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Sample records for affairs va health

  1. Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

    ERIC Educational Resources Information Center

    Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

    2008-01-01

    Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…

  2. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ..., manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the VA... Intent to Enter into an Enhanced-Use Lease. SUMMARY: The Secretary of VA intends to enter into an EUL...

  3. Determination of VA health care costs.

    PubMed

    Barnett, Paul G

    2003-09-01

    In the absence of billing data, alternative methods are used to estimate the cost of hospital stays, outpatient visits, and treatment innovations in the U.S. Department of Veterans Affairs (VA). The choice of method represents a trade-off between accuracy and research cost. The direct measurement method gathers information on staff activities, supplies, equipment, space, and workload. Since it is expensive, direct measurement should be reserved for finding short-run costs, evaluating provider efficiency, or determining the cost of treatments that are innovative or unique to VA. The pseudo-bill method combines utilization data with a non-VA reimbursement schedule. The cost regression method estimates the cost of VA hospital stays by applying the relationship between cost and characteristics of non-VA hospitalizations. The Health Economics Resource Center uses pseudo-bill and cost regression methods to create an encounter-level database of VA costs. Researchers are also beginning to use the VA activity-based cost allocation system.

  4. 76 FR 70831 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... Care)) Activity; Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs... Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of... necessary to promote quality and efficient delivery of health care through the use of health...

  5. The effect of pre-existing mental health comorbidities on the stage at diagnosis and timeliness of care of solid tumor malignances in a Veterans Affairs (VA) medical center.

    PubMed

    Wadia, Roxanne J; Yao, Xiaopan; Deng, Yanhong; Li, Jia; Maron, Steven; Connery, Donna; Gunduz-Bruce, Handan; Rose, Michal G

    2015-09-01

    There are limited data on the impact of mental health comorbidities (MHC) on stage at diagnosis and timeliness of cancer care. Axis I MHC affect approximately 30% of Veterans receiving care within the Veterans Affairs (VA) system. The purpose of this study was to compare stage at diagnosis and timeliness of care of solid tumor malignancies among Veterans with and without MHC. We performed a retrospective analysis of 408 charts of Veterans with colorectal, urothelial, and head/neck cancer diagnosed and treated at VA Connecticut Health Care System (VACHS) between 2008 and 2011. We collected demographic data, stage at diagnosis, medical and mental health co-morbidities, treatments received, key time intervals, and number of appointments missed. The study was powered to assess for stage migration of 15-20% from Stage I/II to Stage III/IV. There was no significant change in stage distribution for patients with and without MHC in the entire study group (p = 0.9442) and in each individual tumor type. There were no significant differences in the time intervals from onset of symptoms to initiation of treatment between patients with and without MHC (p = 0.1135, 0.2042 and 0.2352, respectively). We conclude that at VACHS, stage at diagnosis for patients with colorectal, urothelial and head and neck cancers did not differ significantly between patients with and without MHC. Patients with MHC did not experience significant delays in care. Our study indicates that in a medical system in which mental health is integrated into routine care, patients with Axis I MHC do not experience delays in cancer care.

  6. VA Health Care: Improved Monitoring Needed for Effective Oversight of Care for Women Veterans

    DTIC Science & Technology

    2016-12-01

    of community providers of specialty care, mental health care, limited emergency care, and maternity and limited newborn care when such care is not...and Percentage of VA Community -Based Outpatient Clinics that Provide Primary Care Lacking a Women’s Health Primary Care Provider and Women Veteran... Community Care TPA third party administrator VA Department of Veterans Affairs VAMC Veterans Affairs medical center VHA Veterans Health

  7. Technology Changes and VA Mental Health Computer Applications

    PubMed Central

    Gottfredson, Douglas; Finkelstein, Allan; Christensen, Phillip; Weaver, Richard; Sells, Jeffery; Miller, David; Anderson, Ronald

    1993-01-01

    Since 1972, the Department of Veterans Affairs has had mental health computer applications for clinicians, managers, and researchers, operating on main frame and mini computers. The advent of personal computers has provided the opportunity to further enhance mental health automation. With Congressional support, VA's Mental Health and Behavioral Sciences Service placed micro computers in 168 VA Medical Centers and developed additional mental health applications. Using wide area networking procedures, a National Mental Health Database System (NMHDS) was established. In addition, a Computer-assisted Assessment, Psychotherapy, Education, and Research system (CAPER), a Treatment Planner, a Suicide and Assaultive Behavior Monitoring system, and a national registry of VA mental health treatment resources were developed. Each of these computer applications is demonstrated and discussed.

  8. 78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA has specifically contracted, this rulemaking will only affect home health and hospice care providers who do...

  9. Characteristics and VA Health Care Utilization of U.S. Veterans Who Completed Suicide in Oregon between 2000 and 2005

    ERIC Educational Resources Information Center

    Basham, Chandra; Denneson, Lauren M.; Millet, Lisa; Shen, Xun; Duckart, Jonathan; Dobscha, Steven K.

    2011-01-01

    Oregon Violent Death Reporting System data were linked with Veterans Affairs (VA) administrative data to identify and describe veterans who completed suicide in Oregon from 2000 to 2005 (n = 968), and to describe their VA health care utilization in the year prior to death. Twenty-two percent had received health care in the VA system. Of these, 57%…

  10. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ...-day period was $2,537.40 in FY 2010. The average Medicare reimbursement level for skilled home care....74 less per day from VA for a 60-day episode of care. On average, each of the 8400 providers cares... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care by Non-VA...

  11. 78 FR 51067 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-20

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO34 VA Health Professional Scholarship and Visual Impairment and... Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual... provide financial assistance to certain students seeking a degree in visual impairment or orientation...

  12. Review and Evaluation of the VA Enrollee Health Care Projection Model

    DTIC Science & Technology

    2008-01-01

    ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INTERNATIONAL AFFAIRS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND TECHNOLOGY...SUBTITLE Review and Evaluation of the VA Enrollee Health Care Projection Model 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...Military Health Policy Research Review and Evaluation of the VA Enrollee Health Care Projection Model The RAND Corporation is a nonprofit research

  13. VA Health Care Facilities Locator

    MedlinePlus

    ... VA » Locations » Find Locations Locations Find Locations The javascript used here is for validation purpose only. Your browser doesn't seem to support javascript or has it disabled. This site is a ...

  14. 76 FR 71439 - Amendment to an Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., manage, maintain and operate the additional EUL development. As consideration for the lease, the lessee... AFFAIRS Amendment to an Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for.... ACTION: Notice of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  15. 76 FR 72046 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to enter into an EUL for..., Virginia. As consideration, the selected lessee will be required to finance, design, develop,...

  16. 76 FR 72048 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to enter into an EUL..., Danville Campus in Danville, Illinois. As consideration for the EUL, the lessee will be required to...

  17. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... operate the EUL development. As consideration for the lease, the lessee will be required to construct... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development.... ACTION: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  18. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  19. 76 FR 67023 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  20. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., renovate, manage, operate and maintain the EUL development. As consideration for the lease, the lessee will... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development.... ACTION: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  1. 76 FR 5432 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the Charlie...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ..., develop, renovate, manage, maintain and operate the EUL development. As consideration for the lease, the... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the Charlie... Intent to Enter into an Enhanced-Use Lease. SUMMARY: The Secretary of VA intends to enter into an EUL...

  2. 75 FR 72871 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... lease, the lessee will be required to build, operate, and maintain a transitional housing facility... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... an Enhanced-Use Lease. SUMMARY: The Secretary of VA intends to enter into an EUL on a 1-acre...

  3. 76 FR 67022 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ..., operate and maintain the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...: Notice of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  4. 76 FR 71440 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  5. 76 FR 71440 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., Illinois. The selected lessee will finance, design, develop, construct, manage, maintain and operate the... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  6. 76 FR 72046 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... selected lessee will be required to finance, design, develop, construct, maintain and operate a permanent... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to enter into an...

  7. 76 FR 71440 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development.... ACTION: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  8. 76 FR 72047 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to enter into an... Center in Walla Walla, Washington. As consideration, the selected lessee will be required to...

  9. 76 FR 67021 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ..., manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...: Notice of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  10. 76 FR 71441 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  11. 76 FR 71439 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., Alabama. The selected lessee will finance, design, develop, renovate, manage, maintain and operate the EUL... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development.... ACTION: Notice of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  12. 76 FR 71443 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...: Notice of intent to enter into an Enhanced-Use Lease. SUMMARY: The Secretary of VA intends to enter...

  13. 76 FR 72046 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... will finance, design, develop, renovate, construct, maintain and operate a permanent housing... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to enter into...

  14. 76 FR 72048 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to enter into an..., Nebraska. As consideration, the selected lessee will be required to finance, design, develop,...

  15. 76 FR 67023 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ..., Oregon. The selected lessees will finance, design, develop, construct, manage, maintain and operate the... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development.... ACTION: Notice of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  16. 76 FR 67022 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... operate the EUL development. As consideration for the lease, the lessee will be required to construct... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  17. 76 FR 72045 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... finance, design, develop, construct, maintain and operate the EUL development. The lessee will also be... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to enter into an...

  18. 76 FR 61151 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development.... ACTION: Notice of Intent to Enter into an Enhanced-Use Lease. SUMMARY: The Secretary of VA intends...

  19. 76 FR 71439 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...: Notice of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  20. 76 FR 71440 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., Washington. The selected lessee will finance, design, develop, construct, manage, maintain and operate the... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  1. 76 FR 71441 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... and operate the EUL development. As consideration for the lease, the lessee will be required to... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA intends to...

  2. 76 FR 72046 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ..., the lessee will be required to finance, design, develop, renovate, operate, and maintain one building... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development.... ACTION: Notice of intent to enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  3. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ..., construct, manage, maintain and operate the EUL development. As consideration for the lease, the lessee will... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... of Veterans Affairs. ACTION: Notice of Intent to Enter into an Enhanced-Use Lease. SUMMARY:...

  4. 76 FR 60965 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... operate the EUL development. As consideration for the lease, the lessees will be required to construct... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development... Affairs. ACTION: Notice of intent to enter into an enhanced-use lease. SUMMARY: The Secretary of...

  5. 78 FR 68364 - Payment for Home Health Services and Hospice Care to Non-VA Providers; Delay of Effective Date

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. The preamble of that final rule stated the effective date was November 15, 2013..., applicable to non-VA home health services and hospice care. Section 17.56 provides, among other things,...

  6. Eastern Colorado Health Care System (VA Hospital) NPDES Permit

    EPA Pesticide Factsheets

    Under NPDES permit CO-0034991, the U.S. Department of Veterans Affairs (VA) is authorized to discharge from its wastewater treatment facility in Adams County, Colorado, to a storm sewer to Toll Gate Creek, a tributary of Sand Creek.

  7. VA Health Care Facilities Locator

    MedlinePlus

    ... Loan Guaranty Medical Care Vocational Rehabilitation and Employment Health Care Benefits: 1-877-222-8387 Additional Numbers and Websites Resource Phone Number Website Bereavement Counseling 1-202-461-6530 Children of Women ... Civilian Health and Medical Program (CHAMPVA) 1-800-733-8387 ...

  8. VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs. Final rule.

    PubMed

    2013-08-20

    The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations.

  9. 76 FR 72047 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... placement for senior, disabled, homeless and/or at-risk Veterans and their families. FOR FURTHER INFORMATION... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the...

  10. 76 FR 72045 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... preference and priority placement for homeless, at-risk, disabled, and senior Veterans and their families and... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the...

  11. 77 FR 75918 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO34 VA Health Professional Scholarship and Visual Impairment and... program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP... visual impairment or orientation or mobility, in order to increase the supply of qualified...

  12. The Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight

    DTIC Science & Technology

    2013-09-18

    Master Sharing Agreement (MSA) and Joint Policies governing claims and reimbursement between Department of Veterans Affairs (VA) and DoD for health ...timely reimbursement for health care services provided. Specifically, the MSA and Joint Policies did not comply with DoD Regulations, deliver an...to review the reimbursement policy ; and Assistant Secretary of Defense ( Health Affairs) require the DoD/VA Program Coordination Office present the

  13. TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (P.L. 111-148)

    DTIC Science & Technology

    2010-04-22

    if enacted, clarify that the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), Spina Bifida Health Care Program...5 Will VA Coverage of Children with Spina Bifida and Certain Birth Defects... Spina Bifida and Certain Birth Defects Meet the “Minimum Essential Coverage” Requirement? It is unclear weather the Spina Bifida Health Care Program

  14. 76 FR 67022 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for a Mixed-Use...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ..., manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for a Mixed-Use.... ACTION: Notice of Intent to Enter into an Enhanced-Use Lease (EUL). SUMMARY: The Secretary of VA...

  15. 75 FR 69742 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Restoration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ...] [FR Doc No: 2010-28632] DEPARTMENT OF VETERANS AFFAIRS Enhanced-Use Lease (EUL) of Department of... Lease. SUMMARY: The Secretary of VA intends to enter into an EUL of the 1889 Soldiers Home Chapel... 2.5 acres at the Clement J. Zablocki VAMC in Milwaukee, Wisconsin. The selected Lessee will...

  16. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA): preauthorization of durable medical equipment. Final rule.

    PubMed

    2009-07-01

    This document amends the Department of Veterans Affairs (VA) medical regulations for the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) preauthorization section by increasing the dollar ceiling for purchase or rental of durable medical equipment (DME) from $300 to $2,000.

  17. Chaplaincy and mental health in the department of Veterans affairs and department of defense.

    PubMed

    Nieuwsma, Jason A; Rhodes, Jeffrey E; Jackson, George L; Cantrell, William C; Lane, Marian E; Bates, Mark J; Dekraai, Mark B; Bulling, Denise J; Ethridge, Keith; Drescher, Kent D; Fitchett, George; Tenhula, Wendy N; Milstein, Glen; Bray, Robert M; Meador, Keith G

    2013-01-01

    Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: 1) input from key subject matter experts; 2) quantitative data from the VA / DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and 3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

  18. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans AffairsVA Manhattan Campus

    SciTech Connect

    Stephen Schey; Jim Francfort

    2014-10-01

    This report focuses on the Department of Veterans Affairs, VA Manhattan Campus (VA- Manhattan) fleet to identify the daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support successful introduction of plug-in electric vehicles (PEVs) into the agency’s fleet. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively called PEVs) can fulfill the mission requirements.

  19. Gap analysis: transition of health care from Department of Defense to Department of Veterans Affairs.

    PubMed

    Randall, Marjorie J

    2012-01-01

    This study examined the effectiveness of Public Law 110-181, "National Defense Authorization Act of Fiscal Year 2008, Title XVI-Wounded Warriors Matter," as it relates to health care for returning Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combat veterans. Specifically, it examined the gap between the time an OEF/OIF combat service member left active service and subsequently obtained health care within the Veteran Affairs (VA) Healthcare System, and which factors influenced or impeded the veteran from obtaining health care sooner. Data were collected from 376 OEF/OIF combat veterans who sought health care at the Nashville or Murfreesboro VA Medical Centers. A questionnaire was designed exclusively for this study. The average time gap for an OEF/OIF combat veteran to transition from Department of Defense to VA health care was 3.83 months (SD 7.17). Twenty-six percent of respondents reported there were factors that impeded them from coming to the VA sooner. Factors included lack of knowledge about VA benefits, transportation/distance, perceptions of losing military career, seeking help as sign of weakness, and VA reputation. The study provided some evidence to support that Department of Defense and VA are meeting mandates for providing seamless transition of health care set forth by "Public Law 110-181, National Defense Authorization Act of Fiscal Year 2008."

  20. Racial and Ethnic Disparities in the VA Health Care System: A Systematic Review

    PubMed Central

    Freeman, Michele; Toure, Joahd; Tippens, Kimberly M.; Weeks, Christine; Ibrahim, Said

    2008-01-01

    Objectives To better understand the causes of racial disparities in health care, we reviewed and synthesized existing evidence related to disparities in the “equal access” Veterans Affairs (VA) health care system. Methods We systematically reviewed and synthesized evidence from studies comparing health care utilization and quality by race within the VA. Results Racial disparities in the VA exist across a wide range of clinical areas and service types. Disparities appear most prevalent for medication adherence and surgery and other invasive procedures, processes that are likely to be affected by the quantity and quality of patient–provider communication, shared decision making, and patient participation. Studies indicate a variety of likely root causes of disparities including: racial differences in patients’ medical knowledge and information sources, trust and skepticism, levels of participation in health care interactions and decisions, and social support and resources; clinician judgment/bias; the racial/cultural milieu of health care settings; and differences in the quality of care at facilities attended by different racial groups. Conclusions Existing evidence from the VA indicates several promising targets for interventions to reduce racial disparities in the quality of health care. PMID:18301951

  1. National Dissemination of Cognitive Behavioral Therapy for Depression in the Department of Veterans Affairs Health Care System: Therapist and Patient-Level Outcomes

    ERIC Educational Resources Information Center

    Karlin, Bradley E.; Brown, Gregory K.; Trockel, Mickey; Cunning, Darby; Zeiss, Antonette M.; Taylor, C. Barr

    2012-01-01

    Objective: The Department of Veterans Affairs (VA) health care system is nationally disseminating and implementing cognitive behavioral therapy for depression (CBT-D). The current article evaluates therapist and patient-level outcomes associated with national training in and implementation of CBT-D in the VA health care system. Method: Therapist…

  2. Variations in the Use of mHealth Tools: The VA Mobile Health Study

    PubMed Central

    2016-01-01

    Background Mobile health (mHealth) technologies exhibit promise for offering patients and their caregivers point-of-need tools for health self-management. This research study involved the dissemination of iPads containing a suite of mHealth apps to family caregivers of veterans who receive care from the Veterans Affairs (VA) Health Administration and have serious physical or mental injuries. Objective The goal of the study was to identify factors and characteristics of veterans and their family caregivers that predict the use of mHealth apps. Methods Veteran/family caregiver dyads (N=882) enrolled in VA’s Comprehensive Assistance for Family Caregivers program were recruited to participate in an mHealth pilot program. Veterans and caregivers who participated and received an iPad agreed to have their use of the apps monitored and were asked to complete a survey assessing Caregiver Preparedness, Caregiver Traits, and Caregiver Zarit Burden Inventory baseline surveys. Results Of the 882 dyads, 94.9% (837/882) of caregivers were women and 95.7% (844/882) of veteran recipients were men. Mean caregiver age was 40 (SD 10.2) years and mean veteran age was 39 (SD 9.15) years, and 39.8% (351/882) lived in rural locations. Most (89%, 788/882) of the caregivers were spouses. Overall, the most frequently used app was Summary of Care, followed by RX Refill, then Journal, Care4Caregivers, VA Pain Coach, and last, VA PTSD Coach. App use was significantly predicted by the caregiver being a spouse, increased caregiver computer skills, a rural living location, lower levels of caregiver preparedness, veteran mental health diagnosis (other than posttraumatic stress disorder), and veteran age. Conclusions This mHealth Family Caregiver pilot project effectively establishes the VA’s first patient-facing mHealth apps that are integrated within the VA data system. Use varied considerably, and apps that were most used were those that assisted them in their caregiving responsibilities

  3. The future role of the health sciences library in the Department of Veterans Affairs.

    PubMed Central

    Wiesenthal, D

    1993-01-01

    The Department of Veterans Affairs (VA) conducted a survey to ascertain the perceptions of 322 library service chiefs and health care administrators within the VA health care system. Participants were asked to rate the desirability and probability of twenty-five predetermined statements and to identify the forces that would have an impact, either positive or negative, on whatever statements became reality. The response rate was 93%. Analysis of the data indicated that there was no significant difference between the library managers and health care administrators in their perceptions. Results indicate that both groups believe libraries serve an integral role in VA medical centers and that library services cannot be provided as successfully off site. The data also appear to reveal a clear consensus on the part of both groups for increased library involvement in educational activities and information delivery. PMID:8471999

  4. Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

    PubMed Central

    Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M.; Weinick, Robin M.; Woods, Dulani; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade. PMID:28083423

  5. VA-academic partnerships: challenges and rewards for new VA mental health investigators.

    PubMed

    Ayers, Catherine; Arch, Joanna

    2013-12-01

    This study presents the perspectives of academic-VA partners who have recently completed a randomized clinical trial within a VA outpatient clinic. The authors reflect on the challenges and rewards of implementing academic-VA community clinical research partnerships with the aim of assisting new VA investigators and VA collaborators. Staff resistance, time demands, processing delays, and unforeseen barriers represent challenges. However, they are balanced by numerous rewards, including establishment of a research clinic, innovative staff training, and advancement of effectiveness knowledge in community settings. Implications and recommendations for successful VA-academic partnerships are described to help future projects minimize challenges and maximize rewards.

  6. Duplicate Federal Payments for Dual Enrollees in Medicare Advantage Plans and the Veterans Affairs Health Care System

    PubMed Central

    Trivedi, Amal N.; Grebla, Regina C.; Jiang, Lan; Yoon, Jean; Mor, Vincent; Kizer, Kenneth W.

    2013-01-01

    Context Some veterans are eligible to enroll simultaneously in a Medicare Advantage (MA) plan and the Veterans Affairs health care system (VA). This scenario produces the potential for redundant federal spending because MA plans would receive payments to insure veterans who receive care from the VA, another taxpayer-funded health plan. Objective To quantify the prevalence of dual enrollment in VA and MA, the concurrent use of health services in each setting, and the estimated costs of VA care provided to MA enrollees. Design Retrospective analysis of 1 245 657 veterans simultaneously enrolled in the VA and an MA plan between 2004–2009. Main Outcome Measures Use of health services and inflation-adjusted estimated VA health care costs. Results Among individuals who were eligible to enroll in the VA and in an MA plan, the number of persons dually enrolled increased from 485 651 in 2004 to 924 792 in 2009. In 2009, 8.3% of the MA population was enrolled in the VA and 5.0% of MA beneficiaries were VA users. The estimated VA health care costs for MA enrollees totaled $13.0 billion over 6 years, increasing from $1.3 billion in 2004 to $3.2 billion in 2009. Among dual enrollees, 10% exclusively used the VA for outpatient and acute inpatient services, 35% exclusively used the MA plan, 50% used both the VA and MA, and 4% received no services during the calendar year. The VA financed 44% of all outpatient visits (n=21 353 841), 15% of all acute medical and surgical admissions (n=177 663), and 18% of all acute medical and surgical inpatient days (n=1 106 284) for this dually enrolled population. In 2009, the VA billed private insurers $52.3 million to reimburse care provided to MA enrollees and collected $9.4 million (18% of the billed amount; 0.3% of the total cost of care). Conclusions The federal government spends a substantial and increasing amount of potentially duplicative funds in 2 separate managed care programs for the care of same individuals. PMID:22735360

  7. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs. James J. Peters VA Medical Center, Bronx, NY

    SciTech Connect

    Schey, Stephen; Francfort, Jim

    2014-10-01

    This report focuses on the Department of Veterans Affairs, James J. Peters VA Medical Center (VA - Bronx) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  8. 77 FR 3841 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... Care)) Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans... VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of a... promote quality and efficient delivery of health care through the use of health information...

  9. The Effect of Increased Travel Reimbursement Rates on Health Care Utilization in the VA

    ERIC Educational Resources Information Center

    Nelson, Richard E.; Hicken, Bret; West, Alan; Rupper, Randall

    2012-01-01

    Purpose: The reimbursement rate that eligible veterans receive for travel to Department of Veterans Affairs (VA) facilities increased from 11 to 28.5 cents per mile on February 1, 2008. We examined the effect of this policy change on utilization of outpatient, inpatient, and pharmacy services, stratifying veterans based on distance from a VA…

  10. Mentoring health information professionals in the Department of Veterans Affairs.

    PubMed

    Lloyd, Susan S; Fenton, Susan H

    2008-04-07

    As a major employer of health information professionals, the VA faces significant recruitment and retention challenges. The authors evaluated mentoring as a retention tool through a review of existing literature and the retrospective review of a VA health information management mentoring program. The literature review showed a link between employer mentorship and employee retention, regardless of the nature and structure of the mentoring relationship. Most organizations support employees who are willing to serve as mentors through increased compensation, recognition, and other types of support. No literature was found that studied retention rates for more than three years after a mentoring experience. The review of the VA mentoring program showed increased retention in the three years following enrollment in the program, but the increase was not statistically significant. The review did not demonstrate improvement in retention over a seven-year period. The combined evaluation gives mixed findings for mentorship as a retention tool and demonstrates the need for more research on the topic.

  11. MyHealtheVet (VA's personal health record)

    MedlinePlus

    ... Case of Emergency Profiles Download My Data Account Pharmacy RX Refill Medications + Supplements Research Health Healthy Living ... Case of Emergency Profiles Download My Data Account Pharmacy Pharmacy Pharmacy Home RX Refill Medications + Supplements Research ...

  12. 76 FR 71441 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... of a Permanent Housing Facility in Fort Harrison, MT AGENCY: Department of Veterans Affairs. ACTION... System in Fort Harrison, Montana. The selected lessee will finance, design, develop, construct,...

  13. 76 FR 67257 - Computer Matching Program Between the Department of Veterans Affairs (VA) and the Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-31

    ... veterans, servicemembers, and reservists who have applied for or who are receiving education benefit... education benefit payments under the Post-9/11 GI Bill. These benefit records are contained in a VA system of records identified as 58VA21/ 22/28 entitled: Compensation, Pension, Education and...

  14. Building strong research partnerships between public health and researchers: a VA case study.

    PubMed

    Midboe, Amanda M; Elwy, A Rani; Durfee, Janet M; Gifford, Allen L; Yakovchenko, Vera; Martinello, Richard A; Ross, David; Czarnogorski, Maggie; Goetz, Matthew B; Asch, Steven M

    2014-12-01

    We are in a new era of partner-based implementation research, and we need clear strategies for how to navigate this new era. Drawing on principles from community-based participatory research, the Clinical Public Health group of the Department of Veterans Affairs and the HIV/Hepatitis Quality Enhancement Research Initiative (HHQUERI) forged a longstanding partnership that has improved the care of Veterans with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus. An exemplar HIV testing project epitomizes this partnership and is discussed in terms of the lessons learned as a result of our high level of collaboration around design, analysis, implementation, and dissemination across projects over the past several years. Lessons learned through this partnered testing program involve respecting different time horizons among the partners, identifying relevant research questions for both parties, designing flexible studies, engaging all partners throughout the research, and placing an emphasis on relationship building at all times. These lessons and strategies can benefit others conducting partner-based research both within the Veterans Health Administration (VA) and in other integrated healthcare systems.

  15. Toward a Virtual Lifetime Electronic Record: The Department of Veterans Affairs Experience with the Nationwide Health Information Network

    PubMed Central

    Bouhaddou, Omar; Bennett, Jamie; Teal, Jennifer; Pugh, Margaret; Sands, Melissa; Fontaine, Frank; Swall, Marie; Dhar, Sanjay; Mallia, Tony; Morgan, Brian; Cromwell, Tim

    2012-01-01

    Health information exchange is expected of all electronic health records (EHRs) in order to ensure safe, quality care coordination. The U.S. Department of Veterans Affairs (VA) has a long history of information exchange across VA facilities and with the U.S. Department of Defense (DoD). However, since a majority of VA and DoD patients receive a portion of their health care from the private sector, it is essential that both agencies enable health information exchange with private sector providers. This has been made possible by the use of the specifications and trust agreement developed by the Nationwide Health Information Network (NwHIN) initiative. Currently, VA has 12 medical centers exchanging information with the private sector and is evaluating the value of the exchange. The authors report on the success of these pilots as well as on the challenges, which include stricter technical specifications and a more efficient approach to patient identification (ID) matching and consent management. PMID:23304272

  16. The Impact of VA's Geriatric Research, Education and Clinical Centers on Academic Affiliates

    ERIC Educational Resources Information Center

    Bragg, Elizabeth J.; Meganathan, Karthikeyan; Shay, Kenneth; Gilman, Stuart C.; Zeiss, Robert A.; Hettler, Debbie L.

    2011-01-01

    The education mission of the Department of Veterans Affairs (VA) is to train health professionals to benefit VA and the United States. One approach for achieving that mission, along with VA's research and clinical missions, was the establishment of Geriatric Research, Education and Clinical Centers (GRECCs) in 1975. These were developed at VA…

  17. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the non-VA provider may have within the commercial health care industry. (iii) The amount that the... Health Insurance Portability and Accountability Act mandated national standard coding sets. VA will pay...

  18. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the non-VA provider may have within the commercial health care industry. (iii) The amount that the... Health Insurance Portability and Accountability Act mandated national standard coding sets. VA will pay...

  19. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the non-VA provider may have within the commercial health care industry. (iii) The amount that the... Health Insurance Portability and Accountability Act mandated national standard coding sets. VA will pay...

  20. 75 FR 30915 - Computer Matching Program Between the Department of Veterans Affairs (VA) and the Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-02

    ... eligibility status of Veterans, Servicemembers, and reservists, and eligible dependents who have applied for... is to enable VA to verify that individuals meet the conditions of military service and...

  1. VA/DOD Federal Health Care Center: Costly Information Technology Delays Continue and Evaluation Plan Lacking

    DTIC Science & Technology

    2012-06-01

    portability, which would allow VA and DOD clinicians to place, manage, and update clinical orders from either VA or DOD electronic health records systems...on, which includes five dedicated, full-time pharmacists to conduct manual checks of patient records to reconcile allergy information and identify

  2. VA Health Care: Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events

    DTIC Science & Technology

    2015-07-01

    VA HEALTH CARE Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events Report to Congressional...2015 4. TITLE AND SUBTITLE VA Health Care: Actions Needed to Assess Decrease in Root Cause Analyses of Adverse Events 5a. CONTRACT NUMBER 5b...Analyses of Adverse Events Why GAO Did This Study Adverse events are incidents that pose a risk of injury to a patient as the result of a medical

  3. Federal Health Care Center: VA and DOD Need to Address Ongoing Difficulties and Better Prepare for Future Integrations

    DTIC Science & Technology

    2016-02-01

    which provide health care to both VA and DOD beneficiaries. The encounters for the West Campus include care provided at VA’s three offsite community ...29For example, geriatric and mental health clinical areas were initially grouped with other...clinical areas in directorates led by the VA Chief Medical Executive and VA Nurse Executive, respectively. The reorganization grouped geriatric and mental

  4. Homeland security and public health: role of the Department of Veterans Affairs, the US Department of Homeland Security, and implications for the public health community.

    PubMed

    Koenig, Kristi L

    2003-01-01

    The terrorist attacks of 11 September 2001 led to the largest US Government transformation since the formation of the Department of Defense following World War II. More than 22 different agencies, in whole or in part, and >170,000 employees were reorganized to form a new Cabinet-level Department of Homeland Security (DHS), with the primary mission to protect the American homeland. Legislation enacted in November 2002 transferred the entire Federal Emergency Management Agency and several Department of Health and Human Services (HHS) assets to DHS, including the Office of Emergency Response, and oversight for the National Disaster Medical System, Strategic National Stockpile, and Metropolitan Medical Response System. This created a potential separation of "health" and "medical" assets between the DHS and HHS. A subsequent presidential directive mandated the development of a National Incident Management System and an all-hazard National Response Plan. While no Department of Veterans Affairs (VA) assets were targeted for transfer, the VA remains the largest integrated healthcare system in the nation with important support roles in homeland security that complement its primary mission to provide care to veterans. The Emergency Management Strategic Healthcare Group (EMSHG) within the VA's medical component, the Veteran Health Administration (VHA), is the executive agent for the VA's Fourth Mission, emergency management. In addition to providing comprehensive emergency management services to the VA, the EMSHG coordinates medical back-up to the Department of Defense, and assists the public via the National Disaster Medical System and the National Response Plan. This article describes the VA's role in homeland security and disasters, and provides an overview of the ongoing organizational and operational changes introduced by the formation of the new DHS. Challenges and opportunities for public health are highlighted.

  5. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.10 Selection of non-VA... providers who provide temporary residential assistance for homeless persons with serious mental illness,...

  6. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.10 Selection of non-VA... providers who provide temporary residential assistance for homeless persons with serious mental illness,...

  7. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.10 Selection of non-VA... providers who provide temporary residential assistance for homeless persons with serious mental illness,...

  8. 77 FR 19975 - VA Acquisition Regulation: Simplified Acquisition Procedures for Health-Care Resources (Section...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... Procedures for Health-Care Resources (Section 610 Review) AGENCY: Department of Veterans Affairs. ACTION... acquisition of health-care resources, consisting of commercial services or the use of medical equipment or space, pursuant to the Veterans' Health Care Eligibility Reform Act of 1996 (38 U.S.C. 8151-8153)....

  9. VA Health Care: Actions Needed to Improve Newly Enrolled Veterans Access to Primary Care

    DTIC Science & Technology

    2015-03-01

    medical centers provide veterans with timely access to outpatient primary and specialty care, as well as mental health care. (See app. I for the...D.C.: Oct. 8, 2015); and GAO, VA Mental Health: Clearer Guidance on Access Policies and Wait- Time Data Needed, GAO-16-24 (Washington, D.C.: Oct. 28...21We recently reported that VA similarly focuses on only a portion of the overall time veterans wait to see mental health providers. See GAO-16-24

  10. VA Health Care: Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed

    DTIC Science & Technology

    2016-09-01

    VA HEALTH CARE Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed Report to...Monitor Organizational Structure Changes Needed What GAO Found Recent internal and external reviews of Veterans Health Administration (VHA...operations have identified deficiencies in its organizational structure and recommended changes that would require significant restructuring to address

  11. VA Health Care: Further Action Needed to Address Weaknesses in Management and Oversight of Non-VA Medical Care

    DTIC Science & Technology

    2014-06-18

    medical care when a VA facility is unable to provide certain specialty care services, such as cardiology or orthopedics, or when a veteran would have...needing treatment in several specialties—including audiology, cardiology , and ophthalmology—were referred to non-VA providers for this reason

  12. Electronic Health Records: DOD and VA Have Increased Their Sharing of Health Information, but More Work Remains

    DTIC Science & Technology

    2008-07-01

    participating in recent initiatives ed by the Office of the National Coordinator for Health Information echnology (within the Department of Health...veterans, many DOD and VA patients tend to be highly mobile and may have health records residing at multiple medical facilities within

  13. VA Community Mental Health Service Providers' Utilization of and Attitudes toward Telemental Health Care: The Gatekeeper's Perspective

    ERIC Educational Resources Information Center

    Jameson, John Paul; Farmer, Mary Sue; Head, Katharine J.; Fortney, John; Teal, Cayla R.

    2011-01-01

    Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined. Purpose: The purpose of this study was to investigate the…

  14. VA Health Care: Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing Accuracy of Suicide Data

    DTIC Science & Technology

    2014-11-01

    VA HEALTH CARE Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing...00-2014 4. TITLE AND SUBTITLE VA Health Care: Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing...Use for Major Depressive Disorder and in Increasing Accuracy of Suicide Data Why GAO Did This Study In 2013, VA estimated that about 1.5 million

  15. Predicting Adoption of Telemedicine by VA Mental Health Professionals

    ERIC Educational Resources Information Center

    Pak, Wesley Chong Y.

