Search

2024 NOV 16 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Veterans. According to news reporting from Miami, [...]

2024 JUN 22 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on Biotechnology - Pharmacogenomics have been presented. According to news [...]

2024 FEB 1 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Current study results on chronic kidney disease have been published. According to news reporting [...]

2024 JAN 6 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in Opioids. According to news reporting originating in [...]

Even if you don’t think you are suffering from long Covid, the effects of the infection could be lingering years after recovery, The Washington Post reports. An analysis of Veterans [...]

2023 JUN 17 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on veterans have been published. According to news reporting [...]

2022 NOV 26 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- According to news reporting based on a preprint abstract, our journalists obtained [...]

2022 JUL 28 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Investigators publish new report on breast cancer. According to news reporting out of Nashville, [...]

Objective: Academic detailing in partnership with the Opioid Overdose Education and Naloxone Distribution (OEND) program was implemented to increase naloxone access for the prevention of opioid overdose mortality in veterans at the U.S. Department of Veterans Affairs (VA). However, implementation was not uniform leading to varying levels of intervention exposure potentially impacting naloxone prescribing. We examined the impact of implementation strength (proportion of providers exposed to academic detailing) at each station on naloxone prescribing from September 2014 to December 2017. Study Design and Setting: Retrospective cohort design with fixed effects models at the VA. Data Collection/Extraction Methods: We used VA Corporate Data Warehouse for data on pharmacy dispensing, station-, provider- and patient-level characteristics. OEND-specific academic detailing activities came from data recorded by academic detailers using Salesforce.com. Principal Findings: VA stations wherein 100 percent of providers exposed to an OEND-related academic detailing educational outreach visit experienced an increased incident rate of naloxone prescribing that was 5.52 times the incident rate of stations where no providers were exposed; alternatively, this is equivalent to an average monthly increase of 2.60 naloxone prescriptions per 1000 population at risk for opioid overdose. Conclusions: Our findings highlight the importance of academic detailing's implementation strength on naloxone prescribing. Decision makers must carefully consider the implementation process to achieve the greatest effectiveness from the intervention. KEYWORDS academic detailing, educational outreach, implementation, naloxone, opioid overdose, veterans, 1 | BACKGROUND Opioid overdose mortality has become a national epidemic and public health policy concern in the United States (U.S.). There were over 47 000 opioid overdose deaths in [...]

Objective: To develop and test predictive models of housing instability and homelessness based on responses to a brief screening instrument administered throughout the Veterans Health Administration (VHA).Data Sources/Study Setting: Electronic medical record data from 5.8 million Veterans who responded to the VHA's Homelessness Screening Clinical Reminder (HSCR) between October 2012 and September 2015.Study Design: We randomly selected 80% of Veterans in our sample to develop predictive models. We evaluated the performance of both logistic regression and random forests--a machine learning algorithm--using the remaining 20% of cases.Data Collection/Extraction Methods: Data were extracted from two sources: VHA's Corporate Data Warehouse and National Homeless Registry.Principal Findings: Performance for all models was acceptable or better. Random forests models were more sensitive in predicting housing instability and homelessness than logistic regression, but less specific in predicting housing instability. Rates of positive screens for both outcomes were highest among Veterans in the top strata of model-predicted risk.Conclusions: Predictive models based on medical record data can identify Veterans likely to report housing instability and homelessness, making the HSCR screening process more efficient and informing new engagement strategies. Our findings have implications for similar instruments in other health care systems.KEYWORDShomelessness, veterans, 1 | INTRODUCTIONHousing instability and especially homelessness, which is an acute form of housing instability, are associated with a range of adverse health outcomes (1,2) and increased costs for health [...]

