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https://www.readbyqxmd.com/read/29157323/prevalence-and-factors-associated-with-multidrug-resistant-gram-negative-organisms-in-patients-with-spinal-cord-injury
#1
Charlesnika T Evans, Margaret A Fitzpatrick, Makoto M Jones, Stephen P Burns, Linda Poggensee, Swetha Ramanathan, Sherri L LaVela, Nasia Safdar, Katie J Suda
OBJECTIVE Infections caused by multidrug-resistant gram-negative organisms (MDRGNOs) have been increasing every year. The objective of this study was to describe the prevalence of MDRGNOs and factors associated with MDRGNOs in patients with spinal cord injury or disorder (SCI/D). DESIGN Retrospective cohort study. METHODS Department of Veterans Affairs (VA) electronic health record data from 142 VA facilities were evaluated for 19,642 patients with SCI/D. Multivariable cluster-adjusted models were fit to identify factors associated with MDRGNO...
November 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29157038/applying-u-s-national-guidelines-for-ototoxicity-monitoring-in-adult-patients-perspectives-on-patient-populations-service-gaps-barriers-and-solutions
#2
Dawn Konrad-Martin, Gayla L Poling, Angela C Garinis, Candice E Ortiz, Jennifer Hopper, Keri O'Connell Bennett, Marilyn F Dille
OBJECTIVES: To promote establishment of effective ototoxicity monitoring programs (OMPs), this report reviews the U.S. national audiology guidelines in relation to "real world" OMP application. Background is provided on the mechanisms, risks and clinical presentation of hearing loss associated with major classes of ototoxic medications. DESIGN: This is a non-systematic review using PubMed, national and international agency websites, personal communications between ototoxicity experts, and results of unpublished research...
November 20, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/29154594/morally-injurious-events-and-psychological-distress-among-veterans-examining-the-mediating-role-of-religious-and-spiritual-struggles
#3
Wyatt R Evans, Melinda A Stanley, Terri L Barrera, Julie J Exline, Kenneth I Pargament, Ellen J Teng
OBJECTIVE: Potentially morally injurious events (PMIEs)-violations (perpetrated or witnessed) of one's deeply held beliefs or values-have been associated with several forms of psychological distress. The values violated by PMIEs are often influenced by one's religion/spirituality (r/s). Struggles with one's r/s beliefs and/or practices may also contribute to elevated psychological distress. To further develop a framework for understanding and treating the sequelae of PMIE exposure, we examined the role of r/s struggles in the relation between PMIE exposure and psychological distress...
November 20, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/29154017/patient-attitudes-and-experiences-that-predict-medication-discontinuation-in-the-veterans-health-administration
#4
Amy Linsky, Steven R Simon, Kelly Stolzmann, Mark Meterko
OBJECTIVES: Polypharmacy is associated with adverse medication effects. One potential solution is deprescribing, which is the intentional, proactive, rational discontinuation of a medication that is no longer indicated or for which the potential harms outweigh the potential benefits. We identified patient characteristics, attitudes, and health care experiences associated with medication discontinuation. DESIGN, SETTING, AND PARTICIPANTS: We conducted a national mail survey, with the use of the Patient Perceptions of Discontinuation (PPoD) instrument, of 1600 veterans receiving primary care at Veterans Affairs (VA) medical centers and prescribed 5 or more concurrent medications...
November 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29153626/the-association-between-paternal-and-adolescent-depressive-symptoms-evidence-from-two-population-based-cohorts
#5
Gemma Lewis, Martha Neary, Ela Polek, Eirini Flouri, Glyn Lewis
BACKGROUND: Incidence of depression increases markedly around age 13 years, and nearly three-quarters of adults report that their mental health problems started in adolescence. Although maternal depression is a risk factor for adolescent depression, evidence about the association between paternal and adolescent depression is inconclusive, and many studies have methodological limitations. We aimed to assess the association between paternal and adolescent depressive symptoms in two large population-based cohort studies...