    2013-01-01

    Providing primary health and specialty services to 3.4 million rural and highly rural veterans is a challenging task because of geographic barriers and the uneven distribution of rural healthcare providers. Although the Veterans Health Administration is hoping that technology such as telemedicine expands availability of specialties' access to…

  16. Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: Association with mental health diagnoses

    PubMed Central

    Cohen, Beth E.; Maguen, Shira; Bertenthal, Daniel; Shi, Ying; Jacoby, Vanessa; Seal, Karen H.

    2015-01-01

    Background An increasing number of women serve in the military and are exposed to trauma during service that can lead to mental health problems. Understanding how these mental health problems affect reproductive and physical health outcomes will inform interventions to improve care for women veterans. Methods We analyzed national VA data from women Iraq and Afghanistan veterans who were new users of VA healthcare from 10/7/2001 through 12/31/2010 (N=71,504). We used ICD-9 codes to categorize veterans into 5 groups by mental health diagnoses (MH Dx), those with: no MH Dx, PTSD, depression, comorbid PTSD and depression, and MH Dx other than PTSD and depression. We determined the association between mental health category and reproductive and other physical health outcomes defined by ICD-9 codes. Categories included sexually transmitted infections, other infections (e.g. urinary tract infections), pain-related conditions (e.g. dysmenorrhea and dsypareunia), and other conditions (e.g. polycystic ovarian syndrome, infertility, sexual dysfunction). Models were adjusted for sociodemographics and military service factors. Results 31,481 (44%) received at least one mental health diagnosis. Women veterans with any mental health diagnosis had significantly higher prevalences of nearly all categories of reproductive and physical disease diagnoses (p <.0001 for adjusted prevalences). There was a trend of increasing prevalence of disease outcomes in women with PTSD, depression, and comorbid PTSD and depression (p for trend <.0001 for all outcomes). Conclusions Iraq and Afghanistan women veterans with mental health diagnoses had significantly greater prevalences of several important reproductive and physical health diagnoses. These results provide support for VA initiatives to address mental and physical health concerns and improve comprehensive care for women veterans. PMID:22944901

  17. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... for home health services and hospice care, VA will determine the amounts paid under §§ 17.52 or 17.120... and outpatient health care professional services at non-departmental facilities and other medical charges associated with non-VA outpatient care. 17.56 Section 17.56 Pensions, Bonuses, and...

  18. Validation of Screening Questions for Limited Health Literacy in a Large VA Outpatient Population

    PubMed Central

    Griffin, Joan M.; Partin, Melissa R.; Noorbaloochi, Siamak; Grill, Joseph P.; Snyder, Annamay; Bradley, Katharine A.; Nugent, Sean M.; Baines, Alisha D.; VanRyn, Michelle

    2008-01-01

    Objectives Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population. Methods We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of “inadequate or marginal” health literacy based on the S-TOFHLA and 2) inadequate and the combination of “inadequate or marginal” health literacy based on the REALM. Measurements and Main Results Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, “How confident are you filling out medical forms by yourself?” had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69–0.79) and 0.84 (95% CI: 0.79–0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting “inadequate or marginal” health literacy than for detecting inadequate health literacy for each of the 3 questions. Conclusion A single question may be useful for detecting patients with inadequate health literacy in a VA population. PMID:18335281

  19. Using photovoice to explore patient perceptions of patient-centered care in the Veterans Affairs health care system

    PubMed Central

    Balbale, Salva Najib; Morris, Megan A.; LaVela, Sherri L.

    2015-01-01

    Background Accounting for patient views and context is essential in evaluating and improving patient-centered care initiatives, yet few studies have examined the patient perspective. In the Veterans Affairs (VA) Health Care System, several VA facilities have transitioned from traditionally disease- or problem-based care to patient-centered care. We used photovoice to explore perceptions and experiences related to patient-centered care among Veterans receiving care in VA facilities that have implemented patient-centered care initiatives. Design Participants were provided prompts to facilitate their photography, and were asked to capture salient features in their environment that may describe their experiences and perceptions related to patient-centered care. Follow-up interviews were conducted with each participant to learn more about their photographs and intended meanings. Participant demographic data were also collected. Results Twenty-two Veteran patients (n=22) across two VA sites participated in the photovoice protocol. Participants defined patient-centered care broadly as caring for a person as a whole while accommodating for individual needs and concerns. Participant-generated photography and interview data revealed various contextual factors influencing patient-centered care perceptions, including patient-provider communication and relationships, physical and social environments of care, and accessibility of care. Conclusions This study contributes to the growing knowledge base around patient views and preferences regarding their care, care quality, and environments of care. Factors that shaped patient-centered care perceptions and the patient experience included communication with providers and staff, décor and signage, accessibility and transportation, programs and services offered, and informational resources. Our findings may be integrated into system redesign innovations and care design strategies that embody what is most meaningful to patients. PMID

  20. Strategies from a nationwide health information technology implementation: the VA CART story.

    PubMed

    Box, Tamára L; McDonell, Mary; Helfrich, Christian D; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S

    2010-01-01

    The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

  1. Lessons learned from usability testing of the VA's personal health record

    PubMed Central

    Saleem, Jason J; Russ, Alissa L; Jones, Josette; Russell, Scott A; Chumbler, Neale R

    2011-01-01

    In order to create user-centered design information to guide the development of personal health records (PHRs), 24 patients participated in usability assessments of VA's MyHealtheVet program. Observational videos and efficiency measures were collected among users performing four PHR scenarios: registration and log-in, prescription refill, tracking health, and searching for health information. Twenty-five percent of users successfully completed registration. Individuals preferred prescription numbers over names, sometimes due to privacy concerns. Only efficiency in prescription refills was significantly better than target values. Users wanted to print their information to share with their doctors, and questioned the value of MyHealtheVet search functions over existing online health information. In summary, PHR registration must balance simplicity and security, usability tests guide how PHRs can tailor functions to individual preferences, PHRs add value to users' data by making information more accessible and understandable, and healthcare organizations should build trust for PHR health content. PMID:21984604

  2. Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care.

    PubMed

    Maguen, Shira; Madden, Erin; Cohen, Beth E; Bertenthal, Daniel; Neylan, Thomas C; Seal, Karen H

    2015-09-01

    Suicide rates among U.S. military personnel and veterans are a public health concern, and those with mental health conditions are at particular risk. We examined demographic, military, temporal, and diagnostic associations with suicidality in veterans. We conducted a population-based, retrospective cohort study of all Iraq and Afghanistan war veterans who screened positive for posttraumatic stress disorder (PTSD) and/or depression, received a suicide risk assessment, and endorsed hopelessness about the present or future after their last deployment and between January 1, 2010 and June 29, 2014 (N = 45,741). We used bivariate and multivariate logistic regression analyses to examine variables associated with having endorsed suicidal thoughts and a plan. Multiple factors were associated with suicidality outcomes, including longer time from last deployment to screening (proxy for time to seeking VA care), an alcohol use disorder diagnosis, further distance from VA (rurality), and being active duty during military service. Hispanic veterans were at decreased risk of having suicidal ideation and a plan, compared to their white counterparts. In high-risk veterans, some of the strongest associations with suicidality were with modifiable risk factors, including time to VA care and alcohol use disorder diagnoses. Promising avenues for suicide prevention efforts can include early engagement/intervention strategies with a focus on amelioration of high-risk drinking.

  3. Toward a DoD/VA longitudinal health record: politics and the policy landscape.

    PubMed

    Gimbel, Ronald W; Clyburn, Conrad A

    2009-05-01

    Policy implications of an interoperable Department of Defense (DoD) and Veterans Administration (VA) longitudinal health record (LHR) are substantial and far reaching. In this manuscript the authors explore the existing challenges and opportunities, the political landscape, and alternative solutions that have created a favorable environment for legislation and funding to support its development. The authors identify six policy themes emerging from the historic National Forum on the Future of the Defense Health Information System held recently at Georgetown University in Washington DC.

  4. Disruptive Innovation: Implementation of Electronic Consultations in a Veterans Affairs Health Care System

    PubMed Central

    Clark, Justice

    2016-01-01

    Background Electronic consultations (e-consults) offer rapid access to specialist input without the need for a patient visit. E-consult implementation began in 2011 at VA Boston Healthcare System (VABHS). By early 2013, e-consults were available for all clinical services. In this implementation, the requesting clinician selects the desired consultation within the electronic health record (EHR) ordering menu, which creates an electronic form that is pre-populated with patient demographic information and allows free-text entry of the reason for consult. This triggers a message to the requesting clinician and requested specialty, thereby enabling bidirectional clinician-clinician communication. Objective The aim of this study is to examine the utilization of e-consults in a large Veterans Affairs (VA) health care system. Methods Data from the electronic health record was used to measure frequency of e-consult use by provider type (physician or nurse practitioner (NP) and/or physician assistant), and by the requesting and responding specialty from January 2012 to December 2013. We conducted chart reviews for a purposive sample of e-consults and semi-structured interviews with a purposive sample of clinicians and hospital leaders to better characterize the process, challenges, and usability of e-consults. Results A total of 7097 e-consults were identified, 1998 from 2012 and 5099 from 2013. More than one quarter (27.56%, 1956/7097) of the e-consult requests originated from VA facilities in New England other than VABHS and were excluded from subsequent analysis. Within the VABHS e-consults (72.44%, 5141/7097), variability in frequency and use of e-consults across provider types and specialties was found. A total of 64 NPs requested 2407 e-consults (median 12.5, range 1-415). In contrast, 448 physicians (including residents and fellows) requested 2349 e-consults (median 2, range 1-116). More than one third (37.35%, 1920/5141) of e-consults were sent from primary care to

  5. Impact of Rural Residence on Survival of Male Veterans Affairs Patients after Age 65

    ERIC Educational Resources Information Center

    MacKenzie, Todd A.; Wallace, Amy E.; Weeks, William B.

    2010-01-01

    Objectives: More than 1 in 5 Veterans Affairs (VA) users lives in a rural setting. Rural veterans face different barriers to health care than their urban counterparts, but their risk of death relative to their urban counterparts is unknown. The objective of our study was to compare survival between rural and urban VA users. Methods: We linked the…

  6. Department of Veterans Affairs' Implementation of Information Security Education Assistance Program. GAO-10-170R

    ERIC Educational Resources Information Center

    Wilshusen, Gregory C.; Melvin, Valerie C.

    2009-01-01

    The Veterans Benefits, Health Care, and Information Technology Act of 2006 authorizes the Secretary of Veterans Affairs to establish an educational assistance program for information security. The Information Security Education Assistance Program is envisioned as a means for the Department of Veterans Affairs (VA) to attract and retain individuals…

  7. VA Health Care. Additional Efforts to Better Assess Joint Ventures Needed

    DTIC Science & Technology

    2008-03-01

    Kans. Okla. Minn. Iowa Mo. Ark. La. Ill. Miss. Ind. Ky. Tenn. Ala. Ga. S.C. N.C. Va. Ohio N.H. Mass. Mich . Calif. Wash. Wis. N.Y. Maine Vt. W.Va...train VA personnel in a variety of areas, including basic life support and advanced cardiac life support. Finally, VA officials and academic

  8. Social work in the Veterans Health Administration (VA) System: rewards, challenges, roles and interventions.

    PubMed

    Beder, Joan; Postiglione, Paul

    2013-01-01

    For the social worker in the Veterans Health Administration (VA) System, numerous challenges are faced and met while serving the nation's Veterans. As part of the multidisciplinary team, social workers perform a variety of tasks and function in diverse roles. The qualitative survey research reported in this article sought to detail what social workers identified about the impact and rewards of their work and what they saw as the challenges and frustrations. In addition the social workers were asked to clarify their role with the patient and the family. Intervention strategies used in the course of the social workers interaction with the Veterans was also ascertained.

  9. Veterans Affairs Health Care: Addition to GAO’s High Risk List and Actions Needed for Removal

    DTIC Science & Technology

    2015-04-29

    VETERANS AFFAIRS HEALTH CARE Addition to GAO’s High Risk List and Actions Needed for Removal Statement of Debra A...Draper Director, Health Care Testimony Before the Committee on Veterans’ Affairs, U.S. Senate For Release on Delivery Expected at 2:30 p.m. ET...to 00-00-2015 4. TITLE AND SUBTITLE Veterans Affairs Health Care: Addition to GAO’s High Risk List and Actions Needed for Removal 5a. CONTRACT

  10. To designate the facility of the Department of Veterans Affairs located at 9800 West Commercial Boulevard in Sunrise, Florida, as the "William 'Bill' Kling VA Clinic".

    THOMAS, 112th Congress

    Rep. Wasserman Schultz, Debbie [D-FL-20

    2012-09-19

    12/21/2012 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  11. To name the Department of Veterans Affairs community-based outpatient clinic in Pago Pago, American Samoa, the Faleomavaega Eni Fa'aua'a Hunkin VA Clinic.

    THOMAS, 113th Congress

    Rep. Radewagen, Aumua Amata Coleman [R-AS-At Large

    2017-03-06

    03/08/2017 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  12. 78 FR 32126 - VA Dental Insurance Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN99 VA Dental Insurance Program AGENCY: Department of Veterans Affairs... rules and procedures for the VA Dental Insurance Program (VADIP), a pilot program that offers premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Under...

  13. Racial Disparities in Cancer Care in the Veterans Affairs Health Care System and the Role of Site of Care

    PubMed Central

    Samuel, Cleo A.; Landrum, Mary Beth; McNeil, Barbara J.; Bozeman, Samuel R.; Williams, Christina D.

    2014-01-01

    Objectives. We assessed cancer care disparities within the Veterans Affairs (VA) health care system and whether between-hospital differences explained disparities. Methods. We linked VA cancer registry data with VA and Medicare administrative data and examined 20 cancer-related quality measures among Black and White veterans diagnosed with colorectal (n = 12 897), lung (n = 25 608), or prostate (n = 38 202) cancer from 2001 to 2004. We used logistic regression to assess racial disparities for each measure and hospital fixed-effects models to determine whether disparities were attributable to between- or within-hospital differences. Results. Compared with Whites, Blacks had lower rates of early-stage colon cancer diagnosis (adjusted odds ratio [AOR] = 0.80; 95% confidence interval [CI] = 0.72, 0.90), curative surgery for stage I, II, or III rectal cancer (AOR = 0.57; 95% CI = 0.41, 0.78), 3-year survival for colon cancer (AOR = 0.75; 95% CI = 0.62, 0.89) and rectal cancer (AOR = 0.61; 95% CI = 0.42, 0.87), curative surgery for early-stage lung cancer (AOR = 0.50; 95% CI = 0.41, 0.60), 3-dimensional conformal or intensity-modulated radiation (3-D CRT/IMRT; AOR = 0.53; 95% CI = 0.47, 0.59), and potent antiemetics for highly emetogenic chemotherapy (AOR = 0.87; 95% CI = 0.78, 0.98). Adjustment for hospital fixed-effects minimally influenced racial gaps except for 3-D CRT/IMRT (AOR = 0.75; 95% CI = 0.65, 0.87) and potent antiemetics (AOR = 0.95; 95% CI = 0.82, 1.10). Conclusions. Disparities in VA cancer care were observed for 7 of 20 measures and were primarily attributable to within-hospital differences. PMID:25100422

  14. Perceived Racial Discrimination in Health Care: A Comparison of Veterans Affairs and Other Patients

    PubMed Central

    Jeong, Kwonho; Bost, James E.; Kressin, Nancy R.; Ibrahim, Said A.

    2009-01-01

    Objectives. We compared rates of perceived racial discrimination in health care settings for veteran and nonveteran patients and for veterans who used the Veterans Affairs health care system and those who did not. Methods. Data were drawn from the 2004 Behavioral Risk Factor Surveillance System. We used logistic regression to examine whether perceived racial discrimination in health care was associated with veteran status or use of Veterans Affairs health care, after adjusting for patient characteristics. Results. In this sample of 35 902 people, rates of perceived discrimination were equal for veterans and nonveterans (3.4% and 3.5%, respectively; crude odds ratio [OR] = 1.00; 95% confidence interval [CI] = 0.77, 1.28; adjusted OR = 0.92; 95% CI = 0.66, 1.28). Among veterans (n = 3420), perceived discrimination was more prevalent among patients who used Veterans Affairs facilities than among those who did not (5.4% vs 2.7%; OR = 2.08; 95% CI = 1.04, 4.18). However, this difference was not significant after adjustment for patient characteristics (OR = 1.30; 95% CI = 0.54, 3.13). Conclusions. Perceived racial discrimination in health care was equally prevalent among veterans and nonveterans and among veterans who used the Veterans Affairs health care system and those who did not. PMID:19443818

  15. Local Area Unemployment and the Demand for Inpatient Care Among Veterans Affairs Enrollees.

    PubMed

    Wong, Edwin S; Hebert, Paul L; Nelson, Karin M; Hernandez, Susan E; Sylling, Philip W; Fihn, Stephan D; Liu, Chuan-Fen

    2015-08-01

    Prior research examining the relationship between economic conditions and health service demand has focused primarily on outpatient use. This study examines whether local area unemployment, as an indicator of economic conditions, was associated with use of inpatient care, which is theoretically less subject to discretionary use. Using a random sample of 131,603 patients dually enrolled in the Veterans Affairs (VA) Health System and fee-for-service Medicare, we measured VA, Medicare, and total (VA and Medicare) hospitalizations. Overall, local unemployment was not associated with VA, Medicare, or total hospitalization probability. Among low-income veterans exempt from VA copayments, higher local unemployment was moderately associated with a lower probability of hospitalization through Medicare. For veterans subject to VA copayments, higher local unemployment was moderately associated with a higher likelihood of VA hospitalization. These results suggest inpatient use is less sensitive to the economy, although worse economic conditions slightly affected inpatient demand for select veterans.

  16. Authorities and Mechanisms for Purchased Care at the Department of Veterans Affairs

    PubMed Central

    Greenberg, Michael D.; Batka, Caroline; Buttorff, Christine; Dunigan, Molly; Lovejoy, Susan L.; McGovern, Geoffrey; Pace, Nicholas M.; Pillemer, Francesca; Williams, Kayla M.; Apaydin, Eric; Aranibar, Clara; Buenaventura, Maya; Carter, Phillip; Cherney, Samantha; Davis, Lynn E.; Donohue, Amy Grace; Geyer, Lily; Hemler, Joslyn; Roshan, Parisa; Skrabala, Lauren; Simmons, Stephen; Thompson, Joseph; Welch, Jonathan; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the authorities and mechanisms by which the Department of Veterans Affairs (VA) pays for health care services from non-VA providers. Purchased care accounted for 10 percent, or around $5.6 billion, of VA's health care budget in fiscal year 2014, and the amount of care purchased from outside VA is growing rapidly. VA purchases non-VA care through an array of programs, each with different payment processes and eligibility requirements for veterans and outside providers. A review and analysis of statutes, regulations, legislation, and literature on VA purchased care, along with interviews with expert stakeholders, a survey of VA medical facilities, and an evaluation of local-level policy documents revealed that VA's purchased care system is complex and decentralized. Inconsistencies in procedures, unclear goals, and a lack of cohesive strategy for purchased care could have ramifications for veterans' access to care. Adding to the complexity of VA's purchased care system is a lack of systematic data collection on access to and quality of care provided through VA's purchased care programs. The analysis also explored concepts of “episodes of care” and their implications for purchased care by VA. PMID:28083425

  17. Health Foods: Facts and Fakes. Public Affairs Pamphlet No. 498.

    ERIC Educational Resources Information Center

    Margolius, Sidney

    In this booklet the author states that the health food industry has reached a stage where consumers must be wary of false advertising, misleading labelling devices, and other techniques used by manufacturers attempting to capitalize on the popularity of health foods. Included are nearly two dozen examples of health food products which are…

  18. The role of the VA in academic radiology: a report of the ACR's Committee on Governmental and Regulatory Affairs in Academic Radiology.

    PubMed

    Sherrier, Robert H; Chang, Barbara K; Rawson, James V; Romanelli, Gloria

    2012-08-01

    Academic radiology departments have benefited from their relationships with US Department of Veterans Affairs hospitals. Review of the history of the care of veterans shows a unique relationship with academic medical centers. Opportunities for future collaborations include clinical care, teaching, and research.

  19. Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans.

    PubMed

    Hussey, Peter S; Ringel, Jeanne S; Ahluwalia, Sangeeta; Price, Rebecca Anhang; Buttorff, Christine; Concannon, Thomas W; Lovejoy, Susan L; Martsolf, Grant R; Rudin, Robert S; Schultz, Dana; Sloss, Elizabeth M; Watkins, Katherine E; Waxman, Daniel; Bauman, Melissa; Briscombe, Brian; Broyles, James R; Burns, Rachel M; Chen, Emily K; DeSantis, Amy Soo Jin; Ecola, Liisa; Fischer, Shira H; Friedberg, Mark W; Gidengil, Courtney A; Ginsburg, Paul B; Gulden, Timothy; Gutierrez, Carlos Ignacio; Hirshman, Samuel; Huang, Christina Y; Kandrack, Ryan; Kress, Amii; Leuschner, Kristin J; MacCarthy, Sarah; Maksabedian, Ervant J; Mann, Sean; Matthews, Luke Joseph; May, Linnea Warren; Mishra, Nishtha; Miyashiro, Lisa; Muchow, Ashley N; Nelson, Jason; Naranjo, Diana; O'Hanlon, Claire E; Pillemer, Francesca; Predmore, Zachary; Ross, Rachel; Ruder, Teague; Rutter, Carolyn M; Uscher-Pines, Lori; Vaiana, Mary E; Vesely, Joseph V; Hosek, Susan D; Farmer, Carrie M

    2016-05-09

    The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth.

  20. Measurement in Veterans Affairs Health Services Research: Veterans as a Special Population

    PubMed Central

    Morgan, Robert O; Teal, Cayla R; Reddy, Siddharta G; Ford, Marvella E; Ashton, Carol M

    2005-01-01

    Objective To introduce this supplemental issue on measurement within health services research by using the population of U.S. veterans as an illustrative example of population and system influences on measurement quality. Principal Findings Measurement quality may be affected by differences in demographic characteristics, illness burden, psychological health, cultural identity, or health care setting. The U.S. veteran population and the VA health system represent a microcosm in which a broad range of measurement issues can be assessed. Conclusions Measurement is the foundation on which health decisions are made. Poor measurement quality can affect both the quality of health care decisions and decisions about health care policy. The accompanying articles in this issue highlight a subset of measurement issues that have applicability to the broad community of health services research. It is our hope that they stimulate a broad discussion of the measurement challenges posed by conducting “state-of-the-art” health services research. PMID:16178996

  1. Assessing Hospital Disaster Readiness Over Time at the US Department of Veterans Affairs.

    PubMed

    Der-Martirosian, Claudia; Radcliff, Tiffany A; Gable, Alicia R; Riopelle, Deborah; Hagigi, Farhad A; Brewster, Pete; Dobalian, Aram

    2017-02-01

    Introduction There have been numerous initiatives by government and private organizations to help hospitals become better prepared for major disasters and public health emergencies. This study reports on efforts by the US Department of Veterans Affairs (VA), Veterans Health Administration, Office of Emergency Management's (OEM) Comprehensive Emergency Management Program (CEMP) to assess the readiness of VA Medical Centers (VAMCs) across the nation. Hypothesis/Problem This study conducts descriptive analyses of preparedness assessments of VAMCs and examines change in hospital readiness over time.

  2. Veterans Affairs: Sustained Management Attention Needed to Address Numerous IT Challenges

    DTIC Science & Technology

    2016-06-22

    VETERANS AFFAIRS Sustained Management Attention Needed to Address Numerous IT Challenges Statement of Valerie C. Melvin...Sustained Management Attention Needed to Address Numerous IT Challenges What GAO Found In February 2015, GAO designated Veterans Affairs (VA) health care...as a high- risk area based on its concerns about the department’s ability to ensure the quality and safety of veterans’ health care in five broad

  3. Sleep characteristics of Veterans Affairs Adult Day Health Care participants.

    PubMed

    Hughes, Jaime M; Martin, Jennifer L

    2015-01-01

    Addressing sleep disturbance can help to slow functional decline, delay nursing home admission, and improve overall health among older adults; however, sleep is not widely studied in high-risk older adults such as Adult Day Health Care (ADHC) participants. Sixty-eight ADHC participants were interviewed for sleep disturbance using a 28-item screening questionnaire. More than two thirds (n = 48, 70.6%) reported one or more characteristics of poor sleep, and 38% of participants met basic criteria for insomnia. Individuals with insomnia attended ADHC less frequently, reported worse sleep quality and shorter sleep duration, and were more likely to endorse trouble falling asleep, staying asleep, and waking up too early (ps < 0.001). Research is needed to better understand perceptions, predictors, and outcomes of sleep disturbance within ADHC participants.

  4. 78 FR 42455 - Medications Prescribed by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO77 Medications Prescribed by Non-VA Providers AGENCY: Department of... that eligible veterans engaged in current and future conflicts receive medications prescribed by non-VA... comply with a statutory mandate that VA provide medications prescribed by non-VA providers to...

  5. Expanded Access to Non-VA Care Through the Veterans Choice Program. Interim final rule.

    PubMed

    2015-12-01

    The Department of Veterans Affairs (VA) revises its medical regulations that implement section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (hereafter referred to as "the Choice Act"), which requires VA to establish a program to furnish hospital care and medical services through eligible non-VA health care providers to eligible veterans who either cannot be seen within the wait-time goals of the Veterans Health Administration (VHA) or who qualify based on their place of residence (hereafter referred to as the "Veterans Choice Program" or the "Program"). These regulatory revisions are required by the most recent amendments to the Choice Act made by the Construction Authorization and Choice Improvement Act of 2014, and by the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. The Construction Authorization and Choice Improvement Act of 2014 amended the Choice Act to define additional criteria that VA may use to determine that a veteran's travel to a VA medical facility is an "unusual or excessive burden," and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 amended the Choice Act to cover all veterans enrolled in the VA health care system, remove the 60-day limit on an episode of care, modify the wait-time and 40-mile distance eligibility criteria, and expand provider eligibility based on criteria as determined by VA. This interim final rule revises VA regulations consistent with the changes made to the Choice Act as described above.

  6. 76 FR 52575 - Health Care for Homeless Veterans Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... AFFAIRS 38 CFR Part 63 RIN 2900-AN73 Health Care for Homeless Veterans Program AGENCY: Department of... community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program of the... enrolled in the VA health care system. Through the HCHV program, VA identifies homeless veterans...

  7. Evaluating the Effectiveness of Mental Health First Aid Training among Student Affairs Staff at a Canadian University

    ERIC Educational Resources Information Center

    Massey, Jennifer; Brooks, Meghan; Burrow, Jeff

    2014-01-01

    This study evaluates the effectiveness of providing the Mental Health First Aid training program to student affairs staff. The objective of the training was to increase knowledge of mental health, enhance sensitivity, and raise confidence to intervene and assist individuals experiencing a mental health issue. We found the training successfully met…

  8. The Department of Veterans Affairs pre- and post-doctoral nurse fellowships: diverse opportunities for research.

    PubMed

    Hobbs, Jennifer; Shively, Martha; Bormann, Jill; Johnson, Linda; Alt-White, Anna C; Fairman, Julie

    2008-01-01

    The purpose of this article is to explicate research funding and training opportunities available through the Department of Veterans Affairs to nurses seeking advanced preparation at the pre- and post-doctoral levels. A brief discussion of the available resources including student stipend and health insurance, workspace, and research support is presented. Additionally, articulation of the benefits and challenges associated with these types of fellowships is delineated from the perspective of a fellow, Department of Veterans Affairs (VA) site preceptor, and dissertation faculty. Discussion of the post-doctoral fellowship and the extensive resources of the VA related to overall research career development are also addressed.

  9. 76 FR 72048 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for a Mixed-Use...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... the Secretary may enter into an enhanced-use lease if he determines that implementation of a business plan proposed by the Under Secretary for Health for applying the consideration under such a lease...

  10. The VA Point-of-Care Precision Oncology Program: Balancing Access with Rapid Learning in Molecular Cancer Medicine

    PubMed Central

    Fiore, Louis D.; Brophy, Mary T.; Turek, Sara; Kudesia, Valmeek; Ramnath, Nithya; Shannon, Colleen; Ferguson, Ryan; Pyarajan, Saiju; Fiore, Melissa A.; Hornberger, John; Lavori, Philip

    2016-01-01

    The Department of Veterans Affairs (VA) recognized the need to balance patient-centered care with responsible creation of generalizable knowledge on the effectiveness of molecular medicine tools. Embracing the principles of the rapid learning health-care system, a new clinical program called the Precision Oncology Program (POP) was created in New England. The POP integrates generalized knowledge about molecular medicine in cancer with a database of observations from previously treated veterans. The program assures access to modern genomic oncology practice in the veterans affairs (VA), removes disparities of access across the VA network of clinical centers, disseminates the products of learning that are generalizable to non-VA settings, and systematically presents opportunities for patients to participate in clinical trials of targeted therapeutics. PMID:26949343

  11. 78 FR 76064 - Authorization for Non-VA Medical Services; Withdrawal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO47 Authorization for Non-VA Medical Services; Withdrawal AGENCY... amended its regulations regarding payment by VA for medical services under VA's statutory authority to provide non-VA medical care. VA sought to remove an outdated regulatory limitation on...

  12. posttraumatic stress and its relationship to physical health functioning in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA health care.

    PubMed

    Jakupcak, Matthew; Luterek, Jane; Hunt, Stephen; Conybeare, Daniel; McFall, Miles

    2008-05-01

    The relationship between posttraumatic stress and physical health functioning was examined in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA care. Iraq and Afghanistan War veterans (N = 108) who presented for treatment to a specialty postdeployment care clinic completed self-report questionnaires that assessed symptoms of posttraumatic stress disorder (PTSD), chemical exposure, combat exposure, and physical health functioning. As predicted, PTSD symptom severity was significantly associated with poorer health functioning, even after accounting for demographic factors, combat and chemical exposure, and health risk behaviors. These results highlight the unique influence of PTSD on the physical health in treatment seeking Iraq and Afghanistan War veterans.

  13. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Duties of, and standards applicable to, non-VA community-based providers. 63.15 Section 63.15 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  14. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Duties of, and standards applicable to, non-VA community-based providers. 63.15 Section 63.15 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  15. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Duties of, and standards applicable to, non-VA community-based providers. 63.15 Section 63.15 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  16. Improving trends in gender disparities in the Department of Veterans Affairs: 2008-2013.

    PubMed

    Whitehead, Alison M; Czarnogorski, Maggie; Wright, Steve M; Hayes, Patricia M; Haskell, Sally G

    2014-09-01

    Increasing numbers of women veterans using Department of Veterans Affairs (VA) services has contributed to the need for equitable, high-quality care for women. The VA has evaluated performance measure data by gender since 2006. In 2008, the VA launched a 5-year women's health redesign, and, in 2011, gender disparity improvement was included on leadership performance plans. We examined data from VA Office of Analytics and Business Intelligence quarterly gender reports for trends in gender disparities in gender-neutral performance measures from 2008 to 2013. Through reporting of data by gender, leadership involvement, electronic reminders, and population management dashboards, VA has seen a decreasing trend in gender inequities on most Health Effectiveness Data and Information Set performance measures.

  17. Helping safeguard Veterans Affairs' hospital buildings by advanced earthquake monitoring

    USGS Publications Warehouse

    Kalkan, Erol; Banga, Krishna; Ulusoy, Hasan S.; Fletcher, Jon Peter B.; Leith, William S.; Blair, James L.

    2012-01-01

    In collaboration with the U.S. Department of Veterans Affairs (VA), the National Strong Motion Project of the U.S. Geological Survey has recently installed sophisticated seismic systems that will monitor the structural integrity of hospital buildings during earthquake shaking. The new systems have been installed at more than 20 VA medical campuses across the country. These monitoring systems, which combine sensitive accelerometers and real-time computer calculations, are capable of determining the structural health of each structure rapidly after an event, helping to ensure the safety of patients and staff.

  18. Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

    PubMed

    Boyle, Melissa A; Lahey, Joanna N

    2016-01-01

    Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act.

  19. Spousal Labor Market Effects from Government Health Insurance: Evidence from a Veterans Affairs Expansion

    PubMed Central

    Boyle, Melissa A.; Lahey, Joanna N.

    2015-01-01

    Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly-provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands’ labor supply decreases, wives’ labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act. JEL codes: H4, I1, J2 PMID:26734757

  20. 77 FR 50551 - Agency Information Collection: Emergency Submission for OMB Review (PACT VISN20 Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... AFFAIRS Agency Information Collection: Emergency Submission for OMB Review (PACT VISN20 Health Care... No. 2900-New (VA Form 10-0535). SUPPLEMENTARY INFORMATION: Title: PACT VISN20 Health Care Experiences...); Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION:...

  1. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria

    PubMed Central

    Peterson, Rachel; Gundlapalli, Adi V.; Metraux, Stephen; Carter, Marjorie E.; Palmer, Miland; Redd, Andrew; Samore, Matthew H.; Fargo, Jamison D.

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations. PMID:26172386

  2. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    PubMed

    Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  3. 78 FR 55777 - Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... AFFAIRS Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event... Events, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of National Veterans Sports Programs and Special Events (NVSP), Department of Veterans Affairs (VA), is announcing an opportunity...

  4. VA and DOD Health Care: First Federal Health Care Center Established, but Implementation Concerns Need to Be Addressed

    DTIC Science & Technology

    2011-07-01

    develop the automated orders portability capability. This interim process necessitated the hiring of five full-time pharmacists to conduct manual...planning, VA and DOD have not yet fully provided clinicians at the FHCC with the IT capabilities the Executive Agreement identified as needed upon opening

  5. 77 FR 70967 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-28

    ..., Alcoholism, Claims, Day care, Dental health, Drug abuse, Government contracts, Grant programs--health... its regulation governing payment by VA for non-VA outpatient care under VA's statutory authority to provide non-VA care. Under this authority, VA may contract for certain hospital care (inpatient care)...

  6. 75 FR 52751 - Office of Global Health Affairs; Trans-Atlantic Task Force on Antimicrobial Resistance (TATFAR)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... HUMAN SERVICES Office of Global Health Affairs; Trans-Atlantic Task Force on Antimicrobial Resistance... public on the activities of the Trans-Atlantic Taskforce on Antimicrobial Resistance (TATFAR). DATES: A... force to focus ``on urgent antimicrobial resistance issues focused on appropriate therapeutic use...

