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https://www.readbyqxmd.com/read/28089437/systems-innovation-model-an-integrated-interdisciplinary-team-approach-pre-and-post-bariatric-surgery-at-a-veterans-affairs-va-medical-center
#1
Dan Eisenberg, Jessica A Lohnberg, Eric P Kubat, Cheryl C Bates, Lauren M Greenberg, Susan M Frayne
BACKGROUND: Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. OBJECTIVES: To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management...
November 15, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28076250/patient-reported-offers-of-alcohol-treatment-for-primary-care-patients-at-high-risk-for-an-alcohol-use-disorder
#2
Sean Grant, Katherine E Watkins, Andy Bogart, Susan M Paddock, Kimberly A Hepner
BACKGROUND: This study assessed patient-reported alcohol treatment offers by health care providers following routine annual screening for alcohol use in primary care. METHODS: A telephone interview within 30 days of the annual screen assessed demographics, alcohol and other drug use, mental health symptoms, and offers of formal treatment for alcohol by a Veterans Affairs health care provider. We included male patients (n = 349) at high risk for an alcohol use disorder (AUD) who had not received alcohol treatment in the past 3 months...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28073904/comparability-of-health-service-use-by-veterans-with-multisymptom-illness-and-those-with-chronic-diseases
#3
Stella M Gwini, Andrew B Forbes, Malcolm R Sim, Helen L Kelsall
OBJECTIVE: To compare health service utilization and disability claims among military personnel with multisymptom illness (MSI) (but no chronic diseases), those with chronic disease(s) and those without MSI or chronic diseases. MSI is also known as Gulf War illness. DESIGN: Cohort study. SETTING: Australia. PARTICIPANTS: In total, 1288 participants of a Gulf War veterans' study conducted in 2000-2003 (Wave-1) were followed up in 2011-2012 (Wave-2), aged on average 40 years...
January 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28065327/eight-years-of-decreased-methicillin-resistant-staphylococcus-aureus-health-care-associated-infections-associated-with-a-veterans-affairs-prevention-initiative
#4
Martin E Evans, Stephen M Kralovic, Loretta A Simbartl, Rajiv Jain, Gary A Roselle
BACKGROUND: Declines in methicillin-resistant Staphylococcus aureus (MRSA) health care associated infections (HAIs) were previously reported in Veterans Affairs acute care (2012), spinal cord injury (SCIU) (2011), and long-term-care facilities (LTCFs) (2012). Here we report continuing declines in infection rates in these settings through September 2015. METHODS: Monthly data entered into a national database from 127 acute care facilities, 22 SCIUs, and 133 LTCFs were evaluated for trends using negative binomial regression...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28061882/indoor-and-outdoor-pm10-levels-at-schools-located-near-mine-dumps-in-gauteng-and-north-west-provinces-south-africa
#5
Vusumuzi Nkosi, Janine Wichmann, Kuku Voyi
BACKGROUND: Few studies in South Africa have investigated the exposure of asthmatic learners to indoor and outdoor air pollution at schools. This study compared outdoor PM10 and SO2 exposure levels in exposed (1-2 km from gold mine dumps) and unexposed schools (5 km or more from gold mine dumps). It also examined exposure of asthmatic children to indoor respirable dust at exposed and unexposed schools. METHODS: The study was conducted between 1 and 31 October 2012 in five schools from exposed and five from unexposed communities...
January 6, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28056663/principles-for-assessing-adversity-in-toxicologic-clinical-pathology
#6
Lila Ramaiah, Lindsay Tomlinson, Niraj K Tripathi, Laura C Cregar, Allison Vitsky, Barbara von Beust, Valerie G Barlow, William J Reagan, Daniela Ennulat
There is limited direction in the literature or regulatory guidance on determination of adversity for clinical pathology (CP) biomarkers in preclinical safety studies. Toxicologic clinical pathologists representing the American Society for Veterinary Clinical Pathology-Regulatory Affairs Committee and Society of Toxicologic Pathology-Clinical Pathology Interest Group identified principles, overall approach, and unique considerations for assessing adversity in CP data interpretation to provide a consensus opinion...
January 1, 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28055048/detecting-heterogeneous-treatment-effects-to-guide-personalized-blood-pressure-treatment-a-modeling-study-of-randomized-clinical-trials
#7
Sanjay Basu, Jeremy B Sussman, Rod A Hayward
Background: Two recent randomized trials produced discordant results when testing the benefits and harms of treatment to reduce blood pressure (BP) in patients with cardiovascular disease (CVD). Objective: To perform a theoretical modeling study to identify whether large, clinically important differences in benefit and harm among patients (heterogeneous treatment effects [HTEs]) can be hidden in, and explain discordant results between, treat-to-target BP trials...