November 13, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/29150873/survival-in-patients-with-parkinson-s-disease-after-deep-brain-stimulation-or-medical-management
#6
Frances M Weaver, Kevin T Stroupe, Bridget Smith, Beverly Gonzalez, Zhiping Huo, Lishan Cao, Dolores Ippolito, Kenneth A Follett
OBJECTIVE: Deep brain stimulation has been shown to have a significant long-term beneficial effect on motor function. However, whether it affects survival is not clear. In this study, we compared survival rates for Parkinson's disease (PD) patients who underwent deep brain stimulation (DBS) with those who were medically managed. METHODS: A retrospective analysis of Veterans Affairs and Medicare administrative data of veterans with PD who received DBS and were propensity score matched to a cohort of veterans with PD who did not receive DBS between 2007-2013...
November 18, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29148348/increasing-trends-in-the-use-of-hospital-observation-services-for-older-medicare-advantage-and-privately-insured-patients
#7
Keith D Lind, Claire M Noel-Miller, Lindsey R Sangaralingham, Nilay D Shah, Erik P Hess, Pamela Morin, M Fernanda Bellolio
Policy and financial pressures have driven up use of observation stays for patients in traditional Medicare and the Veterans' Affairs Healthcare System. Using claims data (2004-2014) from OptumLabs™ Data Warehouse, we examined whether people in private Medicare Advantage (MA) and commercial plans experienced similar changes. We found that use of observation increased rapidly for patients in MA plans-even though MA plans were not subject to the same pressures as government-run programs. In contrast, use of observation remained constant for people in commercial plans-except for enrollees 65 and older, for whom it increased somewhat...
July 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148338/comprehensive-support-for-family-caregivers-impact-on-veteran-health-care-utilization-and-costs
#8
Courtney Harold Van Houtven, Valerie A Smith, Karen M Stechuchak, Megan Shepherd-Banigan, Susan Nicole Hastings, Matthew L Maciejewski, Gilbert Darryl Wieland, Maren K Olsen, Katherine E M Miller, Margaret Kabat, Jennifer Henius, Margaret Campbell-Kotler, Eugene Z Oddone
This study aimed to examine the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) on Veteran health care utilization and costs. A pre-post cohort design including a nonequivalent control group was used to understand how Veterans' use of Veteran Affairs health care and total health care costs changed in 6-month intervals up to 3 years after PCAFC enrollment. The control group was an inverse probability of treatment weighted sample of Veterans whose caregivers applied for, but were not accepted into, PCAFC...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29145722/outcomes-of-beating-heart-on-pump-utilizing-a-miniature-bypass-circuit-versus-off-pump-cardiac-bypass-at-a-veterans-affairs-medical-center
#9
Matthew Skancke, Kendal Endicott, Richard Amdur, Michael Greenberg, Gregory Trachiotis
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) helps reduce systemic inflammatory changes by maintaining native pulsatile flow. This analysis evaluates the outcomes of OPCAB at a Veterans Affairs Medical Center (VAMC) and evaluates the use of beating heart on-pump (BHOP) bypass grafting as an empiric therapy for high-risk patients. METHODS: We performed a retrospective analysis of 756 patients who underwent coronary bypass grafting between 2004-2015 at a single VAMC...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29142981/commercial-kidney-transplantation-attitude-knowledge-perception-and-experience-of-recipients
#10
Fatma Al Rahbi, Issa Al Salmi
Introduction: Kidney transplantation is the gold standard for patients with end-stage kidney disease. In view of shortages of available organs, long wait times for possible transplantation, and strict regulation, many patients opt for commercial transplantation. This study elicits the reasons and motivations for patients with end-stage kidney disease to elect for commercial transplant. Methods: A questionnaire-based evaluation was conducted during the period from July 2015 until late December 2015...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29142040/use-of-disease-modifying-antirheumatic-drugs-for-inflammatory-arthritis-in-us-veterans-effect-of-specialty-care-and-geographic-distance
#11
Jessica A Walsh, Shaobo Pei, Zachary Burningham, Gopi Penmetsa, Grant W Cannon, Daniel O Clegg, Brian C Sauer
OBJECTIVE: To evaluate the effect of access to and distance from rheumatology care on the use of disease-modifying antirheumatic drugs (DMARD) in US veterans with inflammatory arthritis (IA). METHODS: Provider encounters and DMARD dispensations for IA (rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis) were evaluated in national Veterans Affairs (VA) datasets between January 1, 2015, and December 31, 2015. RESULTS: Among 12,589 veterans with IA, 23...