  7. Health care for homeless veterans. Final rule.

    PubMed

    2011-08-23

    This final rule establishes regulations for contracting with community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program of the Department of Veterans Affairs (VA). The HCHV program assists certain homeless veterans in obtaining treatment from non-VA community-based providers. The final rule formalizes VA's policies and procedures in connection with this program and clarifies that veterans with substance use disorders may qualify for the program.

  8. Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

    PubMed Central

    Hussey, Peter S.; Ringel, Jeanne S.; Ahluwalia, Sangeeta; Price, Rebecca Anhang; Buttorff, Christine; Concannon, Thomas W.; Lovejoy, Susan L.; Martsolf, Grant R.; Rudin, Robert S.; Schultz, Dana; Sloss, Elizabeth M.; Watkins, Katherine E.; Waxman, Daniel; Bauman, Melissa; Briscombe, Brian; Broyles, James R.; Burns, Rachel M.; Chen, Emily K.; DeSantis, Amy Soo Jin; Ecola, Liisa; Fischer, Shira H.; Friedberg, Mark W.; Gidengil, Courtney A.; Ginsburg, Paul B.; Gulden, Timothy; Gutierrez, Carlos Ignacio; Hirshman, Samuel; Huang, Christina Y.; Kandrack, Ryan; Kress, Amii; Leuschner, Kristin J.; MacCarthy, Sarah; Maksabedian, Ervant J.; Mann, Sean; Matthews, Luke Joseph; May, Linnea Warren; Mishra, Nishtha; Miyashiro, Lisa; Muchow, Ashley N.; Nelson, Jason; Naranjo, Diana; O'Hanlon, Claire E.; Pillemer, Francesca; Predmore, Zachary; Ross, Rachel; Ruder, Teague; Rutter, Carolyn M.; Uscher-Pines, Lori; Vaiana, Mary E.; Vesely, Joseph V.; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth. PMID:28083424

  9. 77 FR 64387 - Agency Information Collection (Request for and Authorization To Release Medical Records or Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... AFFAIRS Agency Information Collection (Request for and Authorization To Release Medical Records or Health... Release Medical Records or Health Information, VA Form 10-5345. b. Individual's Request for a Copy of... Rennie, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue...

  10. VA and DOD Health Care: Progress Made on Implementation of 2003 President’s Task Force Recommendations on Collaboration and Coordination, but More Remains to Be Done

    DTIC Science & Technology

    2008-04-01

    L. No. 110-181, § 1614, 122 Stat. 3 , 443-46. iSee GAO, DOD and VA: Preliminary Observations on Efforts to Improve Care Management and Disability...the departments. 3 On May 28, 2001, the President established the 15-member President’s Task Force to Improve Health Care Delivery for Our Nation’s...control number. 1. REPORT DATE 30 APR 2008 2. REPORT TYPE 3 . DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE VA and DOD Health Care

  11. 75 FR 17832 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity... techniques or the use of other forms of information technology. Title: VA Loan Electronic Reporting...

  12. 75 FR 33898 - Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity.... 2900-0021.'' SUPPLEMENTARY INFORMATION: Title: VA Loan Electronic Reporting Interface (VALERI)...

  13. 78 FR 36642 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity... techniques or the use of other forms of information technology. Title: VA Loan Electronic Reporting...

  14. 77 FR 24268 - Agency Information Collection (Dependents' Application for VA Educational Benefits) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... AFFAIRS Agency Information Collection (Dependents' Application for VA Educational Benefits) Activity Under... INFORMATION: Title: Dependents' Application for VA Educational Benefits (Under Provisions of Chapters 33 and... spouses and children of veterans or servicemembers to apply for Survivors' and Dependents'...

  15. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... AFFAIRS Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment... applicant's qualification and suitability as a VA police officer. DATES: Written comments and... information technology. Title: VA Police Officer Pre-Employment Screening Checklist, VA Form 0120. OMB...

  16. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... AFFAIRS Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration Applications); Comment Request AGENCY: Office of National Programs and Special Events, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of National Programs and Special Events (NPSE), Department...

  17. Rapid HIV testing experience at Veterans Affairs North Texas Health Care System's Homeless Stand Downs.

    PubMed

    Hooshyar, Dina; Surís, Alina M; Czarnogorski, Maggie; Lepage, James P; Bedimo, Roger; North, Carol S

    2014-01-01

    In the USA, 21% of the estimated 1.1 million people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) are unaware they are HIV-infected. In 2011, Veterans Health Administration (VHA)'s Office of Public Health in conjunction with VHA's Health Care for Homeless Veterans Program funded grants to support rapid HIV testing at homeless outreach events because homeless populations are more likely to obtain emergent rather than preventive care and have a higher HIV seroprevalence as compared to the general population. Because of a Veterans Affairs North Texas Health Care System (VANTHCS)'s laboratory testing requirement, VANTHCS partnered with community agencies to offer rapid HIV testing for the first time at VANTHCS' 2011 Homeless Stand Downs in Dallas, Fort Worth, and Texoma, Texas. Homeless Stand Downs are outreach events that connect Veterans with services. Veterans who declined testing were asked their reasons for declining. Comparisons by Homeless Stand Down site used Pearson χ², substituting Fisher's Exact tests for expected cell sizes <5. Of the 910 Veterans attending the Homeless Stand Downs, 261 Veterans reported reasons for declining HIV testing, and 133 Veterans were tested, where 92% of the tested Veterans obtained their test results at the events - all tested negative. Veterans' reported reasons for declining HIV testing included previous negative result (n=168), no time to test (n=49), no risk factors (n=36), testing is not a priority (n=11), uninterested in knowing serostatus (n=6), and HIV-infected (n=3). Only "no time to test" differed significantly by Homeless Stand Down site. Nonresponse rate was 54%. Offering rapid HIV testing at Homeless Stand Downs is a promising testing venue since 15% of Veterans attending VANTHCS' Homeless Stand Downs were tested for HIV, and majority obtained their HIV test results at point-of-care while further research is needed to determine how to improve these rates.

  18. Electronic Health Records: VA and DOD Need to Establish Goals and Metrics for Their Interoperability Efforts

    DTIC Science & Technology

    2015-10-27

    largest health care systems, serving millions of veterans and active duty members and their beneficiaries. For almost two decades the departments have...Authorization Act (NDAA) for Fiscal Year 2014 for compliance with national standards, certify that all health care data in their systems complied...to measure the effectiveness of interoperability efforts in terms of improving health care services for patients served by both departments. IPO

  19. Health Occupations Education I. Module No. V-A to V-D.

    ERIC Educational Resources Information Center

    Dunmeyer, Kathryn; And Others

    This set of 4 modules on bedmaking is 1 of 11 sets in the Health Occupations Education I instructional package for the first year of a 2-year course of study. The materials are designed to prepare students through individualized instruction for entry-level job opportunities on health care teams in a variety of practice settings. Each module may…

  20. American Indian Veterans' Views about Their Choices in Health Care: VA, IHS, and Medicare

    ERIC Educational Resources Information Center

    Reifel, Nancy; Bayhylle, Ruth; Harada, Nancy; Villa, Valentine

    2009-01-01

    Legislation during the past three decades has gradually drawn Indian Health Service (IHS)-funded clinics into the mainstream of the US medical care environment. The Indian Self-Determination and Education Reform Act of 1973 and its Indian Education Amendments of 1984 began a movement away from federal management of health services to local tribal…

  1. Homeless and nonhomeless VA service users likely eligible for Medicaid expansion.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2014-01-01

    Administrative data on the population of Department of Veterans Affairs (VA) service users in 2010 under the age of 65 (n = 3,841,225) were analyzed to identify the number and characteristics of homeless and nonhomeless VA service users who are likely to be eligible for the Medicaid expansion (LEME) option under the Affordable Care Act. Results showed that, estimating conservatively, about 1.2 million (21%) current VA users are LEME if all states implement the expansion. Homeless service users were twice as likely to be eligible than nonhomeless users (64% vs 30%). VA service users who are LEME, regardless of housing status, were physically healthier than those not LEME but were more likely to have substance use disorders and posttraumatic stress disorder. These findings suggest that many VA service users are LEME, particularly those who are homeless and/or have mental health needs. Cross-system use of VA and Medicaid-funded services may be advantageous for veterans with extensive medical and psychiatric needs but also risks fragmented care. Information and education for VA clinicians and their patients about possible implications of the Affordable Care Act may be important.

  2. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    PubMed

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system.

  3. VA Mental Health: Clearer Guidance on Access Policies and Wait-Time Data Needed

    DTIC Science & Technology

    2015-10-01

    managed . VHA concurred with GAO’s recommendations but disagreed with certain of its findings, for example, GAO’s calculation of overall wait- times ...Health Care: Management and Oversight of Consult Process Need Improvement to Help Ensure Veterans Receive Timely Outpatient Specialty Care, GAO- 14-808...events or activities, such as ensuring timely access to mental health care, to help ensure management directives are carried out properly.32 VHA

  4. Group Cognitive-Behavioral Therapy for Insomnia in a VA Mental Health Clinic

    ERIC Educational Resources Information Center

    Perlman, Lawrence M.; Arnedt, J. Todd; Earnheart, Kristie L.; Gorman, Ashley A.; Shirley, Katherine G.

    2008-01-01

    Effective cognitive-behavioral therapies for insomnia have been developed over the past 2 decades, but they have not been systematically evaluated in some clinical settings. While insomnia is common among veterans with mental health problems, the availability of effective treatments is limited. We report on the group application of a…

  5. Partnership to improve quality care for veterans: the VA Nursing Academy.

    PubMed

    Harper, Doreen C; Selleck, Cynthia S; Eagerton, Gregory; Froelich, Kimberly

    2015-01-01

    More than 22 million living veterans reside in the United States. In fact, understanding military culture and the experiences of these veterans is important to their ongoing health care and the unique challenges faced by many. The Veterans Affairs (VA) Nursing Academy began in 2007 to fund pilot partnerships between schools of nursing and local VA health care facilities to better serve our veteran population. Fifteen academic/service partnerships were selected for funding between 2007 and 2009 with the goals of expanding faculty and professional development, increasing nursing student enrollment, providing opportunities for educational and practice innovations, and increasing the recruitment and retention of VA nurses. This article details critical components of the partnership developed between the Birmingham VA Medical Center and the University of Alabama at Birmingham School of Nursing, a VA Nursing Academy partnership funded in the 2009 cohort. Site-specific goals of the partnership are described along with a discussion of the framework used to develop the Birmingham VA Nursing Academy, which includes relationship building, engagement, governance, evaluation of outcomes, and sustainability. The logic model developed for the partnership is included, and the interim outputs and outcomes of this practice-academic partnership are detailed, a number of which can be replicated by VAs and schools of nursing across the country.

  6. Perceived challenges for adopting the Personal Health Record (PHR) at Ministry of National Guard Health Affairs (MNGHA)- Riyadh

    PubMed Central

    2016-01-01

    Background The Personal Health Record (PHR) is an electronic record that allows patients to maintain, manage and access their health information in one secure location. However, despite these potential capabilities, the adoption rate of the PHR has been slow due to various challenges. Objectives This study, being the first of its kind in Saudi Arabia, investigates the perceived barriers and /or challenges for PHR adoption in the Ministry of National Guard Health Affairs (MNGHA). The study explored perceived barriers and /or challenges from two different perspectives; a technical perspective and a social perspective. Methods The study was conducted using a mixed methods approach. A cross-sectional study design using a questionnaire was used to measure patients' perceptions of the PHR and a qualitative approach through focus groups was used to capture comments and opinions from technical personnel for perceived technical barriers to PHR adoption. Result Results from 424 patients revealed a positive perception for PHR adoption with almost all of the participants (96.7%) indicating interest in using the PHR and the majority (73.3%) expressing no confidentiality concerns for the online accessibility of their health information. Patients with higher levels of education indicated higher interest in using the PHR and expressed more concern with confidentiality than patients with lower levels of education. However, the majority of patients (78.3%) expressed their lack of awareness of existing patient e-services on the MNGHA website. The themes that emerged from the focus groups reinforced lack of awareness of e-services as a potential barrier for PHR adoption as well as the role of policy in the regulation and business process for PHR adoption. Conclusion This study has highlighted the perceived challenges and barriers for adoption of the PHR in MNGHA-Riyadh. In order to ensure an efficient PHR with a strong adoption rate, effective steps need to be undertaken by building

  7. 76 FR 625 - Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity... Satisfaction Survey, VA Form 10-0507. OMB Control Number: 2900--New (VA Form 10-0507). Type of Review:...

  8. 77 FR 37839 - Veterans' Group Life Insurance (VGLI) No-Health Period Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... AFFAIRS 38 CFR Part 9 RIN 2900-AO24 Veterans' Group Life Insurance (VGLI) No-Health Period Extension... Affairs (VA) proposes to amend its regulations governing eligibility for Veterans' Group Life Insurance... indicate that they are submitted in response to ``RIN 2900-AO24--Veterans' Group Life Insurance (VGLI)...

  9. 78 FR 71041 - VA Compensation and Pension Regulation Rewrite Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-27

    ...The Department of Veterans Affairs (VA) proposes to reorganize and rewrite its compensation and pension regulations in a logical, claimant-focused, and user-friendly format. The intended effect of the proposed revisions is to assist claimants, beneficiaries, veterans' representatives, and VA personnel in locating and understanding these...

  10. 78 FR 63143 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO86 VA Dental Insurance Program--Federalism AGENCY: Department of... its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of...

  11. 78 FR 62441 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO85 VA Dental Insurance Program--Federalism AGENCY: Department of... direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and...

  12. 38 CFR 74.27 - How will VA store information?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false How will VA store information? 74.27 Section 74.27 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information?...

  13. Drug and drug-related supply promotion by pharmaceutical company representatives at VA facilities. Final rule.

    PubMed

    2012-03-05

    This final rule amends the Department of Veterans Affairs (VA) regulations regarding access to VA facilities by pharmaceutical company representatives. The purposes of the rule are to reduce or eliminate any potential for disruption in the patient care environment, manage activities and promotions at VA facilities, and provide pharmaceutical company representatives with a consistent standard of permissible business practice at VA facilities. The amendments will facilitate mutually beneficial relationships between VA and pharmaceutical company representatives.

  14. DoD And VA Health Care: Federal Recovery Coordination Program Continues to Expand But Faces Significant Challenges

    DTIC Science & Technology

    2011-03-01

    FRCP enrollees have more than one diagnosis. a“Medical diagnosis” includes diagnoses such as stroke , heart attack, and cancer. b“Other” includes...coordinator or case manager Acute care Rehab Reintegration Lifetime follow-up Clinical Nonclinical Recovery plan VA/DOD Federal Recovery Coordination...coordinator or case manager Acute care Rehab Reintegration Lifetime follow-up Clinical Nonclinical Recovery plan VA Spinal Cord Injury and Disorders

  15. Accessing VA Healthcare During Large-Scale Natural Disasters.

    PubMed

    Der-Martirosian, Claudia; Pinnock, Laura; Dobalian, Aram

    2017-01-01

    Natural disasters can lead to the closure of medical facilities including the Veterans Affairs (VA), thus impacting access to healthcare for U.S. military veteran VA users. We examined the characteristics of VA patients who reported having difficulty accessing care if their usual source of VA care was closed because of natural disasters. A total of 2,264 veteran VA users living in the U.S. northeast region participated in a 2015 cross-sectional representative survey. The study used VA administrative data in a complex stratified survey design with a multimode approach. A total of 36% of veteran VA users reported having difficulty accessing care elsewhere, negatively impacting the functionally impaired and lower income VA patients.

  16. Helping veterans with mental illness overcome civil legal issues: collaboration between a veterans affairs psychosocial rehabilitation center and a nonprofit legal center.

    PubMed

    Wong, Catherine F; Tsai, Jack; Klee, Anne; Udell, Howard R; Harkness, Laurie; Middleton, Margaret

    2013-02-01

    This article describes the collaboration between a Department of Veterans Affairs (VA) community-based psychosocial rehabilitation center and a nonprofit legal center that primarily addresses the civil legal issues of veterans who have mental illness and/or are homeless. The legal center is located on-site at the VA psychosocial rehabilitation center and serves veterans who receive VA mental health treatment and other social services. Once veterans establish contact with the legal center and authorize the release of their health information, legal center staff members work closely with VA clinicians to help veterans address legal issues that may be obstacles to recovery. Development of this collaboration is described, along with the legal center's funding, clientele, and operations. The most common types of civil legal matters the legal center handles are also briefly described. Experiences of the legal center suggest that professional aid for civil legal problems provided within VA facilities may be beneficial for veterans and warrants empirical study.

  17. 77 FR 30050 - VA National Academic Affiliations Council, Notice of meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ... AFFAIRS VA National Academic Affiliations Council, Notice of meeting The Department of Veterans Affairs... the National Academic Affiliations Council will be held on June 5-6, 2012, in Suite 878 at 1800 G... affecting partnerships between VA and its academic affiliates. On June 5, the Council will review the...

  18. 78 FR 52085 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-22

    ... AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business Verification Guidelines AGENCY... requires the Department of Veterans Affairs (VA) to verify ownership and control of veteran- ] owned small businesses (VOSBs), including service-disabled veteran- owned small businesses (SDVOSBs), in order for...

  19. 76 FR 3017 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-19

    ... to one business has no foundation in law and that there is no compelling reason to limit... AFFAIRS 38 CFR Part 74 RIN 2900-AM78 VA Veteran-Owned Small Business Verification Guidelines AGENCY..., and Information Technology Act of 2006. This law requires the Department of Veterans Affairs (VA)...

  20. 77 FR 38181 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business Verification Guidelines AGENCY... Department of Veterans Affairs (VA) to verify ownership and control of veteran-owned small businesses (VOSBs), including service-disabled veteran-owned small businesses (SDVOSBs) in order for these firms to...

  1. 78 FR 27882 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... AFFAIRS 38 CFR Part 74 RIN 2900-AO63 VA Veteran-Owned Small Business (VOSB) Verification Guidelines AGENCY... and Disadvantaged Business Utilization (OSDBU) is currently reviewing its regulations governing the Department of Veterans Affairs (VA) Veteran-Owned Small Business (VOSB) Verification Program. OSDBU...

  2. U.S. Department of Veterans Affairs Enterprise Reference Terminology strategic overview.

    PubMed

    Lincoln, Michael J; Brown, Steven H; Nguyen, Viet; Cromwell, Tim; Carter, John; Erlbaum, Mark; Tuttle, Mark

    2004-01-01

    The Veterans Health Affairs (VHA) branch of the Department of Veterans Affairs has undertaken an Enterprise Reference Terminology (ERT). VHA, arguably the largest integrated healthcare provider in the United States, has completely computerized virtually all clinical transactions, including physician orders and documentation. The VA is now integrating its clinical records across hundreds of sites of care by means of a Health Data Repository (HDR) project. ERT has been designed to provide a terminology development environment, terminology services, and maintenance services for the clinical and business content in HDR and other VHA applications. Drug, laboratory observations, and clinical document title files have been developed, and the ERT will encompass all HDR domains by 2008. Commercial tools are used to host the VHA's ERT terminology development and server environments. We will select and adopt both open-source and licensable terminology systems to provide ERT content, as well as reuse existing VA-specific terminology content.

  3. Hearing on USERRA, Veterans' Preference in the VA Education Services Draft Discussion Bill. Hearing before the Subcommittee on Education, Training, Employment and Housing of the Committee on Veterans' Affairs, House of Representatives, One Hundred Fourth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

    This document records oral and written testimony given at a hearing before a subcommittee of the U.S. House of Representatives Committee on Veterans' Affairs. The testimony pertains to veterans' preferences in hiring in the federal government and problems veterans are having in being reemployed after stints of active duty or during reductions in…

  4. Veterans Affairs: Health Care and Benefits for Veterans Exposed to Agent Orange

    DTIC Science & Technology

    2010-09-22

    comply with the notice and comment requirements of the Administrative Procedures Act ( APA ).38 Subsequent Actions On September 21, 2006, Secretary...found by the CAVC not to have been properly rescinded under the APA .41 This action was taken by the VA as a preemptive measure in the event the...53 Norma Ketchum and Joel Michalek, “Postservice Mortality of Air Force Veterans Occupationally Exposed to Herbicides During the Vietnam

  5. 77 FR 2348 - Agency Information Collection (VA Enrollment Certification): Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (VA Enrollment Certification): Activity Under OMB Review AGENCY... INFORMATION: Title: VA Enrollment Certification, VA Form 22-1999. OMB Control Number: 2900-0073. Type...

  6. 38 CFR 26.9 - Information on and public participation in VA environmental process.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT...) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During the..., the Office of Environmental Affairs, or a VA element, information is available by writing to...

  7. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  8. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  9. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  10. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  11. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AFFAIRS GENERAL PROVISIONS Referrals of Information Regarding Criminal Violations § 1.203 Information to be reported to VA Police. Information about actual or possible violations of criminal laws related to VA programs, operations, facilities, or involving VA employees, where the violation of criminal...

  12. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Form 10-6298, Architect... VETERANS AFFAIRS CLAUSES AND FORMS FORMS Prescription of Forms 853.236-70 VA Form 10-6298, Architect-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in...

  13. Measuring physicians' productivity in a Veterans' Affairs Medical Center.

    PubMed

    Coleman, David L; Moran, Eileen; Serfilippi, Delchi; Mulinski, Paul; Rosenthal, Ronnie; Gordon, Bruce; Mogielnicki, R Peter

    2003-07-01

    The mission of the Department of Veterans Affairs includes patient care, education, research, and backup to the Department of Defense. Because the measurement of physicians' productivity must reflect both institutional goals and market forces, the authors designed a productivity model that uses measures of clinical workload and academic activities commensurate with the VA's investments in these activities. The productivity model evaluates four domains of physicians' activity: clinical work, education, research, and administration. Examples of the application of the productivity model in the evaluation of VA-paid physician-staff and in the composition of contracts for clinical services are provided. The proposed model is a relatively simple strategy for measuring a broad range of the work of academic physicians in VA medical centers. The model provides incentives for documentation of resident supervision and participation in administrative activities required for effective and efficient clinical care. In addition, the model can aid in determining resource distribution among clinical services and permits comparison with non-VA health care systems. A strategy for modifying the model to incorporate measures of quality of clinical care, research, education, and administration is proposed. The model has been a useful part of the process to ensure the optimum use of resources and to meet clinical and academic institutional goals. The activities and accomplishments used to define physician productivity will have a substantial influence on the character of the medical profession, the vitality of medical education and research, and the cost and quality of health care.

  14. Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites

    ERIC Educational Resources Information Center

    Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola

    2009-01-01

    Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…

  15. 77 FR 12517 - VA Dental Insurance Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... ``be carried out in such Veterans Integrated Services Networks as the Secretary considers appropriate... Veterans Omnibus Health Services Act of 2010 (the 2010 Act). DATES: Comments must be received by VA on or... eligibility for VA outpatient dental services and treatment, and related dental appliances under 38...

  16. 76 FR 56503 - Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... AFFAIRS Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB... INFORMATION: Title: VSO Access to VHA Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900... recorded in VHA electronic health records system. An agency may not conduct or sponsor, and a person is......

  17. 76 FR 20822 - Proposed Information Collection (Living Will and Durable Power of Attorney for Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... AFFAIRS Proposed Information Collection (Living Will and Durable Power of Attorney for Health Care... information needed to record patient's specific instructions about health care decisions in the event he or... Power of Attorney for Health Care, VA Form 10-0137. OMB Control Number: 2900-0556. Type of...

  18. 76 FR 78738 - Agency Information Collection (Locality Pay System for Nurses and Other Health Care Personnel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... AFFAIRS Agency Information Collection (Locality Pay System for Nurses and Other Health Care Personnel... INFORMATION: Title: Locality Pay System for Nurses and Other Health Care Personnel. OMB Control Number: 2900... determine locality pay system for certain health care personnel. VA medical facility Directors will use...

  19. 75 FR 78901 - Payment for Inpatient and Outpatient Health Care Professional Services at Non-Departmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-17

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN37 Payment for Inpatient and Outpatient Health Care Professional... concerning the payment methodology used to calculate VA payments for inpatient and outpatient health care... health facility furnishing the care or services if such care or services were provided in a...

  20. 75 FR 7218 - Payment for Inpatient and Outpatient Health Care Professional Services at Non-Departmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN37 Payment for Inpatient and Outpatient Health Care Professional... calculate VA payments for inpatient and outpatient health care professional services and other medical... other health facility furnishing the care or services if such care or services were provided in...

  1. Evaluation of an implementation model: a national investigation of VA residential programs.

    PubMed

    Cook, Joan M; Dinnen, Stephanie; Coyne, James C; Thompson, Richard; Simiola, Vanessa; Ruzek, Josef; Schnurr, Paula P

    2015-03-01

    This national investigation utilizes qualitative data to evaluate an implementation model regarding factors influencing provider use of two evidence-based treatments for posttraumatic stress disorder (PTSD). Semi-structured qualitative interviews with 198 mental health providers from 38 Department of Veterans Affairs' (VA) residential treatment programs were used to explore these issues regarding prolonged exposure (PE) and cognitive processing therapy (CPT) in VA residential PTSD programs. Several unique and some overlapping predictors emerged. Leadership was viewed as an influence on implementation for both CPT and PE, while a lack of dedicated time and resources was viewed as a deterrent for both. Compatibility of CPT with providers' existing practices and beliefs, the ability to observe noticeable patient improvement, a perceived relative advantage of CPT over alternative treatments, and the presence of a supportive peer network emerged as influential on CPT implementation. Leadership was associated with PE implementation. Implications for the design and improvement of training and implementation efforts are discussed.

  2. 77 FR 64388 - Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... AFFAIRS Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Former POW Medical History, VA Form 10-0048. OMB Control Number: 2900-0427. Type of Review: Extension of a currently approved collection. Abstract: VA Form 10-0048 is completed...

  3. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  4. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  5. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  6. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription...

  7. 78 FR 76061 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse...-VA medical care. In the Federal Register on November 28, 2012, VA proposed to remove an outdated regulatory limitation on veterans' eligibility to be referred for non- VA medical care. On the same date,...

  8. Translating standards into practice: experience and lessons learned at the Department of Veterans Affairs.

    PubMed

    Bouhaddou, Omar; Cromwell, Tim; Davis, Mike; Maulden, Sarah; Hsing, Nelson; Carlson, David; Cockle, Jennifer; Hoang, Catherine; Fischetti, Linda

    2012-08-01

    The increased need for interoperable electronic health records in health care organizations underscores the importance of standards. The US Department of Veterans Affairs (VA) has a long history of developing and adopting various types of health care data standards. The authors present in detail their experience in this domain. A formal organization within VA is responsible for helping to develop and implement standards. This group has produced a Standards Life Cycle (SLC) process endorsed by VA key business and information technology (IT) stakeholders. It coordinates the identification, description, and implementation of standards aligned with VA business requirements. In this paper, we review the adoption of four standards in the categories of security and privacy, terminology, health information exchange, and modeling tools; emphasizing the implementation approach used in each. In our experience, adoption is facilitated by internal staff with expertise in standards development and adoption. Use of processes such as an SLC and tools such as an enterprise requirement repository help formally track and ensure that IT development and acquisition incorporate these standards. An organization should adopt standards that are aligned with its business priorities and favor those that are more readily implementable. To assist with this final point, we offer a standard "Likelihood of Adoption Scale," which changes as standards specifications evolve from PDF documents only, to PDF documents with construction and testing tools, to fully functional reference implementations.

  9. Contraceptive Provision in the VA Healthcare System to Women Who Report Military Sexual Trauma

    PubMed Central

    Mattocks, Kristin; Schwarz, Eleanor Bimla; Borrero, Sonya; Skanderson, Melissa; Zephyrin, Laurie; Brandt, Cynthia; Haskell, Sally

    2014-01-01

    Abstract Background: Women Veterans who suffered military sexual trauma (MST) may be at high risk for unintended pregnancy and benefit from contraceptive services. The objective of this study is to compare documented provision of contraceptives to women Veterans using the Department of Veterans Affairs (VA) health system who report or deny MST. Methods: This retrospective cohort study included women Veterans aged 18–45 years who served in Operation Enduring or Iraqi Freedom and had at least one visit to a VA medical center between 2002 and 2010. Data were obtained from VA administrative and clinical databases. Chi-squared tests and logistic regression were conducted to evaluate the association between MST, ascertained by routine clinical screening, and first documented receipt of hormonal or long-acting contraception. Results: Of 68,466 women Veterans, 13% reported, 59% denied and 28% had missing data for the MST screen. Among the entire study cohort, 30% of women had documented receipt of a contraceptive method. Women reporting MST were significantly more likely than those denying MST to receive a method of contraception (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.07–1.18) including an intrauterine device (odds ratio [OR] 1.29, 95% CI 1.17–1.41) or contraceptive injection (OR 1.17, 95% CI 1.05–1.29). Women who were younger, unmarried, seen at a women's health clinic, or who had more than one visit were more likely to receive contraception. Conclusions: A minority of women Veterans of reproductive age receive contraceptive services from the VA. Women Veterans who report MST, and particularly those who seek care at VA women's health clinics, are more likely to receive contraception. PMID:24787680

  10. Knowledge, Attitude, Practice, and Perceived Barriers of Colorectal Cancer Screening among Family Physicians in National Guard Health Affairs, Riyadh

    PubMed Central

    2014-01-01

    Objectives. The objective of this study is to explore the current knowledge, attitude, and practice of family physicians working in family medicine clinics in National Guard Health Affairs (NGHA), Riyadh, toward colorectal cancer (CRC) screening and to identify the barriers of the screening. Methods. Data were collected using a validated self-administered questionnaire adopted from the National Cancer Institute in USA, customized by adding and eliminating questions to be in line with the institution (NGHA) characteristics. Results. Of the 130 physicians, 56.2% of the physicians were not practicing CRC screening although 94.6% considered CRC screening effective. Board certified physicians had higher knowledge score and were practicing CRC screening more when compared to other physicians. Physicians who reported practicing CRC screening scored more on the knowledge score than those not practicing. Male physicians scored better on attitude score than female physicians. The study found that barriers were cited in higher rates among physicians not practicing CRC screening compared with practicing physicians. Lack of patients' awareness was the most cited barrier. Conclusion. Large percentage of family physicians in this study do not practice CRC screening, despite the knowledge level and the positive attitude. PMID:25328703

  11. Departments of Defense and Veterans Affairs: Status of the Integrated Electronic Health Record (iEHR)

    DTIC Science & Technology

    2013-02-26

    electronic clinical documentation (usually physician, nurse, and other clinician documentation), electronic prescribing (e.g., computerized provider order...health record with access to evidence-based decision support tools that can be used to aid clinicians in decision-making. The EHR can automate and...are computable (that is, in a format that a computer can understand and act on to, for example, provide alerts to clinicians on drug allergies). At a

  12. Assessing Health Status Differences Between Veterans Affairs Home-Based Primary Care and State Medicaid Waiver Program Clients

    PubMed Central

    Wharton, Tracy C.; Nnodim, Joseph; Hogikyan, Robert; Mody, Lona; James, Mary; Montagnini, Marcos; Fries, Brant E.

    2013-01-01

    Objectives Comprehensive health care for older adults is complex, involving multiple comorbidities and functional impairments of varying degrees and numbers. In response to this complexity and associated barriers to care, home-based care models have become prevalent. The home-based primary care (HBPC) model, based at a Michigan Department of Veterans Affairs Medical Center, and the Michigan Waiver Program (MWP) that includes home-based care are 2 of these. Although both models are formatted to address barriers to effective and efficient health care, there are differences in disease prevalence and functional performance between groups. The objective of this study was to explore the differences between the 2 groups, to shed some light on potential trends that could suggest areas for resource allocation by service providers. Design Using a retrospective analysis of data collected using the interRAI-home care, we examined a cross-sectional representation of clients enrolled in HBPC and MWP in 2008. Participants The HBPC sample had 89 participants. The MWP database contained 9324 participants from across the State of Michigan and were weighted to be comparable to the HBPC population in sex and age, and to simulate the HBPC sample size. Results Veterans were more independent in basic activities of daily living performance, but there was no difference in the rate of reported falls between the 2 groups. Veterans had more pain and a higher prevalence of coronary artery disease (z = 7.0; P <.001), Chronic obstructive pulmonary disease (z = 3.9; P < .001), and cancer (z = 8.5; P < .001). There was no statistically significant difference between the 2 groups in terms of the prevalence of geriatric syndromes. Scores on subscales of the interRAI-home care indicated a lower risk of serious health decline and adverse outcomes for MWP compared with HBPC clients (1.4 ± 1.1 vs 0.9 ± 0.1; z = 2.5; P = .012). Veterans receiving home-based care through the Veterans Affairs Medical

  13. Iraq and Afghanistan veterans: national findings from VA residential treatment programs.

    PubMed

    Cook, Joan M; Dinnen, Stephanie; O'Donnell, Casey; Bernardy, Nancy; Rosenheck, Robert; Hoff, Rani

    2013-01-01

    A quality improvement effort was undertaken in Department of Veterans Affairs' (VA) residential treatment programs for Posttraumatic Stress Disorder (PTSD) across the United States. Qualitative interviews were conducted with over 250 directors, providers, and staff during site visits of 38 programs. The aims of this report are to describe clinical issues and distinctive challenges in working with veterans from Iraq and Afghanistan and approaches to addressing their needs. Providers indicated that the most commonly reported problems were: acute PTSD symptomatology; other complex mental health symptom presentations; broad readjustment problems; and difficulty with time demands of and readiness for intensive treatment. Additional concerns included working with active duty personnel and mixing different eras in therapy. Programmatic solutions address structure (e.g., blended versus era-specific therapy), content (e.g., physical activity), and adaptations (e.g., inclusion of family; shortened length of stay). Clinical implications for VA managers and policy makers as well as non-VA health care systems and individual health care providers are noted.

  14. Public Affairs

    DTIC Science & Technology

    2007-11-02

    military assistance to civil authorities ( MACA ), including consequence management activities. The Armed Forces of the United States support the NSHS...mission and the close relationship between HD and homeland security, homeland defense missions may be conducted in a manner similar to MACA (i.e., with a...during a major event. 4. Public Affairs Operations Under the National Response Plan a. The NRP outlines the federal (including DOD MACA ) response to

  15. To designate the community based outpatient clinic of the Department of Veterans Affairs located at 310 Home Boulevard in Galesburg, Illinois, as the "Lane A. Evans VA Community Based Outpatient Clinic".

