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

The COVID-19 pandemic's impact on cardiovascular health behaviors including diet, physical activity, medication adherence, and self-care among people living with HIV (PLWH) remains unknown. Using qualitative analyses, we examined the impact of the COVID-19 pandemic on cardiovascular health behaviors among PLWH. Twenty-four PLWH were enrolled in this multisite study from September to October 2020.

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Association of Perceived Health Competence With Cardiac Rehabilitation Initiation.

J Cardiopulm Rehabil Prev

March 2023

Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut (Dr Hu); Departments of Biostatistics (Dr Huang) and Medicine (Drs Mayberry, Kripalani, Roumie, and Bachmann), Vanderbilt University Medical Center, Nashville, Tennessee; Departments of Population Health Sciences and Medicine, Duke University Medical Center and Durham Veterans Affairs Medical Center, Durham, North Carolina (Dr Bosworth); Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri (Dr Freedland); Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee (Drs Mayberry, Kripalani, Wallston, Roumie and Bachmann); and Medicine Service, Veterans Affairs Tennessee Valley Healthcare System-Nashville Campus, Nashville, Tennessee (Drs Roumie and Bachmann).

Purpose: Cardiac rehabilitation (CR), a program of supervised exercise and cardiovascular risk management, is widely underutilized. Psychological factors such as perceived health competence, or belief in one's ability to achieve health-related goals, may play a role in CR initiation. The aim of this study was to evaluate the association of perceived health competence with CR initiation among patients hospitalized for acute coronary syndrome (ACS) after adjusting for demographic, clinical, and psychosocial characteristics.

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Importance: COVID-19 vaccination rates remain suboptimal in the US. Identifying factors associated with vaccination can highlight existing gaps and guide targeted interventions to improve vaccination access and uptake.

Objective: To describe incidence and patient characteristics associated with primary, first booster, and second booster COVID-19 vaccination in the Veterans Health Administration (VHA).

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Background: The Covid-19 pandemic dramatically changed healthcare delivery, driving rapid expansion of synchronous (i.e., real-time) audio-only and video telehealth, otherwise known as virtual care.

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Continuity of care (COC) and amyloid-β PET scan: the CARE-IDEAS study.

Alzheimers Res Ther

January 2023

Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA.

Article Synopsis
  • High continuity of care (COC) is linked to better outcomes for older adults, but the role of amyloid-β PET scans in this context for those with mild cognitive impairment (MCI) or uncertain dementia types is unclear.
  • Researchers analyzed data from the CARE-IDEAS study (2015-2018), using a specific formula to calculate COC before and after patients received the scan, comparing results based on whether amyloid levels were elevated or not.
  • Results showed minimal change in COC scores post-scan for patients regardless of amyloid levels, indicating that the PET scan did not have a significant impact on care continuity in this Medicare beneficiary group.
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Interventions to improve lung cancer screening among racially and ethnically minoritized groups: A scoping review.

Lung Cancer

February 2023

Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC 27710, USA; Durham Veterans Affairs Medical Center, Durham, NC 27710, USA; Duke Global Health Institute, Duke University, Durham, NC, USA.

Lung cancer screening (LCS) decreases lung cancer related mortality among high-risk people who smoke cigarettes and has been endorsed by the US Preventive Services Task Force (USPSTF) since 2013. However, adoption of LCS has been limited, and disparities in LCS among racially and ethnically minoritized groups have become apparent. While recommendations to improve disparities in LCS have been made, there is a lack of information on how these recommendations have been implemented and their relative effectiveness in improving screening disparities.

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Unlabelled: Prior literature illustrates that sexual minority people (e.g., bisexual, gay, queer) are at increased vulnerability for sexual violence victimization compared to heterosexual peers, including while in college.

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Clear documentation of instructions for resuming anticoagulant and antiplatelet (AC/AP) medications after gastrointestinal endoscopy is essential for high-quality postprocedure care. Yet, these recommendations are frequently absent, which may impact patient safety. We aimed to improve documentation of postprocedural AC/AP instructions through targeted interventions during outpatient endoscopy at a Veterans Affairs Medical Center using validated Quality Improvement methodology.

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Background: Suboptimal medication adherence is a significant problem for patients with serious mental illness. Measuring medication adherence through subjective and objective measures can be challenging, time-consuming, and inaccurate.

Objective: The primary purpose of this feasibility and acceptability study was to evaluate the impact of a digital medicine system (DMS) among Veterans (patients) with serious mental illness as compared with treatment as usual (TAU) on medication adherence.

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Skin cancer is prevalent in sexual minority men but little is known about risk factors and screening specifically among couples in same-sex relationships (SSR). We aimed to compare sunburns, sun-protective behaviors, indoor tanning, and total body skin examinations (TBSEs) between people in SSR with those in opposite-sex relationships (OSR). We conducted a pooled cross-sectional analysis of 2000-2015 data from the National Health Interview Survey, a nationally representative survey of the United States civilian population.

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Consensus elements for observational research on COVID-19-related long-term outcomes.

