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https://www.readbyqxmd.com/read/29457672/gambling-related-cognitive-distortions-predict-level-of-function-among-us-veterans-seeking-treatment-for-gambling-disorders
#1
Steven D Shirk, Megan M Kelly, Shane W Kraus, Marc N Potenza, Kendra Pugh, Christopher Waltrous, Edward Federman, Christopher Krebs, Charles E Drebing
BACKGROUND AND OBJECTIVES: Gambling Disorder (GD) is characterized by recurrent gambling behavior that is associated with significant impairment and distress, high psychiatric comorbidities, and high functional disability. The military veteran population appears particularly susceptible to developing the disorder, but relatively little has been studied among this population. The purpose of the present study is to investigate the clinical psychopathologies and comorbidities of veterans seeking treatment for problem gambling and how problem gambling may impact functioning...
February 19, 2018: American Journal on Addictions
https://www.readbyqxmd.com/read/29456175/metformin-induced-lactic-acidosis-mila-a-case-report-and-review-of-current-diagnostic-paradigm
#2
Lauren Krowl, Hassan Al-Khalisy, Pratibha Kaul
A new diagnostic paradigm has been proposed to better categorize causes of Metformin-Associated Lactic Acidosis (MALA). The diagnostic criteria defines a link between Metformin and lactic acidosis if lactate is >5mmol/L, Ph<7.35 and Metformin assay >5mg/L. Metformin assays are not readily available in emergency departments including nationwide Veteran's Affairs Hospitals; thereby making this proposed classification tool difficult to use in today's clinical practice. We describe a case report of a 45-year-old male, who took twice the amount of Metformin prescribed and presented with Metformin-induced lactic acidosis...
February 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455117/road-traffic-accidents-in-scottish-military-veterans
#3
Beverly P Bergman, Daniel F Mackay, Jill P Pell
Road traffic accidents (RTA) are recognised to be an important cause of death and injury in serving military personnel but little is known about the risk in veterans. We used data from the Scottish Veterans Health Study to examine the risk of RTA in a large national cohort of veterans, in comparison with people who had never served. We conducted a retrospective cohort study of 57,000 veterans and 173,000 non-veterans, followed up for up to 30 years, using survival analysis to compare risk of RTA injury. Subgroup analysis was used to explore trends by birth cohort and length of service...
February 15, 2018: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29453622/cognitive-mediators-of-change-in-physical-functioning-in-response-to-a-multifaceted-intervention-for-managing-osteoarthritis
#4
Shannon Stark Taylor, Eugene Z Oddone, Cynthia J Coffman, Amy S Jeffreys, Hayden B Bosworth, Kelli D Allen
PURPOSE: Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-efficacy, perceived pain control, and pain catastrophizing mediated changes in physical functioning following an osteoarthritis intervention involving weight management, physical activity, and cognitive-behavioral pain management. METHOD: Three hundred Veteran patients of 30 primary care providers with knee and/or hip OA were cluster randomized to an OA intervention group or usual care...
February 16, 2018: International Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/29453610/hepatitis-c-cure-is-associated-with-decreased-healthcare-costs-in-cirrhotics-in-retrospective-veterans-affairs-cohort
#5
Marissa M Maier, Xiao-Hua Zhou, Michael Chapko, Steven L Leipertz, Xuan Wang, Lauren A Beste
BACKGROUND: Approximately 233,898 individuals in the Veterans Affairs healthcare network are hepatitis C virus (HCV)-infected, making the Veterans Affairs the single largest provider of HCV care in the USA. Direct-acting antiviral treatment regimens for HCV offer high cure rates. However, these medications pose an enormous financial burden, and whether HCV cure is associated with decreased healthcare costs is poorly defined. AIMS: To measure downstream healthcare costs in a national population of HCV-infected patients up to 9 years post-HCV antiviral treatment, to compare downstream healthcare costs between cured and uncured patients, and to assess impact of cirrhosis status on cost differences...
February 16, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29453489/fascia-iliaca-blockade-with-the-addition-of-liposomal-bupivacaine-vs-plain-bupivacaine-for-perioperative-pain-management-following-hip-arthroscopy
#6
Richard L Purcell, Kyle E Nappo, Daniel W Griffin, Michael McCabe, Terrence Anderson, Michael Kent
PURPOSE: A newer formulation of bupivacaine, encapsulated within carrier molecules, has garnered attention for its role in providing extended post-operative analgesia. The purpose was to evaluate the addition of liposomal bupivacaine to fascia iliaca blockade during hip arthroscopy. METHODS: Retrospective cohort study of patients undergoing hip arthroscopy with a pre-operative fascia iliaca blockade with either liposomal bupivacaine (Group 1; 266mg + 20 cc 0.5% plain bupivacaine) or bupivacaine (Group 2; 40 cc 0...