    THOMAS, 113th Congress

    Rep. Bustos, Cheri [D-IL-17

    2014-11-13

    11/25/2014 Referred to the Subcommittee on Health. (All Actions) Notes: For further action, see S.2921, which became Public Law 113-234 on 12/16/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Geropsychology Training in a VA Nursing Home Setting

    ERIC Educational Resources Information Center

    Karel, Michele J.; Moye, Jennifer

    2005-01-01

    There is a growing need for professional psychology training in nursing home settings, and nursing homes provide a rich environment for teaching geropsychology competencies. We describe the nursing home training component of our Department of Veterans Affairs (VA) Predoctoral Internship and Geropsychology Postdoctoral Fellowship programs. Our…

  17. Electronic Health Records: VA and DOD Need to Support Cost and Schedule Claims, Develop Interoperability Plans, and Improve Collaboration

    DTIC Science & Technology

    2014-02-01

    Murray Chairman Committee on the Budget United States Senate The Honorable Bernard Sanders Chairman The Honorable Richard Burr Ranking Member...Page 13 GAO-14-302 Electronic Health Records known as the Captain James A. Lovell Federal Health Care Center (FHCC). The FHCC is unique in

  18. VA and DOD Health Care: Department-Level Actions Needed to Assess Collaboration Performance, Address Barriers, and Identify Opportunities

    DTIC Science & Technology

    2012-09-01

    joint venture hired five full-time pharmacists specifically to conduct manual checks of patient records to reconcile allergy information and identify...Bidirectional Health Information Exchange was established in 2004 to allow clinicians in both departments to view limited health information on patients

  19. 38 CFR 3.1706 - Burial allowance for a veteran who died while hospitalized by VA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Burial allowance for a... DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Burial Benefits Burial Benefits: Allowances & Expenses Paid by Va A08se3. § 3.1706 Burial allowance for a veteran who died while hospitalized by VA. Pt. 3, Subpt. B,...

  20. 38 CFR 3.1701 - Deceased veterans for whom VA may provide burial benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... whom VA may provide burial benefits. 3.1701 Section 3.1701 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Burial Benefits Burial Benefits: General § 3.1701 Deceased veterans for whom VA may provide burial benefits. For purposes of providing burial benefits under subpart...

  1. The Impact of VA and Navy Hospital Collaboration on Medical School Education

    ERIC Educational Resources Information Center

    Atre-Vaidya, Nutan; Ross, Arthur, III; Sandu, Ioana C.; Hassan, Tariq

    2009-01-01

    Objective: The U.S. Department of Veterans Affairs (VA) is the largest single provider of medical education in the United States and is often the preferred training site for medical students and residents. However, changing priorities of patients and the marketplace are forcing medical schools and the VA to consider new ways of practicing medicine…

  2. 38 CFR 58.16 - VA Form 10-0144-Certification Regarding Lobbying.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0144-Certification Regarding Lobbying. 58.16 Section 58.16 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.16 VA Form 10-0144—Certification Regarding Lobbying. ER06JA00.013...

  3. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Medication prescribed by non-VA physicians. 17.96 Section 17.96 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any...

  4. 78 FR 77204 - Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-20

    ... AFFAIRS Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys... solicits comments on the information needed to evaluate the National Veterans Sports Programs and Special... ``OMB Control No. 2900-NEW (VA National Veterans Sports Programs and Special Event Surveys)'' in...

  5. 77 FR 21158 - VA Directive 0005 on Scientific Integrity: Availability for Review and Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... AFFAIRS VA Directive 0005 on Scientific Integrity: Availability for Review and Comment AGENCY: Office of... (VA) Directive 0005 on Scientific Integrity. The Draft Directive incorporates the principles of scientific integrity contained in the Presidential Memorandum of March 9, 2009, and the Director, Office...

  6. 48 CFR 819.602-3 - Resolving differences between VA and the Small Business Administration.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... between VA and the Small Business Administration. 819.602-3 Section 819.602-3 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Certificates... Small Business Administration. The Director, OSDBU, is the VA liaison with the SBA. Information...

  7. 38 CFR 74.26 - What types of business information will VA collect?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.26 What types of business information will VA collect? VA will examine a variety of business records. See § 74.12, “What is... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false What types of...

  8. Firearms injuries and deaths: a critical public health issue. American Medical Association Council on Scientific Affairs.

    PubMed Central

    1989-01-01

    The prevention of firearm deaths and injuries is one of the most complex and controversial issues facing the public health profession in recent years. Laws have been enacted to control or discourage private gun ownership, and especially to eliminate guns from the hands of criminals, but the laws' effects in reducing crime and firearm-related injuries and deaths have been disappointing. Gunshot wounds are the 12th leading cause of death in the United States and more than half of all suicides are committed with guns. There are virtually no reliable data on the number of nonfatal firearm injuries. One of the most troubling aspects of handgun violence is that children often are the victims. Educational efforts have been attempted to promote the safer use of firearms, but they have not led to a significant reduction in the number of fatalities, since most firearm incidents are intended to do harm. PMID:2495544

  9. 77 FR 56709 - Proposed Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... Business Utilization, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of Small and Disadvantaged Business Utilization (OSDBU), Department of Veterans Affairs (VA), is announcing an opportunity... Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the...

  10. 75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ...The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed......

  11. 78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ...The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed......

  12. Health effects of radon exposure. Report of the Council on Scientific Affairs, American Medical Association

    SciTech Connect

    Not Available

    1991-04-01

    The consensus of scientists is that exposure to radon is hazardous, but disagreement exists about the effects of lower radon concentrations. Studies of underground miners have indicated that the risk of lung cancer increases in proportion to the intensity and duration of exposure to radon, and a recent authoritative report (BEIR IV) has concluded that estimates based on those studies are appropriate for estimating risks for occupants of homes. The BEIR IV report concluded that smoking cigarettes increases the risk of lung cancer associated with radon. Average radon levels in US homes range from 0.055 to 0.148 Bq/L (1.5 to 4 pCi/L), depending on the circumstances of measurement. Few studies have investigated health outcomes in occupants of homes with high radon levels. In advising patients about reducing the risks associated with radon, physicians should consider the costs, as well as the benefits, of remedial actions, and they should emphasize that, by far, the best way to avoid lung cancer is to stop smoking.

  13. VA AND DEFENSE HEALTH CARE: Progress Made, but DOD Continues To Face Military Medical Surveillance System Challenges

    DTIC Science & Technology

    2002-01-01

    unexplained symptoms in populations that have deployed. • Implement a joint computerized patient record and other automated recordkeeping that meets the...implementation of a health surveillance system that completely spans an individual’s time in service. • Implement strategies to address medically

  14. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools: Protocol for a Randomized Study Funded by the US Department of Veterans Affairs Health Services Research and Development Program

    PubMed Central

    Krein, Sarah L; Striplin, Dana; Marinec, Nicolle; Kerns, Robert D; Farris, Karen B; Singh, Satinder; An, Lawrence; Heapy, Alicia A

    2016-01-01

    Background Cognitive behavioral therapy (CBT) is one of the most effective treatments for chronic low back pain. However, only half of Department of Veterans Affairs (VA) patients have access to trained CBT therapists, and program expansion is costly. CBT typically consists of 10 weekly hour-long sessions. However, some patients improve after the first few sessions while others need more extensive contact. Objective We are applying principles from “reinforcement learning” (a field of artificial intelligence or AI) to develop an evidence-based, personalized CBT pain management service that automatically adapts to each patient’s unique and changing needs (AI-CBT). AI-CBT uses feedback from patients about their progress in pain-related functioning measured daily via pedometer step counts to automatically personalize the intensity and type of patient support. The specific aims of the study are to (1) demonstrate that AI-CBT has pain-related outcomes equivalent to standard telephone CBT, (2) document that AI-CBT achieves these outcomes with more efficient use of clinician resources, and (3) demonstrate the intervention’s impact on proximal outcomes associated with treatment response, including program engagement, pain management skill acquisition, and patients’ likelihood of dropout. Methods In total, 320 patients with chronic low back pain will be recruited from 2 VA healthcare systems and randomized to a standard 10 sessions of telephone CBT versus AI-CBT. All patients will begin with weekly hour-long telephone counseling, but for patients in the AI-CBT group, those who demonstrate a significant treatment response will be stepped down through less resource-intensive alternatives including: (1) 15-minute contacts with a therapist, and (2) CBT clinician feedback provided via interactive voice response calls (IVR). The AI engine will learn what works best in terms of patients’ personally tailored treatment plans based on daily feedback via IVR about their

  15. VA Health Care: Actions Needed to Address Higher-Than-Expected Demand for the Family Caregiver Program

    DTIC Science & Technology

    2014-09-01

    we contacted pointed out that their catchment area covers 147,000 square miles, and some of their caregivers live over 8 hours away, requiring...geographical area . A caregiver whose veteran is rated tier 2 receives the equivalent of 25 hours per week of the wage for a home health aide, and a...location we contacted told us that home visits to remote areas require long driving times, which are challenging to accommodate. Staff at one VAMC

  16. Automated Detection of Privacy Sensitive Conditions in C-CDAs: Security Labeling Services at the Department of Veterans Affairs.

    PubMed

    Bouhaddou, Omar; Davis, Mike; Donahue, Margaret; Mallia, Anthony; Griffin, Stephania; Teal, Jennifer; Nebeker, Jonathan

    2016-01-01

    Care coordination across healthcare organizations depends upon health information exchange. Various policies and laws govern permissible exchange, particularly when the information includes privacy sensitive conditions. The Department of Veterans Affairs (VA) privacy policy has required either blanket consent or manual sensitivity review prior to exchanging any health information. The VA experience has been an expensive, administratively demanding burden on staffand Veterans alike, particularly for patients without privacy sensitive conditions. Until recently, automatic sensitivity determination has not been feasible. This paper proposes a policy-driven algorithmic approach (Security Labeling Service or SLS) to health information exchange that automatically detects the presence or absence of specific privacy sensitive conditions and then, to only require a Veteran signed consent for release when actually present. The SLS was applied successfully to a sample of real patient Consolidated-Clinical Document Architecture(C-CDA) documents. The SLS identified standard terminology codes by both parsing structured entries and analyzing textual information using Natural Language Processing (NLP).

  17. Health care employee perceptions of patient-centered care.

    PubMed

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

    2015-03-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery.

  18. Balancing Demand and Supply for Veterans' Health Care

    PubMed Central

    Farmer, Carrie M.; Hosek, Susan D.; Adamson, David M.

    2016-01-01

    Abstract In response to concerns that the Department of Veterans Affairs (VA) has faced about veterans' access to care and the quality of care delivered, Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 (“Veterans Choice Act”) in August 2014. The law was passed to help address access issues by expanding the criteria through which veterans can seek care from civilian providers. In addition, the law called for a series of independent assessments of the VA health care system across a broad array of topics related to the delivery of health care services to veterans in VA-owned and -operated facilities, as well as those under contract to VA. RAND conducted three of these assessments: Veteran demographics and health care needs (A), VA health care capabilities (B), and VA authorities and mechanisms for purchasing care (C). This article summarizes the findings of our assessments and includes recommendations from the reports for improving the match between veterans' needs and VA's capabilities, including VA's ability to purchase necessary care from the private sector. PMID:28083440

  19. Matching prosthetics order records in VA National Prosthetics Patient Database to healthcare utilization databases.

    PubMed

    Smith, Mark W; Su, Pon; Phibbs, Ciaran S

    2010-01-01

    The National Prosthetics Patient Database (NPPD) is the national Department of Veterans Affairs (VA) dataset that records characteristics of individual prosthetic and assistive devices. It remains unknown how well NPPD records can be matched to encounter records for the same individuals in major VA utilization databases. We compared the count of prosthetics records in the NPPD with the count of prosthetics-related procedures for the same individuals recorded in major VA utilization databases. We then attempted to match the NPPD records to the utilization records by person and date. In general, 40% to 60% of the NPPD records could be matched to outpatient utilization records within a 14-day window around the NPPD dataset entry date. Match rates for inpatient data were lower: 10% to 16% within a 14-day window. The NPPD will be particularly important for studies of certain veteran groups, such as those with spinal cord injury or blast-related polytraumatic injury. Health services researchers should use both the NPPD and utilization databases to develop a full understanding of prosthetics use by individual patients.

  20. China Report, Political, Sociological and Military Affairs

    DTIC Science & Technology

    2007-11-02

    TECHNICAL INFORMATION SERVICE U.S. DEPARTMENT OF COMMERCE - SPRINGFIELD, VA. 22161 .. (7 NOTE JPRS publications contain information primarily from...of the agreement and thinks that the United States and Israel "expect the two parties to depart from the line which is antagonistic to their Middle...Regional Foreign Affairs Office and the Regional Tourism Corporation; and responsible persons of departments concerned in the region attended the banquet

  1. An Evolving Ecosystem for Natural Language Processing in Department of Veterans Affairs.

    PubMed

    Garvin, Jennifer H; Kalsy, Megha; Brandt, Cynthia; Luther, Stephen L; Divita, Guy; Coronado, Gregory; Redd, Doug; Christensen, Carrie; Hill, Brent; Kelly, Natalie; Treitler, Qing Zeng

    2017-02-01

    In an ideal clinical Natural Language Processing (NLP) ecosystem, researchers and developers would be able to collaborate with others, undertake validation of NLP systems, components, and related resources, and disseminate them. We captured requirements and formative evaluation data from the Veterans Affairs (VA) Clinical NLP Ecosystem stakeholders using semi-structured interviews and meeting discussions. We developed a coding rubric to code interviews. We assessed inter-coder reliability using percent agreement and the kappa statistic. We undertook 15 interviews and held two workshop discussions. The main areas of requirements related to; design and functionality, resources, and information. Stakeholders also confirmed the vision of the second generation of the Ecosystem and recommendations included; adding mechanisms to better understand terms, measuring collaboration to demonstrate value, and datasets/tools to navigate spelling errors with consumer language, among others. Stakeholders also recommended capability to: communicate with developers working on the next version of the VA electronic health record (VistA Evolution), provide a mechanism to automatically monitor download of tools and to automatically provide a summary of the downloads to Ecosystem contributors and funders. After three rounds of coding and discussion, we determined the percent agreement of two coders to be 97.2% and the kappa to be 0.7851. The vision of the VA Clinical NLP Ecosystem met stakeholder needs. Interviews and discussion provided key requirements that inform the design of the VA Clinical NLP Ecosystem.

  2. Partnerships in Health Promotion for Black Americans. Proceedings of the Annual Meeting of the National Society of Allied Health (Virginia Beach, VA, March 29-30, 1985).

    ERIC Educational Resources Information Center

    Douglas, Harry E., III, Comp.

    This conference report of the National Society of Allied Health focusses on the theme of health promotion for black Americans, with emphasis on creating cooperative partnerships to address the various social and environmental conditions adversely affecting minority group health status. The keynote speaker provided an historical perspective on…

  3. Iraq and Afghanistan War Veterans with Reintegration Problems: Differences by Veterans Affairs Healthcare User Status.

    PubMed

    Sayer, Nina A; Orazem, Robert J; Noorbaloochi, Siamak; Gravely, Amy; Frazier, Patricia; Carlson, Kathleen F; Schnurr, Paula P; Oleson, Heather

    2015-07-01

    We studied 1,292 Iraq and Afghanistan War veterans who participated in a clinical trial of expressive writing to estimate the prevalence of perceived reintegration difficulty and compare Veterans Affairs (VA) healthcare users to nonusers in terms of demographic and clinical characteristics. About half of participants perceived reintegration difficulty. VA users and nonusers differed in age and military background. Levels of mental and physical problems were higher in VA users. In multivariate analysis, military service variables and probable traumatic brain injury independently predicted VA use. Findings demonstrate the importance of research comparing VA users to nonusers to understand veteran healthcare needs.

  4. USSR Report, Military Affairs

    DTIC Science & Technology

    2007-11-02

    and 24 brigades were destroyed and taken prisoner. The Wehrmacht lost 1,600,000 soldiers and officers. According to German data , irreplaceable...health, taking psychological data into acount, and their physical and general-education preparation. In so doing, how sincere the youth are in...Hospital for Political Affairs Lt-Col Aleksey Tel’nov bade them farewell heartily. The soldiers answered: "Thanks for the help and the care. Thanks, dear military doctors!..." 11409 CSO: 1801/207 END 58

  5. 77 FR 12997 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Representatives at VA Facilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-05

    ... AFFAIRS 38 CFR Part 1 RIN 2900-AN42 Drug and Drug-Related Supply Promotion by Pharmaceutical Company... disruption in the patient care environment, manage activities and promotions at VA facilities, and provide..., VA must continue to maintain strict adherence to its criteria-for-use and prevent undesired...

  6. Developing a Health Information Technology Systems Matrix: A Qualitative Participatory Approach

    PubMed Central

    Chavez, Margeaux; Nazi, Kim M; Antinori, Nicole

    2016-01-01

    Background The US Department of Veterans Affairs (VA) has developed various health information technology (HIT) resources to provide accessible veteran-centered health care. Currently, the VA is undergoing a major reorganization of VA HIT to develop a fully integrated system to meet consumer needs. Although extensive system documentation exists for various VA HIT systems, a more centralized and integrated perspective with clear documentation is needed in order to support effective analysis, strategy, planning, and use. Such a tool would enable a novel view of what is currently available and support identifying and effectively capturing the consumer’s vision for the future. Objective The objective of this study was to develop the VA HIT Systems Matrix, a novel tool designed to describe the existing VA HIT system and identify consumers’ vision for the future of an integrated VA HIT system. Methods This study utilized an expert panel and veteran informant focus groups with self-administered surveys. The study employed participatory research methods to define the current system and understand how stakeholders and veterans envision the future of VA HIT and interface design (eg, look, feel, and function). Directed content analysis was used to analyze focus group data. Results The HIT Systems Matrix was developed with input from 47 veterans, an informal caregiver, and an expert panel to provide a descriptive inventory of existing and emerging VA HIT in four worksheets: (1) access and function, (2) benefits and barriers, (3) system preferences, and (4) tasks. Within each worksheet is a two-axis inventory. The VA’s existing and emerging HIT platforms (eg, My HealtheVet, Mobile Health, VetLink Kiosks, Telehealth), My HealtheVet features (eg, Blue Button, secure messaging, appointment reminders, prescription refill, vet library, spotlight, vitals tracker), and non-VA platforms (eg, phone/mobile phone, texting, non-VA mobile apps, non-VA mobile electronic devices, non-VA

  7. Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

    PubMed

    Heath, Barbara; Bernhardt, Jaime; Michalski, Thomas J; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E; Olds, Danielle; Higgins, Patricia A; Jump, Robin L P

    2016-03-01

    We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Our outcomes suggest opportunities to engage nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting.

  8. The Impact of Private Insurance Coverage on Veterans' Use of VA Care: Insurance and Selection Effects

    PubMed Central

    Shen, Yujing; Hendricks, Ann; Wang, Fenghua; Gardner, John; Kazis, Lewis E

    2008-01-01

    Objective To examine private insurance coverage and its impact on use of Veterans Health Administration (VA) care among VA enrollees without Medicare coverage. Data Sources The 1999 National Health Survey of Veteran Enrollees merged with VA administrative data, with other information drawn from American Hospital Association data and the Area Resource File. Study Design We modeled VA enrollees' decision of having private insurance coverage and its impact on use of VA care controlling for sociodemographic information, patients' health status, VA priority status and access to VA and non-VA alternatives. We estimated the true impact of insurance on the use of VA care by teasing out potential selection bias. Bias came from two sources: a security selection effect (sicker enrollees purchase private insurance for extra security and use more VA and non-VA care) and a preference selection effect (VA enrollees who prefer non-VA care may purchase private insurance and use less VA care). Principal Findings VA enrollees with private insurance coverage were less likely to use VA care. Security selection dominated preference selection and naïve models that did not control for selection effects consistently underestimated the insurance effect. Conclusions Our results indicate that prior research, which has not controlled for insurance selection effects, may have underestimated the potential impact of any private insurance policy change, which may in turn affect VA enrollees' private insurance coverage and consequently their use of VA care. From the decline in private insurance coverage from 1999 to 2002, we projected an increase of 29,400 patients and 158 million dollars for VA health care services. PMID:18211529

  9. Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

    PubMed Central

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

    2015-01-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

  10. 77 FR 64389 - Proposed Information Collection (Health Surveillance for a New Generation of U.S. Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ....Regulations.gov ; or to Cynthia Harvey Pryor, Veterans Health Administration (10P7BFP), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email: cynthia.harvey-pryor@va.gov . Please refer... through FDMS. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or Fax (202)...

  11. The Department of Veterans Affairs, Department of Defense, and Kaiser Permanente Nationwide Health Information Network exchange in San Diego: patient selection, consent, and identity matching.

    PubMed

    Bouhaddou, Omar; Bennett, Jamie; Cromwell, Tim; Nixon, Graham; Teal, Jennifer; Davis, Mike; Smith, Robert; Fischetti, Linda; Parker, David; Gillen, Zachary; Mattison, John

    2011-01-01

    The Nationwide Health Information Network allow for the secure exchange of Electronic Health Records over the Internet. The Department of Veterans Affairs, Department of Defense, and Kaiser Permanente, participated in an implementation of the NwHIN specifications in San Diego, California. This paper focuses primarily on patient involvement. Specifically, it describes how the shared patients were identified, were invited to participate and to provide consent for disclosing parts of their medical record, and were matched across organizations. A total 1,144 were identified as shared patients. Invitation letters containing consent forms were mailed and resulted in 42% participation. Invalid consent forms were a significant issue (25%). Initially, the identity matching algorithms yielded low success rate (5%). However, elimination of certain traits and abbreviations and probabilistic algorithms have significantly increased matching rate. Access to information from external sources better informs providers, improves decisions and efficiency, and helps meet the meaningful use criteria.

  12. Introducing INSPIRE: an implementation research collaboration between the Department of Foreign Affairs, Trade and Development Canada and the World Health Organization.

    PubMed

    Blais, Pierre; Hirnschall, Gottfried; Mason, Elizabeth; Shaffer, Nathan; Lipa, Zuzanna; Baller, April; Rollins, Nigel

    2014-11-01

    The government of Canada, through the Department of Foreign Affairs, Trade and Development (DFATD) has supported global efforts to reduce the impact of the HIV pandemic. In 2012, WHO and DFATD launched an implementation research initiative to increase access to interventions that were known to be effective in the prevention of mother-to-child transmission of HIV and to learn how these could be successfully integrated with other essential services for mothers and children. In addition to facilitating the implementation research projects, DFATD and WHO promoted four approaches: (1) Country-specific implementation research prioritization exercises, (2) Ministry of Health involvement, (3) Country-led, innovative, high-quality research, and (4) Leveraging regional networks and learning opportunities. While no single aspect of INSPIRE is unique, the process endeavors to promote and support high-quality, rigorous, locally-led implementation research that will have a substantial impact on the health and survival of HIV-infected women and their children.

  13. Cost-benefit study of culling claim folders at the Department of Veterans Affairs

    SciTech Connect

    Charles, P.; Hill, L.G.; Johnson, P.; Riemer, C.A.

    1990-04-01

    Culling is the process of sorting through material to separate significant from insignificant information. Argonne National Laboratory (ANL) conducted a study on culling Veterans Benefits Administration (VBA) claim folders for two reasons. The first was to help the Department of Veterans Affairs (VA) learn about culling strategies that could be applied to veterans' claim folders located at the VA's regional offices (ROs) throughout the United States. The second was to show the VA the benefits that could be derived from culling. 24 tabs.

  14. Advanced earthquake monitoring system for U.S. Department of Veterans Affairs medical buildings--instrumentation

    USGS Publications Warehouse

    Kalkan, Erol; Banga, Krishna; Ulusoy, Hasan S.; Fletcher, Jon Peter B.; Leith, William S.; Reza, Shahneam; Cheng, Timothy

    2012-01-01

    In collaboration with the U.S. Department of Veterans Affairs (VA), the National Strong Motion Project (NSMP; http://nsmp.wr.usgs.gov/) of the U.S. Geological Survey has been installing sophisticated seismic systems that will monitor the structural integrity of 28 VA hospital buildings located in seismically active regions of the conterminous United States, Alaska, and Puerto Rico during earthquake shaking. These advanced monitoring systems, which combine the use of sensitive accelerometers and real-time computer calculations, are designed to determine the structural health of each hospital building rapidly after an event, helping the VA to ensure the safety of patients and staff. This report presents the instrumentation component of this project by providing details of each hospital building, including a summary of its structural, geotechnical, and seismic hazard information, as well as instrumentation objectives and design. The structural-health monitoring component of the project, including data retrieval and processing, damage detection and localization, automated alerting system, and finally data dissemination, will be presented in a separate report.

  15. Community residential care program and contract program for veterans with alcohol and drug dependence disorders--VA. Final rule.

    PubMed

    1996-12-02

    This document updates the Department of Veterans Affairs (VA) regulations concerning the Community Residential Care Program and the Contract Program for Veterans with Alcohol and Drug Dependence Disorders by incorporating by reference relevant portions of the latest editions of the National Fire Protection Association Life Safety Code entitled "NFPA 101, Life Safety Code" and "NFPA 101A, Guide on Alternative Approaches to life Safety." This is intended to ensure that buildings used for treatment and residential services for veterans meet appropriate fire and safety standards. Also, this document amends the regulations for such programs by delegating authority to each of the Veterans Integrated Service Network (VISN) Directors of the Veterans Health Administration to grant certain equivalencies or variances to building standards of the Life Safety Code. Further, this final rule does not adopt the portion of the proposed rule concerning the Adult Day Health Care Program since the Adult Day Health Care Program and the corresponding regulations are no longer in existence.

  16. China Report, Economic Affairs.

    DTIC Science & Technology

    2007-11-02

    This is China Report include Economic Affairs. It contains the issues with different topics on People’s Republic of China: Provincial Affairs, Economic Planning, Economic Management, Finance and Banking, Mineral Resources , Industry, Transportation.

  17. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

    PubMed

    Gentes, Emily L; Schry, Amie R; Hicks, Terrell A; Clancy, Carolina P; Collie, Claire F; Kirby, Angela C; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2016-05-01

    Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record

  18. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  19. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  20. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  1. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.10 VA Form 10-3567—State Home Inspection Staffing Profile. ER06JA00.000 ER06JA00.001...

  2. DoD/VA Care Transition Process for Service Members Injured in OIF/OEF

    DTIC Science & Technology

    2008-06-12

    Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time...REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 DEPARTMENT OF...Department of Veterans Affairs (VA) Offices of the Inspector General formed an interagency team, allowing access to DoD and VA facilities, records, and

  3. Issues in defining and measuring veteran community reintegration: proceedings of the Working Group on Community Reintegration, VA Rehabilitation Outcomes Conference, Miami, Florida.

    PubMed

    Resnik, Linda; Bradford, Daniel W; Glynn, Shirley M; Jette, Alan M; Johnson Hernandez, Caitlin; Wills, Sharon

    2012-01-01

    In January 2010, the Department of Veterans Affairs (VA) Rehabilitation Research and Development Service convened a State of the Art (SOTA) conference to advance the field of outcome measurement for rehabilitation-related studies. This article reports on the proceedings of the SOTA Working Group on Community Reintegration. We explored the use of the International Classification of Health, Disability, and Functioning as a theoretical framework for measuring community reintegration; identified key dimensions of community reintegration that could and/or should be measured; discussed challenges in measuring community reintegration; suggested steps to enhance community reintegration measurement; proposed future research that focuses on outcomes measures for community reintegration and the study of community reintegration outcomes; and made policy recommendations that would facilitate community reintegration research within the VA.

  4. Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers

    PubMed Central

    Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

    2015-01-01

    Background Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients’ ability to view, print, and download their health records. Objective The aim of this study was to characterize (1) patients’ use of Blue Button, an online information-sharing tool in VA’s patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Methods Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients’ use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Results Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Conclusions Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of

  5. Black Health Issues in New York State: Condition, Prognosis, Prescription. Preliminary Report, Health Subcommittee. The Governor's Advisory Committee for Black Affairs. Volume 1, Health.

    ERIC Educational Resources Information Center

    New York Governor's Advisory Committee for Black Affairs, Albany.

    This document, which reviews the health problems of blacks in New York State, is the first volume of a study of the needs of the two million blacks in New York. The health status of blacks is examined in each of the following phases of the life cycle: (1) maternal; (2) infancy; (3) childhood; (4) adolescence; (5) adulthood; and (6) the elder…

  6. Black Health Issues in New York State: Condition, Prognosis, Prescription. Executive Summary. Preliminary Report, Health Subcommittee. The Governor's Advisory Committee for Black Affairs. Volume 1, Health.

    ERIC Educational Resources Information Center

    New York Governor's Advisory Committee for Black Affairs, Albany.

    This document summarizes a review of the health problems of blacks in New York. The review comprises the first volume of a study of the needs of the two million blacks in New York. The health status of blacks is examined in each of the following phases of the life cycle: (1) maternal; (2) infancy; (3) childhood; (4) adolescence; (5) adulthood; and…

  7. Balancing Demand and Supply for Veterans' Health Care: A Summary of Three RAND Assessments Conducted Under the Veterans Choice Act.

    PubMed

    Farmer, Carrie M; Hosek, Susan D; Adamson, David M

    2016-06-20

    In response to concerns that the Department of Veterans Affairs (VA) has faced about veterans' access to care and the quality of care delivered, Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 ("Veterans Choice Act") in August 2014. The law was passed to help address access issues by expanding the criteria through which veterans can seek care from civilian providers. In addition, the law called for a series of independent assessments of the VA health care system across a broad array of topics related to the delivery of health care services to veterans in VA-owned and -operated facilities, as well as those under contract to VA. RAND conducted three of these assessments: Veteran demographics and health care needs (A), VA health care capabilities (B), and VA authorities and mechanisms for purchasing care (C). This article summarizes the findings of our assessments and includes recommendations from the reports for improving the match between veterans' needs and VA's capabilities, including VA's ability to purchase necessary care from the private sector.

  8. Veterans' use of Department of Veterans Affairs care and perceptions of outsourcing inpatient care.

    PubMed

    Wakefield, Bonnie J; Tripp-Reimer, Toni; Rosenbaum, Marcy E; Rosenthal, Gary E

    2007-06-01

    The objective of the study was to examine veterans' perceptions of problems and benefits of outsourcing inpatient care from Veterans Affairs (VA) hospitals to private sector hospitals. Primary data were collected from a cross-section of 42 veterans who were VA users and nonusers using focus groups. Focus group discussion examined reasons patients use VA care, differences between VA and civilian care, positive and negative impacts of outsourcing, and special needs of veterans. Analyses revealed five domains related both to use of VA services and perceptions of outsourcing: costs, access, quality of care, contract (i.e., a covenant between veterans and the U.S. government), veteran milieu, and special needs. Participants identified a variety of potential positive and negative impacts. In general, veterans perceived more advantages than disadvantages to outsourcing VA care but still expressed significant concerns related to outsourcing. These issues should be considered in the development of future policy toward outsourcing VA care to the private sector.

  9. Comparing the Quality of Ambulatory Surgical Care for Skin Cancer in a Veterans Affairs Clinic and a Fee-For-Service Practice Using Clinical and Patient-Reported Measures

    PubMed Central

    Linos, Eleni; Arron, Sarah T.; Hills, Nancy K.

    2017-01-01

    The Institute of Medicine has identified serious deficiencies in the measurement of cancer care quality, including the effects on quality of life and patient experience. Moreover, comparisons of quality in Veterans Affairs Medical Centers (VA) and other sites are timely now that many Veterans can choose where to seek care. To compare quality of ambulatory surgical care for keratinocyte carcinoma (KC) between a VA and fee-for-service (FFS) practice, we used unique clinical and patient-reported data from a comparative effectiveness study. Patients were enrolled in 1999–2000 and followed for a median of 7.2 years. The practices differed in a few process measures (e.g., median time between biopsy and treatment was 7.5 days longer at VA) but there were no substantial or consistent differences in clinical outcomes or a broad range of patient-reported outcomes. For example, 5-year tumor recurrence rates were equally low (3.6% [2.3–5.5] at VA and 3.4% [2.3–5.1] at FFS), and similar proportions of patients reported overall satisfaction at one year (78% at VA and 80% at FFS, P = 0.69). These results suggest that the quality of care for KC can be compared comprehensively in different health care systems, and suggest that quality of care for KC was similar at a VA and FFS setting. PMID:28141817

  10. Scientific and organizational collaboration in comparative effectiveness research: the VA cooperative studies program model.

    PubMed

    Huang, Grant D; Ferguson, Ryan E; Peduzzi, Peter N; O'Leary, Timothy J

    2010-12-01

    Comparative effectiveness research (CER) has the ability to improve health and inform patients, clinicians, and decision makers. However, calls for more devoted efforts with regard to CER have been countered by methodological, resource, and translational challenges related to conducting these studies. The Department of Veterans Affairs (VA) Cooperative Studies Program (CSP) is a clinical research infrastructure that has contributed much evidence to support clinical practice for several decades. Although the CSP does not exclusively focus on CER, it employs strategies that lend themselves toward the planning and execution of studies that seek to compare interventions and/or strategies for treating disease. Consequently, the CSP provides a model for addressing important scientific, structural, and operational factors for clinical research, including large, national and multinational comparative effectiveness studies. Exploration of the difficulties the CSP has encountered can help to elucidate barriers that face CER. This article discusses factors and approaches for collaboratively developing and conducting definitive studies that produce outcomes aimed at influencing clinical practice, lessons that have resulted from such efforts, and ongoing challenges. Future program directions are also presented to highlight areas of emphasis and implications for CER within the VA and nationally.

  11. The VA Hypertension Primary Care Longitudinal Cohort: Electronic medical records in the post-genomic era

    PubMed Central

    Salem, Rany M.; Pandey, Braj; Richard, Erin; Fung, Maple M.; Garcia, Erin P.; Brophy, Victoria H.; Schork, Nicholas J.; O'Connor, Daniel T.; Bhatnagar, Vibha

    2011-01-01

    The Veterans Affairs Hypertension Primary Care Longitudinal Cohort (VAHC) was initiated in 2003 as a pilot study designed to link the VA electronic medical record system with individual genetic data. Between June 2003 and December 2004, 1,527 hypertensive participants were recruited. Protected health information (PHI) was extracted from the regional VA data warehouse. Differences between the clinic and mail recruits suggested that clinic recruitment resulted in an over-sampling of African Americans. A review of medical records in a random sample of study participants confirmed that the data warehouse accurately captured most selected diagnoses. Genomic DNA was acquired non-invasively from buccal cells in mouthwash; ~ 96.5 per cent of samples contained DNA suitable for genotyping, with an average DNA yield of 5.02 ± 0.12 micrograms, enough for several thousand genotypes. The coupling of detailed medical databases with genetic information has the potential to facilitate the genetic study of hypertension and other complex diseases. PMID:21216807

  12. 78 FR 59099 - Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity... Reporting Interface (VALERI) System. OMB Control Number: 2900-0021. Type of Review: Revision of a...

  13. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA Small business subcontracting plan minimum requirements. 852.219-9 Section 852.219-9 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts...

