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https://www.readbyqxmd.com/read/28317097/engagement-in-advance-care-planning-and-surrogates-knowledge-of-patients-treatment-goals
#1
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/28301590/predictors-of-suicide-in-the-patient-population-admitted-to-a-locked-door-psychiatric-acute-ward
#2
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
#3
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
#4
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/28290938/postconcussive-symptoms-ptsd-and-medical-disease-burden-in-treatment-seeking-oef-oif-ond-veterans
#5
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
#6
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
#7
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
#8
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/28288681/a-study-to-reduce-readmissions-after-surgery-in-the-veterans-health-administration-design-and-methodology
#9
Laurel A Copeland, Laura A Graham, Joshua S Richman, Amy K Rosen, Hillary J Mull, Edith A Burns, Jeff Whittle, Kamal M F Itani, Mary T Hawn
BACKGROUND: Hospital readmissions are associated with higher resource utilization and worse patient outcomes. Causes of unplanned readmission to the hospital are multiple with some being better targets for intervention than others. To understand risk factors for surgical readmission and their incremental contribution to current Veterans Health Administration (VA) surgical quality assessment, the study, Improving Surgical Quality: Readmission (ISQ-R), is being conducted to develop a readmission risk prediction tool, explore predisposing and enabling factors, and identify and rank reasons for readmission in terms of salience and mutability...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28288458/gastric-acid-suppression-is-associated-with-an-increased-risk-of-adverse-outcomes-in-inflammatory-bowel-disease
#10
Rajesh Shah, Peter Richardson, Hong Yu, Jennifer Kramer, Jason Ken Hou
BACKGROUND: The intestinal microbiota may influence inflammatory bowel disease (IBD) activity. Histamine 2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) can alter the intestinal microbiota. The aim of this study was to assess the relationship between H2RAs, PPIs, and IBD-related outcomes. METHODS: We conducted a case-control study of IBD patients using the Veterans Health Affairs databases. Cases were defined by their first instance of an IBD-related hospitalization or surgery and the exposure of interest was H2RA or PPI use 30 days prior to the outcome...
March 14, 2017: Digestion
https://www.readbyqxmd.com/read/28288076/impact-of-multisystem-health-care-on-readmission-and-follow-up-among-veterans-hospitalized-for-chronic-obstructive-pulmonary-disease
#11
Seppo T Rinne, Anashua R Elwy, Lori A Bastian, Edwin S Wong, Renda S Wiener, Chuan-Fen Liu
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common causes of readmission at Veterans Affairs (VA) hospitals. Previous studies demonstrate worse outcomes for veterans with multisystem health care, though the impact of non-VA care on COPD readmissions is unknown. OBJECTIVE: To examine the association of use of non-VA outpatient care with 30-day readmission and 30-day follow-up among veterans admitted to the VA for COPD. DESIGN: This is a retrospective cohort study using VA administrative data and Medicare claims...
March 10, 2017: Medical Care
https://www.readbyqxmd.com/read/28287932/mental-disorder-prevalence-among-u-s-department-of-veterans-affairs-outpatients-with-spinal-cord-injuries
#12
Scott D McDonald, Melody N Mickens, Lisa D Goldberg-Looney, Brian J Mutchler, Michael S Ellwood, Teodoro A Castillo
OBJECTIVES: Depression and other mental disorders are more prevalent among individuals living with spinal cord injury (SCI) than in the community at large, and have a strong association with quality of life. Yet little is known about the prevalence and predictors of mental disorders among U.S. military Veterans living with SCI. The primary aim of this study was to present an estimate of mental disorder point prevalence in this population. The secondary aim was to examine the relationship of mental disorders to demographics, injury characteristics, and other clinically relevant features such as impairment from mental health problems and life satisfaction...
March 13, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28287774/evaluation-of-a-shared-decision-making-intervention-on-the-utilization-of-evidence-based-psychotherapy-in-a-va-outpatient-ptsd-clinic
#13
Jonathan D Hessinger, Melissa J London, Sheila M Baer
The Veterans Health Administration (VHA) has continued to emphasize the availability, access, and utilization of high quality mental health care particularly in the treatment of posttraumatic stress disorder (PTSD). While dissemination and availability of evidence-based psychotherapies (EBPs) have only increased, treatment engagement and utilization have continued to be oft-noted challenges. Administrators, researchers, and individual clinicians have continued to develop and explore novel systemic and individualized interventions to address these issues...
