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https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#1
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28637450/health-care-use-and-costs-at-the-end-of-life-a-comparison-of-elderly-australian-decedents-with-and-without-a-cancer-history
#2
Rebecca Reeve, Preeyaporn Srasuebkul, Julia M Langton, Marion Haas, Rosalie Viney, Sallie-Anne Pearson
BACKGROUND: There is limited population-level research on end-of-life care in Australia that considers health care use and costs across hospital and community sectors. The aim of this study was to quantify health care use and costs in the last 6 months of life in a cohort of elderly Australian decedents and to examine the factors associated with end-of-life resource use and costs. METHODS: A retrospective cohort study using routinely collected health data from Australian Government Department of Veterans' Affairs clients...
June 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28633678/variation-in-empiric-coverage-versus-detection-of-methicillin-resistant-staphylococcus-aureus-and-pseudomonas-aeruginosa-in-hospitalizations-for-community-onset-pneumonia-across-128-us-veterans-affairs-medical-centers
#3
Barbara E Jones, Kevin Antoine Brown, Makoto M Jones, Benedikt D Huttner, Tom Greene, Brian C Sauer, Karl Madaras-Kelly, Michael A Rubin, Matthew Bidwell Goetz, Matthew H Samore
OBJECTIVE To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia. DESIGN Cross-sectional study. SETTING A total of 128 hospitals in the Veterans Affairs health system. PARTICIPANTS Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010. METHODS We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28632542/creation-and-execution-of-a-novel-anesthesia-perioperative-care-service-at-a-veterans-affairs-hospital
#4
Bret D Alvis, Adam B King, Pratik P Pandharipande, Liza M Weavind, Katelin Avila, Philip J Leisy, Muhammad Ajmal, Michael McHugh, Kirk A Keegan, David A Baker, Ann Walia, Christopher G Hughes
Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways. These are well-described methods that have shown to improve perioperative outcomes. An established perioperative surgical home model can help implementation, efficiency, and adherence to enhanced recovery after surgery pathways...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28629990/employment-stability-in-veterans-and-service-members-with-traumatic-brain-injury-a-va-traumatic-brain-injury-model-systems-study
#5
Christina Dillahunt-Aspillaga, Mary Jo Pugh, Bridget A Cotner, Marc A Silva, Adam Haskin, Xinyu Tang, Marie E Saylors, Risa Nakase-Richardson
OBJECTIVE: To examine incidence and predictors of employment stability in Veterans and Military Service Members (V/SM) with traumatic brain injury (TBI) who return to work. DESIGN: Prospective observational cohort study. SETTING: Four Department of Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRCs). PARTICIPANTS: 110 V/SM with mild (26%), moderate (22%), or severe (52%) TBI enrolled in the VA PRC TBI Model Systems database within 2 years of injury who were discharged between January 2009 and June 2015...
June 16, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28622572/differential-predictive-value-of-ptsd-symptom-clusters-for-mental-health-care-among-iraq-and-afghanistan-veterans-following-ptsd-diagnosis
#6
Noelle B Smith, Jack Tsai, Robert H Pietrzak, Joan M Cook, Rani Hoff, Ilan Harpaz-Rotem
OBJECTIVES: Veterans from the recent conflicts in Iraq and Afghanistan are being diagnosed with posttraumatic stress disorder (PTSD) at high rates. This study examined characteristics associated with mental health service utilization, specifically psychotherapy, through the Department of Veterans Affairs (VA), in a large cohort of Iraq and Afghanistan veterans newly diagnosed with PTSD. METHOD: This study utilized national VA administrative data from Iraq and Afghanistan veterans following an initial diagnosis of PTSD and completed a self-report measure of PTSD symptoms between Fiscal Years 2008-2012 (N=52,456; 91...