  14. 48 CFR 852.219-71 - VA mentor-protégé program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA mentor-protégé program. 852.219-71 Section 852.219-71 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of Provisions and Clauses...

  15. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  16. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  17. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  18. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID TO STATES FOR ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION...

  19. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND...

  20. 38 CFR 39.4 - Submissions of information and documents to VA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Submissions of information and documents to VA. 39.4 Section 39.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID TO STATES FOR ESTABLISHMENT, EXPANSION, AND IMPROVEMENT OF...

  1. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND...

  2. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND...

  3. 75 FR 25321 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... AFFAIRS Agency Information Collection (VA National Rehabilitation Special Events, Event Registration Applications) Activities Under OMB Review AGENCY: Office of National Programs and Special Events, Department of... U.S.C. 3501-21), this notice announces that the Office of National Programs and Special...

  4. 78 FR 76412 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... AFFAIRS Agency Information Collection (VA National Rehabilitation Special Events, Event Registration Applications) Activities Under OMB Review AGENCY: Office of National Programs and Special Events, Department of... U.S.C. 3501-21), this notice announces that the Office of National Programs and Special...

  5. 78 FR 28947 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (VANS)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... CFR 61.1. Authority: Funding applied for under this Notice is authorized by title 38 U.S.C. 2011, 2012... section sets forth provisions for obtaining a van capital grant under 38 U.S.C. 2011. In addition to being... AFFAIRS Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (VANS)...

  6. 78 FR 6849 - Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... INFORMATION CONTACT: Crystal Rennie, Records Management Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492, FAX (202) 632-7583 or email crystal.rennie@va... per Respondent: 5 minutes. Frequency of Response: One-time. Estimated Number of Respondents:...

  7. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  8. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  9. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  10. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  11. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  12. Benchmarking in Student Affairs.

    ERIC Educational Resources Information Center

    Mosier, Robert E.; Schwarzmueller, Gary J.

    2002-01-01

    Discusses the use of benchmarking in student affairs, focusing on issues related to student housing. Provides examples of how benchmarking has influenced administrative practice at many institutions. (EV)

  13. The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care.

    PubMed

    Perlin, Jonathan B; Kolodner, Robert M; Roswell, Robert H

    2004-11-01

    The Veterans Health Administration is the United States' largest integrated health system. Once disparaged as a bureaucracy providing mediocre care, the Department of Veterans Affairs (VA) reinvented itself during the past decade through a policy shift mandating structural and organizational change, rationalization of resource allocation, explicit measurement and accountability for quality and value, and development of an information infrastructure supporting the needs of patients, clinicians, and administrators. Today, the VA is recognized for leadership in clinical informatics and performance improvement, cares for more patients with proportionally fewer resources, and sets national benchmarks in patient satisfaction and for 18 indicators of quality in disease prevention and treatment.

  14. The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care.

    PubMed

    Perlin, Johnathan B; Kolodner, Robert M; Roswell, Robert H

    2005-01-01

    The Veterans Health Administration is the United States' largest integrated health system. Once disparaged as a bureaucracy providing mediocre care, the Department of Veterans Affairs (VA) reinvented itself during the past decade through a policy shift mandating structural and organizational change, rationalization of resource allocation, explicit measurement and accountability for quality and value, and development of an information infrastructure supporting the needs of patients, clinicians, and administrators. Today, the VA is recognized for leadership in clinical informatics and performance improvement, cares for more patients with proportionally fewer resources, and sets national benchmarks in patient satisfaction and for 18 indicators of quality in disease prevention and treatment.

  15. Health Care for Homeless Veterans program. Final rule.

    PubMed

    2015-05-01

    The Department of Veterans Affairs (VA) amends its medical regulations concerning eligibility for the Health Care for Homeless Veterans (HCHV) program. The HCHV program provides per diem payments to non-VA community-based facilities that provide housing, outreach services, case management services, and rehabilitative services, and may provide care and/or treatment to homeless veterans who are enrolled in or eligible for VA health care. The rule modifies VA's HCHV regulations to conform to changes enacted in the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012. Specifically, the rule removes the requirement that homeless veterans be diagnosed with a serious mental illness or substance use disorder to qualify for the HCHV program. This change makes the program available to all homeless veterans who are enrolled in or eligible for VA health care. The rule also updates the definition of homeless to match in part the one used by the Department of Housing and Urban Development (HUD). The rule further clarifies that the services provided by the HCHV program through non-VA community-based providers must include case management services, including non-clinical case management, as appropriate.

  16. Initial Results from the Survey of Organizational Research Climates (SOuRCe) in the U.S. Department of Veterans Affairs Healthcare System

    PubMed Central

    Martinson, Brian C.; Nelson, David; Hagel-Campbell, Emily; Mohr, David; Charns, Martin P.; Bangerter, Ann; Thrush, Carol R.; Ghilardi, Joseph R.; Bloomfield, Hanna; Owen, Richard; Wells, James A.

    2016-01-01

    Background In service to its core mission of improving the health and well-being of veterans, Veterans Affairs (VA) leadership is committed to supporting research best practices in the VA. Recognizing that the behavior of researchers is influenced by the organizational climates in which they work, efforts to assess the integrity of research climates and share such information with research leadership in VA may be one way to support research best practices. The Survey of Organizational Research Climate (SOuRCe) is the first validated survey instrument specifically designed to assess the organizational climate of research integrity in academic research organizations. The current study reports on an initiative to use the SOuRCe in VA facilities to characterize the organizational research climates and pilot test the effectiveness of using SOuRCe data as a reporting and feedback intervention tool. Methods We administered the SOuRCe using a cross-sectional, online survey, with mailed follow-up to non-responders, of research-engaged employees in the research services of a random selection of 42 VA facilities (e.g., Hospitals/Stations) believed to employ 20 or more research staff. We attained a 51% participation rate, yielding more than 5,200 usable surveys. Results We found a general consistency in organizational research climates across a variety of sub-groups in this random sample of research services in the VA. We also observed similar SOuRCe scale score means, relative rankings of these scales and their internal reliability, in this VA-based sample as we have previously documented in more traditional academic research settings. Results also showed more substantial variability in research climate scores within than between facilities in the VA research service as reflected in meaningful subgroup differences. These findings suggest that the SOuRCe is suitable as an instrument for assessing the research integrity climates in VA and that the tool has similar patterns of

  17. Greening America's Capitals - Richmond, VA

    EPA Pesticide Factsheets

    Report from the Greening America's Capitals project in Richmond, VA, to help the city develop design options to protect pedestrians, bicyclists, transit users, and drivers; improve stormwater management; and spur revitalization.

  18. Improved Veteran Access to Care through the Veteran Health Information Exchange (VHIE) Retail Immunization Coordination Project

    PubMed Central

    Botts, Nathan; Pan, Eric; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

    2016-01-01

    The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) Retail Immunization Coordination Project established a partnership between VA and Walgreens to empower Veterans to elect to receive their immunizations at a local Walgreens, which might be located closer to their home than their nearest VA facility. Analysis of Veterans immunized at Walgreens between September 2014 and January 2015 showed that 64% of study Veterans now traveled <5 miles to receive their immunization, 12% of study Veterans traveled between 5 to 10 miles, and 24% of study Veterans traveled more than 10 miles. In addition, we note that 93% of Veterans traveled less than 54 miles, the average distance rural Veterans traveled to the nearest VA facility. We conclude that the VHIE Retail Immunization Coordination Project improved Veteran access to healthcare and discuss future directions of this effort. PMID:28269827

  19. Hearing testing in the U.S. Department of Defense: Potential impact on Veterans Affairs hearing loss disability awards.

    PubMed

    Nelson, J T; Swan, A A; Swiger, B; Packer, M; Pugh, M J

    2016-10-18

    Hearing loss is the second most common disability awarded by the U.S. Department of Veterans Affairs (VA) to former members of the U.S. uniformed services. Hearing readiness and conservation practices differ among the four largest uniformed military services (Air Force, Army, Marine Corps, and Navy). Utilizing a data set consisting of all hearing loss claims submitted to the VA from fiscal years 2003-2013, we examined characteristics of veterans submitting claims within one year of separation from military service. Our results indicate that having a hearing loss disability claim granted was significantly more likely for men, individuals over the age of 26 years at the time of the claim, individuals most recently serving in the U.S. Army, and those with at least one hearing loss diagnosis. Importantly, individuals with at least one test record in the Defense Occupational and Environmental Health Readiness System-Hearing Conservation (DOEHRS-HC) system were significantly less likely to have a hearing loss disability claim granted by the VA. Within the DOEHRS-HC cohort, those with at least one threshold shift or clinical hearing loss diagnosis while on active duty were more than two and three times more likely to have a hearing loss disability claim granted, respectively. These findings indicate that an established history of reduced hearing ability while on active duty was associated with a significantly increased likelihood of an approved hearing loss disability claim relative to VA claims without such a history. Further, our results show a persistent decreased rate of hearing loss disability awards overall. These findings support increased inclusion of personnel in DoD hearing readiness and conservation programs to reduce VA hearing loss disability awards.

  20. The Feasibility of Using Large-Scale Text Mining to Detect Adverse Childhood Experiences in a VA-Treated Population.

    PubMed

    Hammond, Kenric W; Ben-Ari, Alon Y; Laundry, Ryan J; Boyko, Edward J; Samore, Matthew H

    2015-12-01

    Free text in electronic health records resists large-scale analysis. Text records facts of interest not found in encoded data, and text mining enables their retrieval and quantification. The U.S. Department of Veterans Affairs (VA) clinical data repository affords an opportunity to apply text-mining methodology to study clinical questions in large populations. To assess the feasibility of text mining, investigation of the relationship between exposure to adverse childhood experiences (ACEs) and recorded diagnoses was conducted among all VA-treated Gulf war veterans, utilizing all progress notes recorded from 2000-2011. Text processing extracted ACE exposures recorded among 44.7 million clinical notes belonging to 243,973 veterans. The relationship of ACE exposure to adult illnesses was analyzed using logistic regression. Bias considerations were assessed. ACE score was strongly associated with suicide attempts and serious mental disorders (ORs = 1.84 to 1.97), and less so with behaviorally mediated and somatic conditions (ORs = 1.02 to 1.36) per unit. Bias adjustments did not remove persistent associations between ACE score and most illnesses. Text mining to detect ACE exposure in a large population was feasible. Analysis of the relationship between ACE score and adult health conditions yielded patterns of association consistent with prior research.

  1. Public Affairs Manual. Revised 1976 Edition.

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, and Recreation, Washington, DC.

    This public affairs manual is designed for health, physical education, and recreation personnel. It begins with a position statement by the American Alliance for Health, Physical Education, and Recreation (AAHPER). In section two, resources and procedures for crises action at the local and state level are discussed. Several organizational models…

  2. Multidisciplinary HIS DICOM interfaces at the Department of Veterans Affairs

    NASA Astrophysics Data System (ADS)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    2000-05-01

    The U.S. Department of Veterans Affairs (VA) is using the Digital Imaging and Communications in Medicine (DICOM) standard to integrate image data objects from multiple systems for use across the healthcare enterprise. DICOM uses a structured representation of image data and a communication mechanism that allows the VA to easily acquire images from multiple sources and store them directly into the online patient record. The VA can obtain both radiology and non- radiology images using DICOM, and can display them on low-cost clinician's color workstations throughout the medical center. High-resolution gray-scale diagnostic quality multi-monitor workstations with specialized viewing software can be used for reading radiology images. The VA's DICOM capabilities can interface six different commercial Picture Archiving and Communication Systems (PACS) and over twenty different image acquisition modalities. The VA is advancing its use of DICOM beyond radiology. New color imaging applications for Gastrointestinal Endoscopy and Ophthalmology using DICOM are under development. These are the first DICOM offerings for the vendors, who are planning to support the recently passed DICOM Visible Light and Structured Reporting service classes. Implementing these in VistA is a challenge because of the different workflow and software support for these disciplines within the VA HIS environment.

  3. USSR Report, Economic Affairs.

    DTIC Science & Technology

    2007-11-02

    This report from the USSR contains articles on Economic Affairs. The main topics are Economic Policy, Organization and Management; Resource Utilization and Supply; Regional Development ; and Introduction of New Technology;

  4. USSR Report, Economic Affairs.

    DTIC Science & Technology

    1985-05-22

    This report from the USSR contains articles on Economic Affairs. The main topics are Economic Policy, Organization and Management; Planning and Plan Implementation; Investment, Prices, Budget and Finance; Resource Utilization and Supply; and Regional Development .

  5. USSR Report, Economic Affairs.

    DTIC Science & Technology

    1984-11-16

    This report from the USSR contains articles on Economic Affairs. The main topics are Economic Policy, Organization and Management; Investment, Prices, Budget and Finance; Resource Utilization and Supply and Regional Development .

  6. China Report, Economic Affairs.

    DTIC Science & Technology

    2007-11-02

    This is China Report include Economic Affairs. It contains the issues with different topics on People’s Republic of China: National Policy and Issues, Finance and Banking, Mineral Resources , Domestic Trade, Foreign Trade.

  7. USSR Report, International Affairs

    DTIC Science & Technology

    2007-11-02

    Imperialist Expansion (KNIZHNOYE OBOZRENIYE, No 37, 12 Sep 86) 2 SOCIALIST COMMUNITY AND CEMA AFFAIRS Responses to PRAVDA Query on Direct Economic...Ties’ (Ya. Macheyevich, Yu. Shiryayev; PRAVDA, 13 Oct 86) 4 CEMA Economic Integration Defended Against Bourgeois Attacks (A. Nikolskiy...countries; they also reap a profit of 5 billion dollars. 13080/12859 CSO: 1807/039 SOCIALIST COMMUNITY AND CEMA AFFAIRS RESPONSES TO PRAVDA QUERY ON

  8. USSR Report, International Affairs

    DTIC Science & Technology

    2007-11-02

    AFFAIRS CONTENTS SOCIALIST COMMUNITY AND CEMA AFFAIRS International Scientific Coordinating Conference in USSR (ZARYA VOSTOKA, 30 Oct 86) • ■ • • 1 ...Czechoslovak Meeting on S&T Cooperation With CEMA (EKONOMICHESKAYA GAZETA, No 1 , Jan 87) 2 Non-Use of CEMA Economic Experience Queried (V. G...U.S. Export Control Laws Revised (Moscow in English to North America, 1 Mar 87) 64 Reagan’s 1984 Directive on Concentration Camps Noted (Vadim

  9. Proceedings of the First Annual Meeting of the American College of Mental Health Administration, September 21-23, 1980, Williamsburg, VA.

    ERIC Educational Resources Information Center

    Feldman, Saul; And Others

    1981-01-01

    Presents three keynote speeches focusing on the topics of leadership development in mental health services administration and ethical dilemmas in the administration of mental health services. Suggests that didactic content and specific skill training activities must be provided for administrators at all levels. (HLM)

  10. Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE)

    PubMed Central

    Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

    2016-01-01

    The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE’s effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation. PMID:28269897

  11. Public health assessment for US Defense General Supply Center, Richmond, Chesterfield County, Virginia, Region 3. CERCLIS No. VA3971520751. Final report

    SciTech Connect

    Not Available

    1993-04-21

    Defense General Supply Center (DGSC), south of Richmond, Virginia in Chesterfield County, is a military supply distribution center. The facility currently manages and furnishes military general supplies to the Armed Forces and several federal civilian agencies. Contaminants, primarily volatile organic chemicals, in groundwater and surface water have migrated to adjoining communities. A well survey was conducted in March 1987 by the Chesterfield County Health District, part of the Virginia Health Department. Some private wells were sampled at the time of the survey in the Rayon Park area, adjacent to the National Guard Area on DGSC, and the water contained contaminants at levels above regulatory limits. Because of those levels, 21 private wells in the community of Rayon Park were replaced with an alternate water supply in 1987. Because of infrequent exposure to low levels of VOCs in those wells, adverse health effects are not likely. Citizens have expressed concerns about contamination to installation officials and representatives of state and local health departments. They are also concerned about possible adverse health effects associated with past use of contaminated groundwater and on-going monitoring efforts being conducted by DGSC. Those concerns are evaluated in the Public Health Implications section of the public health assessment.

  12. Does comorbid chronic pain affect posttraumatic stress disorder diagnosis and treatment? Outcomes of posttraumatic stress disorder screening in Department of Veterans Affairs primary care.

    PubMed

    Outcalt, Samantha D; Hoen, Helena Maria; Yu, Zhangsheng; Franks, Tenesha Marie; Krebs, Erin E

    2016-01-01

    Because posttraumatic stress disorder (PTSD) is both prevalent and underrecognized, routine primary care-based screening for PTSD has been implemented across the Veterans Health Administration. PTSD is frequently complicated by the presence of comorbid chronic pain, and patients with both conditions have increased symptom severity and poorer prognosis. Our objective was to determine whether the presence of pain affects diagnosis and treatment of PTSD among Department of Veterans Affairs (VA) patients who have a positive PTSD screening test. This retrospective cohort study used clinical and administrative data from six Midwestern VA medical centers. We identified 4,244 VA primary care patients with a positive PTSD screen and compared outcomes for those with and without a coexisting pain diagnosis. Outcomes were three clinically appropriate responses to positive PTSD screening: (1) mental health visit, (2) PTSD diagnosis, and (3) new selective serotonin reuptake inhibitor (SSRI) prescription. We found that patients with coexisting pain had a lower rate of mental health visits than those without pain (hazard ratio: 0.889, 95% confidence interval: 0.821-0.962). There were no significant differences in the rate of PTSD diagnosis or new SSRI prescription between patients with and without coexisting pain.

  13. Assessing the value of laboratory electronic data interchange in the department of veterans affairs.

    PubMed

    Byrne, Colene M; Rudin, Robert S; Johnston, Douglas S; Pan, Eric C

    2010-11-13

    We modeled the adoption, costs and monetezied benefits of the Department of Veterans Affairs' (VA's) internally developed Laboratory Electronic Data Interchange (LEDI) application from 2001-2007. LEDI provides standards-based electronic exchange of laboratory data and secure transmission of laboratory test orders and results. Once the initial development and installation costs were accounted for, LEDI likely produced value for the VA in savings of laboratory staff time for test ordering and results processing. We estimate that the VA needed to realize 20 percent of projected labor saving to recover its investment in LEDI.

  14. Health systems engineering fellowship: curriculum and program development.

    PubMed

    Watts, Bradley V; Shiner, Brian; Cully, Jeffrey A; Gilman, Stuart C; Benneyan, James C; Eisenhauer, William

    2015-01-01

    Industrial engineering and related disciplines have been used widely in improvement efforts in many industries. These approaches have been less commonly attempted in health care. One factor limiting application is the limited workforce resulting from a lack of specific education and professional development in health systems engineering (HSE). The authors describe the development of an HSE fellowship within the United States Department of Veterans Affairs, Veterans Health Administration (VA). This fellowship includes a novel curriculum based on specifically established competencies for HSE. A 1-year HSE curriculum was developed and delivered to fellows at several VA engineering resource centers over several years. On graduation, a majority of the fellows accepted positions in the health care field. Challenges faced in developing the fellowship are discussed. Advanced educational opportunities in applied HSE have the potential to develop the workforce capacity needed to improve the quality of health care.

  15. The Annual Burden of Seasonal Influenza in the US Veterans Affairs Population

    PubMed Central

    Young-Xu, Yinong; Russo, Ellyn; Lee, Jason K. H.; Chit, Ayman

    2017-01-01

    Seasonal influenza epidemics have a substantial public health and economic burden in the United States (US). On average, over 200,000 people are hospitalized and an estimated 23,000 people die from respiratory and circulatory complications associated with seasonal influenza virus infections each year. Annual direct medical costs and indirect productivity costs across the US have been found to average respectively at $10.4 billion and $16.3 billion. The objective of this study was to estimate the economic impact of severe influenza-induced illness on the US Veterans Affairs population. The five-year study period included 2010 through 2014. Influenza-attributed outcomes were estimated with a statistical regression model using observed emergency department (ED) visits, hospitalizations, and deaths from the Veterans Health Administration of the Department of Veterans Affairs (VA) electronic medical records and respiratory viral surveillance data from the Centers for Disease Control and Prevention (CDC). Data from VA’s Managerial Cost Accounting system were used to estimate the costs of the emergency department and hospital visits. Data from the Bureau of Labor Statistics were used to estimate the costs of lost productivity; data on age at death, life expectancy and economic valuations for a statistical life year were used to estimate the costs of a premature death. An estimated 10,674 (95% CI 8,661–12,687) VA ED visits, 2,538 (95% CI 2,112–2,964) VA hospitalizations, 5,522 (95% CI 4,834–6,210) all-cause deaths, and 3,793 (95% CI 3,375–4,211) underlying respiratory or circulatory deaths (inside and outside VA) among adult Veterans were attributable to influenza each year from 2010 through 2014. The annual value of lost productivity amounted to $27 (95% CI $24–31) million and the annual costs for ED visits were $6.2 (95% CI $5.1–7.4) million. Ninety-six percent of VA hospitalizations resulted in either death or a discharge to home, with annual costs

  16. “Will Employers Drop Health Insurance Coverage because of the Affordable Care Act?” Health Affairs 32(9): 1522–1530

    PubMed Central

    Buchmueller, Thomas; Carey, Colleen; Levy, Helen G.

    2014-01-01

    Since the passage of the Affordable Care Act, there has been considerable speculation about how many employers will stop offering health insurance once the major coverage provisions of the Act take effect. While some observers predict little aggregate effect, others believe that 2014 marks the beginning of the end for our current system of employer- sponsored insurance. We address the question “how will employer health insurance offering respond to health reform?” using theoretical and empirical evidence. First, we describe economic models of why employers offer insurance. Second, we recap the relevant provisions of health reform and use our economic framework to consider how they may affect employer offers. Third, we review the various predictions that have been made on this subject. Finally, we offer some observations on interpreting early data from 2014. PMID:24019355

  17. Public affairs plan

    SciTech Connect

    Not Available

    1994-09-01

    The purpose of the Uranium Mill Tailings Remedial Action (UMTRA) Project Public Affairs Plan is to establish goals for the Fiscal Year 1995 UMTRA public affairs program and identify specific activities to be conducted during the year. It also describes the roles of various agencies involved in the conduct of the public affairs program and defines the functions of the Technical Assistance Contractor (TAC) Public Affairs Department. It integrates and replaces the Public Participation Plan (DOE/AL/62350-47D) and Public Information Plan (DOE/AL/623590-71). The plan describes the US Department of Energy`s (DOE) plans to keep stakeholders and other members of the public informed about project policies, plans, and activities, and provide opportunities for stakeholders and interested segments of the public to participate in project decision-making processes. The plan applies to the UMTRA Project Office; the DOE Albuquerque Operations Office, Office of Intergovernmental and External Affairs (OIEA); the UMTRA TAC; the UMTRA Remedial Action Contractor (RAC); and other cooperating agencies.

  18. Moving From Discovery to System-Wide Change: The Role of Research in a Learning Health Care System: Experience from Three Decades of Health Systems Research in the Veterans Health Administration.

    PubMed

    Atkins, David; Kilbourne, Amy M; Shulkin, David

    2017-03-20

    The Veterans Health Administration is unique, functioning as an integrated health care system that provides care to more than six million veterans annually and as a home to an established scientific enterprise that conducts more than $1 billion of research each year. The presence of research, spanning the continuum from basic health services to translational research, has helped the Department of Veterans Affairs (VA) realize the potential of a learning health care system and has contributed to significant improvements in clinical quality over the past two decades. It has also illustrated distinct pathways by which research influences clinical care and policy and has provided lessons on challenges in translating research into practice on a national scale. These lessons are increasingly relevant to other health care systems, as the issues confronting the VA-the need to provide timely access, coordination of care, and consistent high quality across a diverse system-mirror those of the larger US health care system.

  19. Office of Indian Affairs 1984 Annual Report.

    ERIC Educational Resources Information Center

    New Mexico State Commission on Indian Affairs, Santa Fe.

    This report outlines the activities of the New Mexico Office of Indian Affairs (OIA) for 1984 in accordance with its directive to investigate, study, consider and act upon the entire subject of Indian conditions and relations within the State of New Mexico, including but not restricted to, problems of health, economy, education, legislation, and…

  20. 78 FR 59861 - VA Acquisition Regulation: Service-Disabled Veteran-Owned and Veteran-Owned Small Business Status...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ... (definition service-disabled Veteran)''. Upon rendering a decision, new VAAR 819.307(g) provides that the... AFFAIRS 48 CFR Part 819 RIN 2900-AM92 VA Acquisition Regulation: Service-Disabled Veteran-Owned and... Service-Disabled Veteran-Owned Small Businesses (SDVOSB) and Veteran-Owned Small Businesses (VOSB)...

  1. 38 CFR 1.220 - On-site activities by pharmaceutical company representatives at VA medical facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS GENERAL PROVISIONS Security and Law Enforcement at... criteria-for-use are available to the public at www.pbm.va.gov. Exceptions may be applied at the local... facility's Chief of Pharmacy Services. Veterans Integrated Service Network (VISN) means one of the...

  2. 76 FR 3209 - West Los Angeles VA Medical Center Veterans Programs Enhancement Act of 1998; Draft Master Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-19

    ...This Federal Register Notice announces an opportunity for public comment on the West Los Angeles (WLA) Department of Veterans Affairs (VA) Medical Center Veterans Programs Enhancement Act of 1998 (VPEA) Draft Master Plan (hereinafter referred to as the ``Draft Master Plan.'' The purpose of this plan is to satisfy the legislative mandate of the Veterans Programs Enhancement Act of 1998......

  3. Provision of CT Scanning Capability to VA/DoD (Veterans Administration/ Department of Defense) Health Care Facilities through a Shared Mobile CT Unit: A Feasibility Study

    DTIC Science & Technology

    1984-07-27

    all Federal sectoT facilities. Shared services have long been recna, nzed as one way to reduce costs, throuph optima’ itilizaticn of capacity, but...stock arguments against shared services . A CT scanner may be installed in a mobile van and the service moved in its entirety from hospital to hospital...annually. This severely restricted further acquisition by hospitals in most health service areas (5,9,14). Shared Services : A Response to Regulation

  4. HIPAA Privacy and Security Standards: A Gap Analysis for the Compliance Challenge at the Northern Arizona VA Health Care System (NAVAHCS)

    DTIC Science & Technology

    2006-05-31

    and his rights of independence, self-reliance, and privacy (Morreim, 1995). Autonomy is a core value in the field of bioethics and an important...component of privacy. Our culture has been transformed in the last two decades by the rapid introduction of astounding new technology into the world of...increasingly information driven health and business culture . Will the expeditious and unrestricted flow of information make life better? How will it

  5. Patient Perception of Enough Time Spent With Provider Is a Mechanism for Improving Women Veterans' Experiences With VA Outpatient Health Care.

    PubMed

    Trentalange, Mark; Bielawski, Mark; Murphy, Terrence E; Lessard, Katarzyna; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Gaetano, Vera; Haskell, Sally; Bastian, Lori A

    2016-12-01

    We postulated that associations between two specific provider characteristics, class (nurse practitioner relative to physician) and primary care providers who are proficient and interested in women's health (designated women's provider relative to nondesignated) and overall satisfaction with provider, were mediated through women veterans' perception of enough time spent with the provider. A national patient experience survey was administered to 7,620 women veterans. Multivariable models of overall patient satisfaction with provider were compared with and without the proposed mediator. A structural equation model (SEM) of the mediation of the two provider characteristics was also evaluated. Without the mediator, associations of provider class and designation with overall patient satisfaction were significant. With the proposed mediator, these associations became nonsignificant. An SEM showed that the majority (>80%) of the positive associations between provider class and designation and the outcome were exerted through patient perception of enough time spent with provider. Higher ratings of overall satisfaction with provider exhibited by nurse practitioners and designated women's health providers were exerted through patient perception of enough time spent with provider. Future research should examine what elements of provider training can be developed to improve provider-patient communication and patient satisfaction with their health care.

  6. Automated Detection of Privacy Sensitive Conditions in C-CDAs: Security Labeling Services at the Department of Veterans Affairs

    PubMed Central

    Bouhaddou, Omar; Davis, Mike; Donahue, Margaret; Mallia, Anthony; Griffin, Stephania; Teal, Jennifer; Nebeker, Jonathan

    2016-01-01

    Care coordination across healthcare organizations depends upon health information exchange. Various policies and laws govern permissible exchange, particularly when the information includes privacy sensitive conditions. The Department of Veterans Affairs (VA) privacy policy has required either blanket consent or manual sensitivity review prior to exchanging any health information. The VA experience has been an expensive, administratively demanding burden on staffand Veterans alike, particularly for patients without privacy sensitive conditions. Until recently, automatic sensitivity determination has not been feasible. This paper proposes a policy-driven algorithmic approach (Security Labeling Service or SLS) to health information exchange that automatically detects the presence or absence of specific privacy sensitive conditions and then, to only require a Veteran signed consent for release when actually present. The SLS was applied successfully to a sample of real patient Consolidated-Clinical Document Architecture(C-CDA) documents. The SLS identified standard terminology codes by both parsing structured entries and analyzing textual information using Natural Language Processing (NLP). PMID:28269828

  7. VA Education Benefits: Actions Taken, but Outreach and Oversight Could Be Improved. Report to the Ranking Member, Subcommittee on Military Personnel, Committee on Armed Services, House of Representatives. GAO-11-256

    ERIC Educational Resources Information Center

    Bertoni, Daniel

    2011-01-01

    The U.S. Department of Veterans Affairs (VA) provided $9 billion in education benefits to service-members and veterans in fiscal year 2010, mostly through the new Post-9/11 GI Bill. In providing education benefits, VA relies on State Approving Agencies (SAA) to approve schools; and on schools to report students' enrollment status. US Government…

  8. Veterans Health Administration

    MedlinePlus

    ... code here VA » Veterans Health Administration Veterans Health Administration Marine Continues to Serve by Serving Veterans David ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  9. 32 CFR Appendix D to Part 45 - State Directors of Veterans Affairs

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., Johnston, IA 50131-1902. Kansas Executive Director, Kansas Veterans Commission, Jayhawk Tower, suite 701... Rey, PR 00918. Rhode Island Chief, Veterans Affairs Office, Metacom Avenue, Bristol, RI 02809. South... Road, SW., room 1002, P.O. Box 809, Roanoke, VA 24004. Virgin Islands Director, Division of...

  10. 32 CFR Appendix D to Part 45 - State Directors of Veterans Affairs

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., Johnston, IA 50131-1902. Kansas Executive Director, Kansas Veterans Commission, Jayhawk Tower, suite 701... Rey, PR 00918. Rhode Island Chief, Veterans Affairs Office, Metacom Avenue, Bristol, RI 02809. South... Road, SW., room 1002, P.O. Box 809, Roanoke, VA 24004. Virgin Islands Director, Division of...

  11. 75 FR 78807 - Agency Information Collection (Notice to Department of Veterans Affairs of Veteran or Beneficiary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... Incarcerated in Penal Institution) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution, VA Form 21-4193. OMB Control... should be reduced or terminated when he or she is incarcerated in a penal institution in excess of...

  12. More than Listening: A Casebook for Using Counseling Skills in Student Affairs Work

    ERIC Educational Resources Information Center

    Harper, Ruth; Wilson, Nona L.

    2010-01-01

    Helping skills are an essential component of today's student affairs practice. On a day-to-day basis, it is student affairs professionals who often work directly with students in need of mental health support and monitoring. "More Than Listening: A Casebook for Using Counseling Skills in Student Affairs Work" is written for those student affairs…

  13. Chronic disease self-management: improving health outcomes.

    PubMed

    Nodhturft, V; Schneider, J M; Hebert, P; Bradham, D D; Bryant, M; Phillips, M; Russo, K; Goettelman, D; Aldahondo, A; Clark, V; Wagener, S

    2000-06-01

    Chronic disease has become pandemic in the United States, and estimates are that it will affect 148 million people by the year 2030. Patients with chronic illnesses cost the health care system over three times more than individuals without chronic conditions. The US Department of Veterans' Affairs (VA) Sunshine HealthCare Network, composed of VA health care facilities in Florida and Puerto Rico, recognized that the needs of its increasing number of veterans with chronic diseases were unmet by traditional medical interventions. The Network implemented a chronic disease self-management pilot program to evaluate its value for the veteran population. Results of the pilot indicate that this program will make a positive, lasting change in the health status and quality of life for veterans with chronic disease.

  14. Health hazard evaluation determination report number MHETA-82-006-9002, Sewell Coal Company, Number 1 Preparation Plant, Nettie, West Virginia, VA

    SciTech Connect

    Patil, A.; Corwell, R.J.

    1982-08-01

    The potential health effects of exposure to a coal antifreeze agent, Wendon-NF-40 were examined. The study was requested by the United Mine Workers of America and was conducted on March 8, 1982 at the Sewell Coal Company No. 1 Preparation Facility (SIC-1211), Nettie, West Virginia. The antifreeze agent was sprayed on the coal as it fell from a conveyer belt into a large hopper. The spraying operation was enclosed except at one side. The preliminary on site investigation was conducted after the facility had discontinued using the antifreeze agent. Therefore, only bulk samples were collected for qualitative analysis. Workers were interviewed by a NIOSH physician. The qualitative analysis revealed that the primary component of the antifreeze was diethylene-glycol (111466). Two of 10 workers interviewed complained of health problems they felt were related to exposure to Wendon-NF-40. Their symptoms included headache and skin irritation. Due to lack of environmental sampling, NIOSH was unable to determine that a hazard from overexposure to Wendon-NF-40 existed. The authors suggest that organic vapor respirators should be worn by workers when they are in area where inhalation of the mists or sprays is likely.

  15. Genetics Home Reference: carbonic anhydrase VA deficiency

    MedlinePlus

    ... people with carbonic anhydrase VA deficiency have excess ammonia in the blood (hyperammonemia), problems with acid-base ... anhydrases VA and VB implicates both enzymes in ammonia detoxification and glucose metabolism. Proc Natl Acad Sci ...

  16. A random effects multinomial logit analysis of using Medicare and VA healthcare among veterans with dementia

    PubMed Central

    Zhu, Carolyn W.; Livote, Elayne E.; Ross, Joseph S.; Penrod, Joan D.

