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Sample records for affairs va patients

  1. 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

    ... Management and Budget (OMB) (54 FR 25818), as amended by OMB Circular A-130, 65 FR 77677 (2000). A copy of...--VA, published in the Federal Register at 74 FR 29275 (June 19, 2009), and last amended at 75 FR... AFFAIRS Computer Matching Program Between the Department of Veterans Affairs (VA) and the Department...

  2. 38 CFR 58.15 - VA Form 10-0143-Department of Veterans Affairs Certification Regarding Drug-Free Workplace...

    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 10-0143-Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals. 58.15 Section 58.15 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.15 VA Form...

  3. 38 CFR 58.15 - VA Form 10-0143-Department of Veterans Affairs Certification Regarding Drug-Free Workplace...

    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 10-0143-Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals. 58.15 Section 58.15 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.15 VA Form...

  4. 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

    ... of Space for Community Services and Parking in Memphis, TN AGENCY: Department of Veterans Affairs... 0.4-acre parcel at the Memphis VA Medical Center campus in Tennessee. As consideration for the...

  5. 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

    ... 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 Development... Vermont Avenue NW., Washington, DC 20420, (202) 461-7778 (this is not a toll-free number)....

  6. 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

    ... 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 Development...., Washington, DC 20420, (202) 461-7778 (this is not a toll-free number). SUPPLEMENTARY INFORMATION: Title 38...

  7. Release of information from Department of Veterans Affairs records--VA. Proposed rule.

    PubMed

    1998-09-10

    This document proposes to amend Department of Veterans Affairs (VA) regulations governing the confidentiality and release of VA records subject to the Privacy Act, the Freedom of Information Act (FOIA) (including the Electronic Freedom of Information Act Amendments of 1996), and the veterans' records confidentiality statute. The proposed rule sets forth a mechanism for the public to obtain information from the VA. The proposed rule is intended to maximize public availability of VA records to the extent permitted by law and considerations such a personal privacy or law enforcement. Essentially these provisions consist of restatements of statute, interpretations of statute, interpretations of case law, interpretations of Executive Orders, and clarification. The proposed amendments also would implement the Electronic Freedom of Information Act Amendments of 1996, court decisions and Executive Branch guidance issued since the regulations were originally published. Further, this document proposes to delegate authority to the Assistant General Counsel for Professional Staff Group IV for making final Departmental decisions on appeals under the Freedom of Information Act, the Privacy Act, and 38 U.S.C. 5701 and 5705. This would simplify decision making by allowing the highest level individual with direct responsibility for decision making to issue decisions. PMID:10182831

  8. U.S. Dept. Veterans Affairs (VA) SMEC-bio Reporting for Leadership Decision Support

    PubMed Central

    Gamage, Shantini D.; Simbartl, Loretta A.; Kralovic, Stephen M.; Wallace, Katherine S.; Roselle, Gary A.

    2013-01-01

    Objective To assess Reports sent from the United States VA Subject Matter Expertise Center for Biological Events (SMEC-bio) – a proof-of-concept decision support initiative – to the VA Integrated Operations Center (VA IOC). Introduction VA is the U.S. federal agency responsible for providing services to America’s Veterans. Within VA, VHA is the organization responsible for administration of health care services. VHA, with 152 Medical Centers and over 900 outpatient clinics located throughout the U.S. and territories, provided care to over 5 million patients in 2011. After the 2009 H1N1 influenza pandemic, OSP, which oversees VA senior level briefing of preparedness issues, conceptualized and initiated SMEC-bio as a protocol-based mechanism to incorporate timely VHA subject matter expertise into leadership decision making via the VA IOC. Previous work has examined collection and integration of data from VA and interagency sources for trend and predictive analyses (1). This current work is an initial assessment of SMEC-bio reporting, which has been in development for the past year and functions on an ad hoc basis for decision support; needs and gaps can be assessed toward a formalized communication plan with the VA IOC. Methods In May, 2011, SMEC-bio designed a Report template. All SMEC-bio Reports submitted to the VA IOC using the template were assessed based on reason for the Report, timing, data sources used, and outcome. A gap analysis was conducted to identify areas for further improvement. Results Eight SMEC-bio Reports were produced since the template was initiated in May, 2011. The reasons for reporting fell into the following categories: 1) briefings of interagency protocol activations [e.g. National Biosurveillance Integration System (NBIS) protocol]; 2) Requests for Information (RFIs) from the VA IOC regarding specific biological events (e.g. 2012 H3N2v influenza associated with swine at fairs); 3) RFIs from the VA IOC on general infectious diseases

  9. 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...

  10. 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...

  11. 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...

  12. 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

    ... of a Transitional Housing Facility on a 1-Acre Parcel at the George E. Wahlen VA Medical Center (VAMC... of land at the George E. Wahlen VAMC in Salt Lake City, Utah. The selected lessee will finance...), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (202) 461-7778 (this is not...

  13. 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.

  14. 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

    ... INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044C), Department of Veterans... lease if he determines that implementation of a business plan proposed by the Under Secretary for Health... Connecticut Healthcare System, Newington Campus AGENCY: Department of Veterans Affairs. ACTION: Notice...

  15. Considering the issue of dual use in veterans affairs patients: implications & opportunities for improved communication & counseling.

    PubMed

    Howren, M Bryant; Cozad, Ashley J; Kaboli, Peter J

    2015-01-01

    This study sought to ascertain perceptions of communication responsibility in veterans identified as using more than one health care system, otherwise known as dual users. Three hundred and fifteen veterans identified as dual users completed a telephone-based survey including questions about their perspectives regarding communication in the context of dual use. Nearly half (47.3%) indicated that that they believed it was primarily their responsibility to either directly communicate or facilitate communication between their Veterans Affairs (VA) and non-VA providers. Only 11.3% reported that it should be the responsibility of their VA provider, 19.6% believed that their non-VA provider should be responsible, and 7.3% believed both should be involved. Finally, 14.4% believed another person was responsible, such as a system administrator or patient representative. Of those patients indicating that it was their responsibility, a majority (61.7%) indicated that they preferred active involvement in their health care. Patient-centered care allows patients the opportunity to help facilitate communication between multiple health care systems, such as when using VA and non-VA providers, if they so choose. However, given that patient preferences for involvement vary considerably, it is likely that a multifaceted approach to this problem is necessary, involving patients, providers, and other system-level stakeholders. These data suggest a need to inquire about preferred patient roles and counsel patients regarding methods of communication that may serve to decrease fragmentation of care. PMID:25010429

  16. The VA's use of DICOM to integrate image data seamlessly into the online patient record.

    PubMed Central

    Kuzmak, P. M.; Dayhoff, R. E.

    1999-01-01

    The US 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 radiology images and store them directly into the online patient record. Images can then be displayed on low-cost clinician's workstations throughout the medical center. High-resolution diagnostic quality multi-monitor VistA workstations with specialized viewing software can be used for reading radiology images. Various image and study specific items from the DICOM data object are essential for the correct display of images. The VA's DICOM capabilities are now used to interface seven different commercial Picture Archiving and Communication Systems (PACS) and over twenty different radiology image acquisition modalities. PMID:10566327

  17. 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…

  18. Veterans Affairs Health System and Mental Health Treatment Retention among Patients with Serious Mental Illness: Evaluating Accessibility and Availability Barriers

    PubMed Central

    McCarthy, John F; Blow, Frederic C; Valenstein, Marcia; Fischer, Ellen P; Owen, Richard R; Barry, Kristen L; Hudson, Teresa J; Ignacio, Rosalinda V

    2007-01-01

    Objective We examine the impact of two dimensions of access—geographic accessibility and availability—on VA health system and mental health treatment retention among patients with serious mental illness (SMI). Methods Among 156,631 patients in the Veterans Affairs (VA) health care system with schizophrenia or bipolar disorder in fiscal year 1998 (FY98), we used Cox proportional hazards regression to model time to first 12-month gap in health system utilization, and in mental health services utilization, by the end of FY02. Geographic accessibility was operationalized as straight-line distance to nearest VA service site or VA psychiatric service site, respectively. Service availability was assessed using county-level VA hospital beds and non-VA beds per 1,000 county residents. Patients who died without a prior gap in care were censored. Results There were 32, 943 patients (21 percent) with a 12-month gap in health system utilization; 65,386 (42 percent) had a 12-month gap in mental health services utilization. Gaps in VA health system utilization were more likely if patients were younger, nonwhite, unmarried, homeless, nonservice-connected, if they had bipolar disorder, less medical morbidity, an inpatient stay in FY98, or if they lived farther from care or in a county with fewer VA inpatient beds. Similar relationships were observed for mental health, however being older, female, and having greater morbidity were associated with increased risks of gaps, and number of VA beds was not significant. Conclusions Geographic accessibility and resource availability measures were associated with long-term continuity of care among patients with SMI. Increased distance from providers was associated with greater risks of 12-month gaps in health system and mental health services utilization. Lower VA inpatient bed availability was associated with increased risks of gaps in health system utilization. Study findings may inform efforts to improve treatment retention. PMID

  19. 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.

  20. 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

  1. Multimorbidity and healthcare utilisation among high-cost patients in the US Veterans Affairs Health Care System

    PubMed Central

    Zulman, Donna M; Pal Chee, Christine; Wagner, Todd H; Yoon, Jean; Cohen, Danielle M; Holmes, Tyson H; Ritchie, Christine; Asch, Steven M

    2015-01-01

    Objectives To investigate the relationship between multimorbidity and healthcare utilisation patterns among the highest cost patients in a large, integrated healthcare system. Design In this retrospective cross-sectional study of all patients in the U.S. Veterans Affairs (VA) Health Care System, we aggregated costs of individuals’ outpatient and inpatient care, pharmacy services and VA-sponsored contract care received in 2010. We assessed chronic condition prevalence, multimorbidity as measured by comorbidity count, and multisystem multimorbidity (number of body systems affected by chronic conditions) among the 5% highest cost patients. Using multivariate regression, we examined the association between multimorbidity and healthcare utilisation and costs, adjusting for age, sex, race/ethnicity, marital status, homelessness and health insurance status. Setting USA VA Health Care System. Participants 5.2 million VA patients. Measures Annual total costs; absolute and share of costs generated through outpatient, inpatient, pharmacy and VA-sponsored contract care; number of visits to primary, specialty and mental healthcare; number of emergency department visits and hospitalisations. Results The 5% highest cost patients (n=261 699) accounted for 47% of total VA costs. Approximately two-thirds of these patients had chronic conditions affecting ≥3 body systems. Patients with cancer and schizophrenia were less likely to have documented comorbid conditions than other high-cost patients. Multimorbidity was generally associated with greater outpatient and inpatient utilisation. However, increased multisystem multimorbidity was associated with a higher outpatient share of total costs (1.6 percentage points per affected body system, p<0.01) but a lower inpatient share of total costs (−0.6 percentage points per affected body system, p<0.01). Conclusions Multisystem multimorbidity is common among high-cost VA patients. While some patients might benefit from disease

  2. Integrating patient voices into health information for self-care and patient-clinician partnerships: Veterans Affairs design recommendations for patient-generated data applications.

    PubMed

    Woods, Susan S; Evans, Neil C; Frisbee, Kathleen L

    2016-05-01

    Electronic health record content is created by clinicians and is driven largely by intermittent and brief encounters with patients. Collecting data directly from patients in the form of patient-generated data (PGD) provides an unprecedented opportunity to capture personal, contextual patient information that can supplement clinical data and enhance patients' self-care. The US Department of Veterans Affairs (VA) is striving to implement the enterprise-wide capability to collect and use PGD in order to partner with patients in their care, improve the patient healthcare experience, and promote shared decision making. Through knowledge gained from Veterans' and healthcare teams' perspectives, VA created a taxonomy and an evolving framework on which to design and develop applications that capture and help physicians utilize PGD. Ten recommendations for effectively collecting and integrating PGD into patient care are discussed, addressing health system culture, data value, architecture, policy, data standards, clinical workflow, data visualization, and analytics and population reach. PMID:26911810

  3. 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…

  4. Effect of Health-Related Quality of Life on Women and Men’s Veterans Affairs (VA) Health Care Utilization and Mortality

    PubMed Central

    Murdoch, Maureen

    2007-01-01

    Introduction Although women will account for almost 11% of veterans by 2040, we know little about their health and functioning, particularly compared to men. Objective To compare women and men veterans’ health-related quality of life (HRQOL) and VA health care utilization and to see if previously described associations between HRQOL, subsequent VA health care utilization, and mortality in male veterans would generalize to women veterans. Methods Prospective cohort study of all veterans who received medical care from an Upper Midwest Veterans Affairs facility between 10/1/96 and 3/31/98 and returned a mailed questionnaire. Results Women’s effective survey response rate was 52% (n = 1,500); men’s, 58% (n = 35,000). In the following year, 9% of women and 12% of men had at least one hospitalization. One percent of women and 3% of men died in the post-survey year. After adjustment, women’s HRQOL was higher than men’s; for every 10-point decrement in overall physical or mental functioning, women and men had similarly increased risk/odds of subsequently dying, being hospitalized at a VA facility, or making a VA outpatient stop. Among younger women and women who received VA care outside of the Twin City metro area, poorer overall mental or physical health functioning was associated with fewer primary care stops; among their male counterparts, it was associated with more primary care stops. Conclusion Compared to men, women veterans receiving VA health care in the upper Midwest catchment area had better HRQOL and used fewer health services. Although VA health care utilization was similar across gender after adjusting for HRQOL, poorer mental or physical health was associated with fewer primary care stops for selected subgroups of women. PMID:17610020

  5. VA Student Financial Aid: Management Actions Needed to Reduce Overlap in Approving Education and Training Programs and to Assess State Approving Agencies. Report to the Ranking Minority Member, Committee on Veterans' Affairs, U.S. Senate. GAO-07-384

    ERIC Educational Resources Information Center

    Scott, George A.

    2007-01-01

    Since the 1940s, the Department of Veterans Affairs (VA) and its predecessor agencies have contracted with state approving agencies (SAA) to assess whether schools and training programs offer education of sufficient quality for veterans to receive VA education assistance benefits. SAAs are created or designated by state governments but are…

  6. Multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak and its control after use of the Veterans Affairs (VA) MRSA bundle in a VA long-term care facility, 2004-2014.

    PubMed

    Webb, Risa M; Denton, Carmelita; Spruill, Emily; Henson, Gay; Bruce, Lisa; Woods, Gail L; Swiatlo, Andrea; Walker, Erica D; Peel, Chere; Sullivan, Donna

    2016-06-01

    A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak with 91 infections occurred in our Veterans Affairs (VA) community living center over 46 months. Both similar and unique strains were shown by repetitive polymerase chain reaction to contribute to the outbreak, including 1 strain causing infections over a 33-month period. Most infections were soft tissue infections (67%). For 21 months after the initiation of the VA MRSA bundle, no infections were identified, and low rates of infection have been sustained an additional 4 years. The average annual rate of MRSA infection decreased by 62% (P < .001) from 0.6 per 1,000 resident days for 4 years prior to the bundle implementation to 0.09 per 1,000 resident days for 4 years after the bundle implementation. PMID:26922103

  7. 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

    ... education benefit payments under the Post-9/11 GI Bill. These benefit records are contained in a VA system... Rehabilitation and Employment Records--VA, first published in the Federal Register at 74 FR 9294 (March 3, 1976), and last amended at 74 FR 29275 (June 19, 2009), with other amendments as cited therein. DATES:...

  8. 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

    ... supportive services program. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202)...

  9. 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

    ...-site supportive services. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202)...

  10. 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

    ...-term self-sufficiency. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202)...

  11. 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

    ... construct, renovate, operate, and maintain a permanent housing facility; provide preference and priority... of a Permanent Housing Facility in Menlo Park, CA AGENCY: Department of Veterans Affairs. ACTION... Menlo Park, California. The selected lessee will finance, design, develop, construct, manage,...

  12. 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

    ..., renovate, operate and maintain a permanent housing facility and provide preference and priority placement... of a Permanent Housing Facility in Northampton, MA AGENCY: Department of Veterans Affairs. ACTION... Northampton, Massachusetts. The selected lessee will finance, design, develop, construct, manage, maintain...

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

    PubMed

    2012-03-01

    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. PMID:22420057

  14. Use of RxNorm to exchange codified drug allergy information between Department of Veterans Affairs (VA) and Department of Defense (DoD).

    PubMed

    Warnekar, Pradnya P; Bouhaddou, Omar; Parrish, Fola; Do, Nhan; Kilbourne, John; Brown, Steven H; Lincoln, Michael J

    2007-01-01

    Under a congressional mandate, VA and DoD have built a framework to exchange standardized, codified patient drug allergy information through a mediation terminology. Initially, the Unified Medical Language System (UMLS) was deemed to be the most appropriate translator. After both agency files were mapped to UMLS, DoD could understand 45 percent of VA's mapped terms and VA could understand 26 percent of DoD's mapped terms. A significant portion of the non-mediated information was brand names in DoD with generic counterparts in VA. Recently, a Consolidated Health Informatics (CHI) group designated RxNorm as the standard for trade name allergies. An analysis was conducted to estimate mediation improvement using RxNorm. Both agency files were re-mapped to RxNorm. By utilizing the RxNorm defined relationships between brand names and generics and between variants of therapeutic moieties , DoD will understand 74 percent of VA terms and VA will understand 58 percent of DoD terms. PMID:18693943

  15. Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments.