March 13, 2017: Psychological Services
https://www.readbyqxmd.com/read/28280351/regional-variation-in-post-stroke-multidisciplinary-rehabilitation-care-among-veteran-residents-in-community-nursing-homes
#14
Huanguang Jia, Qinglin Pei, Charles T Sullivan, Diane C Cowper Ripley, Samuel S Wu, W Bruce Vogel, Xinping Wang, Douglas E Bidelspach, Jennifer L Hale-Gallardo, Barbara E Bates
INTRODUCTION: Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors' functional recovery and daily living activities. The US Department of Veterans Affairs (VA) places veterans needing post-acute institutional care in private community nursing homes (CNHs). These placements are made under the same rules and regulations across the VA health care system and through individual per diem contracts between local VA facilities and CNHs. However, there is limited information about utilization of these veterans' health services as well as the geographic variation of the service utilization...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28275473/effect-of-coronary-artery-bypass-graft-surgery-on-left-ventricular-systolic-function
#15
Ryan J Koene, Jessica V Kealhofer, Selcuk Adabag, Kairav Vakil, Viorel G Florea
BACKGROUND: Changes in left ventricular (LV) systolic function in response to coronary artery bypass grafting (CABG) have not been fully assessed. METHODS: Between January 2001 and December 2014, 2,838 consecutive patients underwent isolated CABG at the Minneapolis Veterans Affairs Health Care System. Of these, 375 had echocardiographic assessment of LV function before (within 6 months) and after (3 to 24 months) CABG and were included in this analysis. RESULTS: While the mean LV ejection fraction (LVEF) did not change following CABG [(49±13)% vs...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28274228/main-drivers-of-health-expenditure-growth-in-china-a-decomposition-analysis
#16
Tiemin Zhai, John Goss, Jinjing Li
BACKGROUND: In past two decades, health expenditure in China grew at a rate of 11.6% per year, which is much faster than the growth of the country's economy (9.9% per year). As cost containment is a key aspect of China's new health system reform agenda, this study aims to identify the main drivers of past growth so that cost containment policies are focussed in the right areas. METHOD: The analysis covered the period 1993-2012. To understand the drivers of past growth during this period, Das Gupta's decomposition method was used to decompose the changes in health expenditure by disease into five main components that include population growth, population ageing, disease prevalence rate, expenditure per case of disease, and excess health price inflation...
March 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28271430/behavioral-treatment-for-veterans-with-obesity-24-month-weight-outcomes-from-the-aspire-va-small-changes-randomized-trial
#17
Lesley D Lutes, Laura J Damschroder, Robin Masheb, Hyungjin Myra Kim, Leah Gillon, Robert G Holleman, David E Goodrich, Julie C Lowery, Carol Janney, Susan Kirsh, Caroline R Richardson
BACKGROUND: Small Changes (SC) is a weight management approach that demonstrated superior 12-month outcomes compared to the existing MOVE!(®) Weight Management Program at two Veterans Affairs (VA) sites. However, approaches are needed to help graduates of treatment continue to lose or maintain their weight over the longer term. OBJECTIVE: The purpose of the present study was to examine the effectiveness of a second year of low-intensity SC support compared to support offered by the usual care MOVE! programs...
March 7, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28271426/rapid-evidence-review-of-bariatric-surgery-in-super-obesity-bmi%C3%A2-%C3%A2-%C3%A2-50-kg-m-2
#18
Kim Peterson, Johanna Anderson, Erin Boundy, Lauren Ferguson, Katherine Erickson
BACKGROUND: Despite accumulating evidence of the important health benefits of bariatric surgery in morbidly obese patients in general, bariatric surgery outcomes are less clear in higher-risk, high-priority populations of patients with BMI ≥ 50 kg/m(2). To help the Department of Veterans Affairs (VA) Health Services Research & Development Service (HSR&D) develop a research agenda, we conducted a rapid evidence review to better understand bariatric surgery outcomes in adults with BMI ≥ 50 kg/m(2)...
March 7, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28271424/a-randomized-controlled-multisite-study-of-behavioral-interventions-for-veterans-with-mental-illness-and-antipsychotic-medication-associated-obesity
#19
Zachary D Erickson, Crystal L Kwan, Hollie A Gelberg, Irina Y Arnold, Valery Chamberlin, Jennifer A Rosen, Chandresh Shah, Charles T Nguyen, Gerhard Hellemann, Dixie R Aragaki, Charles F Kunkel, Melissa M Lewis, Neena Sachinvala, Patrick A Sonza, Joseph M Pierre, Donna Ames
BACKGROUND: Weight gain and other metabolic sequelae of antipsychotic medications can lead to medication non-adherence, reduced quality of life, increased costs, and premature mortality. Of the approaches to address this, behavioral interventions are less invasive, cost less, and can result in sustained long-term benefits. OBJECTIVE: We investigated behavioral weight management interventions for veterans with mental illness across four medical centers within the Veterans Affairs (VA) Healthcare System...
March 7, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28271121/medication-use-among-veterans-across-health-care-systems
#20
Khoa A Nguyen, David A Haggstrom, Susan Ofner, Susan M Perkins, Dustin D French, Laura J Myers, Marc Rosenman, Michael Weiner, Brian E Dixon, Alan J Zillich
INTRODUCTION: Dual healthcare system use can create gaps and fragments of information for patient care. The Department of Veteran Affairs is implementing a health information exchange (HIE) program called the Virtual Lifetime Electronic Record (VLER), which allows providers to access and share information across healthcare systems. HIE has the potential to improve the safety of medication use. However, data regarding the pattern of outpatient medication use across systems of care is largely unknown...
March 8, 2017: Applied Clinical Informatics
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