    2011-01-01

    Aims To examine longitudinal patterns of VA-only use, dual VA and Medicare use, or Medicare-only use among veterans with dementia. Methods Data on VA and Medicare use (1998–2001) were obtained from and VA administrative datasets and Medicare claims for 2,137 male veterans with a formal diagnosis of Alzheimer’s disease or vascular dementia enrolled in the National Longitudinal Caregiver Study. A random effects multinomial logit model accounting for unobserved individual heterogeneity was used to estimate the effects of patient and caregiver characteristics on use group over time. Results Compared to VA-only use, dual VA and Medicare use was associated with being white, married, higher education, having private insurance, Medicaid, low VA priority level, more functional limitations, and having lived in a nursing home or died in that year. Medicare-only use was associated with older age, being married, higher education, having private insurance, low VA priority level, living further from a VA Medical Center, having more comorbidities, functional limitations, and having lived in a nursing home or died. Veterans whose caregivers reported better health were more likely to be dual users, but those whose caregivers reported more comorbidities were more likely to use Medicare only. Discussion Different aspects of veterans’ needs and caregiver characteristics have differential effect on where veterans seek care. Efforts to coordinate care between VA and Medicare providers are necessary to ensure patients receive high quality care. PMID:20635273

  17. Managing Legal Affairs.

    ERIC Educational Resources Information Center

    Weeks, Richard H.

    2001-01-01

    Discusses school administrators' legal-affairs management responsibilities regarding legal advice, law versus ethics, and sources of law. Suggests strategies for retaining and managing legal counsel and avoiding situations involving litigation, torts, and conflict resolution. Explains general counsel services; outlines education,…

  18. Soviet Union, Military Affairs

    DTIC Science & Technology

    2007-11-02

    agency of the Soviet Union. Permission for further reproduction must be obtained from copyright owner. SOVIET UNION MILITARY AFFAIRS CONTENTS...internationalists, it has always embodied the inviolable friendship of the peoples of the USSR. But are some of us not hypnotized by this principle

  19. Student Affairs Researcher: Information Broker.

    ERIC Educational Resources Information Center

    Hadley, Thomas D.

    1999-01-01

    Examines the skills and research tools necessary for the student affairs researcher to become an agent for organizational learning within the student affairs division and the institution. Draws upon Peter Senge's theory of "The Learning Organization" and discusses the resulting implications for student affairs researchers. (GCP)

  20. Military and VA General Dentistry Training: A National Resource.

    ERIC Educational Resources Information Center

    Atchison, Kathryn A.; Bachand, William; Buchanan, C. Richard; Lefever, Karen H.; Lin, Sylvia; Engelhardt, Rita

    2002-01-01

    Compared the program characteristics of the postgraduate general dentistry (PGD) training programs sponsored by the military and the Veterans Health Administration (VA). Gathered information on program infrastructure and emphasis, resident preparation prior to entering the program, and patients served and types of services provided. Programs…

  1. Haemophilia utilization group study - Part Va (HUGS Va): design, methods and baseline data.

    PubMed

    Zhou, Z-Y; Wu, J; Baker, J; Curtis, R; Forsberg, A; Huszti, H; Koerper, M; Lou, M; Miller, R; Parish, K; Riske, B; Shapiro, A; Ullman, M; Johnson, K

    2011-09-01

    To describe the study design, procedures and baseline characteristics of the Haemophilia Utilization Group Study - Part Va (HUGS Va), a US multi-center observational study evaluating the cost of care and burden of illness in persons with factor VIII deficiency. Patients with factor VIII level ≤ 30%, age 2-64 years, receiving treatment at one of six federally supported haemophilia treatment centres (HTCs) were enrolled in the study. Participants completed an initial interview including questions on socio-demographical characteristics, health insurance status, co-morbidities, access to care, haemophilia treatment regimen, factor utilization, self-reported joint pain and motion limitation and health-related quality of life. A periodic follow-up survey collected data regarding time lost from usual activities, disability days, health care utilization and outcomes of care. HTC clinicians documented participants' baseline clinical characteristics and pharmacy dispensing records for 2 years. Between July 2005 and July 2007, 329 participants were enrolled. Average age was 9.7 years for children and 33.5 years for adults; two-thirds had severe haemophilia. The distributions of age, marital status, education level and barriers to haemophilia care were relatively consistent across haemophilic severity categories. Differences were found in participants' employment status, insurance status and income. Overall, children with haemophilia had quality of life scores comparable to healthy counterparts. Adults had significantly lower physical functioning than the general US population. As one of the largest economic studies of haemophilia care, HUGS Va will provide detailed information regarding the burden of illness and health care utilization in the US haemophilia A population.

  2. Perceptions of other integrative health therapies by Veterans with pain who are receiving massage

    PubMed Central

    Fletcher, Carol Elizabeth; Mitchinson, Allison R.; Trumble, Erika L.; Hinshaw, Daniel B.; Dusek, Jeffery A.

    2016-01-01

    Veterans are increasingly using complementary and integrative health (CIH) therapies to manage chronic pain and other troubling symptoms that significantly impair health and quality of life. The Department of Veterans Affairs (VA) is exploring ways to meet the demand for access to CIH, but little is known about Veterans’ perceptions of the VA’s efforts. To address this knowledge gap, we conducted interviews of 15 inpatients, 8 receiving palliative care, and 15 outpatients receiving CIH in the VA. Pain was the precipitating factor in all participants’ experience. Participants were asked about their experience in the VA and their opinions about which therapies would most benefit other Veterans. Participants reported that massage was well-received and resulted in decreased pain, increased mobility, and decreased opioid use. Major challenges were the high ratio of patients to CIH providers, the difficulty in receiving CIH from fee-based CIH providers outside of the VA, cost issues, and the role of administrative decisions in the uneven deployment of CIH across the VA. If the VA is to meet its goal of offering personalized, proactive, patient-centered care nationwide then it must receive support from Congress while considering Veterans’ goals and concerns to ensure that the expanded provision of CIH improves outcomes. PMID:27004453

  3. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Self-contained breathing apparatus (V-A mines). 57.22315 Section 57.22315 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  4. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Self-contained breathing apparatus (V-A mines). 57.22315 Section 57.22315 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  5. 30 CFR 57.22315 - Self-contained breathing apparatus (V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Self-contained breathing apparatus (V-A mines). 57.22315 Section 57.22315 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... breathing apparatus (V-A mines). Self-contained breathing apparatus of a duration to allow for escape...

  6. Lower-Limb Amputation and Effect of Posttraumatic Stress Disorder on Department of Veterans Affairs Outpatient Cost Trends

    DTIC Science & Technology

    2015-07-01

    brain injury (TBI), and complex limb (arm and leg) injury often lead- ing to amputation and/or reconstruction [1–12]. The rate of limb injuries...posttraumatic stress disorder, TBI = traumatic brain injury, VA = Department of Veterans Affairs. *Address all correspondence to Vibha Bhatnagar, MD, MPH...2005 [20–21], and Injury Severity Score (ISS) coding systems. Additional patient information was pro- vided by the VA Informatics and Computing

  7. USSR Report, International Affairs.

    DTIC Science & Technology

    1987-01-08

    054 FBIS FOREIGN BROADCAST INFORMATION SERVICE REPRODUCED BY U S DEPARTMENT OF COMMERCE NATIONAL TECHNICAL INFORMATION SERVICE SPRINGFIELD, VA...KOMMUNIST GRUZII, No 9, Sep 86) 39 WESTERN EUROPE Briefs Spain^USSR S&T Commission 46 Malta -USSR Commercial Agreement 46 LATIN AMERICA AND...between general national interests and the interests of departments and enterprises occurs in connection with the impor- tation of goods. When world

  8. USSR Report Military Affairs

    DTIC Science & Technology

    2007-11-02

    the after- math of the Chernobyl Nuclear Power Plant accident and the mobilization of labor and technology in the clean-up effort will be published...in the series USSR REPORT: POLITICAL AND SOCIOLOGICAL AFFAIRS under the subtitle AFTERMATH OF CHERNOBYL NUCLEAR POWER PLANT ACCIDENT. This is a...EDITORIALIZES CHERNOBYL ACCIDENT Kiev PRAVDA UKRAINY in Russian 14 May 86 p 1 TRANSPORT WORKERS» EFFORTS AT CHERNOBYL DETAILED Moscow SOTSIALISnCHESKAYA

  9. USSR Report, Military Affairs

    DTIC Science & Technology

    1986-07-29

    math of the Chernobyl Nuclear Power Plant accident and the mobilization of labor and technology in the clean-up effort will be published in the series...USSR REPORT: POLITICAL AND SOCIOLOGICAL AFFAIRS under the subtitle AFTERMATH OF CHERNOBYL NUCLEAR POWER PLANT ACCIDENT. This is a represen- tative... CHERNOBYL ACCIDENT Kiev PRAVDA UKRAINY in Russian 14 May 86 p 1 TRANSPORT WORKERS’ EFFORTS AT CHERNOBYL DETAILED Moscow SOTSIALISTiaESKAYA INDUSTRIYA

  10. USSR Report, International Affairs

    DTIC Science & Technology

    2007-11-02

    4 SOCIALIST COMMUNITY AND CEMA AFFAIRS CEMA Secretary Descibes Priorities, Tasks (V. V. Sychev; EKONOMICHESKAYA GAZETA, No 48, Nov 86...7 Improvement in CEMA Trade Situation Noted by UN (Moscow Domestic Service, 1 Dec 86) 13 CEMA Science, Technology Goals Outlined (Vladimir...Pasko; Moscow Domestic Service, 17 Dec 86) ... 15 Role of Soviet Republics Under CEMA Division of Labor CN. Stepanova; KOMMUNIST MOLDAVII, No 9, Sep

  11. USSR Report. International Affairs.

    DTIC Science & Technology

    2007-11-02

    Opens Soviet Envoy Addresses Forum 2 EAST-WEST RELATIONS History, Prospects for EC- CEMA Cooperation (Vladimir G. Baranovskiy; OBSHCHESTVENNYYE NAUKI...No 6, 1986) 4 SOCIALIST COMMUNITY AND CEMA AFFAIRS USSR Exports and Cooperation With CEMA Countries (B. A. Kheyfets; IZVESTIYA AKADEMII NAUK...EAST-WEST RELATIONS HISTORY, PROSPECTS FOR EC- CEMA COOPERATION Moscow OBSHCHESTVENNYYE NAUKI in Russian No 6, 1986 pp 95-108 [Article by Vladimir

  12. Korean Affairs Report

    DTIC Science & Technology

    2007-11-02

    publications contain information primarily from foreign newspapers, periodicals and books, but also from news agency transmissions and broadcasts...Pyongyang Domestic Service, 23 Dec 86) l Commentary on White Paper About Kumgangsan Dam (Cho Tu-ul; Pyongyang Domestic Service, 26 Dec 86) 3 Party...ruin. /8309 CSO: 4110/056 INTER-KOREAN AFFAIRS COMMENTARY ON WHITE PAPER ABOUT KUMGANGSAN DAM SK280105 Pyongyang Domestic Service in Korean 1150

  13. China Report, Economic Affairs

    DTIC Science & Technology

    2007-11-02

    namely: No clear distinction was drawn between the functions of the government and those of the enterprises; barriers exist between different...enterprise functions in state-owned enterprises became more manifest, administrative control by state organs over economic affairs was strengthened...planned economy as incompatible with the commodity economy; seeing the functions of the socialist state in managing the economy as a monopoly in which

  14. Sofosbuvir and Simeprevir Combination Therapy for HCV Genotype 1 Infection: Results of a Single-Center VA Experience.

    PubMed

    Sclair, Seth N; Hernandez, Maria Del Pilar; Vance, Evan; Gilinski, Dani; Youtseff, Helen; Toro, Maribel; Antoine, Marie; Jeffers, Lennox J; Peyton, Adam

    2016-08-01

    Treatment of chronic hepatitis C virus (HCV) infection remains a priority in the veterans affairs (VA) health care system nationwide, as there is a high burden of liver disease due to HCV infection among US veterans. The combination of sofosbuvir and simeprevir was the first all-oral antiviral regimen used in clinical practice to treat veterans with HCV infection. In this study, we report a single-center experience showing both the feasibility and effectiveness of this all-oral combination to treat HCV genotype 1 infection. One hundred patients with HCV genotype 1 infection were treated between December 2013 and June 2014. Eighty-six patients were treated with sofosbuvir and simeprevir, with or without ribavirin, for 12 weeks; 12 patients were treated with sofosbuvir, pegylated interferon, and ribavirin for 12 weeks; and 2 patients were treated with sofosbuvir and ribavirin for 24 weeks. Overall, treatment was well tolerated and feasible, with compliance rates over 95% in patients treated with all-oral therapy. The sustained virologic response (SVR) rate for sofosbuvir and simeprevir (88.4%) was superior to the rate for sofosbuvir, pegylated interferon, and ribavirin (50.0%). Subgroup analysis showed diminished SVR rates in cirrhotic patients vs noncirrhotic patients. There were no significant differences in SVR when comparing treatment with or without ribavirin or among genotype subtypes. In conclusion, this study demonstrated excellent completion rates for all-oral treatment of veterans with chronic HCV infection. Additionally, treatment was highly effective, nearing a 90% cure rate. Thus, we recommend that the VA health care system continue to incorporate new HCV medications into its formulary so as to expand HCV treatment for US veterans.

  15. Sofosbuvir and Simeprevir Combination Therapy for HCV Genotype 1 Infection: Results of a Single-Center VA Experience

    PubMed Central

    Hernandez, Maria Del Pilar; Vance, Evan; Gilinski, Dani; Youtseff, Helen; Toro, Maribel; Antoine, Marie; Jeffers, Lennox J.; Peyton, Adam

    2016-01-01

    Treatment of chronic hepatitis C virus (HCV) infection remains a priority in the veterans affairs (VA) health care system nationwide, as there is a high burden of liver disease due to HCV infection among US veterans. The combination of sofosbuvir and simeprevir was the first all-oral antiviral regimen used in clinical practice to treat veterans with HCV infection. In this study, we report a single-center experience showing both the feasibility and effectiveness of this all-oral combination to treat HCV genotype 1 infection. One hundred patients with HCV genotype 1 infection were treated between December 2013 and June 2014. Eighty-six patients were treated with sofosbuvir and simeprevir, with or without ribavirin, for 12 weeks; 12 patients were treated with sofosbuvir, pegylated interferon, and ribavirin for 12 weeks; and 2 patients were treated with sofosbuvir and ribavirin for 24 weeks. Overall, treatment was well tolerated and feasible, with compliance rates over 95% in patients treated with all-oral therapy. The sustained virologic response (SVR) rate for sofosbuvir and simeprevir (88.4%) was superior to the rate for sofosbuvir, pegylated interferon, and ribavirin (50.0%). Subgroup analysis showed diminished SVR rates in cirrhotic patients vs noncirrhotic patients. There were no significant differences in SVR when comparing treatment with or without ribavirin or among genotype subtypes. In conclusion, this study demonstrated excellent completion rates for all-oral treatment of veterans with chronic HCV infection. Additionally, treatment was highly effective, nearing a 90% cure rate. Thus, we recommend that the VA health care system continue to incorporate new HCV medications into its formulary so as to expand HCV treatment for US veterans. PMID:27917084

  16. Increasing the ranks of academic researchers in mental health: a multisite approach to postdoctoral fellowship training.

    PubMed

    O'Hara, Ruth; Cassidy-Eagle, Erin L; Beaudreau, Sherry A; Eyler, Lisa T; Gray, Heather L; Giese-Davis, Janine; Hubbard, Jeffrey; Yesavage, Jerome A

    2010-01-01

    This report highlights the use of multisite training for psychiatry and psychology postdoctoral fellows developing careers in academic clinical research in the field of mental health. The objective is to describe a model of training for young investigators to establish independent academic clinical research careers, including (1) program structure and eligibility, (2) program goals and development of a multisite curriculum, (3) use of technology for implementing the program across multiple sites, and (4) advantages and challenges of this multisite approach. In 2000, in collaboration with the Veterans Affairs (VA) Mental Illness Research, Education and Clinical Centers (MIRECCs), the VA Office of Academic Affiliations launched the Special Fellowship Program in Advanced Psychiatry and Psychology. Each of the 10 currently participating VA sites across the United States is affiliated with a MIRECC and an academic medical institution. In the first five years of this fellowship program, 83 fellows (34 psychiatrists and 49 psychologists) have participated. The success of this multisite approach is evidenced by the 58 fellows who have already graduated from the program: 70% have entered academic clinical research positions, and over 25 have obtained independent extramural grant support from the VA or the National Institutes of Health. Multisite training results in a greater transfer of knowledge and capitalizes on the nationwide availability of experts, creating unique networking and learning opportunities for trainees. The VA's multisite fellowship program plays a valuable role in preparing substantial numbers of psychiatry and psychology trainees for a range of academic clinical research and leadership positions in the field of mental health.

  17. Dichotic listening to speech: VA-CD data from elderly subjects.

    PubMed

    Noffsinger, D; Martinez, C D; Andrews, M

    1996-01-01

    The Department of Veterans Affairs (VA) compact disc (VA-CD) Tonal and Speech Materials for Auditory Perceptual Assessment, Disc 1.0 contains three dichotic speech tests. Two of them, namely, dichotic digits and dichotic synthetic sentences, are tasks that are easily and accurately performed by young normal listeners. The third test, dichotic nonsense syllables, is a more difficult task for normal listeners to perform well. Few data have been gathered from use of the VA-CD with subjects other than young adults with normal hearing sensitivity. This account is about 19 elderly patients with hearing loss in a VA long-term care facility and how they performed on the trio of dichotic tasks on the disc. The digits, sentences, and syllables were presented at 80 dB SPL in a dichotic format requiring two responses to each trial. Trials using syllables were also done at 90 dB SPL to quantify the effects of hearing loss. Digits were recognized better than sentences; both were recognized better than syllables, and this was true for both ears. Compared to results from young listeners, correct responsiveness for older people was most reduced on the syllable task, but performance on dichotic sentences was also reduced. The results corroborate previous reports that suggest that many aging auditory systems do not process dichotic nonsense syllables as well as younger ones. The results also suggest that the dichotic procedures on the VA-CD provide a useful continuum of difficulty for the clinician and investigator.

  18. Public affairs committee actions

    NASA Astrophysics Data System (ADS)

    The AGU Public Affairs Committee will create an ad hoc committee to consider possible AGU position statements concerning the effects of nuclear war.The action was taken at the May 31, 1983, meeting of the Committee at the AGU Spring Meeting in Baltimore. Present were Carroll Ann Hodges, Chairman, and members Thomas J. Ahrens, David Cauffman, Jared Cohon, Stamatios Krimigis, Robert Murphy, Raymond Roble, and George Shaw. Also attending were the current Congressional Fellow Arthur Weissman and SPR—Cosmic Rays Section Secretary Miriam Forman.

  19. Revolution in Detection Affairs

    SciTech Connect

    Stern W.

    2013-11-02

    The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovative application of anomaly detection algorithms.

  20. Supra-Earth affairs.

    PubMed

    Othman, Mazlan

    2011-02-13

    The United Nations briefly considered the issue of extra-terrestrial intelligence at the 32nd session of the General Assembly in 1977. As a result, the Office of Outer Space Affairs was tasked to prepare a document on issues related to 'messages to extra-terrestrial civilizations', but this area has not been followed through in more recent times. This discussion paper describes the United Nations' activities in the field of near-Earth objects in some detail, and suggests that this might be used as a model of how Member States could proceed with dealing with this issue in case the existence of extra-terrestrial life/intelligence is established.

  1. Student Affairs Capitalism and Early-Career Student Affairs Professionals

    ERIC Educational Resources Information Center

    Lee, Jenny J.; Helm, Matthew

    2013-01-01

    This study explores student affairs capitalism as the alteration of professional practice towards the financial interests of institutions. Student affairs capitalism has the potential to create dynamics in which the interests of students become secondary to the institution's economic needs. This study examined this phenomenon from the perspectives…

  2. KaVA ESTEMA project

    NASA Astrophysics Data System (ADS)

    Oyadomari, Miyako; Imai, Hiroshi; Cho, Se-Hyung; Asaki, Yoshiharu; Choi, Yoon-Kyong; Kim, Jaeheon; Yun, Youngjoo; Matsumoto, Naoko; Min, Cheul-Hong; Oyama, Tomoaki; Yoon, Sung-Chul; Yoon, Dong-Hwan; Kim, Dong-Jin; Dodson, Richard; Rioja, Maria; Burns, Ross; Orosz, Gabor; Nakagawa, Akiharu; Chibueze O, James; Nakashima, Jun-ichi; Sobolev, Andrey

    2016-07-01

    The ESTEMA (Expanded Study on Stellar Masers) project is one of three Large Programs of the KaVA (the combined array of the Korean VLBI Network and Japanese VLBI Exploration of Radio Astrometry), and conducted in 2015-2016. It aims to publish a database of the largest sample of VLBI images of circumstellar water (H2O) and silicon-monoxide (SiO) maser sources towards circumstellar envelopes (CSEs) of 80 evolved stars in late AGB to early post-AGB phase. Here we present the specifications of the ESTEMA observations and the planned scientific goals in order to share the basic information of the ESTEMA with astronomical community and encourage future collaborations with the ESTEMA and future follow-up observations for the targeted stars.

  3. The Post-9/11 GI Bill: Insights from Veterans Using Department of Veterans Affairs Educational Benefits

    ERIC Educational Resources Information Center

    Bell, Geri L.; Boland, Elizabeth A.; Dudgeon, Brian; Johnson, Kurt

    2013-01-01

    Because the Post-9/11 GI Bill was implemented in August of 2009, increasing numbers of veterans returning from the Global War on Terror (GWT) have drawn on Department of Veterans Affairs (VA) educational benefits. Based on the findings of a mixed-methods study, quantitative and qualitative survey responses from veterans enrolled at a major…

  4. Gender Diversity within the Student Affairs Profession.

    ERIC Educational Resources Information Center

    McEwen, Marylu K.; And Others

    1990-01-01

    Investigated issue of representation of women and men in student affairs profession. Preparation program data, professional association data, and perceptions of student affairs professionals demonstrated a clear shift toward greater proportions of women in student affairs. (Author/NB)

  5. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Notice of total service... Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT... service-disabled veterans (or eligible surviving spouses); (ii) The management and daily...

  6. 48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA Notice of total service... Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT... service-disabled veterans (or eligible surviving spouses); (ii) The management and daily...

  7. VA/DoD Joint Executive Council Fiscal Year 2010

    DTIC Science & Technology

    2010-01-01

    impede collaborative efforts, assert and support mutually beneficial opportunities to improve business practices, ensure high quality cost- effective...in-depth Lean-Six Sigma business process improvement study conducted last year and described in last year’s AR. The first milestone for the MRWG...computable electronic health data sharing between VA and DoD. The number of CHDR active dual consumers increased from over 45,900 in October 2009 to

  8. U.S. Veteran Health Care Utilization Increases after Caregivers' Use of National Caregiver Telephone Support Line.

    PubMed

    Griffin, Joan M; Malcolm, Cari; Wright, Pamela; Hagel Campbell, Emily; Kabat, Margaret; Bangerter, Ann K; Sayer, Nina A

    2017-03-25

    The U.S. Department of Veterans Affairs (VA) established the national Caregiver Support Line (CSL) in February 2011. The CSL is operated by licensed master's degree social workers who provide caregivers of veterans with information about caregiver benefits and services, counseling, and referrals to a caregiver support coordinator at the nearest VA medical center. The authors compared differences in veteran health care utilization patterns in the six months before and after a caregiver call to the CSL, hypothesizing that veterans with caregivers using the CSL had improved access to health care services and improved access increased utilization of health care. A pre- and posttest design was used. CSL calls that resulted in referrals to VA health care services or to local VA caregiver support coordinators were included in the sample. Data were extracted from the CSL database and matched to veteran care utilization data using veteran medical record data. Veteran inpatient stays for general medicine, hospice, respite, and long-term care significantly increased after the CSL call, but other inpatient stays (surgery, neurology) did not. Outpatient services for home health, respite, and mental health all significantly increased. Caregivers' use of the national CSL may help facilitate access for veterans to needed care services.

  9. Delivery of gender-sensitive comprehensive primary care to women veterans: implications for VA Patient Aligned Care Teams.

    PubMed

    Yano, Elizabeth M; Haskell, Sally; Hayes, Patricia

    2014-07-01

    The Veterans Health Administration (VA) has undertaken a major initiative to transform primary care delivery through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home concept, PACTs aim to improve access, continuity, coordination, and comprehensiveness using team-based care that is patient driven and patient centered. However, how PACT principles should be applied to meet the needs of special populations, including women veterans, is not entirely clear. While historical differences in military participation meant women veterans were rarely seen in VA healthcare settings, they now represent the fastest growing segment of new VA users. They also have complex healthcare needs, adding gender-specific services and other needs to the spectrum of services that the VA must deliver. These trends are changing the VA landscape, introducing challenges to how VA care is organized, how VA providers need to be trained, and how VA considers implementation of new initiatives, such as PACT. We briefly describe the evolution of VA primary care delivery for women veterans, review VA policy for delivering gender-sensitive comprehensive primary care for women, and discuss the challenges that women veterans' needs pose in the context of PACT implementation. We conclude with recommendations for addressing some of these challenges moving forward.

  10. Sharing information between the Department of Veterans Affairs and the Department of Defense. Final rule.

    PubMed

    2012-09-05

    This document adopts as final, without change, the interim final rule published in the Federal Register on October 20, 2011. This final rule removes a Department of Veterans Affairs (VA) regulatory restriction on the sharing of certain medical information with the Department of Defense (DoD) that is not required by the applicable statute and is inconsistent with the intent and purpose of that statute.

  11. Dengue Surveillance in Veterans Affairs Healthcare Facilities, 2007–2010

    PubMed Central

    Schirmer, Patricia L.; Lucero-Obusan, Cynthia A.; Benoit, Stephen R.; Santiago, Luis M.; Stanek, Danielle; Dey, Achintya; Martinez, Mirsonia; Oda, Gina; Holodniy, Mark

    2013-01-01

    Background Although dengue is endemic in Puerto Rico (PR), 2007 and 2010 were recognized as epidemic years. In the continental United States (US), outside of the Texas-Mexico border, there had not been a dengue outbreak since 1946 until dengue re-emerged in Key West, Florida (FL), in 2009–2010. The objective of this study was to use electronic and manual surveillance systems to identify dengue cases in Veterans Affairs (VA) healthcare facilities and then to clinically compare dengue cases in Veterans presenting for care in PR and in FL. Methodology Outpatient encounters from 1/2007–12/2010 and inpatient admissions (only available from 10/2009–12/2010) with dengue diagnostic codes at all VA facilities were identified using VA's Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE). Additional case sources included VA data from Centers for Disease Control and Prevention BioSense and VA infection preventionists. Case reviews were performed. Categorical data was compared using Mantel-Haenszel or Fisher Exact tests and continuous variables using t-tests. Dengue case residence was mapped. Findings Two hundred eighty-eight and 21 PR and FL dengue cases respectively were identified. Of 21 FL cases, 12 were exposed in Key West and 9 were imported. During epidemic years, FL cases had significantly increased dengue testing and intensive care admissions, but lower hospitalization rates and headache or eye pain symptoms compared to PR cases. There were no significant differences in clinical symptoms, laboratory abnormalities or outcomes between epidemic and non-epidemic year cases in FL and PR. Confirmed/probable cases were significantly more likely to be hospitalized and have thrombocytopenia or leukopenia compared to suspected cases. Conclusions Dengue re-introduction in the continental US warrants increased dengue surveillance and education in VA. Throughout VA, under-testing of suspected cases highlights the need to emphasize use

  12. 76 FR 30598 - Payment or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ... practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse, Foreign... emergency care payment or reimbursement, and define the payment limitations for those qualifying for payment... claimants from payment or reimbursement by VA for emergency care at non-VA facilities. Parties who...

  13. The effect of threshold amounts for reporting malpractice payments to the National Practitioner Data Bank: analysis using the closed claims data base of the Office of the Assistant Secretary of Defense (Health Affairs).

    PubMed

    Metter, E J; Granville, R L; Kussman, M J

    1997-04-01

    The study determines the extent to which payment thresholds for reporting malpractice claims to the National Practitioner Data Bank identifies substandard health care delivery in the Department of Defense. Relevant data were available on 2,291 of 2,576 medical malpractice claims reported to the closed medical malpractice case data base of the Office of the Assistant Secretary of Defense (Health Affairs). Amount paid was analyzed as a diagnostic test using standard of care assessment from each military Surgeon General office as the criterion. Using different paid threshold amounts per claim as a positive test, the sensitivity of identifying substandard care declined from 0.69 for all paid cases to 0.41 for claims over $40,000. Specificity increased from 0.75 for all paid claims to 0.89 for claims over $40,000. Positive and negative predictive values and likelihood ratio were similar at all thresholds. Malpractice case payment was of limited value for identifying substandard medical practice. All paid claims missed about 30% of substandard care, and reported about 25% of acceptable medical practice.

  14. Academic Affiliations with the Department of Veterans Affairs: Characteristics of the Ohio State University Model.

    ERIC Educational Resources Information Center

    Newcomb, Robert D.; Hill, Richard M.

    1993-01-01

    The Ohio State University School of Optometry affiliation with four Veterans Administration (VA) health care facilities is characterized by a central governing committee, regular faculty appointments for all participating VA staff, substantial interaction with each site, strong orientation for rotating senior optometry students, and joint…

  15. VA Construction Assistance Act of 2014

    THOMAS, 113th Congress

    Rep. Coffman, Mike [R-CO-6

    2013-11-21

    09/17/2014 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  16. Evaluating the Efficacy of a Short Aging Simulation Workshop for an Interdisciplinary Group of Health-Care Employees at a Veterans Affairs Medical Center

    ERIC Educational Resources Information Center

    Halpin, Sean N.

    2015-01-01

    Several interventions aimed at increasing positive attitudes towards older adults among health-care professionals have been introduced. These interventions tend to focus on a small subset of clinical employees, ignoring other clinical and nonclinical hospital staff. The objective of this study was to evaluate the efficacy of a short aging…

  17. An Evaluation of Current CCTV Usage To Support Patient Health Education Activities at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Brecksville Division.

    ERIC Educational Resources Information Center

    Kromke, Diane

    Closed-circuit television (CCTV) is a promising technology used by many medical centers to support health education activities for patients and their families. It may provide one method of reaching multiple patients at various times and locations, providing consistent, easily repeated information in a low stress manner, but it is unclear how much…

  18. Lean Six Sigma in health care and the challenge of implementation of Six Sigma methodologies at a Veterans Affairs Medical Center.

    PubMed

    Pocha, Christine

    2010-01-01

    Six Sigma and Lean Thinking are quality initiatives initially deployed in industry to improve operational efficiency leading to better quality and subsequent cost savings. The financial rationale for embarking on this quality journey is clear; applying it to today's health care remains challenging. The cost of medical care is increasing at an alarming rate; most of these cost increases are attributed to an aging population and technological advances; therefore, largely beyond control. Furthermore, health care cost increases are caused by unnecessary operational inefficiency associated with the direct medical service delivery process. This article describes the challenging journey of implementing Six Sigma methodology at a tertiary care medical center. Many lessons were learned; however, of utmost importance were team approach, "buy in" of the stakeholders, and the willingness of team members to change daily practice and to adapt new and innovative ways how health care can be delivered. Six Sigma incorporated as part of the "company's or hospital's culture" would be most desirable but the learning curve will be steep.

  19. NIOSH testimony on Kuwait before the subcommittee on hospitals and health care, committee on veterans' affairs by J. S. Andrews, September 16, 1992

    SciTech Connect

    Not Available

    1992-09-16

    The testimony summarizes potential adverse health effects related to service in the Persian Gulf as presented by the Department of Health and Human Services. An estimated 9,000 workers from 43 different countries battled the burning oil wells in Kuwait from February 1991 through early November 1991 when the last was capped. Exposures and health effects in US military personnel, Kuwaiti citizens, and fire fighters were described. The hazards to the soldiers were largely dependent on the concentration of the pollutants in the air near the camps. Fortunately, the plume from the fires rose up to 10,000 and 12,000 feet, mixed with the air and then dispersed for several thousand miles downwind over a period of several weeks. The particles and gases contained in the plume were diluted as the plume travelled. Even so, some minor respiratory problems were present among the soldiers. Some of the hydrocarbons measured at low concentrations have been shown to produce cancer in laboratory animals only when present at higher levels of exposure. Based on the exposure information gathered, the author concludes that there will not likely be a detectable increase in lung cancer in Gulf War Veterans as a result of the oil well fires.

  20. Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

    ERIC Educational Resources Information Center

    Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

    2009-01-01

    Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

  1. 7 CFR 371.10 - Legislative and Public Affairs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 5 2014-01-01 2014-01-01 false Legislative and Public Affairs. 371.10 Section 371.10 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION... communications arm of APHIS. (b) Director of LPA. The Director of LPA is responsible for: (1) Advising...

  2. 7 CFR 371.10 - Legislative and Public Affairs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 5 2012-01-01 2012-01-01 false Legislative and Public Affairs. 371.10 Section 371.10 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION... communications arm of APHIS. (b) Director of LPA. The Director of LPA is responsible for: (1) Advising...

  3. Who Knows? Selected Information Resources on International Social Affairs.

    ERIC Educational Resources Information Center

    Feulner, John A., Comp.

    These two annotated listings cite organizations, groups, and programs that provide information on international social affairs. The entries were selected from the data base of the National Referral Center of the Library of Congress. Listings are organized under the following headings: volunteer agencies; food; law; health; population; rural…

  4. 78 FR 36092 - Payment or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... programs--Veterans, Health care, Health facilities, Health professions, Health records, Homeless, Medical and dental schools, Medical devices, Medical research, Mental health programs, Nursing homes... of Veterans Affairs is correcting 38 CFR part 17 as follows: PART 17--MEDICAL 0 1. The...

  5. A Comparison of HAART Outcomes between the US Military HIV Natural History Study (NHS) and HIV Atlanta Veterans Affairs Cohort Study (HAVACS)

    DTIC Science & Technology

    2013-05-01

    Introduction: The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide comprehensive HIV treatment and care to their...and unemployment than individuals who receive HIV care in the DoD. A comparison between individuals receiving HIV treatment and care from the DoD and

  6. Findings of VA/DoD CPG on CAM Therapies for PTSD

    DTIC Science & Technology

    2011-01-26

    post ES 1.4-1.6 versus usual care ES 0.12-0.74 Depression and pain symptoms Mental but not physical health functioning VA/DoD PTSD CPG...The Quadruple Aim: Working Together, Achieving Success 2011 Military Health System Conference Defense Centers of Excellence for Psychological Health ...Elizabeth Harper Cordova, M.A., Wayne Jonas, M.D. 1 Military Health System Conference Report Documentation Page Form ApprovedOMB No. 0704-0188 Public

  7. Military to civilian questionnaire: a measure of postdeployment community reintegration difficulty among veterans using Department of Veterans Affairs medical care.

