1,409 results match your criteria: "Durham Veterans Affairs Medical Center.[Affiliation]"

Objective: Having chronic conditions may result in reduced physical and cognitive function but less is known about multimorbidity with daily movement. We examined the association of multimorbidity and device-measured total daily movement in a nationally representative sample of US adults aged ≥ 30 years from the 2011-2014 National Health and Nutrition Examination Surveys.

Methods: Any multimorbidity (≥2 conditions) and complex multimorbidity (≥3 conditions across ≥ 3 body systems) were quantified using 16 chronic conditions via self-report and/or clinical thresholds.

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Establishing normative data for questionnaires is essential for the accurate interpretation of scores, given that these norms can vary according to different subpopulations and treatment contexts. The purpose of this study was to establish norms for the Eating Disorder Examination-Questionnaire (EDE-Q) among adults receiving higher levels of care (HLOCs) for the treatment of eating disorders. Participants were 2,283 people receiving treatment at the inpatient, residential, partial hospitalization, or intensive outpatient levels of care.

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Effectiveness of Nirmatrelvir-Ritonavir Against the Development of Post-COVID-19 Conditions Among U.S. Veterans : A Target Trial Emulation.

Ann Intern Med

November 2023

Veterans Affairs Portland Health Care System, and Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University, Portland, Oregon (K.L.B.).

Article Synopsis
  • The study investigates the effectiveness of the oral antiviral nirmatrelvir-ritonavir in preventing post-COVID-19 conditions (PCCs) among nonhospitalized veterans who tested positive for COVID-19.
  • Conducted through a retrospective analysis, it compares outcomes of veterans treated with the antiviral to those who did not receive treatment over a period spanning 31 to 180 days post-infection.
  • Results showed no significant differences in the incidence of most PCCs between treated and untreated groups, but a notable reduction in venous thromboembolism and pulmonary embolism was observed in those treated with nirmatrelvir-ritonavir.
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Article Synopsis
  • Cardiovascular disease (CVD) is the top cause of death in the US, with women veterans experiencing higher mortality rates from cardiac disease compared to civilian women, highlighting the need for more research in this area.
  • The study analyzed nearly two decades of data from the US Veterans Health Administration and the Centers for Disease Control and Prevention to compare cardiac disease mortality trends among women veterans and civilian women.
  • Findings showed that between 2000 and 2017, over 817,000 women veterans were treated, with around 19,000 deaths from cardiac disease, accounting for a significant portion of total deaths in this population.
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Objective: To report the burden and correlates of poor physical performance in a diverse cohort of individuals with systemic lupus erythematosus (SLE).

Methods: In this single-visit study of 446 individuals with SLE from a population-based metropolitan Atlanta cohort, we measured physical performance via the Short Physical Performance Battery (score range 0-12; intermediate-low [<10] vs high [≥10]). We also collected demographic, clinical, and psychosocial variables and examined the associations (adjusted odds ratios [aORs]) of intermediate-low versus high physical performance with these characteristics via multivariable logistic regression.

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Purpose Of Review: The goal of this review is to summarize the recent literature linking HIV to metabolic dysfunction-associated steatotic liver disease (MASLD). This is a pressing issue due to the scale of the MASLD epidemic and the urgent need for preventive and therapeutic strategies for MASLD in PWH.

Recent Findings: The prevalence of MASLD in PWH is higher than previously appreciated, approaching 50% depending on the population and definition of MASLD.

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Use of new STOPP/START criteria in the care of older adults.

J Am Geriatr Soc

January 2024

Division of Geriatrics, Department of Medicine, School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.

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We applied implementation science frameworks to identify barriers and facilitators to veterans' acceptance of pharmacogenomic testing (PGx), which was made available as a part of clinical care at 25 VA medical centers. We conducted 30 min interviews with veterans who accepted ( = 14), declined ( = 9), or were contemplating ( = 8) PGx testing. Six team members coded one transcript from each participant group to develop the codebook and finalize definitions.

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Hydroxyurea reduces sickle cell disease (SCD) complications, but medication adherence is low. We tested 2 mobile health (mHealth) interventions targeting determinants of low adherence among patients (InCharge Health) and low prescribing among providers (HU Toolbox) in a multi-center, non-randomized trial of individuals with SCD ages 15-45. We compared the percentage of days covered (PDC), labs, healthcare utilization, and self-reported pain over 24 weeks of intervention and 12 weeks post-study with a 24-week preintervention interval.

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The Eating Disorder Examination-Questionnaire (EDE-Q) is a widely used self-report measure of eating pathology. Despite widespread use, investigations of its factor structure have proved inconclusive and rarely supported the "original" interpretation. The current study evaluates several proposed factor solutions of the EDE-Q using latent variable analysis in a sample of adult women with anorexia nervosa (AN).