    PubMed

    Vigil, Jacob M; Coulombe, Patrick; Alcock, Joe; Kruger, Eric; Stith, Sarah S; Strenth, Chance; Parshall, Mark; Cichowski, Sara B

    2016-04-01

    Ethnic minority patients receive lower priority triage assignments in Veteran's Affairs (VA) emergency departments (EDs) compared to White patients, but it is currently unknown whether this disparity arises from generalized biases across the triage assessment process or from differences in how objective and/or subjective institution-level or person-level information is incorporated into the triage assessment process, thus contributing to disparate treatment.The VA database of electronic medical records of patients who presented to the VA ED from 2008 to 2012 was used to measure patient ethnicity, self-reported pain intensity (PI) levels, heart rate (HR), respiratory rate (RR), and nurse-provided triage assignment, the Emergency Severity Index (ESI) score. Multilevel, random effects linear modeling was used to control for demographic and clinical characteristics of patients as well as age, gender, and experience of triage nurses.A total of 359,642 patient/provider encounters between 129,991 VA patients and 774 nurses were included in the study. Patients were 61% non-Hispanic White [NHW], 28% African-American, 7% Hispanic, 2% Asian-American, <1% American Indian/Alaska Native, and 1% mixed ethnicity. After controlling for demographic characteristics of nurses and patients, African-American, Hispanic, and mixed-ethnicity patients reported higher average PI scores but lower HRs and RRs than NHW patients. NHW patients received higher priority ESI ratings with lower PI when compared against African-American patients. NHW patients with low to moderate HRs also received higher priority ESI scoring than African-American, Hispanic, Asian-American, and Mixed-ethnicity patients; however, when HR was high NHWs received lower priority ESI ratings than each of the minority groups (except for African-Americans).This study provides evidence for systemic differences in how patients' vital signs are applied for determining ESI scores for different ethnic groups. Additional

  16. Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments

    PubMed Central

    Vigil, Jacob M.; Coulombe, Patrick; Alcock, Joe; Kruger, Eric; Stith, Sarah S.; Strenth, Chance; Parshall, Mark; Cichowski, Sara B.

    2016-01-01

    Abstract Ethnic minority patients receive lower priority triage assignments in Veteran's Affairs (VA) emergency departments (EDs) compared to White patients, but it is currently unknown whether this disparity arises from generalized biases across the triage assessment process or from differences in how objective and/or subjective institution-level or person-level information is incorporated into the triage assessment process, thus contributing to disparate treatment. The VA database of electronic medical records of patients who presented to the VA ED from 2008 to 2012 was used to measure patient ethnicity, self-reported pain intensity (PI) levels, heart rate (HR), respiratory rate (RR), and nurse-provided triage assignment, the Emergency Severity Index (ESI) score. Multilevel, random effects linear modeling was used to control for demographic and clinical characteristics of patients as well as age, gender, and experience of triage nurses. A total of 359,642 patient/provider encounters between 129,991 VA patients and 774 nurses were included in the study. Patients were 61% non-Hispanic White [NHW], 28% African-American, 7% Hispanic, 2% Asian-American, <1% American Indian/Alaska Native, and 1% mixed ethnicity. After controlling for demographic characteristics of nurses and patients, African-American, Hispanic, and mixed-ethnicity patients reported higher average PI scores but lower HRs and RRs than NHW patients. NHW patients received higher priority ESI ratings with lower PI when compared against African-American patients. NHW patients with low to moderate HRs also received higher priority ESI scoring than African-American, Hispanic, Asian-American, and Mixed-ethnicity patients; however, when HR was high NHWs received lower priority ESI ratings than each of the minority groups (except for African-Americans). This study provides evidence for systemic differences in how patients’ vital signs are applied for determining ESI scores for different ethnic groups

  17. 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

    ...The Secretary of VA intends to enter into an EUL of the 1889 Soldiers Home Chapel (Building 12), the 1901 Chaplain's Quarters (Building 16), and the surrounding approximately 2.5 acres at the Clement J. Zablocki VAMC in Milwaukee, Wisconsin. The selected Lessee will finance, design, develop, construct, manage, maintain, and operate the Soldiers Home Chapel and Chaplain's......

  18. 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 construct, renovate, operate and maintain a senior housing facility; provide preference and priority... of a Senior Housing Facility in Kerrville, TX AGENCY: Department of Veterans Affairs. ACTION:...

  19. 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 construct, operate, and maintain a permanent housing facility; provide preference and priority placement for... of a Permanent Housing Facility in Bedford, MA AGENCY: Department of Veterans Affairs. ACTION:...

  20. 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 required to construct, renovate, operate and maintain an assisted living facility; provide preference and... of an Assisted Living Facility in Newington, CT AGENCY: Department of Veterans Affairs....

  1. 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, operate and maintain a permanent supportive housing facility with priority placement for homeless... of Permanent Supportive Housing Facility in St. Cloud, MN AGENCY: Department of Veterans Affairs... System in Minnesota. The selected lessee will finance, design, develop, construct, manage, maintain...

  2. 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 construct, renovate, operate, and maintain a permanent housing facility; provide preference and priority... of a Permanent Housing Facility in Vancouver, WA AGENCY: Department of Veterans Affairs....

  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 construct, renovate, operate, and maintain a transitional housing facility; provide preference and priority... of a Transitional Housing Facility in Pineville, LA AGENCY: Department of Veterans Affairs....

  4. 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 construct, renovate, operate, and maintain a permanent housing facility; provide preference and priority... of a Permanent Housing Facility in Fort Harrison, MT AGENCY: Department of Veterans Affairs....

  5. 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 Transitional and Permanent Housing Facility in Bath, NY AGENCY: Department of Veterans Affairs..., renovate, manage, operate and maintain the EUL development. As consideration for the lease, the lessee will be required to construct, renovate, operate, and maintain a transitional and permanent...

  6. 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 required to construct, renovate, operate, and maintain a permanent housing facility, provide preference and... of a Permanent Housing Facility in Brockton, MA AGENCY: Department of Veterans Affairs....

  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

    ..., operate and maintain a permanent housing facility and provide preference and priority placement for... of a Permanent Housing Facility in Hines, IL AGENCY: Department of Veterans Affairs. ACTION: Notice..., Illinois. The selected lessee will finance, design, develop, construct, manage, maintain and operate...

  8. Assessing the effects of the Medicare Prospective Payment System on the demand for VA inpatient services: an examination of transfers and discharges of problem patients.

    PubMed

    Hurley, J; Linz, D; Swint, E

    1990-04-01

    An examination of patient data from three medical districts that vary in urban/rural composition and in their proportion of proprietary hospitals was undertaken to determine if high-cost patients whose illnesses place them in "problem" DRGs (diagnosis-related groups identified as "problems" through interviews with private hospital administrators and from information published by the Wisconsin Hospital Association) are being shifted from non-Department of Veterans Affairs (non-VA) hospitals to VA hospitals. Two outcome measures were employed to detect shifting: patient transfers between non-VA and VA hospitals and discharges of veterans in a sample of DRGs identified as unprofitable by private hospitals. A comparison of patient transfers for fiscal year 1982 and fiscal year 1984 (pre- and post-DRG implementation) revealed substantial increases in the number of transfers, but there appeared to be no concentration of transfers in particular DRGs. An examination of discharges for FY 1982 and FY 1984 within 21 problem DRGs showed average increases ranging from 27 percent to 41 percent among patients aged 65 years or older. A comparison of discharges within a sample of 21 randomly selected DRGs showed either no increase or small decreases in discharges from FY 1982 to FY 1984. The possibility is discussed that some of the cost reductions (or slowing of the rise in costs) attributed to the prospective payment system are merely phantom savings. Hospitals may simply be shifting costs from Medicare to the VA system. PMID:2109742

  9. Suicide Among Patients in the Veterans Affairs Health System: Rural–Urban Differences in Rates, Risks, and Methods

    PubMed Central

    Blow, Frederic C.; Ignacio, Rosalinda V.; Ilgen, Mark A.; Austin, Karen L.; Valenstein, Marcia

    2012-01-01

    Objectives. Using national patient cohorts, we assessed rural–urban differences in suicide rates, risks, and methods in veterans. Methods. We identified all Department of Veterans Affairs (VA) patients in fiscal years 2003 to 2004 (FY03–04) alive at the start of FY04 (n = 5 447 257) and all patients in FY06–07 alive at the start of FY07 (n = 5 709 077). Mortality (FY04–05 and FY07–08) was assessed from National Death Index searches. Census criteria defined rurality. We used proportional hazards regressions to calculate rural–urban differences in risks, controlling for age, gender, psychiatric diagnoses, VA mental health services accessibility, and regional administrative network. Suicide method was categorized as firearms, poisoning, strangulation, or other. Results. Rural patients had higher suicide rates (38.8 vs 31.4/100 000 person-years in FY04–05; 39.6 vs 32.4/100 000 in FY07–08). Rural residence was associated with greater suicide risks (20% greater, FY04–05; 22% greater, FY07–08). Firearm deaths were more common in rural suicides (76.8% vs 61.5% in FY07–08). Conclusions. Rural residence is a suicide risk factor, even after controlling for mental health accessibility. Public health and health system suicide prevention should address risks in rural areas. PMID:22390583

  10. 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

    ...), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email nancy.kessinger@va.gov... AFFAIRS Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA... (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on...

  11. 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…

  12. 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

    ... supportive services program. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202)...

  13. Performance of a Natural Language Processing (NLP) Tool to Extract Pulmonary Function Test (PFT) Reports from Structured and Semistructured Veteran Affairs (VA) Data

    PubMed Central

    Sauer, Brian C.; Jones, Barbara E.; Globe, Gary; Leng, Jianwei; Lu, Chao-Chin; He, Tao; Teng, Chia-Chen; Sullivan, Patrick; Zeng, Qing

    2016-01-01

    Introduction/Objective: Pulmonary function tests (PFTs) are objective estimates of lung function, but are not reliably stored within the Veteran Health Affairs data systems as structured data. The aim of this study was to validate the natural language processing (NLP) tool we developed—which extracts spirometric values and responses to bronchodilator administration—against expert review, and to estimate the number of additional spirometric tests identified beyond the structured data. Methods: All patients at seven Veteran Affairs Medical Centers with a diagnostic code for asthma Jan 1, 2006–Dec 31, 2012 were included. Evidence of spirometry with a bronchodilator challenge (BDC) was extracted from structured data as well as clinical documents. NLP’s performance was compared against a human reference standard using a random sample of 1,001 documents. Results: In the validation set NLP demonstrated a precision of 98.9 percent (95 percent confidence intervals (CI): 93.9 percent, 99.7 percent), recall of 97.8 percent (95 percent CI: 92.2 percent, 99.7 percent), and an F-measure of 98.3 percent for the forced vital capacity pre- and post pairs and precision of 100 percent (95 percent CI: 96.6 percent, 100 percent), recall of 100 percent (95 percent CI: 96.6 percent, 100 percent), and an F-measure of 100 percent for the forced expiratory volume in one second pre- and post pairs for bronchodilator administration. Application of the NLP increased the proportion identified with complete bronchodilator challenge by 25 percent. Discussion/Conclusion: This technology can improve identification of PFTs for epidemiologic research. Caution must be taken in assuming that a single domain of clinical data can completely capture the scope of a disease, treatment, or clinical test. PMID:27376095

  14. 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

    ....kessinger@va.gov . Please refer to ``OMB Control No. 2900-0474'' in any correspondence. During the comment... AFFAIRS Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA... (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on...

  15. 75 FR 61252 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-04

    ....kessinger@va.gov . Please refer to ``OMB Control No. 2900-0474'' in any correspondence. During the comment... AFFAIRS Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA... (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on...

  16. 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:

  17. 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

    ... INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of Veterans... lease if he determines that implementation of a business plan proposed by the Under Secretary for Health... the VA Central Iowa Healthcare System. The selected lessee will finance, design, develop,...

  18. The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program.

    PubMed Central

    Khuri, S F; Daley, J; Henderson, W; Hur, K; Demakis, J; Aust, J B; Chong, V; Fabri, P J; Gibbs, J O; Grover, F; Hammermeister, K; Irvin, G; McDonald, G; Passaro, E; Phillips, L; Scamman, F; Spencer, J; Stremple, J F

    1998-01-01

    OBJECTIVE: To provide reliable risk-adjusted morbidity and mortality rates after major surgery to the 123 Veterans Affairs Medical Centers (VAMCs) performing major surgery, and to use risk-adjusted outcomes in the monitoring and improvement of the quality of surgical care to all veterans. SUMMARY BACKGROUND DATA: Outcome-based comparative measures of the quality of surgical care among surgical services and surgical subspecialties have been elusive. METHODS: This study included prospective assessment of presurgical risk factors, process of care during surgery, and outcomes 30 days after surgery on veterans undergoing major surgery in 123 medical centers; development of multivariable risk-adjustment models; identification of high and low outlier facilities by observed-to-expected outcome ratios; and generation of annual reports of comparative outcomes to all surgical services in the Veterans Health Administration (VHA). RESULTS: The National VA Surgical Quality Improvement Program (NSQIP) data base includes 417,944 major surgical procedures performed between October 1, 1991, and September 30, 1997. In FY97, 11 VAMCs were low outliers for risk-adjusted observed-to-expected mortality ratios; 13 VAMCs were high outliers for risk-adjusted observed-to-expected mortality ratios. Identification of high and low outliers by unadjusted mortality rates would have ascribed an outlier status incorrectly to 25 of 39 hospitals, an error rate of 64%. Since 1994, the 30-day mortality and morbidity rates for major surgery have fallen 9% and 30%, respectively. CONCLUSIONS: Reliable, valid information on patient presurgical risk factors, process of care during surgery, and 30-day morbidity and mortality rates is available for all major surgical procedures in the 123 VAMCs performing surgery in the VHA. With this information, the VHA has established the first prospective outcome-based program for comparative assessment and enhancement of the quality of surgical care among multiple

  19. Pharmaceutical services in the Department of Veterans Affairs.

    PubMed

    Ogden, J E; Muniz, A; Patterson, A A; Ramirez, D J; Kizer, K W

    1997-04-01

    The status of pharmaceutical services in the Department of Veterans Affairs (VA) is described. The VA health care system is transforming itself from a hospital-based organization into 22 health care networks that emphasize primary and ambulatory care. The impact on VA pharmacy has been substantial. Roles of VA pharmacists and technicians have been enhanced, and a clinical career ladder for pharmacists was created. VA pharmacy officials and leaders from the University of Tennessee College of Pharmacy have been partnering since 1988 in strategic planning to determine how VA pharmacy can do business and serve patients better. Areas targeted for implementation or improvement include staff development, prescribing authority for pharmacists, automation, the physical design of VA pharmacies, residency programs, and a pharmacy benefit management (PBM) product line. The VA PBM is working to enhance the appropriate use of pharmaceuticals in the veteran population, reduce overall health care expenditures, and provide a more consistent quality of care. Specific PBM programs involve the implementation of drug treatment guidelines, a national formulary, and national contracts. There are plans for pharmacoepidemiologic and pharmacoeconomic research in the geriatric veteran population. The VA health care system and its pharmacy service are changing in ways intended to bring about easier access to care, higher quality, and increased responsiveness to patients' needs. PMID:9099341

  20. Hemodynamic disturbances and VA/Q matching in hypoxemic cirrhotic patients.

    PubMed

    Castaing, Y; Manier, G

    1989-11-01

    Arterial oxygen desaturation is commonly found in patients with cirrhosis of the liver, but severe hypoxemia is unusual. To investigate the mechanism of the impairment in gas exchange, six severely hypoxemic (mean PaO2, 55.9 +/- 5.9 mm Hg) cirrhotic patients (five confirmed by biopsy), without pulmonary or cardiovascular disease and in the absence of acute hepatic disease, were submitted to right heart catheterization. Inequalities of VA/Q were estimated in the respiratory steady state using the multiple inert gas technique. The mean pulmonary arterial pressure was low (7.2 +/- 2.3 mm Hg) and the cardiac output high (Q = 11.0 +/- 2.06 L/min), indicating a low PVR. The VA/Q mismatching of the ventilated and perfused units ranged from mild to moderate, but a large percentage of Q flowed through unventilated areas. Furthermore, there was a significant difference between predicted and measured PaO2 (9.27 +/- 5.9 mm Hg; p less than 0.01), which was attributed to either an unmeasured postpulmonary shunt (between portal and pulmonary vein) or a diffusion defect. The impairment in gas exchange in these patients is thus due primarily to an intrapulmonary, and possibly extrapulmonary, shunt. This was thought to be due mainly to an impaired regulatory mechanism of the microcirculation by the hepatic dysfunction. PMID:2805838

  1. 75 FR 16912 - Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... AFFAIRS Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request... measure patients' satisfaction with VA's dental services. DATES: Written comments and recommendations on..., Dental Patient Satisfaction Survey, VA Form 10-0503. OMB Control Number: 2900-New (VA Form 10-0503)....

  2. 78 FR 79563 - Proposed Information Collection (VA MATIC Authorization); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ...), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email nancy.kessinger@va.gov... AFFAIRS Proposed Information Collection (VA MATIC Authorization); Comment Request AGENCY: Veterans... Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on...

  3. 78 FR 29436 - Proposed Information Collection (HUD/VA Addendum to Uniform Residential Loan Application...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-20

    ...), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email nancy.kessinger@va.gov... AFFAIRS Proposed Information Collection (HUD/VA Addendum to Uniform Residential Loan Application) Activity.... SUMMARY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing...

  4. 77 FR 56711 - Proposed Information Collection (VA MATIC Enrollment/Change); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email nancy.kessinger@va.gov . Please refer to... AFFAIRS Proposed Information Collection (VA MATIC Enrollment/Change); Comment Request AGENCY: Veterans... Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on...

  5. Relationship Quality and Patient-Assessed Quality of Care in VA Primary Care Clinics: Development and Validation of the Work Relationships Scale

    PubMed Central

    Finley, Erin P.; Pugh, Jacqueline A.; Lanham, Holly Jordan; Leykum, Luci K.; Cornell, John; Veerapaneni, Poornachand; Parchman, Michael L.