    PubMed

    Sayer, Nina A; Frazier, Patricia; Orazem, Robert J; Murdoch, Maureen; Gravely, Amy; Carlson, Kathleen F; Hintz, Samuel; Noorbaloochi, Siamak

    2011-12-01

    The primary objective of this study was to describe the development, reliability, and construct validity of scores on the Military to Civilian Questionnaire (M2C-Q), a 16-item self-report measure of postdeployment community reintegration difficulty. We surveyed a national, stratified sample of 1,226 Iraq and Afghanistan veterans who used U.S. Department of Veterans Affairs (VA) medical care; 745 completed the M2C-Q and validated mental health screening measures. All analyses were based on weighted estimates. The internal consistency of the M2C-Q was .95 in this sample. Factor analyses indicated a single total score was the best-fitting model. Total scores were associated with measures theoretically related to reintegration difficulties including perception of overall difficulty readjusting back into civilian life (R(2) = .49), probable PTSD (d = 1.07), probable problem drug or alcohol use (d = 0.34), and overall mental health (r = -.83). Subgroup analyses revealed a similar pattern of findings in those who screened negative for PTSD. Nonwhite and unemployed veterans reported greater community reintegration difficulty (d = 0.20 and 0.45, respectively). Findings offer preliminary support for the reliability and construct validity of M2C-Q scores.

  8. Collaborative Academic Training of Psychiatrists and Psychologists in VA and Medical School Settings

    ERIC Educational Resources Information Center

    Scaturo, Douglas J.; Huszonek, John J.

    2009-01-01

    Objective: The authors review the background and contemporary strengths of Dean's Committee Veterans Affairs Medical Centers in the collaborative academic training of psychiatrists and psychologists. Methods: The authors discuss the problems and prospects of the current health care environment as it impacts the behavioral health treatment of…

  9. The transformation experience of the Veterans Health Administration and its relevance to Canada.

    PubMed

    Fooks, Cathy; Decter, Michael

    2005-01-01

    Over the past few years, there has been a steady stream of visitors to Canada from the US Veterans Health Administration (VA). Led by the former Under Secretary for Health in the Department of Veterans Affairs, Dr. Ken Kizer, they come to tell the remarkable story of how the VA transformed itself from a hospital-based bureaucracy described as "dangerous, dirty and scandal-ridden" to a healthcare system for veterans recognized for its high-quality, patient-centred care. It is a fascinating story of how a publicly funded healthcare service changed its entire approach to patient care with a quality improvement lens at its core. Fifteen years ago, critics of the VA called for its complete privatization as the only solution to fixing its problems. A team of quality champions set out to prove otherwise. Canada has some lessons to learn. The VA is a compelling role model for Canadian reformers, in large measure, due to its public sector character.

  10. Indigenous Affairs = Asuntos Indigenas, 1997.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1997

    1997-01-01

    This document contains the three 1997 English-language issues of Indigenous Affairs and the three corresponding issues in Spanish. (The last two quarterly issues were combined.) These periodicals provide a resource on the history, current conditions, and struggles for self-determination and human rights of indigenous peoples around the world.…

  11. Indigenous Affairs = Asuntos Indigenas, 1996.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1996

    1996-01-01

    This document contains the four 1996 English-language issues of Indigenous Affairs and the four corresponding issues in Spanish. These newsletters provide a resource on the history, current conditions, and struggles for self-determination and human rights of indigenous peoples around the world. Articles on the United States and Canada (1) discuss…

  12. Office Automation in Student Affairs.

    ERIC Educational Resources Information Center

    Johnson, Sharon L.; Hamrick, Florence A.

    1987-01-01

    Offers recommendations to assist in introducing or expanding computer assistance in student affairs. Describes need for automation and considers areas of choosing hardware and software, funding and competitive bidding, installation and training, and system management. Cites greater efficiency in handling tasks and data and increased levels of…

  13. Joint Doctrine for Civil Affairs

    DTIC Science & Technology

    2007-11-02

    Authorities ( MACA ), DODD 5525.5, DOD Cooperation with Civilian Law Enforcement Officials, and JP 3-07.7, Joint Doctrine for Civil Support. II-15 Civil Affairs...Joint Operation Planning and Execution System JP joint publication JTF joint task force LOAC law of armed conflict MACA military assistance to civil

  14. Recent Developments in Student Affairs

    ERIC Educational Resources Information Center

    Holloway, John P.

    1974-01-01

    The rapid development and application to universities and colleges of the constitutional principles of the First Amendment are analyzed with special reference to Healy v. James and its present and possible future ramifications in the area of student affairs including use of university facilities, student conduct, and organizational activities. (JT)

  15. Sustainability, Student Affairs, and Students

    ERIC Educational Resources Information Center

    Kerr, Kathleen G.; Hart-Steffes, Jeanne S.

    2012-01-01

    Colleges and universities are developing both the next generation of leaders as well as state-of-the-art technology that allow climate reduction aspirations and triple bottom-line outcomes to become realities. Divisions of student affairs play a crucial role in the sustainability movement in colleges and universities. The technology-savvy,…

  16. Indigenous Affairs = Asuntos Indigenas, 2000.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 2000

    2000-01-01

    This document contains the four English-language issues of Indigenous Affairs published in 2000 and four corresponding issues in Spanish. The Spanish issues contain all or some of the articles contained in the English issues plus additional articles on Latin America. These periodicals provide a resource on the history, current conditions, and…

  17. Indigenous Affairs = Asuntos Indigenas, 1998.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1998

    1998-01-01

    This document contains the four 1998 English-language issues of Indigenous Affairs and the four corresponding issues in Spanish. These periodicals provide a resource on the history, current conditions, and struggles for self-determination and human rights of indigenous peoples around the world. The first issue is a theme issue on the indigenous…

  18. Effectiveness of Sofosbuvir, Ledipasvir/Sofosbuvir, or Paritaprevir/Ritonavir/Ombitasvir and Dasabuvir Regimens for Treatment of Patients With Hepatitis C in the Veterans Affairs National Health Care System

    PubMed Central

    Ioannou, George N.; Beste, Lauren A.; Chang, Michael F.; Green, Pamela K.; Lowy, Elliott; Tsui, Judith I.; Su, Feng; Berry, Kristin

    2017-01-01

    BACKGROUND & AIMS We investigated the real-world effectiveness of sofosbuvir, ledipasvir/sofosbuvir, and paritaprevir/ ritonavir/ombitasvir and dasabuvir (PrOD) in treatment of different subgroups of patients infected with hepatitis C virus (HCV) genotypes 1, 2, 3, or 4. METHODS We performed a retrospective analysis of data from 17,487 patients with HCV infection (13,974 with HCV genotype 1; 2131 with genotype 2; 1237 with genotype 3; and 135 with genotype 4) who began treatment with sofosbuvir (n = 2986), ledipasvir/sofosbuvir (n = 11,327), or PrOD (n = 3174), with or without ribavirin, from January 1, 2014 through June 20, 2015 in the Veterans Affairs health care system. Data through April 15, 2016 were analyzed to assess completion of treatments and sustained virologic response 12 weeks after treatment (SVR12). Mean age of patients was 61 ± 7 years, 97% were male, 52% were non-Hispanic white, 29% were non-Hispanic black, 32% had a diagnosis of cirrhosis (9.9% with decompensated cirrhosis), 36% had a Fibrosis-4 index score >3.25 (indicator of cirrhosis), and 29% had received prior antiviral treatment. RESULTS An SVR12 was achieved by 92.8% (95% confidence interval [CI], 92.3%–93.2%) of subjects with HCV genotype 1 infection (no significant difference between ledipasvir/sofosbuvir and PrOD regimens), 86.2% (95% CI, 84.6%–87.7%) of those with genotype 2 infection (treated with sofosbuvir and ribavirin), 74.8% (95% CI, 72.2%–77.3%) of those with genotype 3 infection (77.9% in patients given ledipasvir/sofosbuvir plus ribavirin, 87.0% in patients given sofosbuvir and pegylated-interferon plus ribavirin, and 70.6% of patients given sofosbuvir plus ribavirin), and 89.6% (95% CI 82.8%–93.9%) of those with genotype 4 infection. Among patients with cirrhosis, 90.6% of patients with HCV genotype 1, 77.3% with HCV genotype 2, 65.7% with HCV genotype 3, and 83.9% with HCV genotype 4 achieved an SVR12. Among previously treated patients, 92.6% with genotype 1; 80

  19. VA eScreening program: Technology to improve care for post-9/11 veterans.

    PubMed

    Pittman, James O E; Floto, Elizabeth; Lindamer, Laurie; Baker, Dewleen G; Lohr, James B; Afari, Niloofar

    2017-02-01

    The Veterans Health Administration (VHA) provides health care services to a growing number of veterans. There is ample support for the use of technology-based self-screening to support health care delivery. We developed the VA eScreening program for veterans to directly provide self-report mental and physical health information through a veteran-facing portal that communicates with the electronic medical records system. A total of 1,372 newly enrolling veterans in 2 cohorts participated in a study to assess veteran satisfaction, determine accessibility and clinical processes, measure screening differences, and examine connection to care between eScreening and paper screening. Veterans who completed eScreening were slightly more satisfied with screening than those who completed paper screening. Accessibility, rate of screening completion, and clinical processes were significantly better with eScreening than paper screening. Except for higher alcohol use in the paper-based cohort, veterans who completed paper and eScreening were similar in the rates of positive health screens. Connection to VA services, rate and speed of vesting in the health care system, and time to document required suicide risk assessments were better with the VA eScreening program than paper screening. The VA eScreening program is a unique and promising tool that may leverage limited resources to improve screening and care for veterans. (PsycINFO Database Record

  20. The Digital Identity of Student Affairs Professionals

    ERIC Educational Resources Information Center

    Ahlquist, Josie

    2016-01-01

    This chapter highlights opportunities in the digital space for student affairs professionals. A blended approach, grounded in the new technology competency recently added in the ACPA and NASPA student affairs professional competencies, is proposed for student affairs professionals' digital identity development. It includes the awareness of one's…

  1. Lower-limb amputation and effect of posttraumatic stress disorder on Department of Veterans Affairs outpatient cost trends.

    PubMed

    Bhatnagar, Vibha; Richard, Erin; Melcer, Ted; Walker, Jay; Galarneau, Michael

    2015-01-01

    Department of Veterans Affairs (VA) outpatient costs were analyzed for combat Veterans injured in Iraq and Afghanistan from 2001 to 2008. Patients had serious lower-limb injuries (n = 170) or unilateral (n = 460) or bilateral (n = 153) lower-limb amputation(s). Total costs over the follow-up period (2003 to 2012) and annual costs were analyzed. Unadjusted mean costs per year in 2012 U.S. dollars were $7,200, $14,700 and $18,700 for limb injuries and unilateral and bilateral lower-limb amputation(s), respectively (p < 0.001). Multivariate modeling indicated that annual cost declined after the first year in the VA for Veterans with limb injuries (p < 0.001, repeated measures). In contrast, annual costs doubled after 3-5 years with unilateral (p < 0.001) and bilateral amputation(s) (p < 0.001). Among amputees, prosthetics comprised more than 50% of outpatient cost; unadjusted mean cost per year for prosthetics was 7-9 times higher in comparison with Veterans with limb injuries. Amputation status was associated with an adjusted 3.12-fold increase in mean prosthetic cost per year (p < 0.001, generalized linear model). In addition, posttraumatic stress disorder (PTSD) was associated with increased prosthetic cost by amputation status (p < 0.001) and increased psychiatric and pharmacy costs (both p < 0.001). Results indicate relatively high and sustained outpatient costs driven by prosthetics following amputation. Finally, PTSD affected cost for multiple domains of health, highlighting the importance of accurate diagnosis, treatment, and support for PTSD.

  2. 77 FR 38179 - Autopsies at VA Expense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... clarifies that the authority to order an autopsy includes transporting the body at VA's expense to the place... dies while receiving fee-basis care under Sec. 17.52 and to pay the expense of transporting the body... substantive changes. We made a couple of nonsubstantive edits to proposed Sec. 17.170(a)(1). Effect...

  3. Conceptualizing and Categorizing Race and Ethnicity in Health Services Research

    PubMed Central

    Ford, Marvella E; Kelly, P Adam

    2005-01-01

    Objectives Veterans Affairs (VA) patient populations are becoming increasingly diverse in race and ethnicity. The purpose of this paper is to (1) document the importance of using consistent standards of conceptualizing and categorizing race and ethnicity in health services research, (2) provide an overview of different methods currently used to assess race and ethnicity in health services research, and (3) suggest assessment methods that could be incorporated into health services research to ensure accurate assessment of disease prevalence and incidence, as well as accounts of appropriate health services use, in patients with different racial and ethnic backgrounds. Design A critical review of published literature was used. Principal Findings Race is a complex, multidimensional construct. For some individuals, institutionalized racism and internalized racism are intertwined in the effects of race on health outcomes and health services use. Ethnicity is most commonly used as a social–political construct and includes shared origin, shared language, and shared cultural traditions. Acculturation appears to affect the strength of the relationships among ethnicity, health outcomes, and health services use. Conclusions Improved and consistent methods of data collection need to be developed for use by VA researchers across the country. VA research sites with patients representing specific population groups could use a core set of demographic items in addition to expanded modules designed to assess the ethnic diversity within these population groups. Improved and consistent methods of data collection could result in the collection of higher-quality data, which could lead to the identification of race- and ethnic-specific health services needs. These investigations could in turn lead to the development of interventions designed to reduce or eliminate these disparities. PMID:16179001

  4. Acquired Immune Deficiency Syndrome (AIDS) and the Veterans' Administration. Hearing before the Subcommittee on Hospitals and Health Care of the Committee on Veterans' Affairs. House of Representatives, One Hundredth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

    This document presents witness testimony and prepared statements from the Congressional hearing called to examine the issue of acquired immune deficiency syndrome (AIDS) and the role of the Veterans' Administration (VA) in combating AIDS. Opening statements are included from Representatives G. V. Montgomery, J. Roy Rowland, Joseph P. Kennedy, II,…

  5. Korean Affairs Report No. 308.

    DTIC Science & Technology

    1983-09-14

    Dropouts Can Enter Underenrolled Departments Editorial on Education System Change. FOREIGN RELATIONS Daily Editorial on President Chon’s ’Vision...than 521,000 million won from "old politicians," "minister and vice-ministers of the government," "high-ranking officials" and big entrepreneurs to...revision of the controversial college gradua- tion system, while the Foreign Affairs and Defense Committees are for the recent defection of a Chinese

  6. American Health Care Association

    MedlinePlus

    ... preferred... Read More Executive Director | Dogwood Village of Orange County US - VA - Orange, Executive Director Dogwood Village of Orange County Health and Rehabilitation and Senior Living, a ...

  7. 38 CFR 3.1700 - Types of VA burial benefits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Types of VA burial... ADJUDICATION Burial Benefits Burial Benefits: General § 3.1700 Types of VA burial benefits. Pt. 3, Subpt. B, Nt. (a) Burial benefits. VA provides the following types of burial benefits, which are discussed in §§...

  8. 12 CFR 3.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 1 2014-01-01 2014-01-01 false VaR-based measure. 3.205 Section 3.205 Banks...-Weighted Assets-Market Risk § 3.205 VaR-based measure. (a) General requirement. A national bank or Federal... VaR-based measure described in paragraph (c)(1) of this section)....

  9. 12 CFR 324.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false VaR-based measure. 324.205 Section 324.205... CAPITAL ADEQUACY OF FDIC-SUPERVISED INSTITUTIONS Risk-Weighted Assets-Market Risk § 324.205 VaR-based... VaR-based measure described in paragraph (c)(1) of this section)....

  10. Enhanced T-lymphocyte blastogenic response to tuberculin (PPD) in children of northeast (NE) Thailand supplemented with vitamin A (VA) and zinc (Zn)

    SciTech Connect

    Kramer, T.R.; Udomkesmalee, E.; Dhanamitta, S.; Sirisinha, S.; Charoenkiatkul, S.; Tantipopipat, S.; Banjong, O.; Rojroongwasinkul, N.; Smith, J.C. Jr. Mahidol Univ., Nakhon Pathom )

    1991-03-15

    Beneficial effects of Va and/or Zn supplementation of children in NE Thailand are described in a companion abstract. In the same study, blastogenic response (BR) of T-lymphocytes to concanavalin-A (ConA) and PPD were assayed in cultures containing mononuclear cells (MNC) or whole blood (WB). Methods were previously described. Children were previously vaccinated with BCG. BR to ConA of MNC or WB from children supplemented with VA, Zn, VA + Zn or placebo were similar. BR to PPD of MNC was higher in children receiving VA + Zn than placebo, but not in children supplemented with VA or Zn alone. Data indicate that children with suboptimal VA and Zn nutriture supplemented with < 2 times RDA of these nutrients showed enhanced cellular immunity to PPD. This observation is relevant to BCG immunization program and thus may benefit public health.

  11. Night and Day in the VA: Associations between Night Shift Staffing, Nurse Workforce Characteristics, and Length of Stay

    PubMed Central

    de Cordova, Pamela B.; Phibbs, Ciaran S.; Schmitt, Susan; Stone, Patricia W.

    2014-01-01

    In hospitals, nurses provide patient care around the clock, but the impact of night staff characteristics on patient outcomes is not well understood. The aim of this study was to examine the association between night nurse staffing and workforce characteristics and the length of stay (LOS) in 138 Veterans Affairs (VA) hospitals using panel data from 2002 through 2006. Staffing in hours per patient day was higher during the day than at night. The day nurse workforce had more educational preparation than the night workforce. Nurses’ years of experience at the unit, facility, and VA level were greater at night. In multivariate analyses controlling for confounding variables, higher night staffing and a higher skill mix were associated with reduced LOS. PMID:24403000

  12. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  13. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  14. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  15. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  16. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  17. How Do Healthcare Employees Rate the Ethics of Their Organization? An Analysis Based on VA IntegratedEthics@ Staff Survey Data.

    PubMed

    Cohen, Jennifer H; Foglia, Mary Beth; Kwong, Katherine; Pearlman, Robert; Fox, Ellen

    2015-01-01

    Healthcare organizations with an ethical culture experience higher levels of employee productivity, less staff turnover, better levels of patient safety, resource and cost savings, and higher levels of patient satisfaction. Employees' perceptions of the ethics of their organization are considered a good indicator of the ethics culture. How employees rate the ethics of their organization is not well understood. Previous research has identified a number of attributes that are salient to employees' perceptions in this area. However, little is known about how employees synthesize their perceptions of these attributes to rate the ethics of their organization. Without this knowledge, managers have little specific information to act on to improve practices that would in turn improve employees' perceptions of their organization's ethics. For this study, we used data from Department of Veterans Affairs' (VA) 2014 IntegratedEthics@ Staff Survey administered to Veterans Health Administration (VHA) staff. We used multivariate regression analyses to investigate how VHA employees weigh their perceptions of eight attributes of an ethical organization to inform an overall rating of the ethics of their organization. We found that employee perceptions of fairness, clarity of expectations, accountability, and leadership's prioritization of ethics had the strongest associations with the overall rating. In addition, employees disproportionately weighed their positive perceptions in determining their overall rating. Therefore, a strategy to improve employees' perceptions of these attributes could potentially have the greatest marginal return on investment with respect to improving employees' perceptions of the ethics of an organization.

  18. A Primary Care Perspective of Posttraumatic Stress Disorder for the Department of Veterans Affairs

    PubMed Central

    Ramaswamy, Sriram; Madaan, Vishal; Qadri, Faiz; Heaney, Christopher J.; North, Terry C.; Padala, Prasad R.; Sattar, Syed P.; Petty, Frederick

    2005-01-01

    Posttraumatic stress disorder (PTSD) is a major mental disorder associated with significant morbidity, psychosocial impairment, and disability. The diagnosis of PTSD can be missed in a primary care setting, as patients frequently present with somatic complaints or depression and are often reluctant to discuss their traumatic experiences. As recent studies of veterans returning from the Gulf War and the Iraqi War suggest high rates of PTSD, the U.S. Department of Veterans Affairs (VA) Hospitals are gearing up to face this challenge. It is important to screen these veterans for symptoms of PTSD and make an appropriate referral if required. In this article, we attempt to review PTSD with a special focus on the VA population. In addition to discussing the epidemiology, diagnosis, and treatment options for PTSD, we also suggest screening questions for both combat-related and military sexual trauma–related PTSD. PMID:16163401

  19. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    PubMed

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts.

  20. Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

    PubMed Central

    2012-01-01

    Background Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA) has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs). However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI) as a strategy to facilitate the adoption of collaborative-care management in CBOCs. Methods This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews. Results Adoption: 69.0% (58/84) of primary care providers referred patients to the program. Reach: 9.0% (298/3,296) of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. Fidelity: During baseline care manager encounters, education/activation was provided to 100% (298/298) of patients, barriers were assessed and addressed for 100% (298/298) of patients, and depression severity was monitored for 100% (298/298) of patients. Less than half (42.5%, 681/1603) of follow-up encounters during the acute stage were completed

  1. Revolution in nuclear detection affairs

    NASA Astrophysics Data System (ADS)

    Stern, Warren M.

    2014-05-01

    The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovative application of anomaly detection algorithms.

  2. Revolution in nuclear detection affairs

    SciTech Connect

    Stern, Warren M.

    2014-05-09

    The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovative application of anomaly detection algorithms.

  3. Geographic Variation in Rosiglitazone Use Surrounding FDA Warnings in the Department of Veterans Affairs

    PubMed Central

    Ahuja, Vishal; Sohn, Min-Woong; Birge, John R.; Syverson, Chad; Budiman-Mak, Elly; Emanuele, Nicholas; Cooper, Jennifer M.; Huang, Elbert S.

    2016-01-01

    BACKGROUND Geographic variation in the use of prescription drugs, particularly those deemed harmful by the FDA, may lead to variation in patient exposure to adverse drug events. One such drug is the glucose-lowering drug rosiglitazone, for which the FDA issued a safety alert on May 21, 2007, following the publication of a meta-analysis that suggested a 43% increase in the risk of myocardial infarction with the use of rosiglitazone. This alert was followed by a black box warning on August 14, 2007, that was updated 3 months later. While large declines have been documented in rosiglitazone use in clinical practice, little is known about how the use of rosiglitazone and other glucose-lowering drugs varied within the Department of Veterans Affairs (VA), surrounding the FDA alerts. Understanding this variation within integrated health care systems is essential to formulating policies that enhance patient protection and quality of care. OBJECTIVE To document variation in the use of rosiglitazone and other glucose-lowering drugs across 21 Veterans Integrated Service Networks (VISNs). METHODS We conducted a retrospective analysis of drug use patterns for all major diabetes drugs in a national cohort of 550,550 veterans with diabetes from 2003 to 2008. This included the time periods when rosiglitazone was added to (November 2003) and removed from (October 2007) the VA national formulary (VANF). We employed multivariable logistic regression models to statistically estimate the association between a patient’s location and the patient’s odds of using rosiglitazone. RESULTS Aggregate rosiglitazone use increased monotonically from 7.7%, in the quarter it was added to the VANF (November 4, 2003), to a peak of 15.3% in the quarter when the FDA issued the safety alert. Rosiglitazone use decreased sharply afterwards, reaching 3.4% by the end of the study period (September 30, 2008). The use of pioglitazone, another glucose-lowering drug in the same class as rosiglitazone, was

  4. Extracting Concepts Related to Homelessness from the Free Text of VA Electronic Medical Records.

    PubMed

    Gundlapalli, Adi V; Carter, Marjorie E; Divita, Guy; Shen, Shuying; Palmer, Miland; South, Brett; Durgahee, B S Begum; Redd, Andrew; Samore, Matthew

    2014-01-01

    Mining the free text of electronic medical records (EMR) using natural language processing (NLP) is an effective method of extracting information not always captured in administrative data. We sought to determine if concepts related to homelessness, a non-medical condition, were amenable to extraction from the EMR of Veterans Affairs (VA) medical records. As there were no off-the-shelf products, a lexicon of terms related to homelessness was created. A corpus of free text documents from outpatient encounters was reviewed to create the reference standard for NLP training and testing. V3NLP Framework was used to detect instances of lexical terms and was compared to the reference standard. With a positive predictive value of 77% for extracting relevant concepts, this study demonstrates the feasibility of extracting positively asserted concepts related to homelessness from the free text of medical records.

  5. InterVA versus Spectrum: how comparable are they in estimating AIDS mortality patterns in Nairobi's informal settlements?

    PubMed Central

    Oti, Samuel Oji; Wamukoya, Marilyn; Mahy, Mary; Kyobutungi, Catherine

    2013-01-01

    Background The Spectrum computer package is used to generate national AIDS mortality estimates in settings where vital registration systems are lacking. Similarly, InterVA-4 (the latest version of the InterVA programme) is used to estimate cause-of-mortality data in countries where cause-specific mortality data are not available. Objective This study aims to compare trends in adult AIDS-related mortality estimated by Spectrum with trends from the InterVA-4 programme applied to data from a Health and Demographic Surveillance System (HDSS) in Nairobi, Kenya. Design A Spectrum model was generated for the city of Nairobi based on HIV prevalence data for Nairobi and national antiretroviral therapy coverage, underlying mortality, and migration assumptions. We then used data, generated through verbal autopsies, on 1,799 deaths that occurred in the HDSS area from 2003 to 2010 among adults aged 15–59. These data were then entered into InterVA-4 to estimate causes of death using probabilistic modelling. Estimates of AIDS-related mortality rates and all-cause mortality rates from Spectrum and InterVA-4 were compared and presented as annualised trends. Results Spectrum estimated that HIV prevalence in Nairobi was 7%, while the HDSS site measured 12% in 2010. Despite this difference, Spectrum estimated higher levels of AIDS-related mortality. Between 2003 and 2010, the proportion of AIDS-related mortality in Nairobi decreased from 63 to 40% according to Spectrum and from 25 to 16% according to InterVA. The net AIDS-related mortality in Spectrum was closer to the combined mortality rates when AIDS and tuberculosis (TB) deaths were included for InterVA-4. Conclusion Overall trends in AIDS-related deaths from both methods were similar, although the values were closer when TB deaths were included in InterVA. InterVA-4 might not accurately differentiate between TB and AIDS deaths. PMID:24160914

  6. Military Construction, Military Quality of Life and Veterans Affairs: FY2007 Appropriations

    DTIC Science & Technology

    2007-03-06

    Order Code RL33427 Military Construction, Military Quality of Life and Veterans Affairs: FY2007 Appropriations Updated March 6, 2007 Daniel H. Else...Affairs Appropriations Area of Expertise Name Telephone E-Mail Acquisition Stephen H. Chadwick 7-8983 schadwick@crs.loc.gov Base Closure Daniel H...crs.loc.gov abelasco@crs.loc.gov Health Care; Military Richard A. Best, Jr. 7-7607 rbest@crs.loc.gov Military Construction Daniel H. Else 7-4996 delse

  7. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  8. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  9. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  10. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  11. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  12. Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

    ERIC Educational Resources Information Center

    Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea

    2012-01-01

    The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…

  13. Frequency of HIV Screening in the Veterans Health Administration: Implications for Early Diagnosis of HIV Infection

    ERIC Educational Resources Information Center

    Valdiserri, Ronald O.; Rodriguez, Fred; Holodniy, Mark

    2008-01-01

    We evaluated the frequency of HIV testing across the Department of Veterans Affairs (VA), the largest provider of HIV care in the United States. An electronic survey was used to determine the volume and location of HIV screening, confirmatory testing, rapid testing and laboratory consent policies in VA medical centers between October 1, 2005, and…

  14. Health Disparities Among Sexual Minority Women Veterans

    PubMed Central

    Foynes, Melissa Ming; Shipherd, Jillian C.

    2013-01-01

    Abstract Background Lesbian and bisexual (i.e., sexual minority) identity is more common among women veterans than among male veterans. Unique health issues have been identified among women veterans and among sexual minority women, but little is known about women who are both sexual minorities and veterans. This study aimed to compare demographic and health information from sexual minority women veterans with sexual minority women non-veterans and heterosexual women veterans. Methods Behavioral Risk Factor Surveillance Survey data were pooled from ten U.S. states that elected to ask sexual identity during 2010. The analytic sample was comprised of women who identified both their sexual identity and veteran status (n=1,908). Mental health indicators were frequent mental distress, sleep problems, low social/emotional support, and low satisfaction with life. Health risk indicators included current smoking, overweight, and obesity. Physical health status was defined by three components: disability requiring assistive equipment, >14 days of poor physical health in the past 30 days, and activity limitations. Results Compared with heterosexual women veterans, sexual minority women veterans had higher odds of mental distress (odds ratio [OR]=3.03, 95% confidence interval [CI]: 1.61–5.70) and smoking (OR=2.31, 95%CI: 1.19–4.48). After adjusting for demographic correlates, sexual minority women veterans had three times the odds of poor physical health (OR=3.01, 95%CI: 1.51–5.99) than their sexual minority non-veteran peers. Conclusions Results suggest sexual minority women veterans may experience unique health disparities relevant to provision of care in both Veterans Affairs (VA) and non-VA healthcare systems. Future research requires availability of data that include sexual minority status. PMID:23746281

  15. East Europe Report, Economic and Industrial Affairs

    DTIC Science & Technology

    2007-11-02

    22201. JPRS-EEI-84-095 20 August 19 84 EAST EUROPE REPORT ECONOMIC AND INDUSTRIAL AFFAIRS CONTENTS INTERNATIONAL AFPAIRS CEMA Conference Expresses...Soviet Idea of Integration (V. Meier; FRANKFURTER ALLGEMEINE, 16 Jul 84) 1 CEMA Cooperation in Machine Construction Reviewed (AUSSENWIRTSCHAFT...Viktor Meier; FRANKFURTER ALLGEMEINE, 17 Jul 84) 69 - b - INTERNATIONAL AFFAIRS CEMA CONFERENCE EXPRESSES SOVIET IDEA OF INTEGRATION

  16. East Europe Report, Economic and Industrial Affairs

    DTIC Science & Technology

    2007-11-02

    Europe Report ECONOMIC AND INDUSTRIAL AFFAIRS .one QOALST T^CTED a FBIS FOREIGN BROADCAST INFORMATION SERVICE REPRODUCED BY NATIONAL...REPORT ECONOMIC AND INDUSTRIAL AFFAIRS CONTENTS BULGARIA Foreign Trade Development in First Quarter of 1984 1 Minister Examines New Economic...Effect on Air Pollution 52 Electronic Industry Results Reviewed ’HOSPODARSKE NOVINY . 1 Tun 84) 5 8 Challenges of Environmental Protection

  17. Indigenous Affairs = Asuntos Indigenas, 1994-1995.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1995

    1995-01-01

    This document consists of the eight issues of the IWGIA newsletter "Indigenous Affairs" published during 1994-95. Each issue is published in separate English and Spanish versions. The newsletter is published by the International Work Group for Indigenous Affairs (IWGIA), an organization that supports indigenous peoples in their efforts…

  18. Does Student Affairs Have an Enduring Mission?

    ERIC Educational Resources Information Center

    Sandeen, Arthur

    2011-01-01

    Student affairs is a relatively new profession and has changed in significant ways in response to new developments in higher education, innovations in practice, new conceptual paradigms, and changing economic and political conditions. As a result there is much debate about the core mission and purpose of student affairs and whether it is possible…

  19. Putting the Focus on Current Affairs.

    ERIC Educational Resources Information Center

    Gibson, Susan

    1992-01-01

    Argues for increased attention to current events in social studies instruction. Suggests using mass media sources to supplement contemporary affairs teaching. Recommends that teachers create learning centers and display areas; encourage students to maintain current affairs folders, scrapbooks, journals, and learning logs; give current affairs…

  20. Challenges of Assessment in Student Affairs

    ERIC Educational Resources Information Center

    Blimling, Gregory S.

    2013-01-01

    This chapter focuses on how the climate of accountability in higher education is compelling student affairs organizations to develop comprehensive assessment programs, the challenges faced in creating those programs, and ways student affairs professionals can meet those challenges. For the purpose of this chapter, the author has defined assessment…

  1. Professional Competency Areas for Student Affairs Practitioners

    ERIC Educational Resources Information Center

    ACPA College Student Educators International, 2010

    2010-01-01

    This set of "Professional Competency Areas" is intended to define the broad professional knowledge, skills, and for some competencies, attitudes expected of student affairs professionals working in the U.S., regardless of their area of specialization or positional role within the field. All student affairs professionals should be able to…

  2. Professional Competencies for Student Affairs Practice

    ERIC Educational Resources Information Center

    Munsch, Patty; Cortez, Lori

    2014-01-01

    The purpose of this chapter is to explore the integration of the ACPA/NASPA Professional Competency Areas for Student Affairs Practitioners (ACPA/NASPA, 2010) on community college campuses. The competencies provide specific skill sets for a broad range of student affairs practice areas that should be met by professionals throughout their careers.…

  3. 12 CFR 217.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 2 2014-01-01 2014-01-01 false VaR-based measure. 217.205 Section 217.205... ADEQUACY OF BOARD-REGULATED INSTITUTIONS Risk-Weighted Assets-Market Risk § 217.205 VaR-based measure. (a... paragraph (c)(2) of this section based on the model used to calculate the VaR-based measure described...

  4. Veterans Affairs and Academic Medical Center Affiliations: The North Texas Experience

    ERIC Educational Resources Information Center

    Mohl, Paul Cecil; Hendrickse, William; Orsak, Catherine; Vermette, Heidi

    2009-01-01

    Objective: The authors review the more than 30-year history of the academic affiliation between the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas and the Mental Health Service at the Veterans Affairs North Texas Health Care System. Methods: The authors interviewed individuals involved at various stages…

  5. 76 FR 75509 - Autopsies at VA Expense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-02

    ... November 21, 2011, for publication. List of Subjects in 38 CFR Part 17 Administrative practice and...; Health records; Homeless; Mental health programs; Nursing homes; Philippines, Reporting and...

  6. Strategic plan for geriatrics and extended care in the veterans health administration: background, plan, and progress to date.

    PubMed

    Shay, Kenneth; Hyduke, Barbara; Burris, James F

    2013-04-01

    The leaders of Geriatrics and Extended Care (GEC) in the Veterans Health Administration (VHA) undertook a strategic planning process that led to approval in 2009 of a multidisciplinary, evidence-guided strategic plan. This article reviews the four goals contained in that plan and describes VHA's progress in addressing them. The goals included transforming the healthcare system to a veteran-centric approach, achieving universal access to a panel of services, ensuring that the Veterans Affair's (VA) healthcare workforce was adequately prepared to manage the needs of the growing elderly veteran population, and integrating continuous improvement into all care enhancements. There has been substantial progress in addressing all four goals. All VHA health care has undergone an extensive transformation to patient-centered care, has enriched the services it can offer caregivers of dependent veterans, and has instituted models to better integrate VA and non-VA cares and services. A range of successful models of geriatric care described in the professional literature has been adapted to VA environments to gauge suitability for broader implementation. An executive-level task force developed a three-pronged approach for enhancing the VA's geriatric workforce. The VHA's performance measurement approaches increasingly include incentives to enhance the quality of management of vulnerable elderly adults in primary care. The GEC strategic plan was intended to serve as a road map for keeping VHA aligned with an ambitious but important long-term vision for GEC services. Although no discrete set of resources was appropriated for fulfillment of the plan's recommendations, this initial report reflects substantial progress in addressing most of its goals.