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Background And Aims: Heartburn is the most common symptom seen in gastroenterology practice. We aimed to optimize cost-effective evaluation and management of heartburn.

Methods: We developed a decision analytic model from insurer and patient perspectives comparing 4 strategies for patients failing empiric proton pump inhibitors (PPIs): (1) PPI optimization without testing, (2) endoscopy with PPI optimization for all patients, (3) endoscopy with PPI discontinuation when erosive findings are absent, and (4) endoscopy/ambulatory reflux monitoring with PPI discontinuation as appropriate for phenotypic management.

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Purpose Of Review: To conduct a scoping review of articles which examined the impact of COVID-19 on HTN and HTN medication adherence among underrepresented racial/ethnic minorities.

Recent Findings: Seven studies were included in this review and impact of COVID-19 was examined at 4 levels: patient, provider, health system and society. The results indicated that patient level factors, such as high unemployment and inequitable access to telemedicine due to society factors- lack of access to high-speed Internet and variation in the offering of telehealth by health systems, were most impactful on adherence.

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A review of implementation intentions as a tool to benefit high-need patients and healthcare systems: U.S. veterans affairs as an exemplar.

Patient Educ Couns

November 2023

Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. Electronic address:

Implementation intentions (if-then plans) are an evidence-based behavior change strategy designed to translate behavioral intentions into habits [1]. Despite extensive evidence of its potential utility, this behavior change strategy is underutilized and under-researched in high-need healthcare contexts within the United States (U.S.

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Cardiac sarcoidosis (CS) is a relapsing-remitting disease, and immune suppression (IS) is the mainstay of therapy. Predictors of relapse for patients with CS in remission are not well characterized. We assessed incidence of relapse in consecutive patients with CS treated with high-dose steroids and/or steroid-sparing agents (SSA) in our center from 2000 to 2020.

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Most research on avoidant/restrictive food intake disorder (ARFID) has been with children and adolescents, while the limited research on adults with ARFID has been in the domain of outpatient treatment. This descriptive study sought to explore psychological characteristics ( = 45; measured with self-report questionnaires) and physiological characteristics ( = 66; e.g.

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Gastroesophageal Reflux Disease.

Prim Care

September 2023

Division of Gastroenterology, Duke University School of Medicine, 10207 Cerny Street, Suite 200, Raleigh, NC 27617, USA; Division of Gastroenterology, Durham Veterans Affairs Medical Center. Electronic address:

Symptoms potentially attributable to gastroesophageal reflux disease are among those most commonly reported to primary care providers in the outpatient setting. In this review, we discuss clinical approaches to the evaluation and management of these symptoms, including proton pump inhibitor trials as well as specific indications or clinical settings that warrant referral to Gastroenterology specialists.

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Background: Potentially inappropriate medications, or medications that generally carry more risk of harm than benefit in older adults, are commonly prescribed to older adults receiving dialysis. Deprescribing, a systematic approach to reducing or stopping a medication, is a potential solution to limit potentially inappropriate medications use. Our objective was to identify clinicians and patient perspectives on factors related to deprescribing to inform design of a deprescribing program for dialysis clinics.

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Article Synopsis
  • Firefighters face behavioral health challenges but often avoid seeking help due to mental health stigma, particularly internal stigma regarding treatment.
  • The study introduced a peer-led campaign called Stamp Out Stigma (SOS) aimed at reducing stigma within the fire service through testimonials and training interventions.
  • Results showed that participation in the SOS workshop significantly lowered both self-stigma and internalized stigma among firefighters, indicating its effectiveness in encouraging openness towards mental health treatment.
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Background: Transportation has been identified as a specific source of burden for cancer caregivers. This study examined cancer caregivers' subjective experiences and objectives costs associated with transportation over a 6-month period of providing end-of-life care to a family member or friend.

Methods: This was a multi-site longitudinal, prospective cohort study that followed 223 caregiver-patient dyads.

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Article Synopsis
  • NAFLD and HFpEF share common risk factors like obesity and diabetes, prompting this study to explore serum metabolites linking the two conditions.
  • A retrospective analysis of 89 patients with biopsy-confirmed NAFLD showed that 41.6% had HFpEF, and out of 1151 detected metabolites, 53 were associated with HFpEF, predominantly lipid metabolites.
  • The study suggests that altered lipid metabolism may be a significant mechanism connecting HFpEF and NAFLD.
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Introduction: Artificial intelligence chatbots could serve as an information resource for patients and a tool for clinicians. Their ability to respond appropriately to questions regarding gastroesophageal reflux disease is unknown.

Methods: Twenty-three prompts regarding gastroesophageal reflux disease management were submitted to ChatGPT, and responses were rated by 3 gastroenterologists and 8 patients.

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