Challenges, Facilitators, and Recommendations for Implementation of Home Dialysis in the Veterans Health Administration: Patient, Caregiver, and Clinician Perceptions.

Background: Home dialysis confers similar survival and greater quality of life than in-center hemodialysis for adults with ESKD but remains underutilized. We examined challenges and facilitators to implementation of home dialysis and identified stakeholder-centered strategies for improving it.

Methods: We conducted a qualitative, cross-sectional, multisite evaluation that included five geographically dispersed Veterans Health Administration (VHA) home dialysis programs.

Electronic Health Record Portal Messages and Interactive Voice Response Calls to Improve Rates of Early Season Influenza Vaccination: Randomized Controlled Trial.

Background: Patient reminders for influenza vaccination, delivered via an electronic health record patient portal and interactive voice response calls, offer an innovative approach to engaging patients and improving patient care.

Objective: The goal of this study was to test the effectiveness of portal and interactive voice response outreach in improving rates of influenza vaccination by targeting patients in early September, shortly after vaccinations became available.

Methods: Using electronic health record portal messages and interactive voice response calls promoting influenza vaccination, outreach was conducted in September 2015.

Screening for Gambling Disorder in VA Primary Care Behavioral Health: A Pilot Study.

The current pilot study assessed the prevalence of at-risk/problem gambling using the Brief Biosocial Gambling Screen (BBGS) among a sample of U.S. military veterans seeking mental health treatment services in a primary care medical setting at a Veterans Affairs (VA) hospital in the Northeast.

Beneficial association of angiotensin-converting enzyme inhibitors and statins on the occurrence of possible Alzheimer's disease after traumatic brain injury.

Background: Pathological analysis of brain tissue from animals and humans with a history of traumatic brain injury (TBI) suggests that TBI could be one of the risk factors facilitating onset of dementia with possible Alzheimer's disease (AD), but medications to prevent or delay AD onset are not yet available.

Methods: This study explores four medication classes (angiotensin-converting enzyme inhibitors (ACEI), beta blockers, metformin, and statins) approved by the Food and Drug Administration (FDA) for other indications and evaluates their influence when used in combination on the risk of possible AD development for patients with a history of TBI. We identified patients with history of TBI from an existing Department of Veterans Affairs (VA) national database.

Enhancing behavioral change among lung cancer survivors participating in a lifestyle risk reduction intervention: a qualitative study.

Purpose: Early detection and improved treatment have increased lung cancer survival. Lung cancer survivors have more symptom distress and lower function compared with other cancer survivors; however, few interventions are available to improve health-related quality of life (HR-QOL). Lifestyle risk reduction interventions have improved HR-QOL in other cancer survivors.

Dental Care in an Equal Access System Valuing Equity: Are There Racial Disparities?

Background: Racial disparities in dental care have previously been shown in the Veterans Health Administration (VA)-a controlled access setting valuing equitable, high-quality care.

Objectives: The aim of this study is to examine current disparities in dental care by focusing on the receipt of root canal therapy (RCT) versus tooth extraction.

Research Design: This is a retrospective analysis of data contained in the VA's electronic health records.

A cohort study examining headaches among veterans of Iraq and Afghanistan wars: Associations with traumatic brain injury, PTSD, and depression.

Objectives: To describe the prevalence and persistence of headache and associated conditions in an inception cohort of U.S. veterans of Iraq and Afghanistan wars.

The prevalence of epilepsy and association with traumatic brain injury in veterans of the Afghanistan and Iraq wars.

Objective: To examine the association of epilepsy with traumatic brain injury (TBI) in Afghanistan and Iraq (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]) Veterans.

Design: Cross-sectional observational study.

Participants: A total 256 284 OEF/OIF Veterans who received inpatient and outpatient care in the Veterans Health Administration in fiscal years 2009-2010.

Patient factors associated with transfusion practices in Veterans Affairs intensive care units: implications for further research.

Purpose: We sought to describe how patient characteristics influence the frequency of red blood cell (RBC) transfusions among critically ill patients after taking into account hemoglobin (Hgb) level.

Methods: This was a retrospective cohort study using secondary analysis of administrative data of Veterans Affairs intensive care unit (ICU) admissions. The outcome of interest was RBC transfusion during the first 30 days of ICU admission.

Comparison of health outcomes for male seniors in the Veterans Health Administration and Medicare Advantage plans.

Objectives: To compare the Veterans Health Administration (VHA) with the Medicare Advantage (MA) plans with regard to health outcomes.

Data Sources: The Medicare Health Outcome Survey, the 1999 Large Health Survey of Veteran Enrollees, and the Ambulatory Care Survey of Healthcare Experiences of Patients (Fiscal Years 2002 and 2003).

Study Design: A retrospective study.

Attributions and reported communication of a diagnosis of down syndrome.

This study investigates attributions and reported communication in 97 neonatologists who responded to a vignette-based questionnaire depicting a woman with 1 of 3 prenatal screening histories for Down syndrome (DS) who had just given birth to a child with DS: not offered screening, refused screening, or received a false negative result on screening. Neonatologists reported blaming and attributing more control to women who refused prenatal screening for DS. Attributions of blame, but not control, were associated with reports of communicating more negative information on DS to parents.

Money: personal issues affect professional practice.

Money is a taboo subject. Clinicians have much ambivalence about money, both personally and professionally, and are often more comfortable discussing clients' issues around money than examining their own. As a result, how clinicians handle money with clients is often determined by the clinicians' personal feelings about money; however, they do not explore the meaning and origin of these feelings or determine how these feelings affect their practices.