June 13, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28617159/ambulatory-care-coordination-issues-with-dual-use-veteran-organ-transplant-recipients
#7
Stephanie A Thrall, Leonard E Egede, David J Taber
The previous literature indicates that patients receiving ongoing care in both Veterans Affairs (VA) and non-VA setting (dual care) may have reduced health outcomes. The objective of this study was to assess the impact of dual care provided to a veteran solid organ transplant population. This was a retrospective cohort study of stable solid organ transplant recipients receiving care at both a Veterans Affairs Medical Center and transplant center. Forty-six veteran organ transplant recipients met inclusion criteria...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28614184/coordinating-care-across-health-care-systems-for-veterans-with-gynecologic-malignancies-a-qualitative-analysis
#8
Jessica L Zuchowski, Joya G Chrystal, Alison B Hamilton, Elizabeth W Patton, Laurie C Zephyrin, Elizabeth M Yano, Kristina M Cordasco
BACKGROUND: Veterans concurrently using both Veterans Affairs (VA) and community providers and facilities have increased coordination needs related to bridging their care across health care settings. Women Veterans commonly require a combination of VA and community care if they have women-specific specialty care needs, such as gynecologic malignancies. OBJECTIVES: We assessed VA women's health providers' and administrators' perceptions of coordination challenges for Veterans' gynecologic cancer care, and potential approaches for addressing these challenges...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28609600/who-do-australian-general-practitioners-refer-to-physiotherapy
#9
Sarah Dennis, Ian Watts, Ying Pan, Helena Britt
BACKGROUND: Physiotherapy plays an important role in the health of many Australians. The aims of this study were to assess changes in the rate of general practitioner (GP) referral to physiotherapists in Australia from 1998 to 2014, and to determine patient characteristics associated with increased likelihood of such referral. METHODS: Secondary analysis was undertaken of data from the Bettering the Evaluation and Care of Health program using weighted encounter data years 1998-99 to 2014-15 inclusive...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28607236/sri-lanka-s-national-assessment-on-innovation-and-intellectual-property-for-access-to-medical-products
#10
Hemantha Beneragama, Manisha Shridhar, Thushara Ranasinghe, Vajira Hw Dissanayake
In 2008, the Global strategy and plan of action on public health, innovation and intellectual property (GSPA-PHI) was launched by the World Health Organization, to stimulate fresh thinking on innovation in, and access to, medicines and to build sustainable research on diseases disproportionately affecting low- and middle-income countries. As part of the activities of the GSPA-PHI, Sri Lanka has been the first country to date to assess the national environment for medical technology and innovation. This year-long, multistakeholder, participative analysis facilitated identification of clear and implementable policy recommendations, for the government to increase its effectiveness in promoting innovation in health products through institutional development, investment and coordination among all areas relevant to public health...
September 2016: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28605268/va-staff-perceptions-of-the-role-of-the-extended-care-referral-process-in-home-and-community-based-services-versus-nursing-home-use-post-hospital-discharge
#11
Edward Alan Miller, Orna Intrator, Emily Gadbois, Stefanie Gidmark, James L Rudolph
Little is known about how the extended care referral process-its structure and participants-influences Veterans' use of home and community-based services (HCBS) over nursing home care within the Veterans Health Administration (VHA). This study thus characterizes the extended care referral process within the VHA and its impact on HCBS versus nursing home use at hospital discharge. Data derive from 35 semi-structured interviews at 12 Veterans Affairs Medical Centers (VAMCs). Findings indicate that the referral process is characterized by a commitment by care teams to consider HCBS if possible, varied practice depending on the clinician that most heavily influences care team recommendations, and care team emphasis on respecting Veteran/family preferences even when they are contrary to care team recommendations...
June 12, 2017: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/28602556/attacks-against-health-care-in-syria-2015-16-results-from-a-real-time-reporting-tool
#12
Mohamed Elamein, Hilary Bower, Camilo Valderrama, Daher Zedan, Hazem Rihawi, Khaled Almilaji, Mohammed Abdelhafeez, Nabil Tabbal, Naser Almhawish, Sophie Maes, Alaa AbouZeid
BACKGROUND: Collecting credible data on violence against health services, health workers, and patients in war zones is a massive challenge, but crucial to understanding the extent to which international humanitarian law is being breached. We describe a new system used mainly in areas of Syria with a substantial presence of armed opposition groups since November, 2015, to detect and verify attacks on health-care services and describe their effect. METHODS: All Turkey health cluster organisations with a physical presence in Syria, either through deployed and locally employed staff, were asked to participate in the Monitoring Violence against Health Care (MVH) alert network...
June 7, 2017: Lancet
https://www.readbyqxmd.com/read/28600161/a-problem-solving-intervention-for-cardiovascular-disease-risk-reduction-in-veterans-protocol-for-a-randomized-controlled-trial
#13
Jason A Nieuwsma, Laura O Wray, Corrine I Voils, Jennifer M Gierisch, Margaret Dundon, Cynthia J Coffman, George L Jackson, Rhonda Merwin, Christina Vair, Karen Juntilla, Courtney White-Clark, Amy S Jeffreys, Amy Harris, Michael Owings, Johnpatrick Marr, David Edelman
BACKGROUND: Health behaviors related to diet, tobacco usage, physical activity, medication adherence, and alcohol use are highly determinative of risk for developing cardiovascular disease. This paper describes a study protocol to evaluate a problem-solving intervention that aims to help patients at risk for developing cardiovascular disease address barriers to adopting positive health behaviors in order to reduce cardiovascular risk. METHODS: Eligible patients are adults enrolled in Veterans Affairs (VA) health care who have not experienced a cardiovascular event but are at elevated risk based on their Framingham Risk Score (FRS)...
June 23, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28599817/user-centered-design-to-improve-clinical-decision-support-in-primary-care
#14
Julian Brunner, Emmeline Chuang, Caroline Goldzweig, Cindy L Cain, Catherine Sugar, Elizabeth M Yano
BACKGROUND: A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations...