February 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29452704/substance-use-disorder-among-current-cancer-patients-rates-and-correlates-nationally-in-the-department-of-veterans-affairs
#7
Pochu Ho, Robert Rosenheck
BACKGROUND: Substance use disorders (SUDs) are known to cause or complicate treatment of many types of cancers. OBJECTIVES: We sought to systematically assess rates of current SUDs among patients currently in treatment for cancer. METHODS: The National Veteran Health Administration administrative data from fiscal year 2012 were used to compare veterans with both cancer and comorbid SUDs to veterans with cancer but no SUDs and those with a SUD but no cancer...
January 10, 2018: Psychosomatics
https://www.readbyqxmd.com/read/29452590/factors-associated-with-persistent-posttraumatic-stress-disorder-among-u-s-military-service-members-and-veterans
#8
Richard F Armenta, Toni Rush, Cynthia A LeardMann, Jeffrey Millegan, Adam Cooper, Charles W Hoge
BACKGROUND: Posttraumatic stress disorder (PTSD) can have long-term and far-reaching impacts on health and social and occupational functioning. This study examined factors associated with persistent PTSD among U.S. service members and veterans. METHODS: Using baseline and follow-up (2001-2013) questionnaire data collected approximately every 3 years from the Millennium Cohort Study, multivariable logistic regression was conducted to determine factors associated with persistent PTSD...
February 17, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29452380/relative-vaccine-effectiveness-of-high-dose-versus-standard-dose-influenza-vaccines-among-veterans-health-administration-patients
#9
Yinong Young-Xu, Robertus Van Aalst, Salaheddin M Mahmud, Kenneth J Rothman, Julia Thornton Snider, Daniel Westreich, Vincent Mor, Stefan Gravenstein, Jason K H Lee, Edward W Thommes, Michael D Decker, Ayman Chit
Background: To examine whether a high-dose inactivated influenza vaccine was more efficacious in preventing hospitalizations than a standard-dose vaccine in the Veterans Health Administration (VHA) senior population. Methods: This study estimated the relative vaccine effectiveness (rVE) of high-dose versus standard-dose using a retrospective cohort of VHA patients 65 years of age or older in the 2015-16 influenza season. To adjust for measured confounders, we matched each high-dose recipient with up to four standard-dose recipients vaccinated at the same location within a two-week period and having two or more pre-existing medical co-morbidities...
February 14, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29451462/prior-authorization-do-insurers-pay-bonuses-for-denying-new-drug-requests
#10
Joseph Burns
A MedPage Today blog post suggested that they do. A torrent of online comments followed. Most were somewhere on the spectrum of outraged. For their part, industry veterans said that they're unaware of bonuses for denials but agree that prior authorization processes should be more transparent.
February 2018: Managed Care
https://www.readbyqxmd.com/read/29451116/population-tailored-care-for-homeless-veterans-and-acute-care-use-cost-and-satisfaction-a-prospective-quasi-experimental-trial
#11
Thomas P O'Toole, Erin E Johnson, Matthew Borgia, Amy Noack, Jean Yoon, Elizabeth Gehlert, Jeanie Lo
INTRODUCTION: Although traditional patient-centered medical homes (PCMHs) are effective for patients with complex needs, it is unclear whether homeless-tailored PCMHs work better for homeless veterans. We examined the impact of enrollment in a Veterans Health Administration (VHA) homeless-tailored PCMH on health services use, cost, and satisfaction compared with enrollment in a traditional, nontailored PCMH. METHODS: We conducted a prospective, multicenter, quasi-experimental, single-blinded study at 2 VHA medical centers to assess health services use, cost, and satisfaction during 12 months among 2 groups of homeless veterans: 1) veterans receiving VHA homeless-tailored primary care (Homeless-Patient Aligned Care Team [H-PACT]) and 2) veterans receiving traditional primary care services (PACT)...
February 15, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29451088/a-marginalized-two-part-model-with-heterogeneous-variance-for-semicontinuous-data
#12
Valerie A Smith, John S Preisser
Semicontinuous data, characterized by a point mass at zero followed by a positive, continuous distribution, arise frequently in medical research. These data are typically analyzed using two-part mixtures that separately model the probability of incurring a positive outcome and the distribution of positive values among those who incur them. In such a conditional specification, however, standard two-part models do not provide a marginal interpretation of covariate effects on the overall population. We have previously proposed a marginalized two-part model that yields more interpretable effect estimates by parameterizing the model in terms of the marginal mean...
January 1, 2018: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29450781/measuring-use-of-evidence-based-psychotherapy-for-posttraumatic-stress-disorder-in-a-large-national-healthcare-system
#13
Shira Maguen, Erin Madden, Olga V Patterson, Scott L DuVall, Lizabeth A Goldstein, Kristine Burkman, Brian Shiner
To derive a method of identifying use of evidence-based psychotherapy (EBP) for post-traumatic stress disorder (PTSD), we used clinical note text from national Veterans Health Administration (VHA) medical records. Using natural language processing, we developed machine-learning algorithms to classify note text on a large scale in an observational study of Iraq and Afghanistan veterans with PTSD and one post-deployment psychotherapy visit by 8/5/15 (N = 255,968). PTSD visits were linked to 8.1 million psychotherapy notes...