  7. Managing Challenging Behaviors of Dementia in Veterans: Identifying and Changing Activators and Consequences Using STAR-VA.

    PubMed

    Curyto, Kim J; McCurry, Sue M; Luci, Katherine; Karlin, Bradley E; Teri, Linda; Karel, Michele J

    2017-02-01

    One of the most challenging clinical issues for long-term care staff is the management of dementia-related behavioral symptoms. STAR-VA is an interdisciplinary intervention for managing challenging behaviors of Veterans with dementia in Community Living Centers (CLCs) within the U.S. Department of Veterans Affairs. The goals of the current article are to delineate categories of challenging behaviors found in CLCs, the context in which behaviors occurred, and the interventions used by CLC clinical teams when implementing STAR-VA. In 2013, 17 CLC teams completed STAR-VA training, enrolling 71 Veteran participants. Four independent raters identified common assessment and intervention themes for six behavior categories, coding activators, consequences, goal behaviors, and care plans for each category. Successful care plans included staff changes in communication approaches, incorporation of pleasant events into care, and individualized environmental modifications. Findings illustrate the range of interventions that CLC teams may apply as a result of systematic behavioral assessment informing an understanding of activators and consequences of dementia-related behaviors. [Journal of Gerontological Nursing, 43(2), 33-43.].

  8. Evaluation of a Shared Decision-Making Intervention on the Utilization of Evidence-Based Psychotherapy in a VA Outpatient PTSD Clinic.

    PubMed

    Hessinger, Jonathan D; London, Melissa J; Baer, Sheila M

    2017-03-13

    The Veterans Health Administration (VHA) has continued to emphasize the availability, access, and utilization of high quality mental health care particularly in the treatment of posttraumatic stress disorder (PTSD). While dissemination and availability of evidence-based psychotherapies (EBPs) have only increased, treatment engagement and utilization have continued to be oft-noted challenges. Administrators, researchers, and individual clinicians have continued to develop and explore novel systemic and individualized interventions to address these issues. Pilot studies utilizing shared decision-making models to aid in veteran treatment selection have demonstrated the impact this approach may have on selection of and engagement in EBPs for PTSD. Based on these promising studies, a Department of Veterans Affairs (VA) outpatient PTSD clinic began to implement a shared-decision making intervention as part of a clinic redesign. In seeking to evaluate the impact of this intervention, archival clinical data from 1,056 veterans were reviewed by the authors for rates of treatment selection, EBP initiation, session attendance, and EBP completion. Time elapsed from consult until EBP initiation was also computed by the authors. These variables were then compared on the basis of whether the veteran received the shared-decision making intervention. Veterans who received the intervention were more likely to select and thus initiate an EBP for PTSD sooner than veterans who did not receive this intervention. Veterans, whether receiving the intervention or not, did not differ in therapy session attendance and completion. Implications of these findings and directions for future study are further discussed. (PsycINFO Database Record

  9. Clinical Practice Guideline Implementation Strategy Patterns in Veterans Affairs Primary Care Clinics

    PubMed Central

    Hysong, Sylvia J; Best, Richard G; Pugh, Jacqueline A

    2007-01-01

    Background The Department of Veterans Affairs (VA) mandated the system-wide implementation of clinical practice guidelines (CPGs) in the mid-1990s, arming all facilities with basic resources to facilitate implementation; despite this resource allocation, significant variability still exists across VA facilities in implementation success. Objective This study compares CPG implementation strategy patterns used by high and low performing primary care clinics in the VA. Research Design Descriptive, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low performance on six CPGs. Subjects One hundred and two employees (management, quality improvement, clinic personnel) involved with guideline implementation at each VAMC primary care clinic. Measures Participants reported specific strategies used by their facility to implement guidelines in 1-hour semi-structured interviews. Facilities were classified as high or low performers based on their guideline adherence scores calculated through independently conducted chart reviews. Findings High performing facilities (HPFs) (a) invested significantly in the implementation of the electronic medical record and locally adapting it to provider needs, (b) invested dedicated resources to guideline-related initiatives, and (c) exhibited a clear direction in their strategy choices. Low performing facilities exhibited (a) earlier stages of development for their electronic medical record, (b) reliance on preexisting resources for guideline implementation, with little local adaptation, and (c) no clear direction in their strategy choices. Conclusion A multifaceted, yet targeted, strategic approach to guideline implementation emphasizing dedicated resources and local adaptation may result in more successful implementation and higher guideline adherence than relying on standardized resources and taxing preexisting channels. PMID:17355583

  10. 76 FR 34576 - Amendment of Class E Airspace; Waynesboro, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... Airspace at Waynesboro, VA, to accommodate the additional airspace need for the Standard Instrument Approach Procedures developed for Eagle's Nest Airport. This action enhances the safety and management of... procedures developed at Eagle's Nest Airport, Waynesboro, VA. This action is necessary for the safety...

  11. 38 CFR 17.71 - Revocation of VA approval.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Revocation of VA approval... Community Residential Care § 17.71 Revocation of VA approval. (a) If a hearing official determines under... residential care facility and notify the community residential care facility of this revocation. (b)...

  12. 76 FR 52230 - Establishment of Class E Airspace; Forest, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; Forest, VA AGENCY... Airspace at Forest, VA, to accommodate the new Area Navigation (RNAV) Global Positioning System (GPS... published in the Federal Register a notice of proposed rulemaking to establish Class E airspace at...

  13. FACILITIES FOR EDUCATION IN VA HOSPITALS. FINAL REPORT.

    ERIC Educational Resources Information Center

    GREEN, ALAN C.; AND OTHERS

    THIS STUDY WAS AUTHORIZED BY THE VA DEPARTMENT OF MEDICINE AND SURGERY FOR THE PURPOSE OF IDENTIFYING AND DETERMINING THE FACILITIES NEEDED TO PROPERLY HOUSE AND SUPPORT EDUCATION ACTIVITIES IN EXISTING AND FUTURE VA HOSPITALS AND TO PRODUCE ARCHITECTURAL GUIDANCE IN THE DESIGN OF THE FACILITIES. CURRENT PRACTICES AND SIGNIFICANT TRENDS IN MEDICAL…

  14. 2014 - 2015 Civil Affairs Issue Papers: The Future of Civil Affairs

    DTIC Science & Technology

    2015-02-18

    the future of Civil Affairs includes some hopeful prospects thanks to practical steps recently taken.” All three panels agreed that in looking to...Guard and Reserve forces will continue into the future . This is at odds with the prior, strategic use of those forces, which historically expected...2014 - 2015 CIVIL AFFAIRS ISSUE PAPERS: THE FUTURE OF CIVIL AFFAIRS Edited by Christopher Holshek John C. Church, Jr.ISBN: 978-0-9861865-0-9 USAWC

  15. The APS in Public Affairs

    NASA Astrophysics Data System (ADS)

    Lustig, Harry

    2000-04-01

    Although the American Physical Society was created for the interchange of scientific ideas, the call to the founding meeting included the observation that the organization "could not fail to have an important influence in all matters affecting the interest of physicists". However for most of its history APS did not behave like "just another interest group in American society". Instead, at the beginning, it limited itself to such successful initiatives as the creation of the Bureau of Standards and such unsuccessful ones as adoption of the metric system. After World War II, speaking out on behalf of the freedom of science and scientists, such as Astin, Condon, and Oppenheimer, became important. In the 1970's, pushed by members, the Society became more "political", sponsoring sessions and studies on defense issues, taking a stand for the Equal Rights Amendment and creating the Panel on Public Affairs and the Forum on Physics and Society. Only in the last fifteen years has the APS unabashedly lobbied for the economic interests of physics and physicists. Adopting this new, if unavoidable role may have unintended consequences for the willingness and effectiveness of APS in speaking out on other public issues.

  16. Iraq and Afghanistan Veterans: National Findings from VA Residential Treatment Programs

    PubMed Central

    Cook, Joan M.; Dinnen, Stephanie; O’Donnell, Casey; Bernardy, Nancy; Rosenheck, Robert; Desai, Rani

    2013-01-01

    A quality improvement effort was undertaken in Department of Veterans Affairs’ (VA) residential treatment programs for Posttraumatic Stress Disorder (PTSD) across the United States. Qualitative interviews were conducted with over 250 directors, providers, and staff during site visits of 38 programs. The aims of this report are to describe clinical issues and distinctive challenges in working with veterans from Iraq and Afghanistan and approaches to addressing their needs. Providers indicated that the most commonly reported problems were: acute PTSD symptomotology; other complex mental health symptom presentations; broad readjustment problems; and difficulty with time demands of and readiness for intensive treatment. Additional concerns included working with active duty personnel and mixing different eras in therapy. Programmatic solutions address structure (e.g., blended versus era-specific therapy), content (e.g., physical activity), and adaptations (e.g., inclusion of family; shortened length of stay). Clinical implications for VA managers and policy makers as well as non-VA health care systems and individual health care providers are noted. PMID:23458113

  17. JPRS Report, Soviet Union, International Affairs

    DTIC Science & Technology

    2007-11-02

    This report covers 1)Worldwide Topics 2)East-West Relations 3)Socialist Community, CEMA 4)General Economic Affairs 5)West Europe 6)East Europe 7)Latin America 8)China, East Asia and 9)Near East and South Asia.

  18. Public affairs events at Ocean Sciences Meeting

    NASA Astrophysics Data System (ADS)

    Uhlenbrock, Kristan

    2012-02-01

    AGU public affairs will be cohosting two special events at Ocean Sciences 2012 that offer scientists opportunities to expand their communication, policy, and media experience. Join the conversations that highlight two important topics to connect science to society.

  19. USSR Report, Economic Affairs, No. 1037.

    DTIC Science & Technology

    1983-01-24

    This report from the USSR contains articles on Economic Affairs. The articles are PLANNING AND PLAN IMPLEMENTATION: Overall Approach to Solution of Planning, Incentive Problems Urged, and REGIONAL DEVELOPMENT : Union Republic Statistical Officials Quantify Progress.

  20. Teratology Public Affairs Committee position paper: maternal obesity and pregnancy.

    PubMed

    Scialli, Anthony R

    2006-02-01

    Compared to normal-weight women, obese women have an increased risk of infertility and pregnancy complications. The most consistently described pregnancy complications are hypertensive disorders, gestational diabetes mellitus, thromboembolic events, and cesarean section. Fetal and neonatal complications may include congenital malformations, macrosomia, and shoulder dystocia. The literature suggests that women with a body mass index (BMI) >or=30 have approximately double the risk of having a child with a neural tube defect (NTD) compared to normal-weight women, and the increased risk associated with higher maternal body weight does not appear to be modified by folic acid supplementation. The Public Affairs Committee of the Teratology Society supports the public health initiatives identified by the U.S. Food and Drug Administration in 2004 and the research initiatives identified by the National Institutes of Health in 2004. The Public Affairs Committee recommends that clinicians counsel women about appropriate caloric intake and exercise and that health-care providers educate parents about appropriate childhood nutrition. Breast-feeding should be encouraged based on evidence of a protective effect against childhood obesity, as well as other health advantages.

  1. Professionalism, Scholarly Practice, and Professional Development in Student Affairs

    ERIC Educational Resources Information Center

    Carpenter, Stan; Stimpson, Matthew T.

    2007-01-01

    This article presents a synthesis of recent literature on professionalism in student affairs. Attention is given to the nature of professionalism, a discussion of student affairs as a profession, the scholarly practice of student affairs, and professional development in student affairs. The authors note that an assumption of professionalism…

  2. China Report, Political, Sociological and Military Affairs

    DTIC Science & Technology

    2007-11-02

    AFFAIRS Xu Dixin on Population Control, Free Economy (Xu Dixin; SHIJIE JINGJI DAOBAO, 26 Nov 84) »o 11 Procuratorial Organs Praised for...NATIONAL AFFAIRS PROCURATORIAL ORGANS PRAISED FOR CORRECTING INJUSTICES Beijing ZHONGGUO FAZHI BAO in Chinese 19 Oct 84 p 1 [Article by Xu Sen [1776...2773]: " Procuratorial Organs Nationwide Handled 6 Million Cases in 6 Years"] [Text] In the past 6 years, procuratorial organs at all levels dealt

  3. Restructuring Civil Affairs for Persistent Engagement

    DTIC Science & Technology

    2010-04-29

    Simpson II U.S. Army School of Advanced Military Studies United States Army Command and General Staff College Fort Leavenworth, Kansas AY 2010...CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Major Samuel K. Simpson II, United States Army 5d. PROJECT NUMBER 5e...should increase and realign the force structure of the reserve and active components civil affairs; split the U.S. Army Civil Affairs and Psychological

  4. East Europe Report, Economic and Industrial Affairs

    DTIC Science & Technology

    2007-11-02

    180100 JPRS-EEl-84-053 8 May 1984 East Europe Report ECONOMIC AND INDUSTRIAL AFFAIRS Wfaaöcai üaitoüteö ^^mAUTTmmmcfmiis 19980729 050...Virginia 22201. JPRS-EEI-84-053 8 May 1984 EAST EUROPE REPORT ECONOMIC AND INDUSTRIAL AFFAIRS CONTENTS CZECHOSLOVAKIA Brigade Khozraschet, Team Work...SVET HOSPODARSTVI, 22 Sep 83) 15 GERMAN DEMOCRATIC REPUBLIC March 1984 EINHEIT: Technology’s Role in SED Economic Strategy (EINHEIT, No

  5. CE: Veteran Women: Mental Health-Related Consequences of Military Service.

    PubMed

    Ganzer, Christine Anne

    2016-11-01

    : The last two decades have seen increasing numbers of women entering all branches of the U.S. armed forces. Now that women in the military are no longer prohibited from holding direct combat positions, they are often exposed to traumatic events that place them at higher risk for mental health conditions. Nurses working within the Veterans Affairs (VA) system and those working in non-VA settings are likely to encounter female veterans. It's essential for all nurses to be knowledgeable about the mental health issues commonly seen in this population, and to understand the importance of screening, not only for mental health issues but also for physical conditions that may be related to service.Numerous studies have focused on the mental health effects of deployment among military men, but very few have been conducted among military women. To learn more, the literature was searched for relevant articles published between January 2005 and December 2015. The research supports the contention that both active-duty and veteran women are at increased risk for postdeployment mental health problems, including posttraumatic stress disorder, military sexual trauma, and suicide. This article discusses the relevant research; identifies gaps in the literature; and addresses the nursing practice implications, including screening.

  6. Changing Patterns of Glucose-Lowering Medication Use in VA Nursing Home Residents with Diabetes, 2005 – 2011

    PubMed Central

    Lee, Sei J.; Stijacic-Cenzer, Irena; Barnhart, Caroline; McClymont, Keelan; Steinman, Michael A

    2015-01-01

    Objective Although nursing home (NH) residents make up a large and growing proportion of Americans with diabetes mellitus, little is known about how glucose-lowering medications are used in this population. We sought to examine glucose-lowering medication use in Veterans Affairs (VA) NH residents with diabetes between 2005–2011. Research Design and Methods Retrospective cohort study, utilizing linked laboratory, pharmacy, administrative and NH Minimum Dataset (MDS) 2.0 databases in 123 VA NHs. A total of 9,431 long-stay (>90 days) VA NH residents over age 65 followed for 52,313 person-quarters. We identified receipt of glucose lowering medications including insulin, metformin, sulfonylureas, thiazolidinediones and others (alpha-glucosidase inhibitors, meglitinides, glucagon like peptide-1 analogs, dipeptidyl peptidase-4 inhibitors and amylin analogues) per quarter. Results The rates of sulfonylurea use in long-stay NH residents dropped dramatically from 24% in 2005 to 12% in 2011 (p<0.001), driven in large part by the dramatic decrease in glyburide use (10% to 2%, p<0.001). There was sharp drop in thiazolidinedione use in 2007 (4% to <1%, p<0.001). Metformin use was stable, ranging between 7% to 9% (p=0.24). Insulin use increased slightly from 30% to 32% (p<0.001). Use of other classes of glucose-lowering medications was stable (p=0.22) and low, remaining below 1.3%. Conclusions and Relevance Between 2005 and 2011, there were dramatic declines in use of sulfonylureas and thiazolidinediones in VA NH residents, suggesting that prescribing practices can be quickly changed in this setting. PMID:26272298

  7. 75 FR 73016 - Proposed Establishment of Class E Airspace; Kenbridge, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ... examined during normal business hours at the office of the Eastern Service Center, Federal Aviation... the Earth. * * * * * AEA VA E5 Kenbridge, VA Lunenburg County Airport, VA (Lat. 36 57'37'' N.,...

  8. Automated quality measurement in Department of the Veterans Affairs discharge instructions for patients with congestive heart failure.

    PubMed

    Garvin, Jennifer H; Elkin, Peter L; Shen, Shuying; Brown, Steven; Trusko, Brett; Wang, Enlai; Hoke, Linda; Quiaoit, Ylenia; Lajoie, Joan; Weiner, Mark G; Graham, Pauline; Speroff, Theodore

    2013-01-01

    Quality measurement is an important issue for the United States Department of Veterans Affairs (VA). In this study, we piloted the use of an informatics tool, the Multithreaded Clinical Vocabulary Server (MCVS), which extracted automatically whether the VA Office of Quality and Performance measures of quality of care were met for the completion of discharge instructions for inpatients with congestive heart failure. We used a single document, the discharge instructions, from one section of the medical records for 152 patients and developed a reference standard using two independent reviewers to assess performance. When evaluated against the reference standard, MCVS achieved a sensitivity of 0.87, a specificity of 0.86, and a positive predictive value of 0.90. The automated process using the discharge instruction document worked effectively. The use of the MCVS tool for concept-based indexing resulted in mostly accurate data capture regarding quality measurement, but improvements are needed to further increase the accuracy of data extraction.

  9. Telomere Length, Long-Term Black Carbon Exposure, and Cognitive Function in a Cohort of Older Men: The VA Normative Aging Study

    PubMed Central

    Colicino, Elena; Wilson, Ander; Frisardi, Maria Chiara; Prada, Diddier; Power, Melinda C.; Hoxha, Mirjam; Dioni, Laura; Spiro, Avron; Vokonas, Pantel S.; Weisskopf, Marc G.; Schwartz, Joel D.; Baccarelli, Andrea A.

    2016-01-01

    Background: Long-term air pollution exposure has been associated with age-related cognitive impairment, possibly because of enhanced inflammation. Leukocytes with longer telomere length (TL) are more responsive to inflammatory stimuli, yet TL has not been evaluated in relation to air pollution and cognition. Objectives: We assessed whether TL modifies the association of 1-year exposure to black carbon (BC), a marker of traffic-related air pollution, with cognitive function in older men, and we examined whether this modification is independent of age and of C-reactive protein (CRP), a marker of inflammation. Methods: Between 1999 and 2007, we conducted 1–3 cognitive examinations of 428 older men in the Veterans Affairs (VA) Normative Aging Study. We used covariate-adjusted repeated-measure logistic regression to estimate associations of 1-year BC exposure with relative odds of being a low scorer (≤ 25) on the Mini-Mental State Examination (MMSE), which is a proxy of poor cognition. Confounders included age, CRP, and lifestyle and sociodemographic factors. Results: Each doubling in BC level was associated with 1.57 (95% CI: 1.20, 2.05) times higher odds of low MMSE scores. The BC-MMSE association was greater only among individuals with longer blood TL (5th quintile) (OR = 3.23; 95% CI: 1.37, 7.59; p = 0.04 for BC-by-TL-interaction). TL and CRP were associated neither with each other nor with MMSE. However, CRP modified the BC-MMSE relationship, with stronger associations only at higher CRP (5th quintile) and reference TL level (1st quintile) (OR = 2.68; 95% CI: 1.06, 6.79; p = 0.04 for BC-by-CRP-interaction). Conclusions: TL and CRP levels may help predict the impact of BC exposure on cognitive function in older men. Citation: Colicino E, Wilson A, Frisardi MC, Prada D, Power MC, Hoxha M, Dioni L, Spiro A III, Vokonas PS, Weisskopf MG, Schwartz JD, Baccarelli AA. 2017. Telomere length, long-term black carbon exposure, and cognitive function in a cohort of older

  10. Treating age-related macular degeneration: comparing the use of two drugs among medicare and veterans affairs populations.

    PubMed

    Pershing, Suzann; Pal Chee, Christine; Asch, Steven M; Baker, Laurence C; Boothroyd, Derek; Wagner, Todd H; Bundorf, M Kate

    2015-02-01

    While new biologics have revolutionized the treatment of age-related macular degeneration-the leading cause of severe vision loss among older adults-these new drugs have also raised concerns over the economic impact of medical innovation. The two leading agents are similar in effectiveness but vary greatly in price-up to $2,000 per injection for ranibizumab compared to $50 for bevacizumab. We examined the diffusion of these drugs in fee-for-service Medicare and Veterans Affairs (VA) systems during 2005-11, in part to assess the impact that differing financial incentives had on prescribing. Physicians treating Medicare patients have a direct financial incentive to prescribe the more expensive agent (ranibizumab), while VA physicians do not. Medicare injections of the more expensive ranibizumab peaked in 2007 at 47 percent. Beginning in 2009 the less expensive bevacizumab became the predominant therapy for Medicare patients, accounting for more than 60 percent of injections. For VA patients, the distribution of injections across the two drugs was relatively equal, particularly from 2009 to 2011. Our analysis indicates that there are opportunities in both the VA and Medicare to adopt more value-conscious treatment patterns and that multiple mechanisms exist to influence utilization.

  11. Addressing the Health Concerns of VA Women with Sexual Trauma

    DTIC Science & Technology

    2015-10-01

    high school boys Role Co-I NIDA R34DA038770-01A1 (Zlotnick) 4/01/2015-3/31/2018 2.04 calendar Computer-Based Intervention for Battered...School Boys 1U01CE002531-01 (Orchowski: PI) 9/1/14 – 8/31/18 4.56 CM National Center for Injury Prevention and Control Preventing sexual...aggression among high school boys Role: PI Community-Level Primary Prevention of Dating and Sexual Violence in Middle Schools 1U01CE002651-01

  12. Common Mental Health Issues

    ERIC Educational Resources Information Center

    Stock, Susan R.; Levine, Heidi

    2016-01-01

    This chapter provides an overview of common student mental health issues and approaches for student affairs practitioners who are working with students with mental illness, and ways to support the overall mental health of students on campus.

  13. BRCA testing within the Department of Veterans Affairs: concordance with clinical practice guidelines.

    PubMed

    Chun, Danielle S; Berse, Brygida; Venne, Vickie L; DuVall, Scott L; Filipski, Kelly K; Kelley, Michael J; Meyer, Laurence J; Icardi, Michael S; Lynch, Julie A

    2017-01-01

    Guideline-concordant cancer care is a priority within the Department of Veterans Affairs (VA). In 2009, the VA expanded its capacity to treat breast cancer patients within VA medical centers (VAMCs). We sought to determine whether male and female Veterans diagnosed with breast cancer received BRCA testing as recommended by the National Comprehensive Cancer Network (NCCN) guidelines on Genetic/Familial High-Risk Assessment in Breast and Ovarian Cancer (v. 1.2010-1.2012). Using the 2011-2012 VA Central Cancer Registry and BRCA test orders from Myriad Genetics, we conducted a retrospective study. The outcome variable was a recommendation for genetic counseling or BRCA testing, determined by chart review. Independent variables expected to predict testing included region, site of care, and patient characteristics. We performed descriptive analysis of all patients and conducted multivariable logistic regression on patients who sought care at VAMCs that offered BRCA testing. Of the 462 Veterans who met NCCN testing criteria, 126 (27 %) received guideline-concordant care, either a referral for counseling or actual testing. No BRCA testing was recommended in 49 (50 %) VAMCs that provide cancer treatment. Surprisingly, patients with second primary breast cancer were less likely to be referred/tested (OR 0.39; CI 0.17, 0.89; p = 0.025). For patients under age 51, a yearly increase in age decreased likelihood of referral or testing (OR 0.85; CI 0.76, 0.94; p < 0.001). There were no differences in testing by race. In conclusion, there was significant underutilization and lack of access to BRCA testing for Veterans diagnosed with breast cancer. Our research suggests the need for clinical decision support tools to facilitate delivery of guideline-concordant cancer care and improve Veteran access to BRCA testing.

  14. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... of a Skilled and Intermediate Nursing Home Care Facility in Mather, CA AGENCY: Department of Veterans... permanent long-term care facility (skilled nursing home and assisted living services); provide...

  15. 76 FR 72047 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... of a Parking Structure, Professional Medical Office Structure, a Hotel and General Use Retail Space... building, a hotel, and general use retail space. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office...

  16. The Gendered Nature of Student Affairs: Issues of Gender Equity in Student Affairs Professional Associations

    ERIC Educational Resources Information Center

    Ashley, Evelyn LaVette

    2010-01-01

    This study examined the gendered nature of the student affairs profession by investigating how three student affairs professional associations, the National Association of Student Personnel Administrators (NASPA), ACPA: College Student Educators International, and the Association of College and University Housing Officers International (ACUHO-I)…

  17. Putting Descartes before the Horse: Opportunities for Advancing the Student Affairs Link with Academic Affairs.

    ERIC Educational Resources Information Center

    Lamarid, Lucas

    1999-01-01

    Article challenges the division between student and academic affairs and encourages a view of learning and reason in a more holistic and integrated fashion. Outlines the historical factors for the separation of student and academic affairs and offers the programs instituted at Bellarmine College as examples of effective collaboration between…

  18. Academic Affairs and Student Affairs Partnerships Promoting Diversity Initiatives on Campus: A Grounded Theory

    ERIC Educational Resources Information Center

    LePeau, Lucy Anne

    2012-01-01

    Higher education research suggests student affairs and academic affairs partner to address challenges on campus, such as building inclusive environments for diverse students and staff, but evidence about "how" partnerships form is lacking in the literature. The purpose of this constructivist grounded theory was to understand…

  19. Preparing for Fiscal Leadership in Student Affairs: The Senior Student Affairs Officer Voice

    ERIC Educational Resources Information Center

    Stewart, Stephanie C.; Williams, Terry E.

    2010-01-01

    Success within today's challenging economic environment mandates that senior student affairs officers in higher education possess a sophisticated financial and budgetary skill set. Limited research addresses avenues through which professionals might best acquire the financial acumen needed. To address this gap, 19 senior student affairs officers…

  20. Student Affairs and Academic Affairs Collaborations in the Community College Setting

    ERIC Educational Resources Information Center

    Gulley, Needham Yancey; Mullendore, Richard H.

    2014-01-01

    The relationship between academic affairs and student affairs units in higher education settings has traditionally and historically been troubled by the divergent understandings of each other's institutional role and the systematic division of labor between the two. However, for a variety of reasons, not the least of which is a desire to…

  1. 30 CFR 57.22222 - Ventilation materials (I-A, I-B, I-C, II-A, III, V-A, and V-B mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Ventilation materials (I-A, I-B, I-C, II-A, III, V-A, and V-B mines). 57.22222 Section 57.22222 Mineral Resources MINE SAFETY AND HEALTH....22222 Ventilation materials (I-A, I-B, I-C, II-A, III, V-A, and V-B mines). Brattice cloth...

  2. 30 CFR 57.22222 - Ventilation materials (I-A, I-B, I-C, II-A, III, V-A, and V-B mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Ventilation materials (I-A, I-B, I-C, II-A, III, V-A, and V-B mines). 57.22222 Section 57.22222 Mineral Resources MINE SAFETY AND HEALTH....22222 Ventilation materials (I-A, I-B, I-C, II-A, III, V-A, and V-B mines). Brattice cloth...

  3. 30 CFR 57.22220 - Air passing unsealed areas (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Air passing unsealed areas (I-A, II-A, III, and V-A mines). 57.22220 Section 57.22220 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... passing unsealed areas (I-A, II-A, III, and V-A mines). Air that has passed by or through...

  4. Mental Health Concerns: Veterans & Active Duty

    MedlinePlus

    ... through My Health e Vet , the VA’s online personal health record. This site for veterans, active duty ... their families provides access to health records, a personal health journal, online VA prescription refill information and ...

  5. [Social change and Pharmaceutical Affairs Law (PAL)].

    PubMed

    Masuyama, Koichi; Isobe, Soichiro

    2010-01-01

    Former Japanese pharmaceutical laws, originally based on the Pharmaceutical Marketing and Handling Regulations enacted in 1874 were in operation for many years before World War II. However, in order to address several drug issues, such as poor drug quality and insufficiences regarding the role of pharmacists during the War, the laws needed to be unified and revised. In this paper, we analyzed the record of discussions held by the Imperial Diet on the bill for the Pharmaceutical Affairs Law (PAL) in 1943. This is also regarded as the origin of the current PAL (LawNo.145 in 1960). Through this analysis, we tried to clarify the relationship between the social change and the role of PAL in society. During the War, the bill was discussed, aiming at the improvement of both human resources who treated drugs, and the quality of drug materials. Diet members discussed three main points, namely, "the duty of pharmacists", "the mission of the Japan Pharmaceutical Association" and "the quality control of pharmaceutical products". Notably, the bill pharmacists are required not only to dispense drugs, a role they had previously, but also to manage drug and food hygiene through the quality control of pharmaceutical products and the inspection of food and drink, in order to improve the public health in Japan. Originally, the law was passed to deal with the extraordinary circumstances during the War, but through our analysis, we found that they proactively improved the role of the law to comply with various drug issues raised during the War, the rapid change of the pharmaceutical hygiene concept and the social transformation.

  6. House Committee on Veterans' Affairs

    MedlinePlus

    ... access quality health care close to home. Next s… Facebook Updates United States Military Connect with Us Sign ... Office: (202) 225-3527 Fax: (202) 225-5486 Facebook Twitter Instagram Youtube Minority Contact Back to top

  7. Alcohol consumption and health status in very old veterans.

    PubMed

    Denneson, Lauren M; Lasarev, Michael R; Dickinson, Kathryn C; Dobscha, Steven K

    2011-03-01

    Previous research has linked drinking with health, but has yet to address alcohol consumption and the relationship between drinking and health among very old veterans. To help fill this gap, the authors present a cross-sectional self-report study on 1105 veterans age 90 and older who completed the national Veteran's Affairs (VA) Survey of the Health Experiences of Patients (SHEP) for fiscal year (FY) 2005. Alcohol consumption was measured using Alcohol Use Disorders Identification Test scores (AUDIT-C). Health status was measured using the Veterans Rand Health Survey: VR-12. Among men (n = 1063), 60% were abstainers. No significant differences in mental health component (MCS; F(3,1040) = 1.80, P = .15) or physical health component (PCS; F(3,1040) = 1.48, P = .22) scores were detected across consumption categories. Among women (n = 42), 47% were abstainers. These results suggest many very old veterans abstain from alcohol and, among men, the associations between health status and drinking observed in younger groups may not be present in very old age.

  8. RadNet Air Data From Virginia Beach, VA

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Virginia Beach, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  9. 75 FR 76279 - Drawbridge Operation Regulation; James River, Hopewell, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... the SR 156 Benjamin Harrison Memorial Bridge, across the James River, mile 65.0, at Hopewell, VA. The... the closed to navigation position the SR 156 Benjamin Harrison Memorial Bridge across the James...

  10. 76 FR 43575 - Amendment of Class E Airspace; Staunton, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-21

    ... 30320; telephone (404) 305-6364. SUPPLEMENTARY INFORMATION: History On March 18, 2011, the FAA published... areas extending upward from 700 feet or more above the surface of the earth. * * * * * AEA VA...

  11. Exploration Day at Busch Gardens, Williamsburg, Va. - Aug. 5, 2011

    NASA Video Gallery

    Friday, August 8, was NASA Days at Busch Gardens Williamsburg, Va. NASA exhibits and educational specialists worked to inspire young and old, and NASA astronaut Susan Kilrain -- a veteran of two Sp...

  12. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-08

    ... technological information from political or commercial influence; Prohibit suppression or alteration of... ``inappropriate influence.'' The definition of ``inappropriate influence'' should be more explicit. VA Response... analyses will be protected from political and commercial influence. The term ``inappropriate...

  13. VA Is Here for the People Who Support Our Veterans

    MedlinePlus

    ... on track. Calls can be referred to local Suicide Prevention Coordinators and other VA providers who specialize in issues such as: Post-traumatic stress (PTS/PTSD) Traumatic brain injury (TBI) Military sexual ...

  14. VA INFORMATION TECHNOLOGY: Important Initiatives Begun, Yet Serious Vulnerabilities Persist

    DTIC Science & Technology

    2007-11-02

    Technology Management Issues United States General Accounting Office GAO Testimony Before the Subcommittee on Oversight and Investigations, Committee on...VA INFORMATION TECHNOLOGY Important Initiatives Begun, Yet Serious Vulnerabilities Persist Statement of David L. McClure Director, Information

  15. 75 FR 35511 - Virginia Disaster Number VA-00028

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster Number VA-00028 AGENCY: Small Business Administration. ACTION: Amendment 3..., is hereby amended to include the following areas as adversely affected by the disaster....

  16. RadNet Air Data From Harrisonburg, VA

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Harrisonburg, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  17. RadNet Air Data From Richmond, VA

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Richmond, VA from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  18. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... (Authority: 38 U.S.C. 1725) Note to § 17.1000: In cases where a patient is admitted for inpatient care, health care providers furnishing emergency treatment who believe they may have a basis for filing a claim....1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment...

  19. The Establishment of Minority Affairs Offices in Schools of Dentistry: Pros and Cons.

    ERIC Educational Resources Information Center

    Ballard, Billy R.

    2003-01-01

    Discusses the establishment of Minority Affairs Offices in dental schools, which follow the American Association of Medical Colleges' model as one method of addressing the declining enrollment and compounding oral health disparities of underrepresented minorities--African Americans, Hispanics, and Native Americans. (EV)

  20. The Veterans Affairs National Quality Scholars program: a model for interprofessional education in quality and safety.

    PubMed

    Patrician, Patricia A; Dolansky, Mary A; Pair, Vincent; Bates, Mekeshia; Moore, Shirley M; Splaine, Mark; Gilman, Stuart C

    2013-01-01

    The Quality and Safety Education for Nurses (QSEN) project is enhancing the emphasis on quality care and patient safety content in nursing schools. A partnership between QSEN and the Veterans Affairs National Quality Scholars program resulted in a unique experiential, interdisciplinary fellowship for both nurses and physicians. This article introduces the Veterans Affairs National Quality Scholars program and provides examples of learning activities and fellows' accomplishments. Interprofessional quality and safety education at the doctoral and postdoctoral levels is germane to improving the quality of health care.