January 3, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28051985/eye-care-productivity-and-access-in-the-veterans-affairs-health-care-system
#8
Mary G Lynch, April Maa, William Delaune, Joel Chasan, Glenn C Cockerham
OBJECTIVES: Eye care in the Veterans Affairs Health Care System is challenged with increasing demand and higher prevalence of patients with complex ocular conditions. Understanding factors that impact eye care productivity and access is necessary for appropriate allocation of resources. The purpose of this study was to determine the impact of various eye clinic personnel on eye care provider productivity and patient access. METHODS: Utilizing data from the Veterans Health Administration National Data Warehouse, workload and level of staffing were analyzed...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28050745/an-evolving-ecosystem-for-natural-language-processing-in-department-of-veterans-affairs
#9
Jennifer H Garvin, Megha Kalsy, Cynthia Brandt, Stephen L Luther, Guy Divita, Gregory Coronado, Doug Redd, Carrie Christensen, Brent Hill, Natalie Kelly, Qing Zeng Treitler
In an ideal clinical Natural Language Processing (NLP) ecosystem, researchers and developers would be able to collaborate with others, undertake validation of NLP systems, components, and related resources, and disseminate them. We captured requirements and formative evaluation data from the Veterans Affairs (VA) Clinical NLP Ecosystem stakeholders using semi-structured interviews and meeting discussions. We developed a coding rubric to code interviews. We assessed inter-coder reliability using percent agreement and the kappa statistic...
February 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28050717/improving-patient-safety-avoiding-unread-imaging-exams-in-the-national-va-enterprise-electronic-health-record
#10
Sarah Bastawrous, Benjamin Carney
In the current digital and filmless age of radiology, rates of unread radiology exams remain low, however, may still exist in unique environments. Veterans Affairs (VA) health care systems may experience higher rates of unread exams due to coexistence of Veterans Health Information Systems and Technology Architecture (VistA) imaging and commercial picture archiving and communication systems (PACS). The purpose of this patient safety initiative was to identify any unread exams and causes leading to unread exams...
January 3, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28046080/the-annual-burden-of-seasonal-influenza-in-the-us-veterans-affairs-population
#11
Yinong Young-Xu, Robertus van Aalst, Ellyn Russo, Jason K H Lee, Ayman Chit
Seasonal influenza epidemics have a substantial public health and economic burden in the United States (US). On average, over 200,000 people are hospitalized and an estimated 23,000 people die from respiratory and circulatory complications associated with seasonal influenza virus infections each year. Annual direct medical costs and indirect productivity costs across the US have been found to average respectively at $10.4 billion and $16.3 billion. The objective of this study was to estimate the economic impact of severe influenza-induced illness on the US Veterans Affairs population...
2017: PloS One
https://www.readbyqxmd.com/read/28045351/primary-care-mental-health-integration-in-the-va-health-system-associations-between-provider-staffing-and-quality-of-depression-care
#12
Debra S Levine, John F McCarthy, Brittany Cornwell, Laurie Brockmann, Paul N Pfeiffer
OBJECTIVES: The study examined whether staffing of Primary Care-Mental Health Integration (PCMHI) services in the Department of Veterans Affairs (VA) health system is related to quality of depression care. METHODS: Site surveys and administrative data from 349 VA facilities for fiscal year 2013 were used to calculate PCMHI staffing (full-time equivalents) per 10,000 primary care patients and discipline-specific staffing proportions for PCMHI psychologists, social workers, nurses, and psychiatric medication prescribers...
January 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28043270/-the-effect-of-occupational-exposure-to-coal-tar-pitch-workers-health
#13
X C Sun, F Zhang, W Zhang, C D Lu, Z H Zhang, B Feng, H Y Wei, X Meng, X L Chen, H Shao, Z X Wang
Objective: To investigate the effect of occupational exposure to coal tar pitch on workers' health and metabolism. Methods: 805 workers exposed to coal tar pitch were selected as exposure group from the produce and em-ploy factory. Other people handle administrative and logistical affairs who not exposed to coal tar pitch were selected as control group. Fix-point sample of air were collected to detect the concentration of coal tar pitch. Do physical examination and questionnaire to collect workers' basic and healthy information...
November 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/28038980/epidermal-growth-factor-receptor-mutational-testing-and-erlotinib-treatment-among-veterans-diagnosed-with-lung-cancer-in-the-united-states-department-of-veterans-affairs
#14
Julie A Lynch, Brygida Berse, Danielle Chun, Donna Rivera, Kelly K Filipski, Scott Kulich, Benjamin Viernes, Scott L DuVall, Michael J Kelley
INTRODUCTION: We examined mutational testing of the epidermal growth factor gene (EGFR) and erlotinib treatment among veterans diagnosed with non-small-cell lung cancer in the United States Department of Veterans Affairs (VA). Our objectives were to identify the prevalence of clinically actionable EGFR mutations, to determine whether testing and treatment were guideline concordant, to evaluate the impact of testing and treatment on survival, and to estimate the rate of testing. PATIENTS AND METHODS: Test results were linked to electronic health records from VA Corporate Data Warehouse and the VA Central Cancer Registry...