Objective. To examine factors associated with 0- to 7-day admission after outpatient surgery in high-volume specialties: general surgery, orthopedics, urology, ear/nose/throat, and podiatry. Study Design. We calculated rates and assessed diagnosis codes for 0- to 7-day admission after outpatient surgery for Centers for Medicare and Medicaid Services (CMS) and Veterans Health Administration (VA) dually enrolled patients age 65 and older. We also estimated separate multilevel logistic regression models to compare patient, procedure, and facility characteristics associated with postoperative admission. Data Collection. 2011-2013 surgical encounter data from the VA Corporate Data Warehouse; geographic data from the Area Health Resources File; CMS enrollment and hospital admission data. Principal Findings. Among 63,585 outpatient surgeries in 124 facilities, 0- to 7-day admission rates ranged from 5 percent (podiatry) to 28 percent (urology); nearly 66 percent of the admissions occurred on the day of surgery. Only 97 admissions were detected in the CMS data (1 percent). Surgical complications were diagnosed in 4 percent of admissions. Procedure complexity, measured by relative value units or anesthesia risk score, was associated with admission across all specialties. Conclusion. As many as 20 percent of VA outpatient surgeries result in an admission. Complex procedures are more likely to be followed by admission, but more evidence is required to determine how many of these reflect potential safety or quality problems. Key Words. Ambulatory surgery, adverse event detection, readmissions, health services research, Veterans Health Administration, Hospital admission following outpatient surgery may be associated with a patient safety problem. Similar to readmissions following inpatient surgery, some outpatient surgical admissions may be preventable with improvements in surgical [...]

Objective. To design and test the validity of a method to identify homelessness among Medicaid enrollees using mailing address data. Data Sources/Study Setting. Enrollment and claims data on Medicaid expansion enrollees in Hennepin and Ramsey counties who also provided self-reported information on their current housing situation in a psychosocial needs assessment. Study Design. Construction of address-based indicators and comparison with self-report data. Principal Findings. Among 1,677 enrollees, 427 (25 percent) self-reported homelessness, of whom 328 (77 percent) had at least one positive address indicator. Depending on the type of addresses included in the indicator, sensitivity to detect self-reported homelessness ranged from 30 to 76 percent and specificity from 79 to 97 percent. Conclusions. An address-based indicator can identify a large proportion of Medicaid enrollees who are experiencing homelessness. This approach may be of interest to researchers, states, and health systems attempting to identify homeless populations. Key Words. Medicaid expansion, homelessness, determinants of health/population health/socioeconomic causes of health, Homelessness is a serious social problem affecting over half a million Americans on any given night (Henry et al. 2015). People who are homeless experience substantial morbidity and premature mortality [...]

Objective. To assess the influence of relational climate on quality of diabetes care. Data Sources/Study Setting. The study was conducted at the Department of Veterans Affairs (VA). The VA AH Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA administrative datasets. Study Design. Multilevel panel data (2008-2012) with patients nested into clinics. Data Collection/Extraction Methods. Diabetic patients were identified using ICD-9 codes and assigned to the clinic with the highest frequency of primary care visits. Multiple quality indicators were used, including an all-or-none process measure capturing guideline compliance, the actual number of tests and procedures, and three intermediate continuous outcomes (cholesterol, glycated hemoglobin, and blood pressure). Principal Findings. The study sample included 327,805 patients, 212 primary care clinics, and 101 parent facilities in 2010. Across all study years, there were 1,568,180 observations. Clinics with the highest relational climate were 25 percent more likely to provide guideline-compliant care than those with the lowest relational climate (OR for a 1-unit increase: 1.02, p-value Conclusions. Relational climate is positively associated with tests and procedures provision, but not with intermediate outcomes of diabetes care. Key Words. Diabetes, primary care, quality of care, relational climate, Successful diabetes quality improvement strategies often involve enhancing team functioning. Expanding roles, building multidisciplinary teams, and collaboratively providing care are a common quality improvement formula (Wagner 2000; Shojania et al. [...]

2021 AUG 21 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on Enzymes and Coenzymes - Protein-Tyrosine Kinases is now [...]