1,079 results match your criteria: "Providence VA Medical Center.[Affiliation]"

Introduction: Respiratory syncytial virus (RSV) is the leading cause of hospitalization among US infants. Characterizing service utilization during infant RSV hospitalizations may provide important information for prioritizing resources and interventions.

Objective: The objective of this study was to describe the procedures and services received by infants hospitalized during their first RSV episode in their first RSV season, in addition to what proportion of infants died during this hospitalization.

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Cardiovascular Risk Prediction Scores in Type 1 Diabetes: A Systematic Review and Meta-Analysis.

JACC Adv

January 2025

Division of Diabetes, Department of Medicine, Endocrinology and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA.

Background: The extent of the performance and utility of scores for the risk of cardiovascular disease (CVD) in persons with type 1 diabetes (T1DM) largely remains unclear.

Objective: The purpose of this study was to synthesize data on the performance of CVD risk scores in people living with T1DM.

Methods: This study is a systematic review and meta-analysis.

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Pulmonary hypertension (PH) increases the mortality of preterm infants with bronchopulmonary dysplasia (BPD). There are no curative therapies for this disease. Lung endothelial carnitine palmitoyltransferase 1a (Cpt1a), the rate-limiting enzyme of the carnitine shuttle system, is reduced in a rodent model of BPD.

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Article Synopsis
  • Alzheimer's disease (AD) is characterized by various pathological features including amyloid-β deposition and tau hyperphosphorylation, with cerebral microvascular dysfunction likely playing a role in its progression.
  • Researchers investigated the microvascular responses and potassium channel activity in an AD mouse model induced by streptozotocin (STZ), using behavioral tests and cellular assays.
  • The study found that STZ-AD mice showed poorer performance on behavioral tests and had impaired microvascular responses, which were further deteriorated by exposure to soluble Aβ, indicating a potential link between microvascular dysfunction and AD pathology.
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Coronavirus disease 2019 (COVID-19), caused by infection with the enveloped RNA betacoronavirus, SARS-CoV-2, led to a global pandemic involving over 7 million deaths. Macrophage inflammatory responses impact COVID-19 severity; however, it is unclear whether macrophages are infected by SARS-CoV-2. We sought to identify mechanisms regulating macrophage expression of ACE2, the primary receptor for SARS-CoV-2, and to determine if macrophages are susceptible to productive infection.

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Background: The Activities Measure for Upper Limb Amputation (AM-ULA), an activity measure for prosthesis users, uses a complex grading rubric to assign a single score to task performance which may limit responsiveness.

Purpose: To enhance AM-ULA responsiveness by exploring a scoring that uses multiple grading elements.

Study Design: Cross-sectional study.

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Article Synopsis
  • Pulmonary vascular disease is a complex condition that can arise from various underlying health issues, and precision medicine is becoming a viable approach for its diagnosis and treatment.
  • The 2023 Grover Conference Series focused on advancing our understanding of precision medicine's role in pulmonary vascular disease by examining clinical phenotypes, genetics, epigenetics, biomarker discovery, and the implications for clinical trials and care.
  • Despite promising developments, there are still challenges in effectively implementing these advanced tools in patient care.
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Introduction: Five million US Veterans had possible exposure to open burn pits used for waste disposal through service in Iraq (2003-2011) and Afghanistan (2001-2014). Burn pits generate toxic exposures that may be associated with adverse health outcomes. We examined all-cause and cause-specific mortality in relation to deployment to bases with open burn pits.

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Home- and community-based services (HCBS) are increasingly favored over nursing home care by older consumers and by policymakers. Consumer-reported unmet service needs in HCBS are important service quality and person-centeredness indicators. Yet, we know little about consumer-reported unmet needs among HCBS users.

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Medically Tailored Meals in Heart Failure: A Systematic Review of the Literature, 2013-2023.

J Card Fail

December 2024

Center for Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island.

Background: Dietary interventions have potential to improve symptoms and outcomes in patients with heart failure (HF), but there are barriers to eating nutrient-dense diets. One strategy to address challenges is to provide medically tailored meals (MTMs), fully prepared meals that align with an individual's nutritional needs. In this systematic review, we examined clinical outcomes of studies that provided MTMs to patients with HF.

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Kawasaki disease (KD), characterized by systematic vasculitis, is a leading cause of pediatric heart disease. Although recent studies have highlighted the critical role of deubiquitinases in vascular pathophysiology, their specific contribution to KD remains largely unknown. Herein, we investigated the function of the deubiquitinase USP7 in both KD patients and a CAWS-induced KD murine model.

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Effects of optimism and stage of change on alcohol use and problems among sexual minority men with HIV participating in a brief motivational interviewing intervention.

J Subst Use Addict Treat

December 2024

Alcohol Research Center on HIV, Brown University School of Public Health, Providence, RI, United States of America; Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, United States of America. Electronic address:

Introduction: Disseminating effective alcohol interventions for sexual minority men (SMM) with HIV remains a crucial public health endeavor. Motivational interviewing (MI) interventions are an established approach to reducing alcohol use, yet more research is needed to determine predictors of MI treatment outcomes and underlying mechanisms related to sustained behavior change among SMM with HIV. This pre-registered secondary analysis tested whether action-related stage of change mediated effects of a MI intervention on future alcohol use and problems among SMM with HIV, and whether individual differences in trait optimism moderated these associations.

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Geographic Variation in Prosthesis Prescription Disparities Between White and Black Veterans After Major Lower Limb Amputation: A Retrospective Cohort Analysis.

Arch Phys Med Rehabil

December 2024

Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI; Rehabilitation Research & Development Service (RR&D), Providence VA Medical Center, Providence, RI.