February 15, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29450685/reducing-long-term-opioid-use-in-the-veterans-health-administration
#14
EDITORIAL
Taeko Minegishi, Austin Frakt
No abstract text is available yet for this article.
February 15, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29447742/a-comparative-analysis-of-current-lipid-treatment-guidelines-nothing-stands-still
#15
REVIEW
Anjan Tibrewala, Arif Jivan, William J Oetgen, Neil J Stone
Lipid treatment guidelines have continued to evolve as new evidence emerges. We sought to review similarities and differences of 5 lipid treatment guidelines from the American College of Cardiology/American Heart Association, Canadian Cardiovascular Society, European Society for Cardiology/European Atherosclerosis Society, U.S. Preventive Services Task Force, and U.S. Veterans Affairs/Department of Defense. All guidelines utilize rigorous evidentiary review, highlight statin therapy for primary and secondary prevention of atherosclerotic cardiovascular disease, and emphasize a clinician-patient risk discussion...
February 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29447589/do-student-service-members-veterans-experience-worse-mental-health-stigma-than-their-peers-a-comparative-study-in-a-national-sample
#16
Joseph M Currier, Ryon C McDermott, Brook M Sims
OBJECTIVES: Examine differences in mental health treatment-related stigma in student service members and veterans (SSM/Vs) and peers from 57 post-secondary institutions across the United States. METHODS: In total, 909 SSM/Vs and 1818 demographically- and institutionally-matched non-SSM/Vs completed assessments of stigma-related barriers to mental health service utilization as part of the Healthy Minds Study between 2011 and 2015. RESULTS: When compared to non-SSM/V peers, SSM/Vs reported more mental health treatment-related stigma toward help-seekers and less confidence in the helpfulness of therapy/counseling and psychotropic medications...
February 15, 2018: Journal of American College Health: J of ACH
https://www.readbyqxmd.com/read/29447416/managing-opioid-use-disorder-and-co-occurring-posttraumatic-stress-disorder-among-veterans
#17
Rhonda Snow, Stephanie T Wynn
Support and safety measures are essential for Veterans admitted to acute psychiatric units with co-occurring posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) to avoid unpleasant withdrawal symptoms. A human patient simulator was used to train clinicians to recognize opioid withdrawal symptoms. Clinicians were educated to assess for opioid withdrawal symptoms using the Clinical Opiate Withdrawal Scale. Knowledge was evaluated via pre/posttest. All participants' (N = 12) posttest scores improved...
February 15, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29444671/tailoring-an-educational-program-on-the-ahrq-patient-safety-indicators-to-meet-stakeholder-needs-lessons-learned-in-the-va
#18
Marlena H Shin, Peter E Rivard, Michael Shwartz, Ann Borzecki, Enzo Yaksic, Kelly Stolzmann, Lisa Zubkoff, Amy K Rosen
BACKGROUND: Given that patient safety measures are increasingly used for public reporting and pay-for performance, it is important for stakeholders to understand how to use these measures for improvement. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) are one particularly visible set of measures that are now used primarily for public reporting and pay-for-performance among both private sector and Veterans Health Administration (VA) hospitals. This trend generates a strong need for stakeholders to understand how to interpret and use the PSIs for quality improvement (QI)...
February 14, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29443720/retained-guidewires-in-the-veterans-health-administration-getting-to-the-root-of-the-problem
#19
Leila Cherara, Gary L Sculli, Douglas E Paull, Lisa Mazzia, Julia Neily, Peter D Mills
OBJECTIVES: The aims of this study were to investigate the demographics, causes, and contributing factors of retained guidewires (GWs) and to make specific recommendations for their prevention. METHODS: The Veterans Administration patient safety reporting system database for 2000-2016 was queried for cases of retained GWs (RGWs). Data extracted for each case included procedure location, provider experience, insertion site, urgency, time to discovery, root causes, and corrective actions taken...
February 13, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29443439/complexity-of-the-relationships-of-pain-posttraumatic-stress-and-depression-in-combat-injured-populations-an-integrative-review-to-inform-evidence-based-practice
#20
Nicholas A Giordano, Christine Bader, Therese S Richmond, Rosemary C Polomano
BACKGROUND: Understanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat-injured military personnel is unique to modern conflicts and understudied in the nursing literature. AIM: This integrative review synthesizes clinical presentations and relationships of combat injury, PTSD, depression, and pain in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) United States military service members and veterans...
February 14, 2018: Worldviews on Evidence-based Nursing
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