November 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29138735/social-determinants-of-maternal-health-in-afghanistan-a-review
#12
Said Ahmad Maisam Najafizada, Ivy Lynn Bourgeault, Ronald Labonté
Introduction: Afghanistan has a high maternal mortality rate of 400 per 100,000 live births. Although direct causes of maternal morbidity and mortality in Afghanistan include hemorrhage, obstructed labor, infection, high blood pressure, and unsafe abortion, the high burden of diseases responsible for maternal mortality arises in large part due to social determinants of health. The focus of this literature review is to examine the impact of various social determinants of health on maternal health in Afghanistan, filling an important gap in the existing literature...
2017: Central Asian Journal of Global Health
https://www.readbyqxmd.com/read/29138051/sarcopenia-in-peripheral-arterial-disease-prevalence-and-impact-on-functional-status
#13
Odessa Addison, Steven J Prior, Rishi Kundi, Monica C Serra, Leslie I Katzel, Andrew W Gardner, Alice S Ryan
OBJECTIVES: To determine the prevalence of sarcopenia in older men with peripheral arterial disease (PAD) and to compare to a subset of the group to age, race, sex, and body mass index (BMI)-matched non-PAD control counterparts. We also sought to compare the functional status of those with PAD with and without sarcopenia. DESIGN: Cohort study. SETTING: A Veterans Affairs medical center. PARTICIPANTS: Sedentary, community dwelling men age 50+ years with a confirmed diagnosis of PAD (N=108; 44% black; BMI 27...
November 11, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29137891/human-leukocyte-antigen-hla-and-gulf-war-illness-gwi-hla-drb1-13-02-spares-subcortical-atrophy-in-gulf-war-veterans
#14
Lisa M James, Peka Christova, Brian E Engdahl, Scott M Lewis, Adam F Carpenter, Apostolos P Georgopoulos
BACKGROUND: Gulf War Illness (GWI) is a multisystem disorder that has affected a substantial number of veterans who served in the 1990-91 Gulf War. The brain is prominently affected, as manifested by the presence of neurological, cognitive and mood symptoms. We reported previously on the protective role of six Human Leukocyte Antigen (HLA) alleles in GWI (Georgopoulos et al., 2016) and their association with regional brain function (James et al., 2016). More recently, we reported on the presence of subcortical brain atrophy in GWI (Christova et al...
