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https://www.readbyqxmd.com/read/29047423/antimicrobial-nonsusceptibility-of-gram-negative-bloodstream-isolates-veterans-health-administration-system-united-states-2003-2013-1
#1
Michihiko Goto, Jennifer S McDanel, Makoto M Jones, Daniel J Livorsi, Michael E Ohl, Brice F Beck, Kelly K Richardson, Bruce Alexander, Eli N Perencevich
Bacteremia caused by gram-negative bacteria is associated with serious illness and death, and emergence of antimicrobial drug resistance in these bacteria is a major concern. Using national microbiology and patient data for 2003-2013 from the US Veterans Health Administration, we characterized nonsusceptibility trends of community-acquired, community-onset; healthcare-associated, community-onset; and hospital-onset bacteremia for selected gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter spp...
November 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29047323/cooking-classes-a-diabetes-self-management-support-intervention-enhancing-clinical-values
#2
Cally Byrne, Neal Kurmas, Christopher J Burant, Anne Utech, Alison Steiber, Mary Julius
Purpose The purpose of this study is to examine the relationship between Healthy Teaching Kitchen (HTK) attendance among veterans who are diagnosed with type 2 diabetes mellitus (T2DM) and clinical outcomes as measured by A1C and blood pressure. Methods This retrospective chart review collected data from veterans with T2DM who participated in the Diabetes Self-Management Support (DSMS) HTK program at the Louis Stokes Cleveland VA Medical Center (LSCVAMC) between February 2013 and May 2016. Data collected included demographic information, frequency of DSMS HTK attendance, 3 A1C values, and 3 blood pressure values...
October 1, 2017: Diabetes Educator
https://www.readbyqxmd.com/read/29047199/student-veterans-construction-and-enactment-of-resilience-a-constructivist-grounded-theory-study
#3
Andrew Thomas Reyes, Christopher A Kearney, Katrina Isla, Ross Bryant
INTRODUCTION: Adjusting to college life is one of the most difficult experiences in a military veteran's transition to civilian life. Many military veterans returning to college not only encounter academic challenges, but also deal with physical and psychiatric disabilities, loss of military camaraderie, and social disconnect. These often negatively affect their personal and academic lives. Hence, it is important to explore resilience in order to best support student veterans as they transition from military to civilian life...
October 19, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/29047076/increased-rates-of-documented-alcohol-counseling-in-primary-care-more-counseling-or-just-more-documentation
#4
Douglas Berger, Gwen T Lapham, Susan M Shortreed, Eric J Hawkins, Anna D Rubinsky, Emily C Williams, Carol E Achtmeyer, Daniel R Kivlahan, Katharine A Bradley
BACKGROUND: Clinical performance measures often require documentation of patient counseling by healthcare providers. Little is known about whether such measures encourage delivery of counseling or merely its documentation. OBJECTIVE: To assess changes in provider documentation of alcohol counseling and patient report of receiving alcohol counseling in the Veterans Administration (VA) from 2009 to 2012. DESIGN: Retrospective time-series analysis...
October 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29045920/the-association-of-alcohol-consumption-patterns-with-self-rated-physical-health-and-psychiatric-distress-among-afghanistan-and-iraq-era-u-s-veterans
#5
Patrick S Calhoun, Sarah M Wilson, Eric A Dedert, Katherine C Cunningham, Thomas K Burroughs, Terrell A Hicks, Jean C Beckham, Harold S Kudler, Kristy Straits-Troster
Alcohol misuse is associated with negative mental and physical health outcomes, which presents a public health concern in veterans. However, less is known regarding outcomes among veterans with low to moderate alcohol consumption. This study included veterans with military service in Iraq and/or Afghanistan (N = 1083) who resided in the VA Mid-Atlantic region catchment area (North Carolina, Virginia, and parts of West Virginia). Participants completed a mailed survey that inquired about demographics, past-year alcohol consumption, self-rated physical health, and psychiatric symptoms...