Medicine (Baltimore)

November 2022

Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center; Department of Population Health Sciences, Duke University, Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC, USA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its long-term outcomes may be jointly caused by a wide range of clinical, social, and economic characteristics. Studies aiming to identify mechanisms for SARS-CoV-2 morbidity and mortality must measure and account for these characteristics to arrive at unbiased, accurate conclusions. We sought to inform the design, measurement, and analysis of longitudinal studies of long-term outcomes among people infected with SARS-CoV-2.

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Resident involvement in cataract surgery at the Veterans Health Administration: complications, case complexity, and the role of experience.

J Cataract Refract Surg

March 2023

From the Duke Eye Center, Durham, North Carolina (Aggarwal, Wisely, Challa); Durham Veterans Affairs Medical Center, Durham, North Carolina (Pepin, Bryan, Raghunathan, Challa); Duke Anesthesiology, Durham, North Carolina (Raghunathan).

Purpose: To characterize intraoperative complications, case complexity, and changes in complication rates with surgical experience for cataract surgeries involving residents at the Veterans Health Administration (VHA).

Setting: All VHA facilities where cataract surgery was performed.

Design: Multicenter, retrospective cohort study.

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Reply to Suresh.

Am J Physiol Lung Cell Mol Physiol

November 2022

Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University, Durham, North Carolina.

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Article Synopsis
  • The study aimed to evaluate how communication quality during family-centered rounds differed among caregivers of various racial and ethnic backgrounds.
  • Researchers conducted an observational study involving surveys and audio recordings of caregiver interactions with medical teams, analyzing both objective and subjective communication quality.
  • The results showed that Black and Latinx caregivers experienced significantly lower levels of participation, respect, and partnership compared to white caregivers, highlighting disparities in healthcare communication.
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Premature dropout from posttraumatic stress disorder treatment (PTSD) hinders treatment response. Studies have primarily used quantitative methodology to identify factors that contribute to Veterans' premature dropout, which has yielded mixed results. Qualitative methods provide rich data and generate additional hypotheses about why Veterans discontinue PTSD treatment.

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MRI Quantification of Placebo Effect in Nonalcoholic Steatohepatitis Clinical Trials.

Radiology

March 2023

From the Department of Radiology (M.A.N., M.R.B.), Division of Gastroenterology, Department of Medicine (C.A.M., M.R.B.), Department of Biostatistics & Bioinformatics (R. Lerebours, S.L., A.F.), Department of Pathology (C.G.), and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710; Rutgers University Hospital, School of Medicine, Newark, NJ (M.C.); Liver Imaging Group, Department of Radiology (M.S.M., C.B.S.), and Division of Gastroenterology, Department of Medicine (R. Loomba), University of California at San Diego School of Medicine, San Diego, Calif; Department of Medicine, Durham Veterans Affairs Medical Center, Durham, NC (C.A.M.); and Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn (M.F.A.).

Background Several early-phase clinical trials for the treatment of nonalcoholic steatohepatitis (NASH) use liver fat content as measured with the MRI-derived proton density fat fraction (PDFF) for a primary outcome. These trials have shown relative reductions in liver fat content with placebo treatment alone, a phenomenon termed "the placebo effect." This phenomenon confounds the results and limits generalizability to future trials.

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Response.

Gastrointest Endosc

November 2022

Portland Veterans Affairs Medical Center, Portland, Oregon, USA; Division of Gastroenterology and Hepatology, School of Medicine, Oregon Health and Science University, Portland, Oregon, USA.

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Purpose: The current study aimed to determine baseline clinical features among adults receiving varied levels of care for transdiagnostic eating disorders (N = 5206, 89.9% female, mean age 29 years old) that may be associated with increased care utilization.

Methods: We used negative binomial regression models to evaluate associations among eating disorder diagnoses, other psychiatric features (e.

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Background: Frailty is present in ≥50% of older adults receiving dialysis. Our objective was to a develop an administrative data-based frailty index and assess the frailty index's predictive validity for mortality and future hospitalizations.

Methods: We used United States Renal Data System data to establish two cohorts of adults aged ≥65 years, initiating dialysis in 2013 and in 2017.

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Background: Health care providers are increasingly screening patients for unmet social needs (eg, food, housing, transportation, and social isolation) and referring patients to relevant community-based resources and social services. Patients' connection to referred services is often low, however, suggesting the need for additional support to facilitate engagement with resources. SMS text messaging presents an opportunity to address barriers related to contacting resources in an accessible, scalable, and low-cost manner.

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Background: Obesity (body mass index [BMI]≥30kg/m) among US adults has tripled over the past 45 years, but it is unclear how this population-level weight change has occurred.

Objective: We sought to identify distinct long-term BMI trajectories and examined associations with demographic and clinical characteristics.

Design: The design was latent trajectory modeling over 10 years of a retrospective cohort.

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Background: The effectiveness of a third mRNA COVID-19 vaccine dose (booster dose) against the Omicron (B.1.1.

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