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a complementary affair

Amanda Hull, Stephanie Brooks Holliday, Christine Eickhoff, Patrick Sullivan, Rena Courtney, Kayla Sossin, Alyssa Adams, Matthew Reinhard
Complementary and integrative health (CIH) services are being used more widely across the nation, including in both military and veteran hospital settings. Literature suggests that a variety of CIH services show promise in treating a wide range of physical and mental health disorders. Notably, the Department of Veterans Affairs is implementing CIH services within the context of a health care transformation, changing from disease based health care to a personalized, proactive, patient-centered approach where the veteran, not the disease, is at the center of care...
April 5, 2018: Psychological Services
Karleen Giannitrapani, Matthew McCaa, Marie Haverfield, Robert D Kerns, Christine Timko, Steven Dobscha, Karl Lorenz
Introduction: Pain is a longstanding and growing concern among US military veterans. Although many individuals rely on medications, a growing body of literature supports the use of complementary non-pharmacologic approaches when treating pain. Our objective is to characterize veteran experiences with and barriers to accessing alternatives to medication (e.g., non-pharmacologic treatments or non-pharmacologic approaches) for pain in primary care. Materials and Methods: Data for this qualitative analysis were collected as part of the Effective Screening for Pain (ESP) study (2012-2017), a national randomized controlled trial of pain screening and assessment methods...
March 26, 2018: Military Medicine
Melat Gebre, Anna Woodbury, Vitaly Napadow, Venkatagiri Krishnamurthy, Lisa C Krishnamurthy, Roman Sniecinski, Bruce Crosson
BACKGROUND: Fibromyalgia is a chronic pain state that includes widespread musculoskeletal pain, fatigue, psychiatric symptoms, cognitive and sleep disturbances, and multiple somatic symptoms. Current therapies are often insufficient or come with significant risks, and while there is an increasing demand for non-pharmacologic and especially non-opioid pain management such as that offered through complementary and alternative medicine therapies, there is currently insufficient evidence to recommend these therapies...
February 6, 2018: JMIR Research Protocols
Babak Daneshfard, Mohammad Reza Sanaye, Majid Nimrouzi
When a paradigm starts to show signs of failure to cope with significant questions in any basic/applied branch of human knowledge, there come on the scene those who have perused the related literature enough to either answer those major questions according to the established paradigm or proffer a (wholly) new way of looking at things. In the latter case, the history of science tells us, a paradigm shift takes place. Modern medicine cannot be proven to be totally disconnected from its traditional roots. Where traditional medicine came to give its place to present-day conventional medicine, a number of humanistic aspects of healing, in addition to some axioms of old wisdom, were actually lost...
January 15, 2018: Alternative Therapies in Health and Medicine
Shannon N Zenk, Elizabeth Tarlov, Lisa M Powell, Coady Wing, Stephen A Matthews, Sandy Slater, Howard S Gordon, Michael Berbaum, Marian L Fitzgibbon
PURPOSE: To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. DESIGN: Retrospective cohort. SETTING: Continental United States. PARTICIPANTS: A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group...
March 2018: American Journal of Health Promotion: AJHP
Laura S Ellerbe, Luisa Manfredi, Shalini Gupta, Tyler E Phelps, Thomas R Bowe, Anna D Rubinsky, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics...
April 4, 2017: Addiction Science & Clinical Practice
Jaime A Davidson, Lance Sloan
Metformin is recommended as a first-line therapy for patients with type 2 diabetes mellitus (T2DM). However, many patients do not achieve glycemic goals with metformin monotherapy and require subsequent combination therapy with other antihyperglycemic agents (AHAs). For newly diagnosed patients with high blood glucose, initial combination therapy may be required to achieve glycemic control. The American Association for Clinical Endocrinologists algorithm for the treatment of T2DM recommends metformin plus a sodium glucose co-transporter 2 (SGLT2) inhibitor as the first oral combination in patients who present with HbA1c ≥7...