December 7, 2016: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28035293/imbalance-in-cardiovascular-surgery-medical-service-use-between-regions
#15
Myunghwa Kim, Seok-Jun Yoon, Ji Suk Choi, Myo Jeong Kim, Sung Bo Sim, Kun Sei Lee, Hyun Keun Chee, Nam Hee Park, Choon Seon Park
BACKGROUND: This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions. METHODS: This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28028855/odds-of-viral-suppression-by-single-tablet-regimens-multiple-tablet-regimens-and-adherence-level-in-hiv-aids-patients-receiving-antiretroviral-therapy
#16
S Scott Sutton, Joseph Magagnoli, James W Hardin
STUDY OBJECTIVE: To evaluate the odds of achieving viral suppression in HIV patients utilizing antiretroviral therapy as a single-tablet regimen (STR) or multiple-tablet regimen (MTR). DESIGN: Retrospective cohort study. DATA SOURCES: South Carolina Medicaid medical and pharmacy paid claims data were obtained from the South Carolina Revenue and Fiscal Affairs Office; laboratory data were obtained from the South Carolina Department of Health and Environmental Control...
December 27, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28028786/determination-of-fluoride-in-organic-and-non-organic-wines
#17
Soraya Paz, Juan Ramón Jaudenes, Angel José Gutiérrez, Carmen Rubio, Arturo Hardisson, Consuelo Revert
Fluorine is an element of great importance to human health, as it is considered to be an essential element. However, both a deficiency and an excess, it can cause various problems. It is for this reason that values have been established regarding the recommended daily intake (RDI) and acceptable daily intake (ADI). The largest source of incorporation of fluoride is water, but it can be found in other foods and beverages, such as vegetables, tea, and wine. The aim of the study was to establish the fluoride concentration in organic and non-organic wines from different appellations of origin of the Canary Islands and mainland Spain, in order to assess the contribution of fluoride and toxic risk...
December 27, 2016: Biological Trace Element Research
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#18
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28018534/does-psychological-safety-impact-the-clinical-learning-environment-for-resident-physicians-results-from-the-va-s-learners-perceptions-survey
#19
Karina D Torralba, Lawrence K Loo, John M Byrne, Samuel Baz, Grant W Cannon, Sheri A Keitz, Annie B Wicker, Steven S Henley, T Michael Kashner
BACKGROUND : Psychological safety (PS) is the perception that it is safe to take interpersonal risks in the work environment. In teaching hospitals, PS may influence the clinical learning environment for trainees. OBJECTIVE : We assessed whether resident physicians believe they are psychologically safe, and if PS is associated with how they rate satisfaction with their clinical learning experience. METHODS : Data were extracted from the Learners' Perceptions Survey (LPS) of residents who rotated through a Department of Veterans Affairs health care facility for academic years 2011-2014...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28017403/efficacy-and-effectiveness-of-an-rvsv-vectored-vaccine-in-preventing-ebola-virus-disease-final-results-from-the-guinea-ring-vaccination-open-label-cluster-randomised-trial-ebola-%C3%A3-a-suffit
#20
Ana Maria Henao-Restrepo, Anton Camacho, Ira M Longini, Conall H Watson, W John Edmunds, Matthias Egger, Miles W Carroll, Natalie E Dean, Ibrahima Diatta, Moussa Doumbia, Bertrand Draguez, Sophie Duraffour, Godwin Enwere, Rebecca Grais, Stephan Gunther, Pierre-Stéphane Gsell, Stefanie Hossmann, Sara Viksmoen Watle, Mandy Kader Kondé, Sakoba Kéïta, Souleymane Kone, Eewa Kuisma, Myron M Levine, Sema Mandal, Thomas Mauget, Gunnstein Norheim, Ximena Riveros, Aboubacar Soumah, Sven Trelle, Andrea S Vicari, John-Arne Røttingen, Marie-Paule Kieny
BACKGROUND: rVSV-ZEBOV is a recombinant, replication competent vesicular stomatitis virus-based candidate vaccine expressing a surface glycoprotein of Zaire Ebolavirus. We tested the effect of rVSV-ZEBOV in preventing Ebola virus disease in contacts and contacts of contacts of recently confirmed cases in Guinea, west Africa. METHODS: We did an open-label, cluster-randomised ring vaccination trial (Ebola ça Suffit!) in the communities of Conakry and eight surrounding prefectures in the Basse-Guinée region of Guinea, and in Tomkolili and Bombali in Sierra Leone...
December 23, 2016: Lancet
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