The Role of Affect and Coping in Diabetes Self-Management in Rural Adults with Uncontrolled Diabetes and Depressive Symptoms.

Many patients with diabetes have poorly controlled blood sugar levels and remain at risk for serious diabetes complications, despite access to effective diabetes treatments and services. Using the transactional model of stress and coping framework, the study investigated the contributions of affect (Positive and Negative Affect Schedule) and coping (maladaptive and adaptive coping from the Brief Cope) on diabetes self-management behaviors, namely diet and exercise. One hundred seventy-eight rural adults with uncontrolled diabetes and moderate depressive symptoms completed the measures.

Evaluating screening approaches for hepatocellular carcinoma in a cohort of HCV related cirrhosis patients from the Veteran's Affairs Health Care System.

Background: Hepatocellular carcinoma (HCC) has limited treatment options in patients with advanced stage disease and early detection of HCC through surveillance programs is a key component towards reducing mortality. The current practice guidelines recommend that high-risk cirrhosis patients are screened every six months with ultrasonography but these are done in local hospitals with variable quality leading to disagreement about the benefit of HCC surveillance. The well-established diagnostic biomarker α-Fetoprotein (AFP) is used widely in screening but the reported performance varies widely across studies.

Association of low-density lipoprotein pattern with mortality after myocardial infarction: Insights from the TRIUMPH study.

Background: Studies of incident coronary heart disease risk within low-density lipoprotein (LDL) subclass (small, dense vs large, buoyant) have shown mixed results. No prospective cohort study has examined the association of small, dense, or large, buoyant LDL with mortality after myocardial infarction (MI).

Objective: The objective of the study was to examine association of LDL pattern after MI and death.

Delivery of mental health treatment to combat veterans with psychiatric diagnoses and TBI histories.

Traumatic brain injury (TBI) and mental health (MH) disorders are prevalent in combat veterans returning from Afghanistan and/or Iraq (hereafter referred to as returning veterans). Accurate estimates of service utilization for veterans with and without TBI exposure (referred to as TBI history) are imperative in order to provide high quality healthcare to returning veterans. We examined associations between TBI history and MH service utilization in a subsample of returning veterans who were newly diagnosed with posttraumatic stress disorder (PTSD), depression, and/or anxiety in the 2010 fiscal year (N = 55,458).

Recognition of anxiety, depression, and PTSD in patients with COPD and CHF: Who gets missed?

Objective: This study sought to identify patient factors associated with mental health (MH) recognition and treatment in medically ill Veterans.

Method: Retrospective data from patient electronic medical records (EMR) and self-report data were reviewed for 180 Veterans with cardiopulmonary conditions who met diagnostic criteria for anxiety, depression, or posttraumatic stress disorder on the Mini-International Neuropsychiatric Interview. Multivariate logistic regression examined the association of medical record MH recognition and MH service use with patient factors, including anxiety and depression severity, self-efficacy, locus of control, coping, illness intrusiveness, and health-related quality of life (QOL).

Cognitive and Perceptual Factors, Not Disease Severity, Are Linked with Anxiety in COPD: Results from a Cross-Sectional Study.

Purpose: Guided by the Transactional Model of Stress and Coping, the purpose of this cross-sectional study was to examine clinical factors-demographics, chronic obstructive pulmonary disease (COPD) severity, cognitive/perceptual variables (appraisal and coping)-and their relationship to clinically elevated symptoms of anxiety in a sample of veterans with COPD.

Method: Participants included a sample of veterans with COPD, with or without comorbid congestive heart failure, and clinically significant symptoms of anxiety (n = 172, mean age = 65.3, SD = 8.

Value of lymph node positivity in treatment planning for early stage pancreatic cancer.

Background: Multimodal therapy is recommended for early stage pancreatic cancer, although whether all patients benefit and the optimal timing of chemotherapy remain unclear.

Methods: Retrospective cohort study of patients aged 18-79 years with stage I-II pancreatic ductal adenocarcinoma in the National Cancer Database (2004-2012). Patients were grouped based on treatment strategy as surgery only, adjuvant, and preoperative.

Systolic and pulse pressure associate with incident knee osteoarthritis: data from the Osteoarthritis Initiative.

We evaluated the relationship of systolic blood pressure, diastolic blood pressure, pulse pressure, and treatment with antihypertensives with knee osteoarthritis incidence in a US cohort. We performed a longitudinal study (2004-2010) nested within the Osteoarthritis Initiative Study including only individuals without knee osteoarthritis at baseline. Systolic blood pressure, diastolic blood pressure, and pulse pressure were assessed at baseline, 12-, 24-, and 36-month visits.

Supervision Needs Following Veteran and Service Member Moderate to Severe Traumatic Brain Injury: A VA TBI Model Systems Study.

Objective: To characterize supervision levels across residential settings at 1 year post-TBI and explore predictors of supervision in a Veteran and Service-member population.

Setting: Five VA Polytrauma Rehabilitation Centers.

Participants: A total of 302 individuals enrolled in the VA TBI Model Systems (TBIMS) research program.

Development of a clinical prediction algorithm for knee osteoarthritis structural progression in a cohort study: value of adding measurement of subchondral bone density.

Background: Risk prediction algorithms increase understanding of which patients are at greatest risk of a harmful outcome. Our goal was to create a clinically useful prediction algorithm for structural progression of knee osteoarthritis (OA), using medial joint space loss as a proxy; and to quantify the benefit of including periarticular bone mineral density (BMD) in the algorithm.

Methods: Participants were from the Osteoarthritis Initiative (OAI) Progression Cohort, with X-ray readings of medial joint space at 36- and 48-month visits, and a 30- or 36-month medial-to-lateral tibial BMD ratio (M:L BMD ratio) value.

