep disorder among older adults. Oral appliances are increasingly prescribed as therapy for obstructive sleep apnea. Adherence to oral appliance therapy is highly variable. Based on value-expectancy theory and other social-psychological theories, adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. We examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy...
October 14, 2016: Clinical Therapeutics
Raya Elfadel Kheirbek, Janusz Wojtusiak, Sorina O Vlaicu, Farrokh Alemi
BACKGROUND: Heart failure is the leading cause for 30-day all-cause readmission. Although racial disparities in health care are well documented, their impact on 30-day all-cause readmission rate is inconclusive. OBJECTIVE: We examined the impact of racial disparity on 30-day readmission for hospitalized patients with heart failure. METHODS: This is a retrospective secondary data analysis for a large veteran cohort in 130 Veterans Affairs Medical Centers...
October 2016: Quality Management in Health Care
Anthony Razzak, Dineen Smith, Maliha Zahid, Georgios Papachristou, Asif Khalid
Background and aims: Adenoma detection rate (ADR) and cecal withdrawal time (CWT) have been identified as measures of colonoscopy quality. This study evaluates the impact of monitoring these measures on provider performance. Methods: Six blinded gastroenterologists practicing at a Veterans Affairs Medical Center were prospectively monitored over 9 months. Data for screening, adenoma surveillance, and fecal occult blood test positive (FOBT +) indicated colonoscopies were obtained, including exam preparation quality, cecal intubation rate, CWT, ADR, adenomas per colonoscopy (APC), and adverse events...
October 2016: Endoscopy International Open
Craig S Rosen, Kathryn J Azevedo, Quyen Q Tiet, Carolyn J Greene, Amanda E Wood, Patrick Calhoun, Thomas Bowe, Bruce P Capehart, Eric F Crawford, Mark A Greenbaum, Alex H S Harris, Michael Hertzberg, Steven E Lindley, Brandy N Smith, Paula P Schnurr
OBJECTIVE: This study assessed whether adding telephone care management to usual outpatient mental health care improved treatment attendance, medication compliance, and clinical outcomes of veterans with posttraumatic stress disorder (PTSD). METHODS: In a multisite randomized controlled trial, 358 veterans were assigned to either usual outpatient mental health treatment (N=165) or usual care plus twice-a-month telephone care management (TCM) and support in the first three months of treatment (N=193)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
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