September 28, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29045696/group-visits-for-overdose-education-and-naloxone-distribution-in-primary-care-a-pilot-quality-improvement-initiative
#6
Juliette F Spelman, Stephanie Peglow, Amy R Schwartz, Lucille Burgo-Black, Katelyn McNamara, William C Becker
Objective: Opioid prescribing for chronic pain significantly contributes to opioid overdose deaths in the United States. Naloxone as a take-home antidote to opioid overdose is underutilized and has not been evaluated in the high-risk chronic pain population. The objective was to increase overdose education and naloxone distribution (OEND) to high-risk patients on long-term opioid therapy for pain by utilizing group visits in primary care. Design: Quality improvement intervention among two primary care clinics...
October 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29045064/epidemiology-and-burden-of-influenza-in-the-u-s-department-of-veterans-affairs
#7
Cynthia Lucero-Obusan, Patricia L Schirmer, Aaron Wendelboe, Gina Oda, Mark Holodniy
We describe influenza activity in the US Veterans Affairs (VA) population for the 2010-2011 through 2015-2016 seasons and compare with national CDC FluView data. VA confirmed influenza cases ranged from 1,005-11,506 per season; triage calls from 6,090-10,346; outpatient visits from 3,849-13,406; antiviral prescriptions from 3,650-32,826; hospitalizations from 546-4,673; and deaths in hospitalized patients from 17-139. Peak activity was generally the same as observed nationally by the CDC. For the seasons analyzed, correlation between VA and CDC %ILI visits (r=0...
October 16, 2017: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29044720/observational-comparative-effectiveness-of-pharmaceutical-treatments-for-obesity-within-the-veterans-health-administration
#8
Ted R Grabarczyk
STUDY OBJECTIVE: To compare the effectiveness of weight-management medications used to assist with weight loss in real-world clinical practice in the Veterans Health Administration (VHA). DESIGN: Retrospective, multicenter, observational cohort study. DATA SOURCE: National VA Corporate Data Warehouse. PATIENTS: A total of 66,035 VA patients aged 18 years or older with a body mass index of 25 kg/m(2) or greater who had an initial fill for a study medication (orlistat [6153 patients], phentermine [304 patients], lorcaserin [298 patients], or phentermine-topiramate extended release [233 patients]) or participation in the VA's MOVE! weight management program with at least three total visits in a clinic coded as a MOVE clinic in the subsequent 24 weeks (59,047 patients) between January 1, 2012 and July 1, 2016...
October 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29044408/testing-a-positive-psychological-intervention-for-osteoarthritis
#9
Leslie R M Hausmann, Ada Youk, C Kent Kwoh, Said A Ibrahim, Michael J Hannon, Debra K Weiner, Rollin M Gallagher, Acacia Parks
Objective: Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial-oriented treatments are underexplored. We developed and tested an intervention to build positive psychological skills (e.g., gratitude) to reduce osteoarthritis symptom severity, including pain and functioning, and to improve psychosocial well-being in patients with knee or hip osteoarthritis. Design: Two-arm randomized design with six-month follow-up. Setting: An academic Veterans Affairs Medical Center...
October 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29043947/outpatient-continuing-care-after-residential-substance-use-disorder-treatment-in-the-u-s-veterans-health-administration-facilitators-and-challenges
#10
Anna D Rubinsky, Laura S Ellerbe, Shalini Gupta, Tyler E Phelps, Thomas Bowe, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Veterans Health Administration (VHA), residential treatment programs are an important part of the continuum of care for patients with substance use disorders (SUDs). Outpatient continuing care after residential treatment helps maintain early recovery and treatment gains. Knowing more about the drivers of variation in continuing care practices and performance across residential programs might inform quality improvement efforts. METHODS: We operationalized measures of continuing care and calculated these metrics for each of VHA's 63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs) and 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track in fiscal year 2012...