    2013-01-01

    PURPOSE Efforts to better understand the impact of clinic member relationships on care quality in primary care clinics have been limited by the absence of a validated instrument to assess these relationships. The purpose of this study was to develop and validate a scale assessing relationships within primary care clinics. METHODS The Work Relationships Scale (WRS) was developed and administered as part of a survey of learning and relationships among 17 Department of Veterans Affairs (VA) primary care clinics. A Rasch partial-credit model and principal components analysis were used to evaluate item performance, select the final items for inclusion, and establish unidimensionality for the WRS. The WRS was then validated against semistructured clinic member interviews and VA Survey of Healthcare Experiences of Patients (SHEP) data. RESULTS Four hundred fifty-seven clinicians and staff completed the clinic survey, and 247 participated in semistructured interviews. WRS scores were significantly associated with clinic-level reporting for 2 SHEP variables: overall rating of personal doctor/nurse (r2 =0.43, P <.01) and overall rating of health care (r2= 0.25, P <.05). Interview data describing relationship characteristics were consistent with variability in WRS scores across low-scoring and high-scoring clinics. CONCLUSIONS The WRS shows promising validity as a measure assessing the quality of relationships in primary care settings; moreover, primary care clinics with lower WRS scores received poorer patient quality ratings for both individual clinicians and overall health care. Relationships play an important role in shaping care delivery and should be assessed as part of efforts to improve patient care within primary care settings. PMID:24218378

  6. Surgery for constipation in patients with prior spinal cord injury: The Department of Veterans Affairs experience

    PubMed Central

    West, Jason R.; Mohiuddin, Shoeb A.; Hand, William R.; Grossmann, Erik M.; Virgo, Katherine S.; Johnson, Frank E.

    2013-01-01

    Objective Patients with spinal cord injury (SCI) typically have difficulty with constipation. Some undergo surgery for bowel management. We predicted that SCI patients would have higher mortality and/or morbidity rates following such surgery than neurally intact patients receiving the same procedures. We sought to evaluate this using a large population-based data set. Methods Patients receiving care at Department of Veterans Affairs Medical Centers (DVAMCs) with computer codes for SCI and constipation who later underwent colectomy, colostomy, or ileostomy during fiscal years 1993–2002 were identified. Charts were requested from the VAMCs where the surgery had been performed and a retrospective chart review of these charts was done. We collected data on patient demographics, six specific pre-operative co-morbidities, surgical complications, and post-operative mortality. Comparisons were made to current literature evaluating a population receiving total abdominal colectomy and ileorectal anastomosis for constipation but not selected for SCI. Results Of 299 patients identified by computer search, 43 (14%) had codes for SCI and 10 of 43 (24%) met our inclusion criteria. All were symptomatic and had received appropriate medical management. Co-morbid conditions were present in 9 of 10 patients (90%). There were no deaths within 30 days. The complication rate was zero. The mean post-operative length of stay was 17 days. Conclusions Patients with SCI comprise about 14% of the population who receive surgery for severe constipation in the Department of Veterans Affairs system. The mortality and morbidity rates in these patients are similar to those reported in other constipated patients who have surgery for intractable constipation. Our data suggest that stoma formation ± bowel resection in patients with SCI is a safe and effective treatment for chronic constipation. PMID:23809590

  7. 77 FR 39346 - Proposed Information Collection (Statement of Accredited Representative in Appealed Case, VA Form...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email Sue.Hamlin@mail.va.gov . Please refer to... AFFAIRS Proposed Information Collection (Statement of Accredited Representative in Appealed Case, VA Form... Affairs. ACTION: Notice. SUMMARY: The Board of Veterans' Appeals (BVA), Department of Veterans Affairs...

  8. 78 FR 53195 - Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... AFFAIRS Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request... patient satisfaction with VA's dental services. DATES: Written comments and recommendations on the... refer to ``OMB Control No. 2900-0764 (Dental Patient Satisfaction Survey)'' in any...

  9. 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

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

    PubMed

    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. 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.

  12. 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…

  13. Partnering With VA Stakeholders to Develop a Comprehensive Patient Safety Data Display: Lessons Learned From the Field.

    PubMed

    Chen, Qi; Shin, Marlena H; Chan, Jeffrey A; Sullivan, Jennifer L; Borzecki, Ann M; Shwartz, Michael; Rivard, Peter E; Hatoun, Jonathan; Rosen, Amy K

    2016-01-01

    Health care systems are increasingly burdened by the large numbers of safety measures currently being reported. Within the Veterans Administration (VA), most safety reporting occurs within organizational silos, with little involvement by the frontline users of these measures. To provide a more integrated picture of patient safety, the study team partnered with multiple VA stakeholders and engaged potential frontline users at 2 hospitals to develop a Guiding Patient Safety (GPS) tool. The GPS is currently in its fourth generation; once approval is obtained from senior leadership, implementation will begin. Stakeholders were enthusiastic about the GPS's user-friendly format, comprehensive content, and potential utility for improving safety. These findings suggest that stakeholder engagement is a critical first step in the development of tools that will more likely be used by frontline users. Policy makers and researchers may consider adopting this innovative partnered-research model in developing future national initiatives to deliver meaningful programs to frontline users. PMID:25500716

  14. ESRD care within the US Department of Veterans Affairs: a forward-looking program with an illuminating past.

    PubMed

    Watnick, Suzanne; Crowley, Susan T

    2014-03-01

    The first governmental agency to provide maintenance hemodialysis to patients with end-stage renal disease (ESRD) was the Veterans Administration (VA; now the US Department of Veterans Affairs). Many historical VA policies and programs set the stage for the later care of both veteran and civilian patients with ESRD. More recent VA initiatives that target restructuring of care models based on quality management, system-wide payment policies to promote cost-effective dialysis, and innovation grants aim to improve contemporary care. The VA currently supports an expanded and diversified nationwide treatment program for patients with ESRD using an integrated patient-centered care paradigm. This narrative review of ESRD care by the VA explores not only the medical advances, but also the historical, socioeconomic, ethical, and political forces related to the care of veterans with ESRD. PMID:24331978

  15. Use of Medicare and DOD data for improving VA race data quality.

    PubMed

    Stroupe, Kevin T; Tarlov, Elizabeth; Zhang, Qiuying; Haywood, Thomas; Owens, Arika; Hynes, Denise M

    2010-01-01

    We evaluated the improvement in Department of Veterans Affairs (VA) race data completeness that could be achieved by linking VA data with data from Medicare and the Department of Defense (DOD) and examined agreement in values across the data sources. After linking VA with Medicare and DOD records for a 10% sample of VA patients, we calculated the percentage for which race could be identified in those sources. To evaluate race agreement, we calculated sensitivities, specificities, positive predictive values (PPVs), negative predictive values, and kappa statistics. Adding Medicare (and DOD) data improved race data completeness from 48% to 76%. Among older patients (≥65 years), adding Medicare data improved data completeness to nearly 100%. Among younger patients (<65 years), combining Medicare and DOD data improved completeness to 75%, 18 percentage points beyond that achieved with Medicare data alone. PPVs for white and African-American categories were 98.6 and 94.7, respectively, in Medicare and 97.0 and 96.5, respectively, in DOD data using VA self-reported race as the gold standard. PPVs for the non-African-American minority groups were lower, ranging from 30.5 to 48.2. Kappa statistics reflected these patterns. Supplementing VA with Medicare and DOD data improves VA race data completeness substantially. More study is needed to understand poor rates of agreement between VA and external sources in identifying non-African-American minority individuals. PMID:21110252

  16. Comparative Evaluation of Serotonin Toxicity among Veterans Affairs Patients Receiving Linezolid and Vancomycin

    PubMed Central

    Patel, N.; Rivera, A.; Tristani, L.; Lazariu, V.; Vandewall, H.; McNutt, L. A.

    2013-01-01

    Despite the theoretical risk of serotonin toxicity (ST) with linezolid, “real-world” clinical evaluations of the risk of ST in patients receiving linezolid have been limited to case reports and noncomparator studies. An observational, matched-cohort study was conducted to evaluate the risk of ST among hospitalized patients who received linezolid or vancomycin at the Upstate New York Veterans Affairs Healthcare Network (Veterans Integrated Service Network 2 [VISN-2]). Matching criteria included VISN-2 hospital, hospital ward, prior hospital length of stay, age, and baseline platelet counts. The patients' electronic medical records were evaluated for symptoms consistent with ST and the Hunter serotonin toxicity criteria (HSTC) using an intensive, natural word search algorithm. The study included 251 matched pairs. Demographics and comorbidities were similar between groups. Over half of the study population received at least one concurrent medication with serotonergic activity. Receipt of agents with serotonergic activity was more pronounced in the vancomycin group, and the higher frequency was due to concomitant antihistamine and antiemetic use. Antidepressant use, including selective serotonin reuptake inhibitors (SSRIs), was similar between groups. No patients in either group were found to meet the criteria using the word search algorithm for ST. Fewer linezolid patients than vancomycin patients met the HSTC overall (3.2% versus 8.8%) and when stratified by receipt of a concurrent serotonergic agent (4.3% versus 12.4%). Of the patients meeting the HSTC, most had past or present comorbidities that may have contributed to or overlapped the HSTC. This study of hospitalized patients revealed comparably low frequencies of adverse events potentially related to ST among patients who received linezolid or vancomycin. PMID:24041888

  17. 76 FR 56504 - Proposed Information Collection (Spinal Cord Injury Patient Care Survey) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... AFFAIRS Proposed Information Collection (Spinal Cord Injury Patient Care Survey) Activity: Comment Request... spinal cord patients' satisfaction with VA rehabilitation and health care system. Affected Public... of automated collection techniques or the use of other forms of information technology. Title:...

  18. Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients☆

    PubMed Central

    Lapham, Gwen T.; Rubinsky, Anna D.; Shortreed, Susan M.; Hawkins, Eric J.; Richards, Julie; Williams, Emily C.; Berger, Douglas; Chavez, Laura J.; Kivlahan, Daniel R.; Bradley, Katharine A.

    2015-01-01

    Background Performance measures for brief alcohol interventions (BIs) are currently based on provider documentation of BI. However, provider documentation may not be a reliable measure of whether or not patients are offered clinically meaningful BIs. In particular, BI documented with clinical decision support in an electronic medical record (EMR) could appear identical irrespective of the quality of BI provided. We hypothesized that differences in how BI was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. Methods Male outpatients with unhealthy alcohol use identified by confidential satisfaction surveys (2009–2012) were assessed for whether they reported receiving BI in the past year (patient-reported BI) and whether they had BI documented in the EMR during the same period (documented BI). We evaluated and compared the prevalence of documented BI to patient-reported BI across 21 VA networks to determine whether documented BI had a variable association with patient-reported BI across the networks. Results Of 9896 eligible male outpatients with unhealthy alcohol use, 59.0% (95% CI 57.4–60.5%) reported BI (50.4–64.9% across networks) and 37.4% (95% CI 36.0–38.9%) had BI documented in the EMR (28.0–44.2% across networks). Overall, 72.9% (95% CI 70.8–75.5%) of patients with documented BI also reported BI. The association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models. Conclusions Performance measures of BI that rely on provider documentation in EMRs appear comparable to patient report for comparing care across VA networks. PMID:26072218

  19. 75 FR 17832 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0021'' in any correspondence. During the... AFFAIRS Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity.... SUMMARY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing...

  20. 77 FR 60746 - Proposed Information Collection (VA/DOD Joint Disability Evaluation Board Claim) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... 20420 or email to ] nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0704'' in any... AFFAIRS Proposed Information Collection (VA/DOD Joint Disability Evaluation Board Claim) Activity: Comment...: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing...

  1. 77 FR 64383 - Proposed Information Collection (Verification of VA Benefits) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... AFFAIRS Proposed Information Collection (Verification of VA Benefits) Activity: Comment Request AGENCY... Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public... name prior to the closing of any VA-guaranteed loans on an automatic basis. DATES: Written comments...

  2. 75 FR 60171 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-29

    ...., Washington, DC 20420 or e-mail nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0521'' in any... AFFAIRS Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA... Affairs (VA), is announcing an opportunity for public comment on the proposed collection of...

  3. 78 FR 53506 - Agency Information Collection (HUD/VA Addendum to Uniform Residential Loan Application) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ....rennie@va.gov . Please refer to ``OMB Control No. 2900-0144.'' SUPPLEMENTARY INFORMATION: Title: HUD/VA... AFFAIRS Agency Information Collection (HUD/VA Addendum to Uniform Residential Loan Application) Activity... information through www.Regulations.gov , or to Office of Information and Regulatory Affairs, Office...

  4. 76 FR 24570 - Proposed Information Collection (Application for VA Education Benefits) Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ...., Washington, DC 20420 or email to nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0154'' in... AFFAIRS Proposed Information Collection (Application for VA Education Benefits) Activity; Comment Request... Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an...

  5. 78 FR 60379 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-01

    ...., Washington, DC 20420 or email nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0521'' in any... AFFAIRS Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA... Affairs (VA), is announcing an opportunity for public comment on the proposed collection of...

  6. 76 FR 67561 - Proposed Information Collection (VA Enrollment Certification) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ..., 810 Vermont Avenue NW., Washington, DC 20420 or email to nancy.kessinger@va.gov . Please refer to... AFFAIRS Proposed Information Collection (VA Enrollment Certification) Activity: Comment Request AGENCY... Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for...

  7. 75 FR 54965 - Proposed Information Collection (Statement of Purchaser or Owner Assuming Seller's Loans, VA Form...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ...., Washington, DC 20420 or e-mail nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0111'' in any... AFFAIRS Proposed Information Collection (Statement of Purchaser or Owner Assuming Seller's Loans, VA Form... Affairs (VA), is announcing an opportunity for public comment on the proposed collection of...

  8. 76 FR 27381 - Proposed Information Collection (Notice of Waiver of VA Compensation or Pension To Receive...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ...., Washington, DC 20420 or e-mail to nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0463'' in... AFFAIRS Proposed Information Collection (Notice of Waiver of VA Compensation or Pension To Receive... of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed...

  9. 76 FR 67557 - Proposed Information Collection (Survey of Veteran Enrollees' Health and Reliance Upon VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ..., 810 Vermont Avenue NW., Washington, DC 20420; or email: cynthia.harvey-pryor@va.gov . Please refer to... AFFAIRS Proposed Information Collection (Survey of Veteran Enrollees' Health and Reliance Upon VA...: Notice. SUMMARY: The Veterans Health Administration (VHA), Department of Veterans Affairs (VA),...

  10. 78 FR 36642 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... nancy.kessinger@va.gov . Please refer to ``OMB Control No. 2900-0021'' in any correspondence. During the... AFFAIRS Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity.... SUMMARY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing...

  11. 38 CFR 26.7 - VA environmental decision making and documents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false VA environmental decision making and documents. 26.7 Section 26.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.7 VA environmental decision making and...

  12. 38 CFR 26.9 - Information on and public participation in VA environmental process.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During...

  13. 38 CFR 26.9 - Information on and public participation in VA environmental process.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During...

  14. 38 CFR 26.9 - Information on and public participation in VA environmental process.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During...

  15. 38 CFR 26.9 - Information on and public participation in VA environmental process.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During...

  16. 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 OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During...

  17. 76 FR 63357 - VA National Academic Affiliations Council; Notice of Establishment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... AFFAIRS VA National Academic Affiliations Council; Notice of Establishment As required by Section 9(a)(2... establishment of the Department of Veterans Affairs (VA) National Academic Affiliations Council. The Secretary... partnerships between VA and its academic affiliates. The Council will provide a forum for discussion and...

  18. Patient-Reported Quality of Supportive Care Among Patients With Colorectal Cancer in the Veterans Affairs Health Care System

    PubMed Central

    van Ryn, Michelle; Phelan, Sean M.; Arora, Neeraj K.; Haggstrom, David A.; Jackson, George L.; Zafar, S. Yousuf; Griffin, Joan M.; Zullig, Leah L.; Provenzale, Dawn; Yeazel, Mark W.; Jindal, Rahul M.; Clauser, Steven B.

    2014-01-01

    Purpose High-quality supportive care is an essential component of comprehensive cancer care. We implemented a patient-centered quality of cancer care survey to examine and identify predictors of quality of supportive care for bowel problems, pain, fatigue, depression, and other symptoms among 1,109 patients with colorectal cancer. Patients and Methods Patients with new diagnosis of colorectal cancer at any Veterans Health Administration medical center nationwide in 2008 were ascertained through the Veterans Affairs Central Cancer Registry and sent questionnaires assessing a variety of aspects of patient-centered cancer care. We received questionnaires from 63% of eligible patients (N = 1,109). Descriptive analyses characterizing patient experiences with supportive care and binary logistic regression models were used to examine predictors of receipt of help wanted for each of the five symptom categories. Results There were significant gaps in patient-centered quality of supportive care, beginning with symptom assessment. In multivariable modeling, the impact of clinical factors and patient race on odds of receiving wanted help varied by symptom. Coordination of care quality predicted receipt of wanted help for all symptoms, independent of patient demographic or clinical characteristics. Conclusion This study revealed substantial gaps in patient-centered quality of care, difficult to characterize through quality measurement relying on medical record review alone. It established the feasibility of collecting patient-reported quality measures. Improving quality measurement of supportive care and implementing patient-reported outcomes in quality-measurement systems are high priorities for improving the processes and outcomes of care for patients with cancer. PMID:24493712

  19. 78 FR 59099 - Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    ... Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 632-7492 or email crystal.rennie@va.gov... AFFAIRS Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity... through www.Regulations.gov , or to Office of Information and Regulatory Affairs, Office of Management...

  20. 38 CFR 17.106 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Social Security Act (42 U.S.C. 1395, et seq.) and 42 CFR part 403, subpart B. No-fault insurance means an... calculated using the applicable method for such charges established by VA in 38 CFR 17.101. (2) If the third... United States under 31 U.S.C. 3701, et seq., 4 CFR parts 101 through 104, 28 CFR part 11, 31 CFR part...

  1. 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.

  2. 78 FR 38452 - Agency Information Collection (VA Police Officer Pre-Employment Screening Checklist) Activities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... AFFAIRS Agency Information Collection (VA Police Officer Pre-Employment Screening Checklist) Activities... ``OMB Control No. 2900-0524.'' SUPPLEMENTARY INFORMATION: Title: VA Police Officer Pre-Employment... checks on applicants seeking employment as VA police officers. VA will use the data collected...

  3. 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...

  4. 77 FR 2348 - Agency Information Collection (VA Enrollment Certification): Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... or email denise.mclamb@va.gov . Please refer to ``OMB Control No. 2900-0073.'' SUPPLEMENTARY... AFFAIRS Agency Information Collection (VA Enrollment Certification): Activity Under OMB Review AGENCY..., 2012. ADDRESSES: Submit written comments on the collection of information through...

  5. 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. PMID:25439452

  6. 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...

