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https://www.readbyqxmd.com/read/28329406/treating-veterans-with-ptsd-and-borderline-personality-symptoms-in-a-12-week-intensive-outpatient-setting-findings-from-a-pilot-program
#1
Laura Meyers, Emily K Voller, Ethan B McCallum, Paul Thuras, Sandra Shallcross, Tina Velasquez, Laura Meis
Rates of comorbidity between borderline personality disorder and posttraumatic stress disorder (PTSD) are high in veteran populations, and clinicians are hesitant to treat PTSD given high rates of suicidality. Given promising early work integrating dialectical behavior therapy (DBT) and prolonged exposure (PE) therapy, we created a 12-week intensive outpatient program combining these two treatments. PE and DBT were provided concurrently to 33 veterans with PTSD symptoms and BPD symptoms at a large, midwestern Veteran Affairs medical center...
March 22, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28328253/a-comprehensive-index-for-predicting-risk-of-anemia-from-patients-diagnoses
#2
Matthew G Tuck, Farrokh Alemi, John F Shortle, Sanj Avramovic, Charles Hesdorffer
This article demonstrates how time-dependent, interacting, and repeating risk factors can be used to create more accurate predictive medicine. In particular, we show how emergence of anemia can be predicted from medical history within electronic health records. We used the Veterans Affairs Informatics and Computing Infrastructure database to examine a retrospective cohort of 9,738,838 veterans over an 11-year period. Using International Clinical Diagnoses Version 9 codes organized into 25 major diagnostic categories, we measured progression of disease by examining changes in risk over time, interactions in risk of combination of diseases, and elevated risk associated with repeated hospitalization for the same diagnostic category...
March 2017: Big Data
https://www.readbyqxmd.com/read/28326433/application-of-electronic-algorithms-to-improve-diagnostic-evaluation-for-bladder-cancer
#3
Daniel R Murphy, Ashley N D Meyer, Viralkumar Vaghani, Elise Russo, Dean F Sittig, Kyle A Richards, Li Wei, Louis Wu, Hardeep Singh
BACKGROUND: Strategies to ensure timely diagnostic evaluation of hematuria are needed to reduce delays in bladder cancer diagnosis. OBJECTIVE: To evaluate the performance of electronic trigger algorithms to detect delays in hematuria follow-up. METHODS: We developed a computerized trigger to detect delayed follow-up action on a urinalysis result with high-grade hematuria (>50 red blood cells/high powered field). The trigger scanned clinical data within a Department of Veterans Affairs (VA) national data repository to identify all patient records with hematuria, then excluded those where follow-up was unnecessary (e...
March 22, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28323324/preventing-hospitalization-with-veterans-affairs-home-based-primary-care-which-individuals-benefit-most
#4
Samuel T Edwards, Somnath Saha, Julia C Prentice, Steven D Pizer
OBJECTIVES: To examine how medical complexity modifies the relationship between enrollment in Department of Veterans Affairs (VA) home-based primary care (HBPC) and hospitalization for ambulatory care-sensitive conditions (ACSC) for veterans with diabetes mellitus and whether the effect of HBPC on hospitalizations varies according to clinical condition. DESIGN: Retrospective cohort study. SETTING: VA and non-VA hospitals. PARTICIPANTS: VA beneficiaries aged 67 and older with diabetes mellitus and enrolled in Medicare (N = 364,972)...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28322769/racial-and-ethnic-disparities-in-contraceptive-knowledge-among-women-veterans-in-the-ecuun-study
#5
Elian Rosenfeld, Lisa S Callegari, Florentina E Sileanu, Xinhua Zhao, E Bimla Schwarz, Maria K Mor, Sonya Borrero
OBJECTIVE: To assess whether racial/ethnic disparities in contraceptive knowledge observed in the general US population are also seen among women Veterans served by the Veterans Affairs (VA) healthcare system. STUDY DESIGN: We analyzed data from a national telephone survey of 2302 women Veterans aged 18-44 who had received care within VA in the prior 12months. Twenty survey items assessed women's knowledge about various contraceptive methods. Multivariable logistic regression was used to examine racial/ethnic variation in contraceptive knowledge items, adjusting for age, marital status, education, income, parity, and branch of military service...
March 17, 2017: Contraception
https://www.readbyqxmd.com/read/28321862/identification-obstacle-to-individuation-or-on-how-to-become-me
#6
Alessandra Cavalli
This paper will explore the use of identification with aspects of a lost object as a defensive strategy to cope with traumatic loss, and will show how in the depth of the analytic work this identification can be accessed and made conscious. Descriptions of work with a three-year-old boy illustrate how the sudden loss of his mother's breasts had made weaning un-accessible to him, and how, in the absence of a good experience of separation, the process of mourning had not been able to take place. Instead, identification with aspects of the lost breast was used as a defence against pain, and this state of affairs was proving a hindrance to individuation...