October 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29043050/prediction-of-biodiversity-hotspots-in-the-anthropocene-the-case-of-veteran-oaks
#11
Olav Skarpaas, Stefan Blumentrath, Marianne Evju, Anne Sverdrup-Thygeson
Over the past centuries, humans have transformed large parts of the biosphere, and there is a growing need to understand and predict the distribution of biodiversity hotspots influenced by the presence of humans. Our basic hypothesis is that human influence in the Anthropocene is ubiquitous, and we predict that biodiversity hot spot modeling can be improved by addressing three challenges raised by the increasing ecological influence of humans: (i) anthropogenically modified responses to individual ecological factors, (ii) fundamentally different processes and predictors in landscape types shaped by different land use histories and (iii) a multitude and complexity of natural and anthropogenic processes that may require many predictors and even multiple models in different landscape types...
October 2017: Ecology and Evolution
https://www.readbyqxmd.com/read/29042822/antipsychotic-prescription-to-identify-delirium-results-from-two-cohorts
#12
Kristin M Zimmerman, Allison M Paquin, James L Rudolph
OBJECTIVES: Detection of delirium in hospitalized patients remains challenging. The objective was to determine if the prescription of antipsychotic medications was associated with delirium. PATIENTS AND METHODS: Two patient cohorts were utilized from a tertiary Veterans Affairs hospital: a palliative care retrospective cohort and a prospective medical cohort. Patients prescribed outpatient antipsychotics were excluded. Retrospectively, delirium was identified using a validated medical record-review instrument...
2017: Clinical Pharmacology: Advances and Applications
https://www.readbyqxmd.com/read/29042345/the-association-of-patient-factors-digital-access-and-online-behavior-on-sustained-patient-portal-use-a-prospective-cohort-of-enrolled-users
#13
Susan S Woods, Christopher W Forsberg, Erin C Schwartz, Kim M Nazi, Judith H Hibbard, Thomas K Houston, Martha Gerrity
BACKGROUND: As electronic health records and computerized workflows expand, there are unprecedented opportunities to digitally connect with patients using secure portals. To realize the value of patient portals, initial reach across populations will need to be demonstrated, as well as sustained usage over time. OBJECTIVE: The study aim was to identify patient factors associated with short-term and long-term portal usage after patients registered to access all portal functions...
October 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29042341/pain-self-management-for-veterans-development-and-pilot-test-of-a-stage-based-mobile-optimized-intervention
#14
Sara S Johnson, Deborah A Levesque, Lynne E Broderick, Dustin G Bailey, Robert D Kerns
BACKGROUND: Chronic pain is a significant public health burden affecting more Americans than cardiovascular disease, diabetes, and cancer combined. Veterans are disproportionately affected by chronic pain. Among previously deployed soldiers and veterans, the prevalence of chronic pain is estimated between 44% and 60%. OBJECTIVE: The objective of this research was to develop and pilot-test Health eRide: Your Journey to Managing Pain, a mobile pain self-management program for chronic musculoskeletal pain for veterans...
October 17, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29040971/characteristics-and-outcomes-of-vertebrobasilar-artery-dissection-with-accompanied-atherosclerosis
#15
Chun Chien, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Chih-Ping Chung
BACKGROUND: With the popularity of MRI use, vertebrobasilar artery dissection (VBD) has been found more frequently in patients with posterior circulation ischemic stroke (PCS). The relationship between VBD and atherosclerosis is unknown. The present study aimed to prove the hypothesis that PCS with pure VBD (p-VBD) and with VBD and accompanied cervical or cerebral artery atherosclerosis (a-VBD) have distinct manifestations. METHODS: Patients with VBD-related PCS who were prospectively enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and August 31, 2014 were recruited for the present study...