  7. 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 Registration Applications); Comment Request AGENCY: Office of National Veterans Sports Programs and Special Events, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of National Veterans...

  8. 76 FR 71623 - Agency Information Collection (Spinal Cord Injury Patient Care Survey) Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... AFFAIRS Agency Information Collection (Spinal Cord Injury Patient Care Survey) Under OMB Review AGENCY.... 2900-New (VA Form 10-0515).'' SUPPLEMENTARY INFORMATION: Title: Spinal Cord Injury Patient Care Survey... Collection. Abstract: Information collected on VA Form 10-0515 will be used to determine spinal cord...

  9. Interdisciplinary Quality Improvement Conference: Using a Revised Morbidity and Mortality Format to Focus on Systems-Based Patient Safety Issues in a VA Hospital: Design and Outcomes.

    PubMed

    Gerstein, Wendy H; Ledford, Judith; Cooper, Jacqueline; Lloyd, Melissa G; Moore, Timothy; Harji, Farzana; Twitty, Vivian; Brooks, Annette; Oliver, Rosalinda C; Goff, James M

    2016-03-01

    The Veterans Healthcare Administration (VA) has embraced patient safety and quality improvement in the quest to improve care for veterans. The New Mexico VA Health Care System introduced a new morbidity and mortality conference, called the Interdisciplinary Quality Improvement Conference (IQIC), using patient case presentations to focus on underlying systems in the clinical care environment. The revised conference design also effectively teaches the 6 Accreditation Council for Graduate Medical Education (ACGME) core requirements for resident education. A formal process was established for case selection, presentation, systems issue identification, tracking, and follow-up. The IQIC has enabled the identification of more than 20 system issues at the study institution. Outcome data show lasting improvement in system issues that were addressed by this mechanism. The VA IQIC is an effective method to both identify and correct systems issues that affect patient care and is an effective method for teaching residents the 6 ACGME requirements for residency education. PMID:25332453

  10. Supra-complete surgery via dual intraoperative visualization approach (DiVA) prolongs patient survival in glioblastoma.

    PubMed

    Eyüpoglu, Ilker Y; Hore, Nirjhar; Merkel, Andreas; Buslei, Rolf; Buchfelder, Michael; Savaskan, Nicolai

    2016-05-01

    Safe and complete resection represents the first step in the treatment of glioblastomas and is mandatory in increasing the effectiveness of adjuvant therapy to prolong overall survival. With gross total resection currently limited in extent to MRI contrast enhancing areas, the extent to which supra-complete resection beyond obvious contrast enhancement could have impact on overall survival remains unclear. DiVA (dual intraoperative visualization approach) redefines gross total resection as currently accepted by enabling for the first time supra-complete surgery without compromising patient safety. This approach exploits the advantages of two already accepted surgical techniques combining intraoperative MRI with integrated functional neuronavigation and 5-ALA by integrating them into a single surgical approach. We investigated whether this technique has impact on overall outcome in GBM patients. 105 patients with GBM were included. We achieved complete resection with intraoperative MRI alone according to current best-practice in glioma surgery in 75 patients. 30 patients received surgery with supra-complete resection. The control arm showed a median life expectancy of 14 months, reflecting current standards-of-care and outcome. In contrast, patients receiving supra-complete surgery displayed significant increase in median survival time to 18.5 months with overall survival time correlating directly with extent of supra-complete resection. This extension of overall survival did not come at the cost of neurological deterioration. We show for the first time that supra-complete glioma surgery leads to significant prolongation of overall survival time in GBM patients. PMID:27036027

  11. 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. PMID:25358031

  12. 76 FR 8402 - Public Availability of the Department of Veterans Affairs FY 2010 Service Contract Inventory

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-14

    ... 2010 (Pub. L. 111-117), Department of Veterans Affairs (VA) is publishing this notice to advise the public of the accessibility of VA's FY 2010 service contract inventory available at http://www1.va.gov...@va.gov . Approved: February 7, 2010. John R. Gingrich, Chief of Staff, Department of Veterans...

  13. 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…

  14. The concentration of hospital care for black veterans in Veterans Affairs hospitals: implications for clinical outcomes.

    PubMed

    Jha, Ashish K; Stone, Roslyn; Lave, Judith; Chen, Huanyu; Klusaritz, Heather; Volpp, Kevin

    2010-01-01

    Where minorities receive their care may contribute to disparities in care, yet, the racial concentration of care in the Veterans Health Administration is largely unknown. We sought to better understand which Veterans Affairs (VA) hospitals treat Black veterans and whether location of care impacted disparities. We assessed differences in mortality rates between Black and White veterans across 150 VA hospitals for any of six conditions (acute myocardial infarction, hip fracture, stroke, congestive heart failure, gastrointestinal hemorrhage, and pneumonia) between 1996 and 2002. Just 9 out of 150 VA hospitals (6% of all VA hospitals) cared for nearly 30% of Black veterans, and 42 hospitals (28% of all VA hospitals) cared for more than 75% of Black veterans. While our findings show that overall mortality rates were comparable between minority-serving and non-minority-serving hospitals for four conditions, mortality rates were higher in minority-serving hospitals for acute myocardial infarction (AMI) and pneumonia. The ratio of mortality rates for Blacks compared with Whites was comparable across all VA hospitals. In contrast to the private sector, there is little variation in the degree of racial disparities in 30-day mortality across VA hospitals, although higher mortality among patients with AMI and pneumonia requires further investigation. PMID:20946426

  15. Development of a clinical event monitor for use with the Veterans Affairs Computerized Patient Record System and other data sources.

    PubMed Central

    Payne, T. H.; Savarino, J.

    1998-01-01

    We are developing an event monitor to operate with the Veterans Affairs Computerized Patient Record System (CPRS). The event monitor is designed to receive messages when important patient events such as posting of new results, patient movement, and orders occur. Our design separates the event monitor from CPRS itself, using communication via a network connection to receive HL7 messages, to access other data needed to run rules, and to communicate with providers by message display, electronic mail and other mechanisms. Results from operation of the event monitor using patient data in our test account show that a wide variety of data can be accessed by the event monitor with acceptable response times. Images Figure 1 PMID:9929199

  16. Survival of patients with spinal cord injury after cardiac arrest in Department of Veterans Affairs hospital: Pilot study.

    PubMed

    Caruso, Deborah; Carter, William E; Cifu, David X; Carne, William

    2014-01-01

    Survivability characteristics after cardiopulmonary resuscitation in the population with spinal cord injury (SCI) are unclear but may be useful for advanced care planning discussions with patients. Retrospective evaluation from records of all SCI patients over 10 yr at a Department of Veterans Affairs medical center who experienced in-hospital cardiac arrest was performed. Demographic data and other common measurements were recorded. Thirty-six male subjects were identified, and only two patients survived to discharge (5.5% survival rate), both of whom were admitted for nonacute issues and were asymptomatic shortly before the cardiac arrest. The mean age at the time of cardiopulmonary arrest was 62.4 yr, with a mean time from cardiac arrest to death of 3.02 d. No significant demographic parameters were identified. Overall, SCI likely portends worse outcome for acutely ill patients in the situation of a cardiac arrest. Conclusions are limited by sample size. PMID:25436984

  17. 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...

  18. Postacute Stroke Rehabilitation Utilization: Are There Differences between Rural-Urban Patients and Taxonomies?

    ERIC Educational Resources Information Center

    Jia, Huanguang; Cowper, Diane C.; Tang, Yuhong; Litt, Eric; Wilson, Lauren

    2012-01-01

    Purpose: To assess the association between Veterans Affairs (VA) stroke patients' poststroke rehabilitation utilization and their residential settings by using 2 common rural-urban taxonomies. Methods: This retrospective study included all VA stroke inpatients in 2001 and 2002. Rehabilitation utilization referred to rehabilitation therapy received…

  19. 76 FR 24567 - Proposed Information Collection (VA MATIC Authorization); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... AFFAIRS Proposed Information Collection (VA MATIC Authorization); Comment Request AGENCY: Veterans... Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the...) at http://www.Regulations.gov ; or to Nancy J. Kessinger, Veterans Benefits Administration...

  20. 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...

  1. Performance-based budgeting in the public sector: an illustration from the VA health care system.

    PubMed

    Yaisawarng, Suthathip; Burgess, James F

    2006-03-01

    This paper estimates frontier cost functions for US Department of Veterans Affairs (VA) hospitals in FY2000 that are consistent with economic theory and explicitly account for cost differences across patients' risk, level of access to care, quality of care, and hospital-specific characteristics. Results indicate that on average VA hospitals in FY2000 operate at efficiency levels of 94%, as compared to previous studies on US private sector hospitals that average closer to 90% efficient. Using these cost frontiers, management systems potentially could be implemented to enhance the equitable allocation of the VA medical care global budget and systematically distribute funds across hospitals and networks. The paper also provides recommendations to improve the efficiency of delivering health care services applicable to public sector organizations. PMID:16331724

  2. 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. PMID:12857686

  3. 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…

  4. 78 FR 48543 - Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... Veterans Affairs (VA) is announcing the availability of 1-year renewal funding for currently operational... Special Need partners and currently operational VA GPD Special Need Grant Recipients which do not involve... under VA's Homeless Providers GPD Program for FY 2011 operational GPD Special Need grant recipients...

  5. 78 FR 6849 - Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... AFFAIRS Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review AGENCY... abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission... VA Benefits, VA Form 26-8937. OMB Control Number: 2900-0406. ] Type of Review: Extension of...

  6. 75 FR 33898 - Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... through http://www.Regulations.gov ; or to VA's OMB Desk Officer, OMB Human Resources and Housing Branch..., (202) 461-7485, FAX (202) 273-0443 or e-mail denise.mclamb@va.gov . Please refer to ``OMB Control No... AFFAIRS Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System)...

  7. 75 FR 48413 - Agency Information Collection (HUD/VA Addendum to Uniform Residential Loan Application) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... information through www.Regulations.gov ; or to VA's OMB Desk Officer, OMB Human Resources and Housing Branch..., (202) 461-7485, FAX (202) 273-0443 or e-mail denise.mclamb@va.gov . Please refer to ``OMB Control No... AFFAIRS Agency Information Collection (HUD/VA Addendum to Uniform Residential Loan Application)...

  8. 75 FR 78808 - Agency Information Collection (VA Request for Determination of Reasonable Value) Activity Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... AFFAIRS Agency Information Collection (VA Request for Determination of Reasonable Value) Activity Under.... SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice... INFORMATION: Title: VA Request for Determination of Reasonable Value VA Form 26- 1805 and 26-1805-1....

  9. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 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...

  10. 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...

  11. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 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...

  12. 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

    ... November 21, 2011 (76 FR 71920), VA proposed to amend its regulations concerning the billing methodology... 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...

  13. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false VA collection rules; third-party payers. 17.106 Section 17.106 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Charges, Waivers, and Collections § 17.106 VA collection rules; third-party payers. (a)(1) General rule. VA has the right to...

  14. 38 CFR 17.106 - VA collection rules; third-party payers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false VA collection rules; third-party payers. 17.106 Section 17.106 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Charges, Waivers, and Collections § 17.106 VA collection rules; third-party payers. (a)(1) General rule. VA has the right to...

  15. Veterans Affairs Research on Health Information Technologies for Diabetes Self-Management Support

    PubMed Central

    Piette, John D.; Kerr, Eve; Richardson, Caroline; Heisler, Michele

    2008-01-01

    Background Like many patients with diabetes, Department of Veterans Affairs (VA) patients frequently fall short of self-management goals and experience multiple barriers to self-care. Health information technologies (HITs) may provide the tools that patients need to manage their illness under the direction of their primary care team. Methods We describe several ongoing projects focused on HIT resources for self-management in VA. VA researchers are developing HITs that seek to bolster a variety of potential avenues for self-management support, including patients′ relationships with other patients, connections with their informal care networks, and communication with their health care teams. Results Veterans Affairs HIT research projects are developing services that can address the needs of patients with multiple challenges to disease self-care, including multimorbidity, health literacy deficits, and limited treatment access. These services include patient-to-patient interactive voice response (IVR) calling systems, IVR assessments with feedback to informal caregivers, novel information supports for clinical pharmacists based on medication refill data, and enhanced pedometers. Conclusion Large health care systems such as the VA can play a critical role in developing HITs for diabetes self-care. To be truly effective, these efforts should include a continuum of studies: observational research to identify barriers to self-management, developmental studies (e.g., usability testing), efficacy trials, and implementation studies to evaluate utility in real-world settings. VA HIT researchers partner with operations to promote the dissemination of efficacious services, and such relationships will be critical to move HIT innovations into practice. PMID:19885173

  16. Does universal active MRSA surveillance influence anti-MRSA antibiotic use? A retrospective analysis of the treatment of patients admitted with suspicion of infection at Veterans Affairs Medical Centers between 2005 and 2010

    PubMed Central

    Jones, Makoto; Huttner, Benedikt; Leecaster, Molly; Huttner, Angela; Damal, Kavitha; Tanner, Windy; Nielson, Christopher; Rubin, Michael A.; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew H.

    2014-01-01

    Objectives After the implementation of an active surveillance programme for MRSA in US Veterans Affairs (VA) Medical Centers, there was an increase in vancomycin use. We investigated whether positive MRSA admission surveillance tests were associated with MRSA-positive clinical admission cultures and whether the availability of surveillance tests influenced prescribers' ability to match initial anti-MRSA antibiotic use with anticipated MRSA results from clinical admission cultures. Methods Analyses were based on barcode medication administration data, microbiology data and laboratory data from 129 hospitals between January 2005 and September 2010. Hospitalized patient admissions were included if clinical cultures were obtained and antibiotics started within 2 days of admission. Mixed-effects logistic regression was used to examine associations between positive MRSA admission cultures and (i) admission MRSA surveillance test results and (ii) initial anti-MRSA therapy. Results Among 569 815 included admissions, positive MRSA surveillance tests were strong predictors of MRSA-positive admission cultures (OR 8.5; 95% CI 8.2–8.8). The negative predictive value of MRSA surveillance tests was 97.6% (95% CI 97.5%–97.6%). The diagnostic OR between initial anti-MRSA antibiotics and MRSA-positive admission cultures was 3.2 (95% CI 3.1–3.4) for patients without surveillance tests and was not significantly different for admissions with surveillance tests. Conclusions The availability of nasal MRSA surveillance tests in VA hospitals did not seem to improve the ability of prescribers to predict the necessity of initial anti-MRSA treatment despite the high negative predictive value of MRSA surveillance tests. Prospective trials are needed to establish the safety and effectiveness of using MRSA surveillance tests to guide antibiotic therapy. PMID:25103488

  17. Veterans Affairs Health System Enrollment and Health Care Utilization After the Affordable Care Act: Initial Insights.

    PubMed

    Silva, Abigail; Tarlov, Elizabeth; French, Dustin D; Huo, Zhiping; Martinez, Rachael N; Stroupe, Kevin T

    2016-05-01

    The Affordable Care Act (ACA) was signed into law in 2010 and its individual mandate and expanded health care coverage options were implemented in 2014. These provisions may affect Veterans Affairs (VA) enrollment and health care utilization. Using data from two VA regional networks, we examined recent patterns in the number of new VA enrollees and their primary care use. Trends were assessed by enrollment priority group (based on the veteran's severity of service-connected disabilities, exposures, and income level) and a state's Medicaid expansion status. Compared to the same time period in the previous year, the number of new enrollees from low-income priority groups was higher during the open enrollment period and the increase was sharper in Medicaid non-expansion states (25-42%) than in expansion states (20-32%). In addition, low-income patients with a copay requirement who enrolled in the VA during the ACA open enrollment had a lower average number of primary care visits than counterparts who had enrolled in prior time periods (1.73 versus 1.87, p < 0.0001). Although this study is an initial step, more research is required to better understand veterans' decision making and behavior in regard to health care coverage through the ACA and related impacts on VA and non-VA health care utilization and care coordination. PMID:27136655

  18. 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:…

  19. A randomized trial of the cost effectiveness of VA hospital-based home care for the terminally ill.

    PubMed

    Hughes, S L; Cummings, J; Weaver, F; Manheim, L; Braun, B; Conrad, K

    1992-02-01

    All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale and satisfaction with care were measured at baseline, one month, and six months. Health services utilization was monitored over the six-month study period and converted to cost. Findings included no differences in patient survival, activities of daily living (ADL), cognitive functioning, or morale, but a significant increase in patient (p = .02) and caregiver (p = .005) satisfaction with care at one month. A substitution effect of HBHC was seen. Those in the experimental group used 5.9 fewer VA hospital days (p = .03), resulting in a $1,639 or 47 percent per capita saving in VA hospital costs (p = .02). As a result, total per capita health care costs, including HBHC, were $769 or 18 percent (n.s.) lower in the HBHC sample, indicating that expansion of VA HBHC to serve terminally ill veterans would increase satisfaction with care at no additional cost. PMID:1737710

  20. Statin Use and Its Facility-Level Variation in Patients With Diabetes: Insight From the Veterans Affairs National Database.