April 2017: Journal of Analytical Psychology
https://www.readbyqxmd.com/read/28317097/engagement-in-advance-care-planning-and-surrogates-knowledge-of-patients-treatment-goals
#7
Terri R Fried, Maria Zenoni, Lynne Iannone, John O'Leary, Brenda T Fenton
OBJECTIVES: A key objective of advance care planning (ACP) is improving surrogates' knowledge of patients' treatment goals. Little is known about whether ACP outside of a trial accomplishes this. The objective was to examine patient and surrogate reports of ACP engagement and associations with surrogate knowledge of goals. DESIGN: Cohort study SETTING: Primary care in a Veterans Affairs Medical Center. PARTICIPANTS: 350 community-dwelling veterans age ≥55 years and the individual they would choose to make medical decisions on their behalf, interviewed separately...
March 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28306156/posttraumatic-stress-disorder-antipsychotic-use-and-risk-of-dementia-in-veterans
#8
Elizabeth E Roughead, Nicole L Pratt, Lisa M Kalisch Ellett, Emmae N Ramsay, John D Barratt, Philip Morris, Graeme Killer
OBJECTIVES: To examine the risk of dementia associated with posttraumatic stress disorder (PTSD) and the contribution of antipsychotic use to this risk. DESIGN: Retrospective cohort study SETTING: Australia. Administrative claims data from the Australian Government Department of Veterans' Affairs were used. PARTICIPANTS: Male Vietnam veterans aged 55 to 65 at baseline (2001-02) with no preexisting dementia diagnosis (N = 15,612). MEASUREMENTS: The association between PTSD and dementia was assessed over 12 years of follow-up...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28303093/understanding-and-self-organization
#9
Natika W Newton
How do we manage to understand a completely novel state of affairs, such as the sudden effects of an unexpected earthquake, or the arrival of a total stranger instead of the sister we were waiting for? In each case, for a moment we might be stunned, but we are able quite quickly to fit these events into our overall framework for understanding the world. However, terrified and despairing we feel, we know what earthquakes are and this event fits that schema; in the case of the stranger we know that this kind of thing happens, and that we must ask the stranger "Who are you, and where is my sister?" This paper asks about the mechanisms by which we rapidly achieve an understanding of our world, both the unexpected changes we may experience, and the ongoing comfortable familiarity we normally have with our surroundings...
2017: Frontiers in Systems Neuroscience
https://www.readbyqxmd.com/read/28301590/predictors-of-suicide-in-the-patient-population-admitted-to-a-locked-door-psychiatric-acute-ward
#10
Roar Fosse, Wenche Ryberg, Merete Kvalsvik Carlsson, Jan Hammer
OBJECTIVE: No prior study appears to have focused on predictors of suicide in the general patient population admitted to psychiatric acute wards. We used a case-control design to investigate the association between suicide risk factors assessed systematically at admission to a locked-door psychiatric acute ward in Norway and subsequent death by suicide. METHOD: From 2008 to 2013, patients were routinely assessed for suicide risk upon admission to the acute ward with a 17-item check list based on recommendations from the Norwegian Directorate of Health and Social Affairs...
2017: PloS One
https://www.readbyqxmd.com/read/28299610/pharmacovigilance-of-regenerative-medicine-under-the-amended-pharmaceutical-affairs-act-in-japan
#11
Yasuko Inokuma
Two Japanese regulatory agencies, the Ministry of Health, Labour and Welfare and the Pharmaceuticals and Medical Devices Agency announced the implementation of a new review system called 'Conditional Approval,' specifically for the emerging field of regenerative medicine, in an amendment to the Pharmaceutical Affairs Act in 2014. Regenerative medicine was regulated in the category of 'Medical Devices' prior to the amendment and was not covered by the Relief Service, a system that provides financial aid to people who have experienced an adverse drug reaction and developed serious side effects as a result...
March 15, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28299314/high-magnitude-of-social-anxiety-disorder-in-school-adolescents
#12
Kindie Mekuria, Haregwoin Mulat, Habtamu Derajew, Tesfa Mekonen, Wubalem Fekadu, Amsalu Belete, Solomon Yimer, Getasew Legas, Melak Menberu, Asmamaw Getnet, Simegnew Kibret
Introduction. Social phobia is the most prevalent and chronic type of anxiety disorder worldwide and it affects occupational, educational, and social affairs of the individual. Social phobia is also known for its association with depression and substance use disorder. Objective. The aim of this study was to assess the prevalence and associated factors of social phobia among high school students in Ethiopia. Methods. Cross-sectional study was conducted among 386 randomly selected students. Data were collected using pretested and self-administered questionnaire...