August 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28594480/comparison-of-drug-benefits-provided-by-veterans-affairs-canada-and-the-canadian-forces-health-services-group
#15
Matthew Chow, Charles J Wicks, Janice Ma, Sylvain Grenier
BACKGROUND: Drug benefits are provided at public expense to all actively serving Canadian Armed Forces (CAF) personnel, with ongoing drug coverage offered by Veterans Affairs Canada (VAC) for selected conditions following termination of employment. Differences in drug coverage between these programs could introduce risks for treatment disruption. OBJECTIVES: Work was undertaken to establish a process that would allow systematic comparison of the entire VAC and CAF formularies, and to identify and explain discordant listings in 14 therapeutic categories that pose risk of adverse outcomes with sudden treatment interruption...
May 23, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28593242/primary-care-based-skin-cancer-screening-in-a-veterans-affairs-health-care-system
#16
Susan M Swetter, Julia Chang, Amanda R Shaub, Martin A Weinstock, Eleanor T Lewis, Steven M Asch
Importance: Skin cancer screening may improve melanoma outcomes and keratinocyte carcinoma morbidity, but little is known about the feasibility of skin cancer training and clinical skin examination (CSE) by primary care practitioners (PCPs) in large health care systems. Objective: To assess the association of skin cancer training and screening by PCPs with dermatology referral patterns and rates of skin biopsies. Design, Setting, and Participants: In this pilot interventional study performed at the Veterans Affairs Palo Alto Health Care System, patients 35 years or older scheduled for an annual health habits screen in the PCP general medicine clinics were studied...
June 7, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28592279/the-effect-of-post-traumatic-stress-disorder-on-intra-operative-analgesia-in-a-veteran-population-during-cataract-procedures-carried-out-using-retrobulbar-or-topical-anesthesia-a-retrospective-study
#17
Yuna Rapoport, Laura L Wayman, Amy S Chomsky
BACKGROUND: A growing proportion of veterans treated at the Veterans Health Administration (VA) have a history of post-traumatic-stress-disorder (PTSD), and there exists a higher rate of PTSD amongst veterans than the general population. The purpose of this study is to determine the correlation between PTSD and intra-operative analgesia, intra-operative time, and anesthesia type for cataract surgery in a veteran population. Secondary objectives are to determine if patient age, and first or second eye surgery affect intra-operative pain control or are correlated with type of anesthesia modality...
June 7, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28590766/examining-burnout-depression-and-self-compassion-in-veterans-affairs-mental-health-staff
#18
David M Atkinson, John L Rodman, Paul D Thuras, Paulo R Shiroma, Kelvin O Lim
OBJECTIVES: Burnout, a state of emotional exhaustion associated with negative personal and occupational outcomes, is prevalent among healthcare providers. A better understanding of the psychological factors that may be associated with resilience to burnout is essential to develop effective interventions. Self-compassion, which includes kindness toward oneself, recognition of suffering as part of shared human experience, mindfulness, and nonjudgment toward inadequacies and failures, may be one such factor...
June 7, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28585880/service-needs-and-barriers-to-care-five-or-more-years-after-moderate-to-severe-tbi-among-veterans
#19
R Jay Schulz-Heik, John H Poole, Marie N Dahdah, Campbell Sullivan, Maheen M Adamson, Elaine S Date, Rose Salerno, Karen Schwab, Odette Harris
PRIMARY OBJECTIVE: The objective of this paper is to identify the most frequent service needs, factors associated with needs, and barriers to care among Veterans and service members five or more years after moderate to severe traumatic brain injury (TBI). RESEARCH DESIGN: Survey administered via telephone 5-16 years after injury (median eight years) and subsequent acute inpatient rehabilitation at a regional Veterans Affairs (VA) medical centre. METHODS AND PROCEDURES: Participants were 119 Veterans and military personnel, aged 23-70 (median 35), 90% male...
June 6, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28583968/racial-and-ethnic-disparities-persist-at-veterans-health-administration-patient-centered-medical-homes
#20
Donna L Washington, W Neil Steers, Alexis K Huynh, Susan M Frayne, Uchenna S Uchendu, Deborah Riopelle, Elizabeth M Yano, Fay S Saechao, Katherine J Hoggatt
Patient-centered medical homes are widely promoted as a primary care delivery model that achieves better patient outcomes. It is unknown if their benefits extend equally to all racial/ethnic groups. In 2010 the Veterans Health Administration, part of the Department of Veterans Affairs (VA), began implementing patient-centered medical homes nationwide. In 2009 significant disparities in hypertension or diabetes control were present for most racial/ethnic groups, compared with whites. In 2014 hypertension disparities were similar for blacks, had become smaller but remained significant for Hispanics, and were no longer significant for multiracial veterans, whereas disparities had become significant for American Indians/Alaska Natives and Native Hawaiians/other Pacific Islanders...
June 1, 2017: Health Affairs
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