    PubMed

    Pokharel, Yashashwi; Akeroyd, Julia M; Ramsey, David J; Hira, Ravi S; Nambi, Vijay; Shah, Tina; Woodard, LeChauncy D; Winchester, David E; Ballantyne, Christie M; Petersen, Laura A; Virani, Salim S

    2016-04-01

    We sought to determine use of any and at least moderate-intensity statin therapy in a national sample of patients with diabetes mellitus (DM), with the hypothesis that nationwide frequency and facility-level variation in statin therapy are suboptimal. We sampled patients with DM age 40 to 75 years receiving primary care between October 1, 2012, and September 30, 2013, at 130 parent facilities and associated community-based outpatient clinics in the Veterans Affairs Health Care System. We examined frequency and facility-level variation in use of any or at least moderate-intensity statin therapy (mean daily dose associated with ≥30% low-density lipoprotein cholesterol lowering). In 911 444 patients with DM, 68.3% and 58.4% were receiving any and moderate- to high-intensity statin therapy, respectively. Patients receiving statin had higher burden of cardiovascular disease, were more likely to be on nonstatin lipid-lowering therapy and to receive care at a teaching facility, and had more frequent primary-care visits. Median facility-level uses of any and at least moderate-intensity statin therapy were 68.7% (interquartile range, 65.9%-70.8%) and 58.6% (interquartile range, 55.8%-61.4%), respectively. After adjusting for several patient-related and some facility-related characteristics, the median rate ratios for any and moderate- to high-intensity statin therapy were 1.20 (95% confidence interval: 1.18-1.22) and 1.29 (95% confidence interval: 1.24-1.33) respectively, indicating 20% to 29% variation in statin use between 2 identical patients receiving care at 2 random facilities. Statin use was suboptimal in a national sample of patients with DM with modest facility-level variation, likely indicating differences in statin-prescribing patterns. PMID:27059708

  1. Professional Quality of Life of Veterans Affairs Staff and Providers in a Patient-Centered Care Environment.

    PubMed

    Locatelli, Sara M; LaVela, Sherri L

    2015-01-01

    Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress. PMID:26218000

  2. Lipid Management Guidelines from the Departments of Veteran Affairs and Defense: A Critique.

    PubMed

    Bennet, Catherine S; Dahagam, Chanukya R; Virani, Salim S; Martin, Seth S; Blumenthal, Roger S; Michos, Erin D; McEvoy, John W

    2016-09-01

    In December 2014, the US Department of Veterans Affairs and Department of Defense (VA/DoD) published an independent clinical practice guideline for the management of dyslipidemia and cardiovascular disease risk, adding to the myriad of recently published guidelines on this topic. The VA/DoD guidelines differ from major US guidelines published by the American College of Cardiology/American Heart Association in 2013 in the following ways: recommending moderate-intensity statins for the majority of patients with statin indications regardless of atherosclerotic cardiovascular disease risk; advocating for limited on-treatment lipid monitoring; and deemphasizing ancillary data, such as coronary artery calcium testing, to improve atherosclerotic cardiovascular disease risk estimation. In the context of manifold treatment recommendations from numerous guideline committees, the VA/DoD recommendations may generate further confusion and mixed messages among healthcare providers about the optimal treatment of dyslipidemia. In this review, we critically appraise the VA/DoD recommendations with a focus on the evidence base for each area where the VA/DoD guidelines differ from the American College of Cardiology/American Heart Association guidelines. We also call for harmonization of lipid treatment guidelines to ensure high-quality and consistent care for patients with, and at risk for, atherosclerotic cardiovascular disease. PMID:27154781

  3. Use of Electronic Health Records in Disaster Response: The Experience of Department of Veterans Affairs After Hurricane Katrina

    PubMed Central

    Brown, Steven H.; Fischetti, Linda F.; Graham, Gail; Bates, Jack; Lancaster, Anne E.; McDaniel, David; Gillon, Joseph; Darbe, Melody; Kolodner, Robert M.

    2007-01-01

    Objectives. We describe electronic health data use by the Department of Veterans Affairs (VA) in the month after Katrina, including supporting technologies, the extent and nature of information accessed, and lessons learned. Methods. We conducted a retrospective study using cross-sectional panels of data collected sequentially over time. Results. By September 30, 2005, clinical data were accessed electronically for at least 38% (14941 of 39910) of patients cared for prior to Hurricane Katrina by New Orleans–area VA medical facilities. Approximately 1000 patients per day had data accessed during the month following Hurricane Katrina, a rate approximately two thirds of pre-Katrina values. Health care data were transmitted to more than 200 sites in 48 states and to at least 2300 users. Conclusions. The VA electronic health records supported continuity of care for evacuated veterans after Katrina. Our findings suggest that pharmacy and laboratory computerization alone will not be sufficient for future disaster support systems. PMID:17413082

  4. How Involved are Non-VA Chaplains in Supporting Veterans?

    PubMed

    Kopacz, Marek S; Feldstein, Bruce D; Asekoff, Cecille Allman; Kaprow, Maurice S; Smith-Coggins, Rebecca; Rasmussen, Kathy A

    2016-08-01

    In terms of supporting veteran populations, little is known of the experiences of chaplains professionally active outside of Department of Veterans Affairs (VA) healthcare settings. The present study looks to examine how involved non-VA chaplains are in supporting veterans as well as their familiarity with the VA. An online survey was distributed in a convenience sample of chaplains, of which n = 39 met the inclusion criterion for this study (i.e., no past or present VA affiliation). The results find that most of the non-VA chaplains encounter veteran service users either on a weekly or monthly basis. Though familiar with VA services, non-VA chaplains were not sure of their veteran service users' VA enrollment status nor did they feel able to adequately advise their veteran service users on VA enrollment. The results suggest that non-VA chaplains actively support veteran populations. Opportunities for enhancing chaplaincy services and VA outreach programs are discussed. PMID:27023459

  5. 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%…

  6. 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. PMID:24817625

  7. 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. PMID:24908442

  8. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any prescription... the Mexican Border Period, World War I, World War II, the Korean Conflict, or the Vietnam Era...

  9. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

    PubMed

    Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John

    2015-01-01

    We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy. PMID:26230276

  10. Integration of Images with the Veterans Affairs Hospital Information System in a Distributed Environment

    PubMed Central

    Dayhoff, Ruth E.; Maloney, Daniel L.; Shepard, Barclay M.

    1989-01-01

    The effective delivery of health care has become increasingly dependent on a wide range of medical data much of which consists of a variety of images. Ordinarily manual as well as computer-based medical records do not contain image data, leaving the physician to deal with a fragmented patient record widely scattered throughout the hospital. The Dept. of Veterans Affairs (VA) has recently implemented a prototype hospital information system (HIS) workstation network to demonstrate the feasibility of an integrated medical image and text information system. This prototype demonstrates the capability for sharing both images and text data located on remote file servers in a networked hospital environment.

  11. 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...

  12. 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...

  13. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  14. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  15. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  16. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  17. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline...

  18. 75 FR 76082 - Agency Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-07

    ... collection of information through http://www.Regulations.gov or to VA's OMB Desk Officer, OMB Human Resources..., NW., Washington, DC 20420, (202) 461-7485, FAX (202) 273-0443 or e-mail denise.mclamb@.va.gov. Please... AFFAIRS Agency Information Collection (Credit Underwriting Standards and Procedures for Processing...

  19. 77 FR 70212 - Agency Information Collection Activities Under OMB Review: VA MATIC Enrollment/Change

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... or email crystal.rennie@va.gov . Please refer to ``OMB Control No. 2900-0525.'' SUPPLEMENTARY... AFFAIRS Agency Information Collection Activities Under OMB Review: VA MATIC Enrollment/Change AGENCY..., 2012. ADDRESSES: Submit written comments on the collection of information through...

  20. 38 CFR 17.66 - Notice of noncompliance with VA standards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AFFAIRS MEDICAL Community Residential Care § 17.66 Notice of noncompliance with VA standards. If the hearing official determines that an approved community residential care facility does not comply with the... standards must be met in order to avoid revocation of VA approval; (c) The community residential...

  1. 38 CFR 17.66 - Notice of noncompliance with VA standards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AFFAIRS MEDICAL Community Residential Care § 17.66 Notice of noncompliance with VA standards. If the hearing official determines that an approved community residential care facility does not comply with the... standards must be met in order to avoid revocation of VA approval; (c) The community residential...

  2. 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 and Applications § 21.9510 Claims, VA's duty to...

  3. 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...

  4. 77 FR 56709 - Proposed Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned Small... for Service Disabled Veteran-Owned Small Business and Veteran-Owned Small Business Concerns, VA...

  5. 77 FR 70210 - Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small....'' SUPPLEMENTARY INFORMATION: Title: VA Subcontracting Report for Service Disabled Veteran-owned Small Business...

  6. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-08

    ... April 9, 2012 (77 FR 21158). FOR FURTHER INFORMATION CONTACT: Billy E. Jones, M.D., Senior Advisor to... was announced in the Federal Register on April 9, 2012 (77 FR 21158). All of the public comments have... AFFAIRS VA Directive 0005 on Scientific Integrity AGENCY: Office of Policy and Planning, Department...

  7. 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…

  8. 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

  9. 75 FR 62635 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-12

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program... needed to determine patients' satisfaction with services provided by or through the Michael E. DeBakey.... Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB...

  10. 75 FR 41577 - VBA/VHA Musculoskeletal Forum: Improving VA's Disability Evaluation Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-16

    ... AFFAIRS VBA/VHA Musculoskeletal Forum: Improving VA's Disability Evaluation Criteria AGENCY: Department of... system. See 38 CFR 4.40-4.73. Specifically, diagnostic code descriptors and evaluation criteria will be... Coordinator, Compensation and Pension Service, Department of Veterans Affairs, 810 Vermont Avenue,...

  11. 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

  12. Lung and colorectal cancer treatment and outcomes in the Veterans Affairs health care system

    PubMed Central

    Zullig, Leah L; Williams, Christina D; Fortune-Britt, Alice G

    2015-01-01

    Lung cancer (LC) and colorectal cancer (CRC) are the second- and third-most commonly diagnosed cancers in the Veterans Affairs (VA) health care system. While many studies have evaluated the treatment quality and outcomes of various aspects of VA LC and CRC care, there are no known reviews synthesizing this information across studies. The purpose of this literature review was to describe LC and CRC treatment (ie, surgical and nonsurgical) and outcomes (eg, mortality, psychosocial, and other) in the VA health care system as reported in the existing peer-reviewed scientific literature. We identified potential articles through a search of published literature using the PubMed electronic database. Our search strategy identified articles containing Medical Subject Headings terms and keywords addressing veterans or veterans’ health and LC and/or CRC. We limited articles to those published in the previous 11 years (January 1, 2003 through December 31, 2013). A total of 230 articles were retrieved through the search. After applying the selection criteria, we included 74 studies (34 LC, 47 CRC, and seven both LC and CRC). VA provides a full array of treatments, often with better outcomes than other health care systems. More work is needed to assess patient-reported outcomes. PMID:25609998

  13. 77 FR 50548 - Agency Information Collection: (PACT Qualitative Evaluation: Patient & Caregiver Interviews...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... AFFAIRS Agency Information Collection: (PACT Qualitative Evaluation: Patient & Caregiver Interviews... & Caregiver). FOR FURTHER INFORMATION CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department... or email: denise.mclamb@va.gov . Please refer to ``OMB Control No. 2900-New (Patient &...

  14. 77 FR 50546 - Agency Information Collection: (PACT Patient Experiences Survey); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... AFFAIRS Agency Information Collection: (PACT Patient Experiences Survey); Comment Request AGENCY: Veterans... proposal for the collection of information under the provisions of the Paperwork Reduction Act (44 U.S.C... patient experiences from this data collection are intended to help form future national VA policy....

  15. 38 CFR 21.8015 - Notification by VA of necessary information or evidence when a claim is filed; time for claimant...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Notification by VA of necessary information or evidence when a claim is filed; time for claimant response and VA action; and VA's duty to assist claimants in obtaining evidence. 21.8015 Section 21.8015 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  16. 76 FR 27379 - Proposed Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... AFFAIRS Proposed Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine... in the Commonwealth Army of the Philippines or in recognized guerrilla organizations. DATES: Written...: Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine Claims), VA Form 21-4169. OMB...

  17. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the facility in possession of the records or documents for response. The procedures outlined in 38 CFR... addition to other applicable protections for the research. (e) Individually identified patient medical...) Participation by VA will benefit VA patient care; or (2) Participation by VA will enhance VA medical...

  18. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the facility in possession of the records or documents for response. The procedures outlined in 38 CFR... addition to other applicable protections for the research. (e) Individually identified patient medical...) Participation by VA will benefit VA patient care; or (2) Participation by VA will enhance VA medical...

  19. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the facility in possession of the records or documents for response. The procedures outlined in 38 CFR... addition to other applicable protections for the research. (e) Individually identified patient medical...) Participation by VA will benefit VA patient care; or (2) Participation by VA will enhance VA medical...

  20. Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital.

    PubMed

    Kind, Amy J H; Brenny-Fitzpatrick, Maria; Leahy-Gross, Kris; Mirr, Jacquelyn; Chapman, Elizabeth; Frey, Brooke; Houlahan, Beth

    2016-02-01

    The Department of Veterans Affairs (VA) Coordinated-Transitional Care (C-TraC) program is a low-cost transitional care program that uses hospital-based nurse case managers, inpatient team integration, and in-depth posthospital telephone contacts to support high-risk patients and their caregivers as they transition from hospital to community. The low-cost, primarily telephone-based C-TraC program reduced 30-day rehospitalizations by one-third, leading to significant cost savings at one VA hospital. Non-VA hospitals have expressed interest in launching C-TraC, but non-VA hospitals differ in important ways from VA hospitals, particularly in terms of context, culture, and resources. The objective of this project was to adapt C-TraC to the specific context of one non-VA setting using a modified Replicating Effective Programs (REP) implementation theory model and to test the feasibility of this protocolized implementation approach. The modified REP model uses a mentored phased-based implementation with intensive preimplementation activities and harnesses key local stakeholders to adapt processes and goals to local context. Using this protocolized implementation approach, an adapted C-TraC protocol was created and launched at the non-VA hospital in July 2013. In its first 16 months, C-TraC successfully enrolled 1,247 individuals with 3.2 full-time nurse case managers, achieving good fidelity for core protocol steps. C-TraC participants experienced a 30-day rehospitalization rate of 10.8%, compared with 16.6% for a contemporary comparison group of similar individuals for whom C-TraC was not available (n = 1,307) (P < .001). The new C-TraC program continues in operation. Use of a modified REP model to guide protocolized adaptation to local context resulted in a C-TraC program that was feasible and sustained in a real-world non-VA setting. A modified REP implementation framework may be an appropriate foundational step for other clinical programs seeking to harness

  1. 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. PMID:26553404

  2. 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 Central

    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. PMID:22195064

  3. 78 FR 21197 - Advisory Committee on Structural Safety of Department of Veterans Affairs Facilities, Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-09

    ... AFFAIRS Advisory Committee on Structural Safety of Department of Veterans Affairs Facilities, Notice of....S.C. App. 2) that a meeting of the Advisory Committee on Structural Safety of Department of Veterans... on matters of structural safety in the construction and remodeling of VA facilities and to...

  4. 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…

  5. Veterans Affairs databases are accurate for gout-related health care utilization: a validation study

    PubMed Central

    2013-01-01

    Introduction The aim of this study was to assess the accuracy of Veterans Affairs (VA) databases for gout-related health care utilization. Methods This retrospective study utilized VA administrative and clinical databases. A random sample of gout patients with visits (outpatient, inpatient or emergent/urgent care) with or without the diagnosis of gout (International Classification of Diseases, ninth revision, common modification ICD-9-CM code of 274.x or 274.xx) at the Birmingham VA hospital was selected. A blinded abstractor performed a review of VA electronic health records for the documentation of gout or gout-related terms (gouty arthritis, tophaceous gout, tophus/tophi, acute gout, chronic gout, podagra, urate stones, urate or uric acid crystals and so on) in the chief complaint, history of present illness or assessment and plan for the visit; this constituted the gold standard for gout-related utilization. The accuracy of database-derived gout-related claims was assessed by calculating sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Results Of 108 potential visits, 85 outpatient, inpatient or urgent care/emergency room visits to a health care provider (85 patients: 84 men and 1 woman with a mean age of 63 years) and retrievable data from medical records constituted the analyzed dataset. Administrative claims for gout-related utilization with ICD-9 code for gout were accurate with a PPV of 86%, specificity of 95%, sensitivity of 86% and NPV of 95%. Conclusions VA databases are accurate for gout-related visits. These findings support their use for studies of health services and outcome studies. It remains to be seen if these findings are generalizable to other settings and databases. PMID:24377421

  6. VA Quagmire Persists.

    PubMed

    Sorrel, Amy Lynn

    2016-01-01

    Ongoing U.S. Department of Veterans Affairs roadblocks mean veterans still end up on long waiting lists to get care, and the physicians treating them end up on long waiting lists to get paid. PMID:27295292

  7. 76 FR 624 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program.... 2900-New (VA Form 10-0476).'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E... their satisfaction with the quality of services/care provided by home care program staff. An agency...

  8. 77 FR 69550 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program... provided by or through the Michael E. DeBakey Home Care Program. DATES: Written comments and... information technology. Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form...

  9. 78 FR 6851 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program....'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form...

  10. Cancer-related Imaging in the Veterans Affairs Health Care System versus Medicare: Does a System with Lower Use Exhibit Less Geographic Variation?

    PubMed Central

    McWilliams, J. Michael; Dalton, Jesse B.; Landrum, Mary Beth; Frakt, Austin B.; Pizer, Steven D.; Keating, Nancy L.

    2014-01-01

    Background Geographic variations in use of medical services have been interpreted as indirect evidence of wasteful care. Less overuse of services, however, may not be reliably associated with less geographic variation. Objective To compare average use and geographic variation in use of cancer-related imaging between fee-for-service Medicare and the Department of Veterans Affairs (VA) health care system. Design Observational analysis of cancer-related imaging from 2003–2005, using Medicare and VA utilization data linked to cancer registry data. We used multilevel models to estimate mean differences in annual imaging use between cohorts of Medicare and VA patients within geographic areas and variation in use across areas for each cohort, adjusting for sociodemographic and tumor characteristics. Setting 40 hospital referral regions. Patients Older men with lung, colorectal, or prostate cancer, including 34,475 traditional Medicare beneficiaries (Medicare cohort) and 6,835 VA patients (VA cohort). Measurements 1)Per-patient count of imaging studies for which lung, colorectal, or prostate cancer was the primary diagnosis (each study weighted by a standardized price); 2)a direct measure of overuse—advanced imaging for prostate cancer at low risk of metastasis. Results Adjusted annual use of cancer-related imaging was lower in the VA cohort than the Medicare cohort (price-weighted count, $197 vs. $379/patient; P<0.001), as was annual use of advanced imaging for prostate cancer at low risk of metastasis ($41 vs. $117/patient; P<0.001). Geographic variation in cancer-related imaging use was similar in magnitude in the VA and Medicare cohorts. Limitations Observational study design. Conclusions Use of cancer-related imaging was lower in the VA health care system than in fee-for-service Medicare, but lower use was not associated with less geographic variation. Geographic variation in service use may not be a reliable indicator of the extent of overuse. Primary Funding

  11. Characteristics and outcomes of patients discharged from the Opioid Renewal Clinic at the Philadelphia VA Medical Center.