2017: Psychiatry Journal
https://www.readbyqxmd.com/read/28295142/creation-of-an-interprofessional-teledementia-clinic-for-rural-veterans-preliminary-data
#13
Becky B Powers, Marcia C Homer, Natalia Morone, Natali Edmonds, Michelle I Rossi
The teledementia clinic is a new model of care that expands the reach of specialized geriatric and dementia care using clinical video telehealth (CVT) to rural veterans, who frequently lack access to specialty care. The clinic is a Veterans Affairs (VA) Geriatric Research, Education, and Clinical Center clinical demonstration project. It is located in the Pittsburgh VA Healthcare System tertiary referral hospital and serves veterans in affiliated rural community-based outpatient clinics (CBOCs). Rural CBOC primary care providers refer clinic patients, or referral is according to previous cognitive impairment diagnosis in a VAPHS geriatric clinic...
March 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28294310/longitudinal-analysis-of-quality-of-diabetes-care-and-relational-climate-in-primary-care
#14
Marina Soley-Bori, Justin K Benzer, James F Burgess
OBJECTIVE: To assess the influence of relational climate on quality of diabetes care. DATA SOURCES/STUDY SETTING: The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA administrative datasets. STUDY DESIGN: Multilevel panel data (2008-2012) with patients nested into clinics. DATA COLLECTION/EXTRACTION METHODS: Diabetic patients were identified using ICD-9 codes and assigned to the clinic with the highest frequency of primary care visits...
March 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28291091/impact-of-acute-kidney-injury-in-patients-hospitalized-with-pneumonia
#15
Lakhmir S Chawla, Richard L Amdur, Charles Faselis, Ping Li, Paul L Kimmel, Carlos E Palant
OBJECTIVES: Pneumonia is a common cause of hospitalization and can be complicated by the development of acute kidney injury. Acute kidney injury is associated with major adverse kidney events (death, dialysis, and durable loss of renal function [chronic kidney disease]). Because pneumonia and acute kidney injury are in part mediated by inflammation, we hypothesized that when acute kidney injury complicates pneumonia, major adverse kidney events outcomes would be exacerbated. We sought to assess the frequency of major adverse kidney events after a hospitalization for either pneumonia, acute kidney injury, or the combination of both...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28290938/postconcussive-symptoms-ptsd-and-medical-disease-burden-in-treatment-seeking-oef-oif-ond-veterans
#16
Joah L Williams, Meghan E McDevitt-Murphy, James G Murphy, Ellen M Crouse
INTRODUCTION: The most common psychological and cognitive sequelae associated with deployments to Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom) are mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). High rates of PTSD are often observed among Veterans with a history of mTBI, and persistent postconcussive symptoms commonly endorsed after mTBI are known to be associated with PTSD. Therefore, this study examined whether PTSD mediates relations between postconcussive symptoms and 2 indices of medical disease burden: 1) the number of disease categories positive for a diagnosis, or system disease burden, and 2) total number of physical diagnoses, or cumulative disease burden...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290933/leveraging-the-partnership-for-patients-initiative-to-improve-patient-safety-and-quality-within-the-military-health-system
#17
Heidi B King, Kimberly Kesling, Carmen Birk, Theodore Walker, Heather Taylor, Michael Datena, Brittany Burgess, Lyndsay Bower
INTRODUCTION: Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290928/indications-of-recruitment-challenges-in-research-with-u-s-military-service-members-a-clinicaltrials-gov-review
#18
Wendy A Cook, Ardith Z Doorenbos
INTRODUCTION: The success of military-relevant health research often depends on recruiting adequate numbers of U.S. military service members as research participants. Researchers have reported difficulties in recruiting service member research participants. Reviews of ClinicalTrials.gov, an online clinical trial registry of publicly and privately sponsored studies, have identified challenges in participant recruitment and barriers to study completion in various research populations. The purpose of this study was to identify indications of difficulty recruiting U...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290927/understanding-primary-care-behavioral-health-across-military-settings-a-preliminary-comparison-between-deployed-and-in-garrison-care
#19
Ryan R Landoll, Matthew K Nielsen, Kathryn K Waggoner
BACKGROUND: Integrated primary care behavioral health (PCBH) is a growing trend in health care delivery, particularly in the Department of Defense and the Department of Veterans Affairs. This consultative model has been applied within the U.S. Air Force for over 15 years and has demonstrated positive health impacts and patient satisfaction. With extended conflicts and engagements, including Operation Enduring Freedom and Operation Iraqi Freedom, deployment behavioral health care has expanded and positively received, but there is less empirical support of particular models of care in a deployed environment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289309/promoting-professional-socialization-within-the-experiential-curriculum-implementation-of-a-high-stakes-professionalism-rubric
#20
Kim Tanzer, Matthew Dintzner
Objectives. To describe the implementation of a high-stakes rubric to assess student professionalism in introductory and advanced pharmacy practice experiences (IPPEs and APPEs) to promote the professional socialization of students in the doctor of pharmacy (PharmD) program at Western New England University (WNE). Findings. A professionalism rubric was adapted from the literature to assess the professional behavior of students enrolled in experiential courses based on evaluation of the following criteria: appropriate communication skills with patients and providers, appearance and dress code, timeliness, and initiative...
February 25, 2017: American Journal of Pharmaceutical Education
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