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Health Affairs

Nabeel Khan, Dhruvan Patel, Yash Shah, Yu-Xiao Yang
BACKGROUND: Iron deficiency anemia (IDA) is an often unrecognized and undertreated complication of ulcerative colitis (UC). We conducted the first nationwide study in the United States to evaluate the prevalence of testing for iron deficiency (ID) in anemic UC patients and determine the frequency of treatment with iron supplementation in patients with IDA. METHODS: Nationwide cohort of patients with newly diagnosed UC in the Veterans Affairs health care system was identified...
October 18, 2016: Inflammatory Bowel Diseases
Swati Lederer, Michael J Fischer, Howard S Gordon, Anuradha Wadhwa, Subhash Popli, Elisa J Gordon
BACKGROUND: Patients with chronic kidney disease (CKD) commonly have unmet information needs. Greater patient participation in healthcare discussions can address these needs and improve health outcomes. We developed a patient-centered question prompt sheet (QPS) to engage CKD patients in healthcare conversations. METHODS: We conducted a two phase, mixed-methods, cross-sectional study involving semi-structured telephone interviews. Patients with an estimated glomerular filtration rate (eGFR) <60 ml/min/1...
October 19, 2016: BMC Nephrology
Marianne H Gillam, Nicole L Pratt, Maria C S Inacio, Elizabeth E Roughead, Sepehr Shakib, Stephen J Nicholls, Stephen E Graves
Background and purpose - It is unclear whether metal particles and ions produced by mechanical wear and corrosion of hip prostheses with metal-on-metal (MoM) bearings have systemic adverse effects on health. We compared the risk of heart failure in patients with conventional MoM total hip arthroplasty (THA) and in those with metal-on-polyethylene (MoP) THA. Patients and methods - We conducted a retrospective cohort study using data from the Australian Government Department of Veterans' Affairs health claims database on patients who received conventional THA for osteoarthritis between 2004 and 2012...
October 19, 2016: Acta Orthopaedica
Christine Anne Ganzer
: A review of recent research and its relevance for nurses in all settings. ABSTRACT: The last two decades have seen increasing numbers of women entering all branches of the U.S. armed forces. Now that women in the military are no longer prohibited from holding direct combat positions, they are often exposed to traumatic events that place them at higher risk for mental health conditions. Nurses working within the Veterans Affairs (VA) system and those working in non-VA settings are likely to encounter female veterans...
October 13, 2016: American Journal of Nursing
Nancy J Carballo, Cathy A Alessi, Jennifer L Martin, Michael N Mitchell, Ron D Hays, Nananda Col, Emily S Patterson, Stella Jouldjian, Karen Josephson, Constance H Fung
PURPOSE: Obstructive sleep apnea is a prevalent sleep disorder among older adults. Oral appliances are increasingly prescribed as therapy for obstructive sleep apnea. Adherence to oral appliance therapy is highly variable. Based on value-expectancy theory and other social-psychological theories, adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. We examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy...
October 14, 2016: Clinical Therapeutics
Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
Raya Elfadel Kheirbek, Janusz Wojtusiak, Sorina O Vlaicu, Farrokh Alemi
BACKGROUND: Heart failure is the leading cause for 30-day all-cause readmission. Although racial disparities in health care are well documented, their impact on 30-day all-cause readmission rate is inconclusive. OBJECTIVE: We examined the impact of racial disparity on 30-day readmission for hospitalized patients with heart failure. METHODS: This is a retrospective secondary data analysis for a large veteran cohort in 130 Veterans Affairs Medical Centers...
October 2016: Quality Management in Health Care
Megan Simmons, Lucia Guerra-Reyes, Beth Meyerson, Kristin Adams, Stephanie Sanders
BACKGROUND: In 2014, the Centers for Disease Control and Prevention and the Office of Population Affairs released a document entitled Providing Quality Family Planning Services (QFP), which outlined recommendations for delivery of family planning services using a client-centered approach. These aimed to standardize service provision and address numerous reproductive health challenges. To date, little is known about QFP implementation or the factors influencing its adoption by clinicians...
October 13, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Craig S Rosen, Kathryn J Azevedo, Quyen Q Tiet, Carolyn J Greene, Amanda E Wood, Patrick Calhoun, Thomas Bowe, Bruce P Capehart, Eric F Crawford, Mark A Greenbaum, Alex H S Harris, Michael Hertzberg, Steven E Lindley, Brandy N Smith, Paula P Schnurr
OBJECTIVE: This study assessed whether adding telephone care management to usual outpatient mental health care improved treatment attendance, medication compliance, and clinical outcomes of veterans with posttraumatic stress disorder (PTSD). METHODS: In a multisite randomized controlled trial, 358 veterans were assigned to either usual outpatient mental health treatment (N=165) or usual care plus twice-a-month telephone care management (TCM) and support in the first three months of treatment (N=193)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
R Scott Johnson, Andrea G Stolar, James F McGuire, Krithika Mittakanti, Sean Clark, Loretta A Coonan, David P Graham
OBJECTIVE: Significant variability exists regarding the criteria and procedures used by different veterans' courts (VCs) across the country. Limited guidance is available regarding which VC model has the most successful outcomes. The purpose of this study was to examine factors associated with incarceration during VC participation. METHODS: This study used data for 1,224 veterans collected from the HOMES (Homeless Operations Management and Evaluation System) database of the Department of Veterans Affairs, as well as data from a national phone survey inventory of all U...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Brandon Battis, Linda Clifford, Mostaqul Huq, Edrick Pejoro, Scott Mambourg
OBJECTIVES: Patients treated with oral chemotherapy appear to have less contact with the treating providers. As a result, safety, adherence, medication therapy monitoring, and timely follow-up may be compromised. The trend of treating cancer with oral chemotherapy agents is on the rise. However, standard clinical guidance is still lacking for prescribing, monitoring, patient education, and follow-up of patients on oral chemotherapy across the healthcare settings. The purpose of this project is to establish an oral chemotherapy monitoring clinic, to create drug and lab specific provider order sets for prescribing and lab monitoring, and ultimately to ensure safe and effective treatment of the veterans we serve...