    PubMed

    Becker, William C; Meghani, Salimah H; Barth, Kelly S; Wiedemer, Nancy; Gallagher, Rollin M

    2009-01-01

    The Opioid Renewal Clinic (ORC) is a pharmacist-run program that assists primary care providers in the management of chronic pain patients with aberrant behavior or high risk of prescription opioid abuse. In this study, charts of all discharged patients over a 22-month span (n = 86) were reviewed for outcomes for two years after discharge. The most frequent reason for discharge from the program was recurrent positive urine drug screens for illicit substances (n = 40; 47%). Only 15 (17%) were seen for addiction treatment in the two-year follow-up period. Forty-one percent of patients (n = 35) were prescribed opioids within two years of discharge. There was a positive correlation between length of time in the ORC and receipt of opioids post discharge. These outcomes reveal areas of need in the management of this complex population. PMID:19283565

  12. Toward a Virtual Lifetime Electronic Record: the Department of Veterans Affairs experience with the Nationwide Health Information Network.

    PubMed

    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

  13. 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

  14. 76 FR 44086 - Agency Information Collection (Notice of Waiver of VA Compensation or Pension To Receive Military...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... the collection of information through http://www.Regulations.gov or to VA's OMB Desk Officer, OMB... AFFAIRS Agency Information Collection (Notice of Waiver of VA Compensation or Pension To Receive Military... Vermont Avenue, NW., Washington, DC 20420, (202) 461-7485, fax (202) 461-0966 or e-mail...

  15. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS 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:...

  16. 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)

  17. Drug information service for drug product procurement in the Veterans Affairs health-care system: preliminary experience.

    PubMed

    Haynes, L M; Patterson, A A; Wade, S U

    1992-03-01

    The preliminary experience of the drug information service of the Department of Veterans Affairs (VA) central office is described. The drug information service assists the drug and pharmaceutical product management section of the pharmacy service for the VA central office. The purpose of the drug information service is to promote efficacious drug therapy while meeting cost containment goals for pharmaceutical products. The pharmacist coordinator of this service has experience in both patient care and drug information service. The drug information service is involved in the following activities: (1) making recommendations for contract bidding on therapeutically equivalent products, (2) identifying prescription duplication within the system, (3) reporting product defects, (4) planning drug procurement in unique situations, such as during war, (5) developing gender-specific therapy, (6) evaluating the appropriateness of brand-name-only purchasing of certain products, (7) evaluating new drug products, (8) compiling national drug-use data, and (9) projecting drug price increases. The VA drug information service has diverse responsibilities meant to optimize drug therapy and reduce pharmacy costs in the VA health-care system. PMID:1598933

  18. A Student Affairs Odyssey.

    ERIC Educational Resources Information Center

    Sandeen, Arthur

    1993-01-01

    Considers the future of student affairs work in higher education. Begins in the year 2003 at meeting of International Association of Student Affairs and travels back in time through other annual meetings of the association. Compares this fictitious odyssey with Homer's "Odyssey" throughout the article. (NB)

  19. 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.

  20. 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

  1. Department of Veterans Affairs

    MedlinePlus

    ... a variety of benefits and services that provide financial and other forms of assistance to Servicemembers, Veterans, their dependents and survivors. Compensation Education & Training Home Loans Life Insurance Vocational Rehabilitation Get Started Burials & Memorials VA operates ...

  2. 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

  3. 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

  4. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Hospital care and medical services in non-VA facilities. 17.52 Section 17.52 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in non-VA facilities. (a) When...

  5. VA Health Care and Health Manpower Training Legislation. Hearing before the Subcommittee on Health and Hospitals of the Committee on Veterans' Affairs; United States Senate, Ninety-second Congress. First Session on S.2219, S.2354, S.2355, S.1924, S.2304, S.1635, S.2340, H. J. Res. 748, H. R. 481, and Related Bills.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Veteran's Affairs.

    Ten legislative bills related to VA health manpower training and education and to veterans' health care were considered at this hearing. The bills concerned the following: (1) establishment of new public nonprofit medical, health profession, and allied health schools and the expansion and improvement of health manpower training programs in VA…

  6. The doctor-patient relationship and how it might apply to world affairs: a saga of warts.

    PubMed

    Goihman-Yahr, Mauricio

    2012-01-01

    A prospective patient in an experimental trial on immunotherapy for warts that I was performing was Palestinian. I advised him that I was Jewish, because I feared his reaction in the domain of an experimental therapeutic trial. The patient rhetorically asked whether I was a physician. If so, no problems should exist. He was admitted to the trial and healed. Reason and common interest may vanquish fear and mistrust. Can this teaching be applied to the Middle East situation? Hatred would have to be defeated first. PMID:22682198

  7. Public affairs plan

    SciTech Connect

    1995-09-01

    The purpose of the Uranium Mill Tailings Remedial Action (UMTRA) Project Public Affairs Plan is to establish goals for the fiscal year (FY) 1996 UMTRA Project public affairs program and to identify specific activities to be conducted during the year. It describes the roles of various agencies involved in the public affairs program and defines the functions of the UMTRA Project Technical Assistance Contractor (TAC) Public Affairs Department. It replaces the FY 1995 Public Affairs Plan (DOE/AL/62350-154). The plan also describes the US Department of Energy`s (DOE) plans to keep stakeholders and other members of the public informed about UMTRA Project policies, plans, and activities, and provide opportunities for stakeholders and interested segments of the public to participate in UMTRA Project decision-making processes. The plan applies to the UMTRA Project Team; the DOE Grand Junction Projects Office (GJPO); the DOE Albuquerque Operations Office, Office of Public Affairs (OPA); the TAC; the UMTRA Project Remedial Action Contractor (RAC); and other cooperating agencies.

  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. PMID:23977714

  9. Communication between VA providers and sexual and gender minority veterans: a pilot study.

    PubMed

    Sherman, Michelle D; Kauth, Michael R; Shipherd, Jillian C; Street, Richard L

    2014-05-01

    Approximately one million gay and lesbian Americans are veterans, and rates of engagement in the Veterans Affairs (VA) health care system may be increasing for both sexual and gender minority veterans. Very little research has examined the experience of these veterans when receiving care at VA health care facilities. The purpose of this study was to explore the experiences, beliefs, and preferences of lesbian, gay, bisexual, or transgender (LGBT) veterans in their communication with VA health care providers. LGBT veterans (n = 58) participated in focus groups or individual interviews and completed self-report measures at two southern VA hospitals. Approximately 2/3 of veterans report that none of their VA providers have specifically asked about their sexual orientation, and 24% of the veterans indicate that they have not disclosed their orientation to any VA provider. Although some veterans want providers to initiate these discussions, veterans also expressed fears about disclosure and its possible negative consequences. Similarly, LGBT veterans report varied opinions about the appropriateness of routine assessment of minority status. Only 28% of these veterans experience VA as welcoming to them as LGBT veterans. Systematic training is needed for all VA providers about the rationale for assessing sexual and gender orientation. Staff education should include specific skills for initiating these assessments, and ways of responding to veteran concerns about discussing this topic in the VA health care system. PMID:24588107

  10. 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.

  11. House Committee on Veterans' Affairs

    MedlinePlus

    ... bills. Union Bosses, VA Bosses Rigging System for Failure Sep 5, 2016 Editorial In an expletive-laden ... bills. Union Bosses, VA Bosses Rigging System for Failure Sep 5, 2016 Editorial In an expletive-laden ...

  12. Using GIS to profile health-care costs of VA Quality-Enhancement Research Initiative diseases.

    PubMed

    Yu, Wei; Cowper, Diane; Berger, Magdalena; Kuebeler, Mark; Kubal, Joe; Manheim, Larry

    2004-06-01

    The Health Services Research and Development (HSR&D) Service at the Department of Veterans Affairs (VA) Health Care System launched a Quality Enhancement Research Initiative (QUERI) in 1998. This study estimated health-care costs of nine diseases under the QUERI project and analyzed geographic differences in health-care costs and utilization across 22 VA Integrated Service Networks (VISNs), using a geographic information system (GIS). Patients with these diseases were identified from diagnoses recorded between October 1999 and September 2000. Annual health-care costs for each disease were estimated in four categories: inpatient medical or surgical, other inpatient, outpatient, and outpatient pharmacy. Geographic differences of costs and health-care utilization across the 22 VISNs for chronic heart failure, diabetes, and spinal-cord injury were mapped using a GIS package. Average costs and patterns of health-care utilization varied substantially across the 22 VISNs. The observed differences in health-care utilization across geographic regions raised questions for further investigation. PMID:15446617

  13. 76 FR 44087 - Agency Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... AFFAIRS Agency Information Collection (Supplement to VA Forms 21-526, 21- 534, and 21-535 (For Philippine..., 21-534, and 21-535 (For Philippine Claims), VA Form 21-4169. OMB Control Number: 2900-0094. Type of... Philippines or recognized guerrilla services. An agency may not conduct or sponsor, and a person is...

  14. Variation in Prescription Use and Spending for Lipid-Lowering and Diabetes Medications in the VA Healthcare System

    PubMed Central

    Gellad, Walid F.; Good, Chester B.; Lowe, John C.; Donohue, Julie M.

    2011-01-01

    Objectives Very little is known about variation in prescription drug use and spending. We examine variation in outpatient prescription use and spending for diabetes and hyperlipidemia in the Veterans Affairs (VA) system and its association with quality measures for these conditions. Study Design and Methods We compared outpatient prescription use, spending and quality of care across 135 VA Medical Centers (VAMCs) in 2008, including 2.3 million patients dispensed lipid-lowering medications and 981,031 dispensed diabetes medications. We calculated VAMC-level cost/patient for these medications, proportion of patients on brand-name drugs, and Healthcare Effectiveness Data and Information Set (HEDIS) scores for hyperlipidemia (LDL<100mg/dl) and diabetes (HgA1c>9 or not measured) at each facility. Results The median cost/patient for lipid-lowering agents in 2008 was $49.60 and varied from $39.68 in the least expensive quartile of VAMCs to $69.57 in the most expensive (p<0.001). For diabetes agents, median cost/patient was $158.34 and varied from $123.34 in the least expensive quartile to $198.31 in the most expensive (p<0.001). The proportion of patients dispensed brand name oral drugs in these classes in VAMCs in the most expensive quartile was twice that in the lowest quartile (p<0.001). There was no correlation between VAMC-level prescription spending and performance on HEDIS measures for lipid-lowering drugs (r=.12 and r=.07) or diabetes agents (r=-.10). Conclusions Despite a closely managed formulary, significant variation in prescription spending and use of brand name drugs exists in the VA. Although we could not explicitly risk adjust, there appears to be no association between spending on medications and quality of care. PMID:20964470

  15. 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... in 48 CFR chapters 1 and 8. Such contracts will be awarded only after the quality, effectiveness and... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Selection of...

  16. 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... in 48 CFR chapters 1 and 8. Such contracts will be awarded only after the quality, effectiveness and... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Selection of...

  17. 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…

  18. 75 FR 61858 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... AFFAIRS Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity... solicits comments for information needed to determine the reasonable value of properties for guaranteed or... PRA of 1995 (Pub. L. 104-13; 44 U.S.C. 3501--3521), Federal agencies must obtain approval from...

  19. 78 FR 59773 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... AFFAIRS Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity... solicits comments for information needed to determine the reasonable value of properties for guaranteed or.... SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 U.S.C. 3501-3521), Federal agencies...

  20. 75 FR 61249 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-04

    ... AFFAIRS Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity... solicits comments for information needed to determine the reasonable value of properties for guaranteed or... PRA of 1995 (Pub. L. 104-13; 44 U.S.C. 3501--3521), Federal agencies must obtain approval from...

  1. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... veteran is receiving contract nursing home care and requires emergency treatment in non-VA facilities... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services...

  2. 77 FR 20889 - Proposed Information Collection (Request One-VA Identification Verification Card) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ...The Office of Operations, Security, and Preparedness (OSP), 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......

  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. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 38 CFR 63.10 - Selection of non-VA community-based providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in 48 CFR chapters 1 and 8. Such contracts will be awarded only after the quality, effectiveness and safety of the applicant's program and facilities have been ascertained to VA's satisfaction, and then... VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.10 Selection of...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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

    ...The Veterans Health Administration (VHA), 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......

  16. 77 FR 70708 - VA Acquisition Regulation: Electronic Submission of Payment Requests

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ...The Department of Veterans Affairs (VA) is issuing a final rule to require contractors to submit payment requests in electronic form in order to enhance customer service, departmental productivity, and adoption of innovative information technology, including the appropriate use of commercial best practices. This document adopts the proposed rule published on April 18, 2012, as a final rule......

  17. 77 FR 38181 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    .... SUPPLEMENTARY INFORMATION: In a final rule published in the Federal Register on February 8, 2010, (73 FR 6098... AFFAIRS 38 CFR Part 74 RIN 2900-AO49 VA Veteran-Owned Small Business Verification Guidelines AGENCY... the Veterans Benefits, Health Care, and Information Technology Act of 2006, which requires...

  18. Use of the internet and an online personal health record system by US veterans: comparison of Veterans Affairs mental health service users and other veterans nationally

    PubMed Central

    Rosenheck, Robert A

    2012-01-01

    Objective The Department of Veterans Affairs (VA) operates one of the largest nationwide healthcare systems and is increasing use of internet technology, including development of an online personal health record system called My HealtheVet. This study examined internet use among veterans in general and particularly use of online health information among VA patients and specifically mental health service users. Methods A nationally representative sample of 7215 veterans from the 2010 National Survey of Veterans was used. Logistic regression was employed to examine background characteristics associated with internet use and My HealtheVet. Results 71% of veterans reported using the internet and about a fifth reported using My HealtheVet. Veterans who were younger, more educated, white, married, and had higher incomes were more likely to use the internet. There was no association between background characteristics and use of My HealtheVet. Mental health service users were no less likely to use the internet or My HealtheVet than other veterans. Discussion Most veterans are willing to access VA information online, although many VA service users do not use My HealtheVet, suggesting more education and research is needed to reduce barriers to its use. Conclusion Although adoption of My HealtheVet has been slow, the majority of veterans, including mental health service users, use the internet and indicate a willingness to receive and interact with health information online. PMID:22847305

  19. The cost of hospital readmissions: evidence from the VA.

    PubMed

    Carey, Kathleen; Stefos, Theodore

    2016-09-01

    This paper is an examination of hospital 30-day readmission costs using data from 119 acute care hospitals operated by the U.S. Veterans Administration (VA) in fiscal year 2011. We applied a two-part model that linked readmission probability to readmission cost to obtain patient level estimates of expected readmission cost for VA patients overall, and for patients discharged for three prevalent conditions with relatively high readmission rates. Our focus was on the variable component of direct patient cost. Overall, managers could expect to save $2140 for the average 30-day readmission avoided. For heart attack, heart failure, and pneumonia patients, expected readmission cost estimates were $3432, $2488 and $2278. Patient risk of illness was the dominant driver of readmission cost in all cases. The VA experience has implications for private sector hospitals that treat a high proportion of chronically ill and/or low income patients, or that are contemplating adopting bundled payment mechanisms. PMID:25576391

  20. Enhanced health event detection and influenza surveillance using a joint Veterans Affairs and Department of Defense biosurveillance application

    PubMed Central

    2011-01-01

    Background The establishment of robust biosurveillance capabilities is an important component of the U.S. strategy for identifying disease outbreaks, environmental exposures and bioterrorism events. Currently, U.S. Departments of Defense (DoD) and Veterans Affairs (VA) perform biosurveillance independently. This article describes a joint VA/DoD biosurveillance project at North Chicago-VA Medical Center (NC-VAMC). The Naval Health Clinics-Great Lakes facility physically merged with NC-VAMC beginning in 2006 with the full merger completed in October 2010 at which time all DoD care and medical personnel had relocated to the expanded and remodeled NC-VAMC campus and the combined facility was renamed the Lovell Federal Health Care Center (FHCC). The goal of this study was to evaluate disease surveillance using a biosurveillance application which combined data from both populations. Methods A retrospective analysis of NC-VAMC/Lovell FHCC and other Chicago-area VAMC data was performed using the ESSENCE biosurveillance system, including one infectious disease outbreak (Salmonella/Taste of Chicago-July 2007) and one weather event (Heat Wave-July 2006). Influenza-like-illness (ILI) data from these same facilities was compared with CDC/Illinois Sentinel Provider and Cook County ESSENCE data for 2007-2008. Results Following consolidation of VA and DoD facilities in North Chicago, median number of visits more than doubled, median patient age dropped and proportion of females rose significantly in comparison with the pre-merger NC-VAMC facility. A high-level gastrointestinal alert was detected in July 2007, but only low-level alerts at other Chicago-area VAMCs. Heat-injury alerts were triggered for the merged facility in June 2006, but not at the other facilities. There was also limited evidence in these events that surveillance of the combined population provided utility above and beyond the VA-only and DoD-only components. Recorded ILI activity for NC-VAMC/Lovell FHCC was more

  1. The Schoen Affair

    NASA Astrophysics Data System (ADS)

    Reich, Eugenie Samuel

    2010-03-01

    The Schoen Affair was a series of groundbreaking fraudulent claims in the fields of organic, plastic and molecular electronics. The Affair was exposed in 2002 and perpetrated by Jan Hendrik Schoen, a researcher at Bell Laboratories in New Jersey. In this talk, I draw on interviews with 125 scientists, emails by Schoen and colleagues, reviews of the fraudulent papers, and analyses of the fake data to illuminate Schoen's motive and modus operandi. I focus particularly on how Schoen first began to fake data as a graduate student, and how he progressed to make fraudulent claims that appeared plausible to managers at Bell Labs and other colleagues. I also describe how his claims were handled by the journals, mostly with respect to the actions of editors and reviewers at the journals Nature and Science.