November 9, 2017: EBioMedicine
https://www.readbyqxmd.com/read/29132630/evaluating-e-consultation-implementations-based-on-use-and-time-line-across-various-specialties
#15
Pratik J Parikh, Corinne Mowrey, Jennie Gallimore, Stephen Harrell, Brian Burke
BACKGROUND: Electronic Consultation (e-consults) can provide improved access, enhance patient and provider satisfaction, and reduce beneficiary travel expenses. We explored how e-consults were implemented across three specialty areas, diabetes (Diab), gastroenterology (GI), and neurosurgery (Neuro), at two Veterans Affairs hospitals in terms of strategies for use and time-lines. METHODS: We conducted observations and electronically shadowed patient e-consultations submitted to a specialty care service by primary care provider(s) at the two sites during a thirteen-month period...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132620/identifying-and-prioritizing-the-tools-techniques-of-knowledge-management-based-on-the-asian-productivity-organization-model-apo-to-use-in-hospitals
#16
Hamid Khajouei, Reza Khajouei
INTRODUCTION: Appropriate knowledge, correct information, and relevant data are vital in medical diagnosis and treatment systems. Knowledge Management (KM) through its tools/techniques provides a pertinent framework for decision-making in healthcare systems. The objective of this study was to identify and prioritize the KM tools/techniques that apply to hospital setting. METHODS: This is a descriptive-survey study. Data were collected using a -researcher-made questionnaire that was developed based on experts' opinions to select the appropriate tools/techniques from 26 tools/techniques of the Asian Productivity Organization (APO) model...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29130810/outcomes-after-angiography-with-sodium-bicarbonate-and-acetylcysteine
#17
Steven D Weisbord, Martin Gallagher, Hani Jneid, Santiago Garcia, Alan Cass, Soe-Soe Thwin, Todd A Conner, Glenn M Chertow, Deepak L Bhatt, Kendrick Shunk, Chirag R Parikh, Edward O McFalls, Mary Brophy, Ryan Ferguson, Hongsheng Wu, Maria Androsenko, John Myles, James Kaufman, Paul M Palevsky
Background Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury and associated adverse outcomes after angiography without definitive evidence of their efficacy. Methods Using a 2-by-2 factorial design, we randomly assigned 5177 patients at high risk for renal complications who were scheduled for angiography to receive intravenous 1.26% sodium bicarbonate or intravenous 0.9% sodium chloride and 5 days of oral acetylcysteine or oral placebo; of these patients, 4993 were included in the modified intention-to-treat analysis...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29130272/effects-of-guideline-and-formulary-changes-on-statin-prescribing-in-the-veterans-affairs
#18
Adam A Markovitz, Rob G Holleman, Timothy P Hofer, Eve A Kerr, Mandi L Klamerus, Jeremy B Sussman
OBJECTIVE: To compare the effects of two sequential policy changes-the addition of a high-potency statin to the Department of Veterans Affairs (VA) formulary and the release of the American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines-on VA provider prescribing. DATA SOURCES/STUDY SETTING: Retrospective analysis of 1,100,682 VA patients, 2011-2016. STUDY DESIGN: Interrupted time-series analysis of changes in prescribing of moderate-to-high-intensity statins among high-risk patients and across high-risk subgroups...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29129955/a-comparative-analysis-of-bioethical-issues-from-view-points-of-religious-affairs-administration-in-turkey-roman-catholicism-and-orthodox-judaism
#19
Cemal Huseyin Güvercin, Kerim M Munir
The arguments set forth by religious authority are important since they play a crucial role in shaping the social values of the public and influence the decision of individuals in practice pertaining to bioethical issues. The Religious Affairs Administration (RAA) was established at the inception of the Republic of Turkey in 1924 to guide religious considerations moving out of the Ottoman caliphate to a secular bioethical framework. In this article, the bioethical views of the RAA under Islamic tradition is examined and contrasted with those influenced by the Roman Catholic and Orthodox Judaic traditions...
July 2017: Acta Bioethica
https://www.readbyqxmd.com/read/29126751/shift-to-community-onset-clostridium-difficile-infection-in-the-national-veterans-health-administration-2003-2014
#20
Kelly R Reveles, Mary Jo V Pugh, Kenneth A Lawson, Eric M Mortensen, Jim M Koeller, Jacqueline R Argamany, Christopher R Frei
BACKGROUND: Clostridium difficile infection (CDI) occurs frequently in inpatient settings; however, community-onset cases have been reported more frequently in recent years. This study evaluated hospital-onset and community-onset CDI in the national Veterans Health Administration (VHA) population over a 12-year period. METHODS: This was a retrospective cohort study of all adult VHA beneficiaries with CDI between October 1, 2002, and September 30, 2014. Data were obtained from the Veterans Affairs Informatics and Computing Infrastructure...
November 7, 2017: American Journal of Infection Control
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