Objective: To examine racial disparities in lower limb prosthesis (LLP) prescription practices between White and Black veterans across different geographic levels within the United States Veterans Health Administration (VHA) and explore how racial disparities in LLP prescription practices differ by amputation level.

Design: Retrospective cohort study.

Setting: VHA facilities across the United States.

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ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.

Am J Gastroenterol

September 2024

Division of Gastroenterology, VA San Diego Healthcare System, Division of Gastroenterology, University of California San Diego, San Diego, California, USA.

Helicobacter pylori is a prevalent, global infectious disease that causes dyspepsia, peptic ulcer disease, and gastric cancer. The American College of Gastroenterology commissioned this clinical practice guideline (CPG) to inform the evidence-based management of patients with H. pylori infection in North America.

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Project G-SPACE: protocol for exploring the influence of green space on sleep and mental health among children.

BMC Pediatr

November 2024

Department of Behavioral and Social Sciences, Department of Epidemiology, Center for Health Promotion and Health Equity, School of Public Health, Brown University, Providence, RI, USA.

Background: The prevention of pediatric mental health disorders is a growing health priority in the United States. While exposure to green space, such as outdoor vegetation, has been linked with improved mental health outcomes in children, little is known about the impact of green space on children's sleep. Sleep has many benefits, but the factors affecting both sleep and mental health as they relate to green space exposure are not well understood in children.

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The Impact of a Guardianship Social Worker on Inpatient Time-To-Guardianship and Costs: Preliminary Findings.

J Gerontol Soc Work

November 2024

Center for Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, Rhode Island, USA.

Unrepresented patients who lack decision-making capacity can remain in hospitals for weeks awaiting guardianship and subsequent discharge, resulting in medically unnecessary and costly extended stays. The guardianship process is complicated and requires collaboration between the medical and legal systems. The Rocky Mountain Regional Veteran Affairs Medical Center created a guardianship social worker position to improve the guardianship process by developing subject matter expertise, infrastructure, and standardized procedures.

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Background: Prior research found that Black veterans with upper limb amputation (ULA) reported greater disability and need for assistance compared to White veterans. The extent to which racial disparities in outcomes exist outside of the Department of Veterans Affairs has not been explored.

Objective: To examine racial disparities in physical function and prosthesis satisfaction among individuals with ULA and assess the potential moderating role of veteran status.

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Objective: To investigate phenotypes of comorbidity before and after an epilepsy diagnosis in a national cohort of post-9/11 Service Members and Veterans and explore phenotypic associations with mortality.

Methods: Among a longitudinal cohort of Service Members and Veterans receiving care in the Veterans Health Administration (VHA) from 2002 to 2018, annual diagnoses for 26 conditions associated with epilepsy were collected over 5 years, ranging from 2 years prior to 2 years after the year of first epilepsy diagnosis. Latent class analysis (LCA) was used to identify probabilistic comorbidity phenotypes with distinct health trajectories.

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Article Synopsis
  • People with dementia are less likely to be admitted to high-rated nursing homes, which is concerning given their greater care needs compared to those without dementia.
  • The study found that moving to higher-rated nursing homes is linked to lower risks of readmission and mortality within 90 days for both groups, but the benefits are more pronounced for individuals with dementia.
  • The results highlight the need for better staffing in nursing homes and emphasize the importance of addressing access disparities to ensure individuals with dementia receive high-quality care.
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Background: Insomnia symptoms are pervasive and persistent in alcohol use disorder (AUD), though little is known about the mechanisms that underlie this association. We previously found that cognitive behavioral therapy for insomnia (CBT-I) reduced alcohol-related problems among veterans by improving insomnia severity (NCT03806491). In this planned secondary analysis of the same clinical trial data, we tested negative emotionality as one potential mechanism to explain this effect.

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Intracortical brain-computer interfaces (iBCIs) enable people with tetraplegia to gain intuitive cursor control from movement intentions. To translate to practical use, iBCIs should provide reliable performance for extended periods of time. However, performance begins to degrade as the relationship between kinematic intention and recorded neural activity shifts compared to when the decoder was initially trained.

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Article Synopsis
  • Current intracortical brain-computer interfaces (iBCIs) primarily use spiking data for decoding neural activity, which can be accurate but requires high sampling rates that can be challenging to maintain.
  • An alternative approach involves using local field potentials (LFPs) to capture continuous signals alongside spikes, but LFPs alone have not matched the performance of spike-based decoding.
  • This study shows that by training models to use LFPs to predict firing rates from spiking data, the performance can improve significantly, allowing for lower power iBCI devices that still achieve high accuracy, even outperforming direct spike decoding in many cases.
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Impact of Non-Alcoholic Fatty Liver Disease on Sepsis Inpatient Outcomes: A Nationwide Sample Analysis (2000-2019).

J Clin Med

September 2024

Department of Medicine, Division of Cardiology, Warren Alpert School of Medicine, Brown University, 222 Richmond St, Providence, RI 02903, USA.

Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) are reported to have an increased risk of developing severe infections, leading to hospitalizations with sepsis. However, data regarding the impact of comorbid NAFLD on in-hospital outcomes of patients with sepsis is scarce. This nationwide retrospective observational study using discharge data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), and Agency for Healthcare Research and Quality included 21,057,911 adult patients who were admitted to hospitals in the United States between 2000 and 2019 with a primary discharge diagnosis of sepsis.

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Background: Simultaneous alcohol and cannabis use is associated with riskier daily drinking. However, little research has tested momentary mechanisms through which simultaneous use predicts continued drinking during acute drinking episodes. The current study tested whether simultaneous use moments predicted within-episode increases in subjective responses, craving, and continued drinking, and whether these relations were potentiated in social versus solitary settings.

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