January 2017: Advances in Therapy
Anita Strezova, Sheila O'Neill, Cathy O'Callaghan, Astrid Perry, Jinzhu Liu, John Eden
OBJECTIVE: This study explored the attitudes to, and experience of, menopause among Macedonian women living in Australia, including attitudes and responses to hormone therapy (HT) and complementary therapies, as well as related psycho-sexual, relationship and other midlife issues. METHODS: Using qualitative methodology, the study was based on seven unstructured, nondirective group discussions. Natural social groups were recruited, meeting wherever each group felt most at home...
October 10, 2016: Menopause: the Journal of the North American Menopause Society
Mark S Bauer, Christopher J Miller, Mingfei Li, Laura A Bajor, Austin Lee
OBJECTIVES: Numerous antimanic treatments have been introduced over the past two decades, particularly second-generation antipsychotics (SGAs). However, it is not clear whether such newer agents provide any advantage over older treatments. METHODS: A historical cohort design investigated the nationwide population of outpatients with bipolar disorder treated in the Department of Veterans Affairs who were newly initiated on an antimanic agent between 2003 and 2010 (N=27 727)...
September 2016: Bipolar Disorders
Angela D Bryan, Arielle S Gillman, Natasha S Hansen
Starting school later, keeping adolescents busy with structured programming, and making free condoms available, as Steinberg (2015) suggests, are important and necessary steps, but they are simply not sufficient if the goal is reducing sexually transmitted infections and unplanned pregnancy. We agree that the current state of affairs, which in many schools involves sexuality education using programs that are not empirically supported, is unacceptable. However, abandoning sexuality education entirely would leave adolescents ill equipped to protect themselves...
July 2016: Perspectives on Psychological Science: a Journal of the Association for Psychological Science
Elizabeth Czekanski
Nurse leaders in the mental health field are challenged to ensure the mental health environment is safe and therapeutic. They must also continually evaluate whether nurses are effectively engaging therapeutically with patients in their care. Undergraduate nursing students and practicing nurses usually receive little or no training in facilitating nurse-led groups. Nurses who are trained and capable of facilitating groups may enhance therapeutic relationships and engage patients to improve treatment outcomes...
July 2016: Nursing Administration Quarterly
Carol Elizabeth Fletcher, Allison R Mitchinson, Erika L Trumble, Daniel B Hinshaw, Jeffery A Dusek
Veterans are increasingly using complementary and integrative health (CIH) therapies to manage chronic pain and other troubling symptoms that significantly impair health and quality of life. The Department of Veterans Affairs (VA) is exploring ways to meet the demand for access to CIH, but little is known about Veterans' perceptions of the VA's efforts. To address this knowledge gap, we conducted interviews of 15 inpatients, 8 receiving palliative care, and 15 outpatients receiving CIH in the VA. Pain was the precipitating factor in all participants' experience...
2016: Journal of Rehabilitation Research and Development
Ann F Chou, Danielle E Rose, Melissa Farmer, Ismelda Canelo, Elizabeth M Yano
BACKGROUND: Preventive service delivery, including cancer screenings, continues to pose a challenge to quality improvement efforts. Although many studies have focused on person-level characteristics associated with screening, less is known about organizational influences on cancer screening. OBJECTIVES: This study aims to understand the association between organizational factors and adherence to cancer screenings. METHODS: This study employed a cross-sectional design using organizational-level, patient-level, and area-level data...
December 2015: Medical Care
Ryann L Engle, Emily R Lopez, Katelyn E Gormley, Jeffrey A Chan, Martin P Charns, Carol VanDeusen Lukas
BACKGROUND: Middle managers play key roles in hospitals as the bridge between senior leaders and frontline staff. Yet relatively little research has focused on their role in implementing new practices. PURPOSE: The aim of this study was to expand the understanding of middle managers' influence in organizations by looking at their activities through the lens of two complementary conceptual frameworks. METHODOLOGY/APPROACH: We analyzed qualitative data from 17 Veterans Affairs Medical Centers with high and low potential to change organizational practices...