  2. Expanded HIV Testing in the US Department of Veterans Affairs, 2009–2011

    PubMed Central

    Halloran, CNS, James; Pedati, Caitlin; Dursa, Erin K.; Durfee, Janet; Martinello, Richard; Davey, Victoria; Ross, David

    2013-01-01

    Objectives. We measured HIV testing and seropositivity among veterans in Veterans Affairs (VA) care for calendar years 2009 through 2011 and analyzed 2011 results by patient demographics. Methods. We performed a repeated-measures cross-sectional study using standardized electronic data extraction from the VA electronic health records for all veterans with at least 1 outpatient visit during 2009 through 2011. We analyzed testing rates and seropositivity by demographic characteristics for 2011. Results. Of veterans with an outpatient visit, 20.0% had an HIV test in 2011, compared with 9.2% in 2009. Documented HIV testing rates were highest in women and Blacks. Of confirmed positive test results, 67.0% were in outpatients older than 50 years. Seropositivity was highest among men aged 30 to 49 years, women aged 50 to 69 years, and Black outpatients of both genders. Implementation of an electronic clinical reminder was associated with higher testing rates. Conclusions. The significant effect of an electronic clinical reminder suggests that such decision support tools can substantially increase testing rates. The frequency of positive test results in older individuals suggests the need for additional work to define optimum approaches to HIV testing in this population. PMID:24134344

  3. MMPI-2 Symptom Validity (FBS) Scale: psychometric characteristics and limitations in a Veterans Affairs neuropsychological setting.

    PubMed

    Gass, Carlton S; Odland, Anthony P

    2014-01-01

    The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Symptom Validity (Fake Bad Scale [FBS]) Scale is widely used to assist in determining noncredible symptom reporting, despite a paucity of detailed research regarding its itemmetric characteristics. Originally designed for use in civil litigation, the FBS is often used in a variety of clinical settings. The present study explored its fundamental psychometric characteristics in a sample of 303 patients who were consecutively referred for a comprehensive examination in a Veterans Affairs (VA) neuropsychology clinic. FBS internal consistency (reliability) was .77. Its underlying factor structure consisted of three unitary dimensions (Tiredness/Distractibility, Stomach/Head Discomfort, and Claimed Virtue of Self/Others) accounting for 28.5% of the total variance. The FBS's internal structure showed factoral discordance, as Claimed Virtue was negatively related to most of the FBS and to its somatic complaint components. Scores on this 12-item FBS component reflected a denial of socially undesirable attitudes and behaviors (Antisocial Practices Scale) that is commonly expressed by the 1,138 males in the MMPI-2 normative sample. These 12 items significantly reduced FBS reliability, introducing systematic error variance. In this VA neuropsychological referral setting, scores on the FBS have ambiguous meaning because of its structural discordance. PMID:24826489

  4. 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

  5. 38 CFR 3.655 - Failure to report for Department of Veterans Affairs examination.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Failure to report for... Adjustments and Resumptions § 3.655 Failure to report for Department of Veterans Affairs examination. (a... a current VA examination or reexamination and a claimant, without good cause, fails to report...

  6. 75 FR 68533 - Funding and Fiscal Affairs, Loan Policies and Operations, and Funding Operations; Capital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-08

    ... 75 FR 39392. ] The comment period is scheduled to expire on November 5, 2010. In a letter dated... 12 CFR Part 615 RIN 3052-AC25 Funding and Fiscal Affairs, Loan Policies and Operations, and Funding..., Office of Regulatory Policy, Farm Credit Administration, 1501 Farm Credit Drive, McLean, VA...

  7. Unintended Consequences of Health Information Technology: Evidence From Veterans Affairs Colorectal Cancer Oncology Watch Intervention

    PubMed Central

    Bian, John; Bennett, Charles L.; Fisher, Deborah A.; Ribeiro, Maria; Lipscomb, Joseph

    2012-01-01

    Purpose We evaluated the Colorectal Cancer (CRC) Oncology Watch intervention, a clinical reminder implemented in Veterans Integrated Service Network 7 (including eight hospitals) to improve CRC screening rates in 2008. Patients and Methods Veterans Affairs (VA) administrative data were used to construct four cross-sectional groups of veterans at average risk, age 50 to 64 years; one group was created for each of the following years: 2006, 2007, 2009, and 2010. We applied hospital fixed effects for estimation, using a difference-in-differences model in which the eight hospitals served as the intervention sites, and the other 121 hospitals served as controls, with 2006 to 2007 as the preintervention period and 2009 to 2010 as the postintervention period. Results The sample included 4,352,082 veteran-years in the 4 years. The adherence rates were 37.6%, 31.6%, 34.4%, and 33.2% in the intervention sites in 2006, 2007, 2009, and 2010, respectively, and the corresponding rates in the controls were 31.0%, 30.3%, 32.3%, and 30.9%. Regression analysis showed that among those eligible for screening, the intervention was associated with a 2.2–percentage point decrease in likelihood of adherence (P < .001). Additional analyses showed that the intervention was associated with a 5.6–percentage point decrease in likelihood of screening colonoscopy among the adherent, but with increased total colonoscopies (all indicators) of 3.6 per 100 veterans age 50 to 64 years. Conclusion The intervention had little impact on CRC screening rates for the studied population. This absence of favorable impact may have been caused by an unintentional shift of limited VA colonoscopy capacity from average-risk screening to higher-risk screening and to CRC surveillance, or by physician fatigue resulting from the large number of clinical reminders implemented in the VA. PMID:23045582

  8. 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

  9. 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.

  10. Using average cost methods to estimate encounter-level costs for medical-surgical stays in the VA.

    PubMed

    Wagner, Todd H; Chen, Shuo; Barnett, Paul G

    2003-09-01

    The U.S. Department of Veterans Affairs (VA) maintains discharge abstracts, but these do not include cost information. This article describes the methods the authors used to estimate the costs of VA medical-surgical hospitalizations in fiscal years 1998 to 2000. They estimated a cost regression with 1996 Medicare data restricted to veterans receiving VA care in an earlier year. The regression accounted for approximately 74 percent of the variance in cost-adjusted charges, and it proved to be robust to outliers and the year of input data. The beta coefficients from the cost regression were used to impute costs of VA medical-surgical hospital discharges. The estimated aggregate costs were reconciled with VA budget allocations. In addition to the direct medical costs, their cost estimates include indirect costs and physician services; both of these were allocated in proportion to direct costs. They discuss the method's limitations and application in other health care systems. PMID:15095543

  11. Agreement Between HEDIS Performance Assessments in the VA and Medicare Advantage: Is Quality in the Eye of the Beholder?

    PubMed

    Trivedi, Amal N; Wilson, Ira B; Charlton, Mary E; Kizer, Kenneth W

    2016-01-01

    Medicare Advantage (MA) plans and the Veterans Affairs (VA) health care system assess quality of care using standardized Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. Little is known, however, about the relative accuracy of quality indicators for persons receiving care in more than one health care system. Among Veterans dually enrolled in an MA plan, we examined the agreement between MA and VA HEDIS assessments. Our study tested the hypothesis that private health plans underreport quality of care relative to a fully integrated delivery system utilizing a comprehensive electronic health record. Despite assessing the same individuals using identical measure specifications, reported VA performance was significantly better than reported MA performance for all 12 HEDIS measures. The VA's performance advantage ranged from 9.8% (glycosylated hemoglobin [HbA1c] < 7.0% in diabetes) to 54.7% (blood pressure < 140/90 mm Hg in diabetes). The overall agreement between VA and MA HEDIS assessments ranged from 38.5% to 62.6%. Performance rates derived from VA and MA aggregate data were 1.6% to 14.3% higher than those reported by VA alone. This analysis suggests that neither MA plans nor the VA fully capture quality of care information for dually enrolled persons. However, the VA's system-wide electronic health record may allow for more complete capture of quality information across multiple providers and settings. PMID:27033565

  12. Improving PTSD/substance abuse treatment in the VA: a survey of providers.

    PubMed

    Najavits, Lisa M; Norman, Sonya B; Kivlahan, Daniel; Kosten, Thomas R

    2010-01-01

    We surveyed 205 Veterans Affairs (VA) staff on treatment of posttraumatic stress disorder (PTSD), substance use disorder (SUD), and the combination (PTSD/SUD). The survey was anonymous and VA-wide. PTSD/SUD was perceived as more difficult to treat than either disorder alone; gratification in the work was stronger than difficulty (for PTSD, SUD, and PTSD/SUD); and difficulty and gratification appeared separate constructs. Respondents endorsed views that represent expert treatment for the comorbidity; however, there was also endorsement of "myths." Thus, there is a need for more training, policy clarifications, service integration, and adaptations for veterans returning from Iraq and Afghanistan. Limitations are described. PMID:20525033

  13. 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…

  14. Women's veteran identity and utilization of VA health services.

    PubMed

    Di Leone, Brooke A L; Wang, Joyce M; Kressin, Nancy; Vogt, Dawne

    2016-02-01

    Women have participated in the United States military since its founding. However, until the mid-20th century, there had been limited recognition of women as official members of the military, and women remain a statistical minority within military and veteran populations. It is therefore important to better understand women's veteran identity (which we define here as one's self-concept as derived from their veteran status) and associated implications for service use and experiences in the Department of Veterans Affairs (VA) health care setting. The present research examined the centrality of, and positive regard for, women's veteran identity among 407 female veterans deployed in support of the recent wars in Iraq and Afghanistan. Data were collected via a mailed national survey. Positive regard for veteran identity, but not veteran identity centrality,was positively associated with participants' age and length of time spent in the military. Results also showed that the centrality of women's veteran identity was positively related to their choice to use VA for health care and their feelings of belonging within VA, and that veteran identity centrality and positive regard for veteran identity are differentially associated with participants' military experiences (e.g., combat exposure, deployment sexual harassment) and mental health symptomatology (e.g., depression). PMID:25729892

  15. 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…

  16. 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

    ... and outpatient health care professional services at non-departmental facilities and other medical...' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.56 VA payment for inpatient and outpatient health care professional services at non-departmental facilities and other...

  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

    ... and outpatient health care professional services at non-departmental facilities and other medical...' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.56 VA payment for inpatient and outpatient health care professional services at non-departmental facilities and other...

  18. 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

    ... and outpatient health care professional services at non-departmental facilities and other medical...' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.56 VA payment for inpatient and outpatient health care professional services at non-departmental facilities and other...

  19. 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

    ... and outpatient health care professional services at non-departmental facilities and other medical...' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.56 VA payment for inpatient and outpatient health care professional services at non-departmental facilities and other...

  20. 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." PMID:22338972

  1. Innovation in veterans' health care and assistance: the Department of Veterans Affairs 10 years after the Gulf War.

    PubMed

    Brown, Mark A; Murphy, Frances M; Mather, Susan H

    2002-03-01

    The Department of Veterans Affairs (VA) has responded to significant challenges in treating and compensating Persian Gulf War veterans by adapting existing programs and developing new ones. The VA established a Gulf War health examination registry and expanded existing "Vet Centers" to provide assistance to Gulf War veterans. Health care eligibility income limitations were eliminated. Outreach efforts included a national newsletter, veterans' organization briefings, and other products. The VA is developing targeted training programs and continuing medical education for health care providers. Numerous major research initiatives have begun. Innovations include the establishment of environmental hazards research centers, clinical demonstration projects, and centers for the study of war-related illness. These efforts required increased coordination among federal agencies and collaboration with other countries. In a precedent-setting development, Congress gave the VA authority to compensate certain veterans with undiagnosed illnesses. Veterans from future conflicts and peacekeeping missions can expect improved services from the VA as a result of these initiatives. PMID:11901564

  2. 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. PMID:25601246

  3. US Veterans' Use Of VA Mental Health Services And Disability Compensation Increased From 2001 To 2010.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2016-06-01

    There has been concern about the capacity of the Department of Veterans Affairs (VA) health care system to provide care for veterans returning from war zones in the Middle East and Afghanistan. We used two nationally representative surveys of US veterans in 2001 and 2010 to examine changes in the veteran population and veterans' use of health care services after a decade of war. The population was older and more diverse in 2010 than in 2001. In both years, veterans who served in the World War II era or earlier were more likely to have been exposed to combat-related trauma than veterans of more recent service eras. In 2010 veterans who served in the Persian Gulf War era (1990 through the wars in Iraq and Afghanistan) were more likely to have used VA mental health services and to have received VA disability compensation than veterans of previous service eras. Compared to veterans in 2001, those in 2010 were two times more likely to have used any VA health services and were more likely to have received VA disability compensation. These findings highlight changes in the veteran population over time that are important to consider in planning for future VA services. PMID:27269011

  4. Perioperative use of anti-rheumatic agents does not increase early postoperative infection risks: a Veteran Affairs' administrative database study.

    PubMed

    Abou Zahr, Zaki; Spiegelman, Andrew; Cantu, Maria; Ng, Bernard

    2015-02-01

    The aim of this study was to validate a novel technique that predicts stopping of disease-modifying anti-rheumatic drugs (DMARDs) and biologic agents (BA) from the Veterans Affairs (VA) database and compare infection risks of rheumatoid arthritis patients who stopped versus continued DMARDs/BA perioperatively. We identified 6,024 patients on 1 DMARD or BA in the perioperative period between 1999 and 2009. Time gap between medication stop date and the next start date predicted drug stoppage (X). Time gap between surgery date and stop date predicted whether stoppage was before surgery (Y). Chart review from Houston VA was used for validation. ROC analyses were performed on chart review data to obtain X and Y cutoffs. The primary endpoints were wound infections and other infections within 30 days. ROC analyses found X ≥ 33 (AUC = 0.954) and Y ≥ -11 (AUC = 0.846). Risk of postoperative infections was not different when stopping and continuing DMARDs/BA preoperatively. Stopping BA after surgery was associated with higher odds of postoperative wound (OR 14.15, 95 % CI 1.76-113.76) and general infection (OR 9.2, 95 % CI 1.99-42.60) compared to not stopping. Stopping DMARDs after surgery was associated with increased risk of postoperative general infection (OR 1.84, 95 % CI 1.07-3.16) compared with not stopping. There was positive association between stopping DMARDs after surgery and postoperative wound infection but failed to achieve statistical significance (OR 1.67, 95 % CI 0.96-2.91). There was no significant difference in postoperative infection risk when stopping or continuing DMARD/BA. Our new validated method can be utilized in the VA and other databases to predict drug stoppage. PMID:25187198

  5. An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS).

    PubMed

    Dolor, Rowena J; Ruybalid, R Lynne; Uyeda, Lauren; Edson, Robert G; Phibbs, Ciaran; Vertrees, Julia E; Shih, Mei-Chiung; Jacobson, Alan K; Matchar, David B

    2010-10-01

    Prior studies suggest patient self-testing (PST) of prothrombin time (PT) can improve the quality of anticoagulation (AC) and reduce complications (e.g., bleeding and thromboembolic events). "The Home INR Study" (THINRS) compared AC management with frequent PST using a home monitoring device to high-quality AC management (HQACM) with clinic-based monitoring on major health outcomes. A key clinical and policy question is whether and which patients can successfully use such devices. We report the results of Part 1 of THINRS in which patients and caregivers were evaluated for their ability to perform PST. Study-eligible patients (n = 3643) were trained to use the home monitoring device and evaluated after 2-4 weeks for PST competency. Information about demographics, medical history, warfarin use, medications, plus measures of numeracy, literacy, cognition, dexterity, and satisfaction with AC were collected. Approximately 80% (2931 of 3643) of patients trained on PST demonstrated competency; of these, 8% (238) required caregiver assistance. Testers who were not competent to perform PST had higher numbers of practice attempts, higher cuvette wastage, and were less able to perform a fingerstick or obtain blood for the cuvette in a timely fashion. Factors associated with failure to pass PST training included increased age, previous stroke history, poor cognition, and poor manual dexterity. A majority of patients were able to perform PST. Successful home monitoring of PT with a PST device required adequate levels of cognition and manual dexterity. Training a caregiver modestly increased the proportion of patients who can perform PST. PMID:20628787

  6. VA Disability Compensation and Money Spent on Substance Use Among Homeless Veterans: A Controversial Association

    PubMed Central

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Objective There has long been concern that public support payments are used to support addictive behaviors. This study examined the amount of money homeless veterans spend on alcohol and drugs and the association between public support income, including VA disability compensation, and expenditures on alcohol and drugs. Methods Data were from 1,160 veterans from 19 sites on entry into the Housing and Urban Development–Veterans Affairs Supportive Housing program. Descriptive statistics and nonparametric analyses were conducted. Results About 33% of veterans reported spending money on alcohol and 22% reported spending money on drugs in the past month. No significant association was found between public support income, VA disability compensation, and money spent on alcohol and drugs. Conclusions A substantial proportion of homeless veterans spend some income on alcohol and drugs, but disability income, including VA compensation, does not seem to be related to substance use or money spent on addictive substances. PMID:25726979

  7. 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…

  8. Vascular and biochemical risk factors of vascular dementia after lacunar strokes (S-VaD) and after multiinfarcts in strategic areas (M-VaD).

    PubMed

    Graban, Ałła; Bednarska-Makaruk, Małgorzata; Bochyńska, Anna; Lipczyńska-Łojkowska, Wanda; Ryglewicz, Danuta; Wehr, Hanna

    2009-08-15

    Vascular cognitive impairment is an important cause of cognitive decline in the elderly. Ischemic lesions in the brain have an influence on the natural history of dementia. Vascular dementia can be caused by small-vessels disease (S-VaD) or by large-artery atherosclerosis with vascular lesions in strategic areas of the brain (M-VaD). In both cases changes in white matter are observed. In 60 patients with S-VaD and in 34 with M-VaD the presence of vascular and biochemical risk factors was evaluated and compared to age and sex matched 126 controls without dementia. Coronary artery disease, atrial fibrillation, hypertension and strokes were observed more frequently in both investigated groups. Of biochemical risk factors, hyperhomocysteinemia (associated with low levels of folic acid and vitamin B 12) and low HDL cholesterol levels were found in both forms of VaD. PMID:19339023

  9. 77 FR 65382 - Notice of Public Meeting for the Draft Environmental Impact Statement for the Foreign Affairs...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... ADMINISTRATION Notice of Public Meeting for the Draft Environmental Impact Statement for the Foreign Affairs... Services Administration (GSA) has prepared and filed a Draft Environmental Impact Statement (EIS) with the... Street, Blackstone VA, 23824. Informational posters will be on display in the Dining Hall,...