October 17, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29040723/resting-state-functional-connectivity-in-combat-veterans-suffering-from-impulsive-aggression
#16
T Varkevisser, T E Gladwin, L Heesink, J van Honk, E Geuze
Impulsive aggression is common amongst military personnel after deployment, and may arise because of impaired top-down regulation of the amgydala by prefrontal regions. This study sought to further explore this hypothesis via resting-state functional connectivity analyses in impulsively aggressive combat veterans. Male combat veterans with (n = 28) and without (n = 30) impulsive aggression problems underwent resting-state fMRI. Functional connectivity analyses were conducted with the following seed-regions: basolateral amygdala (BLA), centromedial amygdala (CeM), anterior cingulate cortex (ACC), and anterior insular cortex (AIC)...
October 12, 2017: Social Cognitive and Affective Neuroscience
https://www.readbyqxmd.com/read/29040715/the-integrated-pain-team-a-mixed-methods-evaluation-of-the-impact-of-an-embedded-interdisciplinary-pain-care-intervention-on-primary-care-team-satisfaction-confidence-and-perceptions-of-care-effectiveness
#17
Natalie Purcell, Kara Zamora, Jenny Tighe, Yongmei Li, Mathew Douraghi, Karen Seal
OBJECTIVE:  To evaluate the impact of the Integrated Pain Team (IPT)-an interdisciplinary chronic pain care intervention embedded in primary care at a large Veterans Affairs health care system. Outcomes evaluated included IPT's impact on the perceived effectiveness of chronic pain care; provider self-confidence; and primary care team satisfaction, stress, and burnout. METHOD:  This mixed-methods quality-improvement study employed: 1) qualitative semistructured interviews of 61 primary care providers, other primary care team members, and organizational stakeholders; and 2) a supplementary quantitative survey of 65 providers, comparing those who had referred patients to IPT with those who had not...
October 12, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29040678/extended-models-for-nosocomial-infection-parameter-estimation-and-model-selection
#18
Alun Thomas, Karim Khader, Andrew Redd, Molly Leecaster, Yue Zhang, Makoto Jones, Tom Greene, Matthew Samore
We consider extensions to previous models for patient level nosocomial infection in several ways, provide a specification of the likelihoods for these new models, specify new update steps required for stochastic integration, and provide programs that implement these methods to obtain parameter estimates and model choice statistics. Previous susceptible-infected models are extended to allow for a latent period between initial exposure to the pathogen and the patient becoming themselves infectious, and the possibility of decolonization...
October 12, 2017: Mathematical Medicine and Biology: a Journal of the IMA
https://www.readbyqxmd.com/read/29038512/levels-of-exhaled-carbon-monoxide-measured-during-an-intervention-program-predict-1-year-smoking-cessation-a-retrospective-observational-cohort-study
#19
Huei-Guan Shie, Sheng-Wei Pan, Wen-Kuang Yu, Wei-Chih Chen, Li-Ing Ho, Hsin-Kuo Ko
Life-long smoking cessation is a critical public health objective, but it is difficult for numerous people. This study aimed to identify the independent predictors of 1-year abstinence in smokers motivated to quit and participating in an intervention program. This 6-year retrospective observational cohort study was conducted in smokers who participated in an intervention program. The exhaled carbon monoxide (CO) was sequentially measured on day 1, 8, 15, and 22 of the intervention program. The primary outcome measure was smoking status at 1 year of follow-up...
October 16, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29037174/vitamin-d-supplementation-as-a-potential-cause-of-u-shaped-associations-between-vitamin-d-levels-and-negative-health-outcomes-a-decision-tree-analysis-for-risk-of-frailty
#20
Gotaro Kojima, Steve Iliffe, Marianne Tanabe
BACKGROUND: A recent controversy in vitamin D research is a "U-shaped association", with elevated disease risks at both high and low 25-hydroxyvitamin D (25 (OH) D) levels. METHODS: This is a cross-sectional study of 238 male nursing home veterans in Hawaii. Classification and regression tree (CART) analysis identified groups based on 25 (OH) D and vitamin D supplementation for frailty risk. Characteristics were examined and compared across the groups using logistic regression and receiver operating characteristic (ROC) curve analyses...
October 16, 2017: BMC Geriatrics
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