January 2017: Health Care Management Review
Paula Sousa, Virginie Felizardo, Daniel Oliveira, Rafael Couto, Nuno M Garcia
Temperature analysis has been considered as a complementary method in medical evaluation and diagnosis. Several studies demonstrated that monitoring the temperature variations of the feet of diabetic patients can be helpful in the early identification of diabetic foot manifestations, and also in changing behaviors, which may contribute to reducing its incidence. In this review, several and most used techniques for assessing the temperature of the feet are presented, along with original published work on specific applications in diabetic foot complications...
July 2015: Expert Review of Medical Devices
Douglas E Paull, Lisa M Mazzia, Julia Neily, Peter D Mills, James R Turner, William Gunnar, Robin Hemphill
BACKGROUND: The Universal Protocol has been associated with the prevention of wrong surgery procedures; however, such events still occur. This article explores wrong surgery events, defined as those incorrect procedures (wrong site, wrong side, wrong procedure, wrong patient, wrong level, wrong implant) that would have occurred despite the Universal Protocol including the performance of a time-out by the surgical team. Understanding why some of these events are not caught by the steps of the Universal Protocol, culminating in the time-out, can help the field to add upstream and downstream safeguards to help prevent these never events...
July 2015: American Journal of Surgery
Carol E Fletcher, Allison R Mitchinson, Erika L Trumble, Daniel B Hinshaw, Jeffery A Dusek
BACKGROUND: The integration of complementary and alternative medicine (CAM) therapies into a large organization such as the Veterans Health Administration (VHA) requires cultural change and deliberate planning to ensure feasibility and buy-in from staff and patients. At present, there is limited knowledge of VHA patient care providers' and administrators' viewpoints regarding CAM therapies and their implementation. OBJECTIVES: Our purpose was to qualitatively examine knowledge, attitudes, perceived value and perceived barriers, and/or facilitators to CAM program implementation among VHA providers and administrators at a large VHA facility...
December 2014: Medical Care
A Rani Elwy, Jennifer M Johnston, Jill E Bormann, Amanda Hull, Stephanie L Taylor
BACKGROUND: Meditation, imagery, acupuncture, and yoga are the most frequently offered mind and body practices in the Department of Veterans Affairs. Yet, the research on mind and body practices has been critiqued as being too limited in evidence and scope to inform clinical treatment. OBJECTIVES: We conducted a systematic scoping review of mind and body practices used with veterans or active duty military personnel to identify gaps in the literature and make recommendations for future primary research...
December 2014: Medical Care
Lisa M Betthauser, Lisa A Brenner, Jeri E Forster, Trisha A Hostetter, Alexandra L Schneider, Theresa D Hernández
BACKGROUND: Although Veterans utilize complementary and alternative medicine (CAM) at rates comparable with civilians, little is known about Veterans' attitudes and beliefs toward CAM. Measures to increase such knowledge may help to identify treatment preferences, particularly among those with signature conditions from the recent conflicts [ie, traumatic brain injury (TBI), posttraumatic stress disorder (PTSD)]. OBJECTIVE: This exploratory study aimed to: (1) determine the factors of the Complementary, Alternative, and Conventional Medicine Attitudes Scale (CACMAS); and to utilize the resulting factors to describe (2) attitudes and beliefs toward CAM; (3) their association with TBI, PTSD, and history of self-directed violence...
December 2014: Medical Care
Matthew J Reinhard, Thomas H Nassif, Katharine Bloeser, Erin K Dursa, Shannon K Barth, Bonnie Benetato, Aaron Schneiderman
BACKGROUND: Complementary and alternative medicine (CAM) is increasingly seen as an adjunct to traditional plans of care. This study utilized a representative sample of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans and OEF/OIF-era veterans to explore the prevalence and characteristics of CAM users. RESEARCH DESIGN: The National Health Study for a New Generation of US Veterans (NewGen) is a longitudinal health study of a population-based cohort of OEF/OIF (deployed) and OEF/OIF-era (nondeployed) veterans...
December 2014: Medical Care
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