October 12, 2016: Journal of Oncology Pharmacy Practice
S L Jackson, S E Safo, L R Staimez, D E Olson, K M V Narayan, Q Long, J Lipscomb, M K Rhee, P Wilson, A M Tomolo, L S Phillips
AIMS: To test the hypothesis that a 50-g oral glucose challenge test with 1-h glucose measurement would have superior performance compared with other opportunistic screening methods. METHODS: In this prospective study in a Veterans Health Administration primary care clinic, the following test performances, measured by area under receiver-operating characteristic curves were compared: oral glucose challenge test; random glucose; and HbA1c level, using an oral glucose tolerance test as the 'gold standard'...
October 11, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Marnie L Brennan, Nick Wright, Wendela Wapenaar, Susanne Jarratt, Pru Hobson-West, Imogen F Richens, Jasmeet Kaler, Heather Buchanan, Jonathan N Huxley, Heather M O'Connor
Disease prevention and control practices are frequently highlighted as important to ensure the health and welfare of farmed animals, although little is known as to why not many practices are carried out. The aim of this study was to identify the motivators and barriers of dairy cattle farmers towards the use of biosecurity measures on dairy farms using a health psychology approach. Twenty-five farmers on 24 farms in Great Britain (GB) were interviewed using the Theory of Planned Behaviour framework. Results indicated that farmers perceived they had the ability to control what happened on their farms in terms of preventing and controlling disease, and described benefits from being proactive and vigilant...
October 11, 2016: Animals: An Open Access Journal From MDPI
Dawn M Klein, Kassi Pham, Leila Samy, Adam Bluth, Kim M Nazi, Matthew Witry, J Stacey Klutts, Kathleen M Grant, Adi V Gundlapalli, Gary Kochersberger, Laurie Pfeiffer, Sergio Romero, Brian Vetter, Carolyn L Turvey
INTRODUCTION: Information continuity is critical to person-centered care when patients receive care from multiple healthcare systems. Patients can access their electronic health record data through patient portals to facilitate information exchange. This pilot was developed to improve care continuity for rural Veterans by (1) promoting the use of the Department of Veterans Affairs (VA) patient portal to share health information with non-VA providers, and (2) evaluating the impact of health information sharing at a community appointment...
October 11, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
(no author information available yet)
The Department of Veterans Affairs (VA) is adding to its medical regulations a program for the repayment of educational loans for certain psychiatrists who agree to a period of obligated service with VA. This program is intended to increase the pool of qualified VA psychiatrists and increase veterans' access to mental health care.
September 29, 2016: Federal Register
Hamada H Altalib, Khalid Elzamzamy, Mary Jo Pugh, Javier Ballester Gonzalez, Kei-Hoi Cheung, Brenda T Fenton, Robert D Kerns, Cynthia A Brandt, W Curt LaFrance
Management of psychogenic nonepileptic seizures (PNES) requires collaboration among and between health care professionals. Although criteria are established for diagnosis of PNES, miscommunication between neurologists, primary care providers, and mental health professionals may occur if the clinical impression is not clearly articulated. We extracted progress notes from the Department of Veterans Affairs (VA) electronic health record (EHR) nationally to study veterans who were evaluated for PNES. Of the 750 patients being worked up for PNES, the majority of patients did not meet criteria for PNES (64...
October 7, 2016: Epilepsy & Behavior: E&B
Gillian E Caughey, Agnes I Vitry, Emmae N Ramsay, Andrew L Gilbert, Sepehr Shakib, Philip Ryan, Adrian Esterman, Robyn A McDermott, Elizabeth E Roughead
BACKGROUND: Little is known about the impact of a general practitioner management plan (GPMP) on health outcomes of patients with diabetes. AIM: To examine the impact of a GPMP on risk of hospitalisation for diabetes. METHODS: A retrospective study using administrative data from the Australian Government Department of Veterans' Affairs was conducted (1st July 2006 to 30th June 2014) of diabetes patients either exposed or unexposed to a GPMP...
October 8, 2016: Internal Medicine Journal
Navid Ghaffarzadegan, Alireza Ebrahimvandi, Mohammad S Jalali
Post-traumatic stress disorder (PTSD) stands out as a major mental illness; however, little is known about effective policies for mitigating the problem. The importance and complexity of PTSD raise critical questions: What are the trends in the population of PTSD patients among military personnel and veterans in the postwar era? What policies can help mitigate PTSD? To address these questions, we developed a system dynamics simulation model of the population of military personnel and veterans affected by PTSD...
2016: PloS One
Jolie N Haun, Margeaux Chavez, Kim M Nazi, Nicole Antinori
BACKGROUND: The US Department of Veterans Affairs (VA) has developed various health information technology (HIT) resources to provide accessible veteran-centered health care. Currently, the VA is undergoing a major reorganization of VA HIT to develop a fully integrated system to meet consumer needs. Although extensive system documentation exists for various VA HIT systems, a more centralized and integrated perspective with clear documentation is needed in order to support effective analysis, strategy, planning, and use...
October 6, 2016: Journal of Medical Internet Research
Sadip Pant, Avnish Tripathi
No abstract text is available yet for this article.
October 11, 2016: Journal of the American College of Cardiology
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