A Psychometric Evaluation of the Pleasant Events Schedule-Alzheimer's Disease (Short Version): Among a Veteran Population.

Alzheimer's disease and other dementias are often associated with a gradual loss of the ability to participate in rewarding activities. Caregivers may struggle with spending quality time with the person with dementia (PWD) when the demands of caregiving dominate. However, the importance of activity participation among PWDs is internationally recognized.

Increased utilization of prolonged exposure and cognitive processing therapy over time: A case example from a large Veterans Affairs posttraumatic stress disorder clinic.

Prior single-site and regional studies have documented difficulties in implementing prolonged exposure (PE) and cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) into practice in Veterans Affairs (VA) Medical Centers, estimating that between 6% and 13% of VA patients with PTSD receive PE or CPT (Lu, Plagge, Marsiglio, & Dobscha, 2016; Mott et al., 2014; Shiner et al., 2013).

Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions.

Psychological interventions have a long history of successful treatment of patients suffering from mental health and certain medical conditions. At the same time, psychotherapy research has revealed key areas of growth for optimizing patient care. These include identifying novel treatment delivery methods that increase treatment adherence, developing new strategies to more effectively address the ever-growing population of patients with comorbid conditions, and elucidating the mechanisms by which effective treatments work in order to further refine their design.

Electronic Detection of Delayed Test Result Follow-Up in Patients with Hypothyroidism.

Background: Delays in following up abnormal test results are a common problem in outpatient settings. Surveillance systems that use trigger tools to identify delayed follow-up can help reduce missed opportunities in care.

Objective: To develop and test an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism.

Finding Diagnostic Errors in Children Admitted to the PICU.

Objectives: To determine whether the Safer Dx Instrument, a structured tool for finding diagnostic errors in primary care, can be used to reliably detect diagnostic errors in patients admitted to a PICU.

Design And Setting: The Safer Dx Instrument consists of 11 questions to evaluate the diagnostic process and a final question to determine if diagnostic error occurred. We used the instrument to analyze four "high-risk" patient cohorts admitted to the PICU between June 2013 and December 2013.

Clinical Manifestations of Helicobacter pylori-Negative Gastritis.

Background & Aims: There are data to suggest the existence of non-Helicobacter pylori gastritis. However, the risk factors and clinical course for H pylori-negative gastritis remain unclear. We aimed to examine the prevalence and determinants of H pylori-negative gastritis in a large multiethnic clinical population.

Sedative-Hypnotic Use Among Older Adults Participating in Anxiety Research.

Older adults are prescribed sedative-hypnotic medications at higher rates than younger adults. These are not recommended for older adults due to risk of sedation, cognitive impairment, and falls. Severe generalized anxiety disorder (GAD) is a possibly appropriate use of these medications in older people, but little is available on use of sedative-hypnotic medications among older adults with GAD.

Determinants of Healthcare Utilization Among Veterans with Inflammatory Bowel Disease.

Background: Identifying patient-level and disease-specific predictors of healthcare utilization in inflammatory bowel disease (IBD) may allow targeted interventions to reduce costs and improve outcomes.

Aim: To identify demographic and clinical predictors of healthcare utilization among veterans with IBD.

Methods: We conducted a single-center cross-sectional study of veterans with IBD from 1998 to 2010.

Shiftwork Is Not Associated with Increased Risk of NAFLD: Findings from the National Health and Nutrition Examination Survey.

Aims: There is increased focus on the metabolic impact of shiftwork, especially given the significant number of employees who work nighttime or rotating shifts. Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. We conducted a cross-sectional study to examine the association between shiftwork and the risk of NAFLD.

Classifying diabetes-burden: A factor analysis of the Problem Areas in Diabetes Scale.

This study sought to identify salient factors associated with the Problem Areas in Diabetes Scale to facilitate improved assessment and treatment of diabetes-related burden. Exploratory factor analysis assessed the factor structure of the Problem Areas in Diabetes Scale among 224 Veterans with uncontrolled type 2 diabetes and depressive symptoms. A four-factor solution of emotional, diabetes management, treatment, and social support burden subscales was extracted.

Mental Health of Transgender Veterans of the Iraq and Afghanistan Conflicts Who Experienced Military Sexual Trauma.

Little is known about military sexual trauma (MST) in transgender veterans. To address this gap, we examined archival data regarding transgender veterans from the Iraq and Afghanistan conflicts. There were 332 transgender veterans treated at the Veterans Health Administration between 2000 and 2013 (78 men, 254 women; mean age 33.

Nonsteroidal Anti-Inflammatory Drug Use is Not Associated With Reduced Risk of Barrett's Esophagus.

Objectives: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduced risk of esophageal adenocarcinoma. Epidemiological studies examining the association between NSAID use and the risk of the precursor lesion, Barrett's esophagus, have been inconclusive.

Methods: We analyzed pooled individual-level participant data from six case-control studies of Barrett's esophagus in the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON).

Assessment of Gaps in Care and the Development of a Care Pathway for Anemia in Patients with Inflammatory Bowel Diseases.

Background: Anemia is a common complication among patients with inflammatory bowel diseases (IBD) and is associated with high rates of IBD-related complications, resource utilization, and impaired quality of life. Despite practice guidelines for anemia in patients with IBD, gaps remain in the perceptions of anemia among health care providers. The aims of this study were to identify gaps in care and to develop a care pathway for anemia in patients with IBD.

Pain Among Community-Dwelling Older Adults with Dementia: Factors Associated with Undertreatment.

Objective: To identify factors associated with no analgesic treatment in community-dwelling older adults with mild-to-moderate dementia and moderate-to-severe pain.

Design: Secondary analysis of a randomized controlled trial.

Setting: Michael E.