Introduction: The Veterans Affairs Surgical Quality Improvement Program (VASQIP) trains surgical quality nurses (SQNs) at each Veterans Affairs (VA) hospital to extract or verify 187 variables from the medical record for all cardiac surgical cases. For ten preoperative laboratory values, VASQIP has a semiautomated (SA) system in which local lab values are automatically extracted, verified by SQNs, and lab values recorded at other VA facilities are manually extracted. The objective of this study was to develop and validate a method to automate the extraction of these ten preoperative laboratory values and compare results with the current SA method.
View Article and Find Full Text PDFIntroduction: Research in soldiers who had been deployed to Iraq or Afghanistan suggests that nonpharmacological treatments may be protective against adverse outcomes. However, the degree to which exercise therapy received in the U.S.
View Article and Find Full Text PDFBackground: Chronic pain presents a significant burden for both federal health care systems designed to serve combat Veterans in the United States (i.e., the Military Health System [MHS] and Veterans Health Administration [VHA]), yet there have been few studies of Veterans with chronic pain that have integrated data from both systems of care.
View Article and Find Full Text PDFBackground: Potential protective effects of nonpharmacological treatments (NPT) against long-term pain-related adverse outcomes have not been examined.
Objective: To compare active duty U.S.
Objectives: To determine the proportion of Army soldiers who utilized care in the Veterans Health Administration (VHA) Polytrauma System of Care (PSC) within the postdeployment year and to describe prevalence of polytrauma diagnoses, and receipt of opioids, nonpharmacologic treatments (NPTs), and mental health treatments in the VHA during the year following first PSC utilization.
Setting: VHA's 4-tiered integrated PSC network of specialized rehabilitation services for military members and veterans with polytrauma.
Participants: Soldiers and veterans who used the PSC during the postdeployment year after an Afghanistan or Iraq deployment ending in fiscal years 2008-2011.
Carpal tunnel release (CTR) can be performed with a variety of anesthesia techniques. General anesthesia is associated with higher risk profile and increased resource utilization, suggesting it should not be routinely used for CTR. The purpose of this study was to examine the patient factors associated with surgeons' requests for general anesthesia for CTR and the frequency of routine use of general anesthesia by Veterans Health Administration (VHA) surgeons and facilities.
View Article and Find Full Text PDFPurpose: To evaluate facility-level variation in the use of services for patients with carpal tunnel syndrome (CTS) receiving care in the Veterans Health Administration (VHA).
Methods: A national cohort of VHA patients diagnosed with CTS during fiscal year 2013 was divided into nonsurgical and operative treatment groups for comparison. We assessed the use of 5 types of CTS-related services (electrodiagnostic studies [EDS], imaging, steroid injection, oral steroids, and therapeutic modalities) in the prediagnosis and postdiagnosis periods before any operative intervention at the patient and facility levels.
Background: Transgender individuals have a gender identity that differs from the sex they were assigned at birth. The population size of transgender individuals in the United States is not well-known, in part because official records, including the US Census, do not include data on gender identity. Population surveys today more often collect transgender-inclusive gender-identity data, and secular trends in culture and the media have created a somewhat more favorable environment for transgender people.
View Article and Find Full Text PDFPsychological pain is a prominent symptom of clinical depression. We asked if frontal alpha asymmetry, frontal EEG power, and frontal fractal dimension asymmetry predicted psychological pain in adults with a history of depression. Resting-state frontal EEG (F3/F4) was recorded while participants (N=35) sat upright with their eyes closed.
View Article and Find Full Text PDFResearch on brain areas involved in experiencing emotion and physical pain is abundant; however, psychological pain has received little attention in studies of the brain. The purpose of this systematic review was to provide an overview of studies on brain function related to psychological pain. The review was limited to studies in which participants experienced actual psychological pain or recalled a significant autobiographical event that may be assumed to have involved psychological pain.
View Article and Find Full Text PDFThe author responds to Dr. Shattell's suggestion (Issues in Mental Health Nursing, 30(5), 2009) that it may be time to add psychic pain to the Joint Commission on Accreditation of Healthcare Organizations' pain management standard. Before we do so, some level of agreement is necessary on issues concerning terminology, measurement, and intervention.
View Article and Find Full Text PDF