  10. 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…

  11. Student Affairs and the Bicentennial

    ERIC Educational Resources Information Center

    Dinniman, Andrew E.

    1974-01-01

    Student Affairs professionals have an active role to play in our nation's anniversary celebration, according to the author. In this article, he describes briefly some Bicentennial programs at different universities and colleges throughout the U.S. (Author/HMV)

  12. House Committee on Veterans' Affairs

    MedlinePlus

    Skip to main content House Committee on Veterans Affairs Search form Search Main menu About Chair History and Jurisdiction History of the CHOB Internship Opportunities Membership Rules and Publications Hearings Archived ...

  13. Judicial Affairs and the Future.

    ERIC Educational Resources Information Center

    Pavela, Gary

    1996-01-01

    American colleges and universities will play an increasingly important role in revitalizing a national sense of identity and community. Judicial affairs offices can contribute to that process by helping students define and protect values essential to community life. (Author)

  14. Chaplains' Engagement with Suicidality among Their Service Users: Findings from the VA/DoD Integrated Mental Health Strategy.

    PubMed

    Kopacz, Marek S; Nieuwsma, Jason A; Jackson, George L; Rhodes, Jeffrey E; Cantrell, William C; Bates, Mark J; Meador, Keith G

    2016-04-01

    Chaplains play an important role in supporting the mental health of current and former military personnel; in this study, the engagement of Department of Veterans Affairs (VA), Army, Navy, and Air Force chaplains with suicidality among their service users were examined. An online survey was used to collect data from 440 VA and 1,723 Department of Defense (DoD) chaplains as part of the VA/DoD Integrated Mental Health Strategy. Differences were noted for demographics, work setting characteristics, encountering suicidality, and self-perceived preparation for dealing with suicidality. Compared to DoD chaplains, VA chaplains encounter more at-risk service users, yet feel less prepared for dealing with suicidality. PMID:26255592

  15. Real-time seismic monitoring of Veterans Affairs hospital buildings

    NASA Astrophysics Data System (ADS)

    Ulusoy, Hasan S.; Kalkan, Erol; Banga, Krishna

    2013-04-01

    This paper describes recent collaborative efforts made by the United States Geological Survey and Department of Veterans Affairs (VA) in real-time seismic monitoring of VA hospital buildings located in seismically active regions. The instrumentation in each building encompasses accelerometers deployed on all floors, a multi-channel recorder, and a server to analyze and archive the building's dynamic response in real-time. The server runs advanced structural health monitoring software, which consists of several data processing and analysis modules. Four different algorithms are implemented in four separate modules to compute shear-wave travel time, modal parameters, base shear force, and inter-story drift ratio from the measured vibration data from the instrumented building. The performance level and damage state of the building are estimated from the inter-story drift ratio and base-shear; the change in modal parameters and wave travel time is also used to detect and locate any possible damage zone(s) in the building. These algorithms are validated and verified using data from full-scale shake table tests. The information obtained from the real-time seismic monitoring system can be used to support timely decisions regarding the structural integrity of the VA hospital buildings immediately after an earthquake, and to help with inspections and necessary repairs and replacements.

  16. The Veterans Access, Choice, and Accountability Act of 2014: Examining Graduate Medical Education Enhancement in the Department of Veterans Affairs.

    PubMed

    Chang, Barbara K; Brannen, Judy L

    2015-09-01

    From 2006 to 2011, the Department of Veterans Affairs (VA) introduced the Graduate Medical Education (GME) Enhancement initiative to increase residency positions at VA training sites. VA once again has an opportunity to fund new residency positions through the Veterans Access, Choice, and Accountability Act of 2014 (VACAA). Congressional requirements under VACAA give priority to positions in primary care, mental health, and other specialties that the Secretary of Veterans Affairs deems appropriate. Moreover, facilities meeting the following criteria will be awarded priority for expansion: no prior GME activities, a shortage of physicians, rural locations, areas with a "high concentration of veterans," or located in Health Professional Shortage Areas as defined by the Health Resources and Services Administration. The authors of this Commentary discuss the implications of the new legislation, reviewing the past VA GME Enhancement efforts to examine the potential impact of further expansion of VA GME positions. Understanding the intent of the legislation and its provisions will allow qualified existing and potentially new affiliates to successfully pursue new residency positions during the five-year period of VA GME expansion under VACAA. PMID:26107878

  17. Adoption of PACS by the Department of Veterans Affairs: the past, the present, and future plans

    NASA Astrophysics Data System (ADS)

    Siegel, Eliot L.; Reiner, Bruce I.; Kuzmak, Peter M.

    2000-05-01

    The diffusion of PACS technology within the Department of Veterans Affairs has followed the 'S' curve transition originally described by Ryan and Gross in 1943. They described a paradigm that describes the diffusion of a new technology into the community. However the rate of adoption of filmless radiology by the VA has been much higher than that of the general healthcare system. This is likely due to the fact that the VA and Department of Defense medical systems are somewhat isolated and independent from other health care systems and are subject to a different rate of diffusion of technology. The early introduction and success of PACS in the VA undoubtedly accelerated its acceptance throughout the system. An additional impetus to the growth of PACS in the VA has been the development of an image management system that has been incorporated into the electronic medical record. The universal use of the VISTA HIS and RIS system throughout the VA and the fact that it was developed 'in-house' as well as its extensive support for DICOM functionality have also played a major role in facilitating the acceptance of Picture Archival and Communication Systems throughout the VA.

  18. Charges billed to third parties for prescription drugs furnished by VA to a veteran for a nonservice-connected disability. Final rule.

    PubMed

    2010-10-01

    This document amends the medical regulations of the Department of Veterans Affairs (VA) concerning ``reasonable charges'' for medical care or services provided or furnished by VA to a veteran for a nonservice-connected disability. More specifically, VA amends the regulations regarding charges billed for prescription drugs not administered during treatment by changing the billing formula to reflect VA's actual drug costs for each drug rather than using a national average drug cost for all prescriptions dispensed. The revised formula for calculating reasonable charges for prescription drug costs will also continue to include an average administrative cost for each prescription. The purpose is to provide VA with a more accurate billing methodology for prescription drugs. PMID:20931727

  19. Suicide Risk Documented During Veterans' Last Veterans Affairs Health Care Contacts Prior to Suicide.

    PubMed

    Denneson, Lauren M; Kovas, Anne E; Britton, Peter C; Kaplan, Mark S; McFarland, Bentson H; Dobscha, Steven K

    2016-06-01

    A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow-up (n = 168; 57%). Fifty-three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide. PMID:26833711

  20. The organization and delivery of women's health care in Department of Veterans Affairs Medical Center.

    PubMed

    Yano, Elizabeth M; Washington, Donna L; Goldzweig, Caroline; Caffrey, Cynthia; Turner, Carole

    2003-01-01

    Congressional eligibility reforms have profoundly changed the array of services to be made available to women veterans in Department of Veterans Affairs (VA) health care facilities. These include access not only to primary and specialty care services already afforded VA users, but also to a full spectrum of gender-specific services, including prenatal, obstetric, and infertility services never before provided in VA settings. The implications of this legislative mandate for delivering care to women veterans are poorly understood, as little or no information has been available about how care for women veterans is organized. This article reports on the first national assessment of variations in the organization of care for women veterans. PMID:12732441

  1. Clopidogrel: A multifaceted affair.

    PubMed

    Martínez-Quintana, Efrén; Tugores, Antonio

    2015-01-01

    Clopidogrel has been the therapy of choice, combined with aspirin, against platelet aggregation in patients at risk of suffering a vascular thrombotic event. Not all patients respond equally to clopidogrel, an observation that has led to searching for a test that, in the clinical setting, could predict patients' "resistance" to therapy. The evidence reveals a complex pharmacokinetic profile for clopidogrel, with multiple players involved, including cytochromes, characteristics of the target tissue, and accompanying clinical conditions. Despite FDA black box warnings recommending CYP2C19 genotyping before clopidogrel use, no robust evidence indicates that CYP2C19 function determines clinical response to the drug, either based on the presence of loss of function alleles or drug interactions with CYP2C19 inhibitors, like omeprazole. A tailored anti-aggregation treatment based on ex vivo platelet reactivity also seems unlikely due to the lack of robustness of most assays. The identification of clinical conditions that are at higher risk of new cardiovascular events, such as diabetes, obesity, coronary artery disease, or specific stenting procedures, seems to be a prudent approach to tailor anti-platelet therapy with more powerful drugs, accompanied by careful counseling to promote patient compliance. PMID:25328019

  2. 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…

  3. The prevalence of body dysmorphic disorder and its clinical correlates in a VA primary care behavioral health clinic.

    PubMed

    Kelly, Megan M; Zhang, Jinxin; Phillips, Katharine A

    2015-07-30

    We examined the prevalence of body dysmorphic disorder (BDD) in a Veterans Affairs (VA) primary care behavioral health clinic. Of 100 Veterans, 11% (95% CI = 6.3-18.6%) had current BDD and 12% (95% CI = 7.0-19.8%) had lifetime BDD. However, only 8.3% of these Veterans had been diagnosed with BDD. BDD was significantly associated with a substantially elevated rate of suicide attempts, major depression, and obsessive-compulsive disorder. This severe disorder appears to be underdiagnosed in VA settings. PMID:25935375

  4. 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.

  5. Claims based on exposure to ionizing radiation (prostate cancer and any other cancer)--VA. Final rule.

    PubMed

    1998-09-24

    This document amends the Department of Veterans Affairs (VA) adjudication regulations concerning compensation for diseases claimed to be the result of exposure to ionizing radiation. This amendment implements a decision by the Secretary of Veterans Affairs that, based on all evidence currently available to him, prostate cancer and any other cancers may be induced by ionizing radiation. The intended effect of this action is to relieve veterans, or their survivors, seeking benefits under the provisions of the Veterans' Dioxin and Radiation Exposure Compensation Standards Act of the burden of having to submit evidence that a veteran's prostate cancer or any other cancer may have been induced by ionizing radiation. PMID:10185808

  6. The VA-Medical School Partnership: The Medical School Perspective.

    ERIC Educational Resources Information Center

    Petersdorf, Robert G.

    1987-01-01

    Issues in the relationship between the Veterans' Administration (VA) and medical schools are discussed, including VA faculty recruitment and retention, ambulatory care in VA teaching hospitals, governance and growth of research within VA medical centers, and effects of cost containment and competition on teaching and training in VA hospitals. (MSE)

  7. 76 FR 75509 - Autopsies at VA Expense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-02

    ... that amendment, VA promulgated 38 CFR 17.38, on October 6, 1999, 64 FR 54212. Section 17.38, inter alia... procedure; Alcohol abuse; Alcoholism; Claims; Day care; Dental health; Drug abuse; Government contracts...-reference to VA regulations that authorize certain outpatient and ambulatory care. The proposed rule...

  8. 78 FR 32126 - VA Dental Insurance Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... in the Federal Register (77 FR 12517) a proposed rule to amend VA regulations to establish VADIP, a... coverage capabilities as determined during the Federal contracting process. See 77 FR 12518. Although VA... 510(b). See 77 FR 12520. We will conduct the Federal contracting process anticipating this...

  9. Organizational Vitality in Student Affairs.

    ERIC Educational Resources Information Center

    Barnes, Stephen F.; O'Donnell, Jo Anne

    Institutional vitality, a broad measure of the quality of organizational life at colleges and universities, has not been systematically addressed in the literature. To identify management and personnel practices which contribute to institutional vitality within student affairs divisions, a two-stage methodology was employed. First, an…

  10. 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…

  11. Online Education in Public Affairs

    ERIC Educational Resources Information Center

    Ginn, Martha H.; Hammond, Augustine

    2012-01-01

    This exploratory study provides an overview of the current landscape of online education in the fields of Master of Public Administration and Master of Public Policy (MPA/MPP) utilizing a dataset compiled from content analysis of MPA/MPP programs' websites and survey of 96 National Association of Schools of Public Affairs and Administration…

  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. 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…

  14. Employment Practices in Student Affairs.

    ERIC Educational Resources Information Center

    McIntire, David A.; Carpenter, D. Stanley

    1981-01-01

    Investigated job search and hiring practices in student affairs work. Questionnaires sent to member institutions of the National Association of Student Personnel Administrators indicated the extensive use of newspapers to advertise positions. Institutions placed a high level of importance on effective resumes and reference letters. (RC)

  15. 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.…

  16. 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,…

  17. 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…

  18. 78 FR 53506 - Proposed Information Collection (Care Coordination Home Telehealth (CCHT) Patient Satisfaction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... Vermont Avenue NW., Washington, DC 20420; or email: cynthia.harvey-pryor@va.gov . Please refer to ``OMB... Survey, VA Form 10-0481); Activity: Comment Request AGENCY: Veterans Health Administration, Department of... Affairs (VA), is announcing an opportunity for public comment on the proposed collection of...

  19. "Do you expect me to receive PTSD care in a setting where most of the other patients remind me of the perpetrator?": Home-based telemedicine to address barriers to care unique to military sexual trauma and veterans affairs hospitals.

    PubMed

    Gilmore, Amanda K; Davis, Margaret T; Grubaugh, Anouk; Resnick, Heidi; Birks, Anna; Denier, Carol; Muzzy, Wendy; Tuerk, Peter; Acierno, Ron

    2016-05-01

    Home-based telemedicine (HBT) is a validated method of evidence-based treatment delivery for posttraumatic stress disorder (PTSD), and justification for its use has centered on closing gaps related to provider availability and distance to treatment centers. However, another potential use of HBT may be to overcome barriers to care that are inherent to the treatment environment, such as with female veterans who have experienced military sexual trauma (MST) and who must present to VA Medical Centers where the majority of patients share features with perpetrator (e.g. gender, clothing) and may function as reminders of the trauma. Delivering evidence-based therapies to female veterans with MST-related PTSD via HBT can provide needed treatment to this population. This manuscript describes an ongoing federally funded randomized controlled trial comparing Prolonged Exposure (PE) delivered in-person to PE delivered via HBT. Outcomes include session attendance, satisfaction with services, and clinical and quality of life indices. It is hypothesized that based on intent-to-treat analyses, HBT delivery of PE will be more effective than SD at improving both clinical and quality of life outcomes at post, 3-, and 6-month follow-up. This is because 'dose received', that is fewer sessions missed, and lower attrition, will be observed in the HBT group. Although the current manuscript focuses on female veterans with MST-related PTSD, implications for other populations facing systemic barriers are discussed. PMID:26992740

  20. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed.

    PubMed

    Schubert, Cathy C; Myers, Laura J; Allen, Katie; Counsell, Steven R

    2016-07-01

    In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation. PMID:27305428

  1. Risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in MRSA-colonized patients discharged from a Veterans Affairs hospital.

    PubMed

    Cadena, J; Richardson, A M; Frei, C R

    2016-02-01

    Currently, limited studies have quantified the risk of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) for MRSA-colonized patients on discharge from hospital. Our retrospective, case-control study identified independent risk factors for the development of MRSA SSTIs among such patients detected by active MRSA nasal screening in an acute care hospital by PCR on admission, and bacteriological cultures on discharge. Cases were MRSA-colonized patients aged ⩾18 years who developed a MRSA SSTI post-discharge and controls were those who did not develop a MRSA SSTI post-discharge. Controls were matched to cases by length of follow-up (±10 days) for up to 18 months. Potential demographic and clinical risk factors for MRSA infection were identified using electronic queries and manual chart abstraction; data were compared by standard statistical tests and variables with P values ⩽0·05 in bivariable analysis were entered into a logistic regression model. Multivariable analysis demonstrated prior hospital admission within 12 months (P = 0·02), prior MRSA infection (P = 0·05), and previous myocardial infarction (P = 0·01) were independently predictive of a MRSA SSTI post-discharge. Identification of MRSA colonization upon admission and recognition of risk factors could help identify a high-risk population that could benefit from MRSA SSTI prevention strategies. PMID:26194247

  2. Schedule for rating disabilities--mental disorders and definition of psychosis for certain VA purposes. Final rule.

    PubMed

    2015-03-19

    The Department of Veterans Affairs (VA) adopts as final, without change, an interim final rule amending its Schedule for Rating Disabilities (VASRD) dealing with mental disorders and its adjudication regulations that define the term "psychosis." Outdated references are replaced with references to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Nomenclature used to refer to certain mental disorders is amended to conform to DSM-5. This rule also provides clarification of the applicability date. PMID:25898428

  3. A Decade’s Experience With Quality Improvement in Cardiac Surgery Using the Veterans Affairs and Society of Thoracic Surgeons National Databases

    PubMed Central

    Grover, Frederick L.; Shroyer, A. Laurie W.; Hammermeister, Karl; Edwards, Fred H.; Ferguson, T. Bruce; Dziuban, Stanley W.; Cleveland, Joseph C.; Clark, Richard E.; McDonald, Gerald

    2001-01-01

    Objective To review the Department of Veteran Affairs (VA) and the Society of Thoracic Surgeons (STS) national databases over the past 10 years to evaluate their relative similarities and differences, to appraise their use as quality improvement tools, and to assess their potential to facilitate improvements in quality of cardiac surgical care. Summary Background Data The VA developed a mandatory risk-adjusted database in 1987 to monitor outcomes of cardiac surgery at all VA medical centers. In 1989 the STS developed a voluntary risk-adjusted database to help members assess quality and outcomes in their individual programs and to facilitate improvements in quality of care. Methods A short data form on every veteran operated on at each VA medical center is completed and transmitted electronically for analysis of unadjusted and risk-adjusted death and complications, as well as length of stay. Masked, confidential semiannual reports are then distributed to each program’s clinical team and the associated administrator. These reports are also reviewed by a national quality oversight committee. Thus, VA data are used both locally for quality improvement and at the national level with quality surveillance. The STS dataset (217 core fields and 255 extended fields) is transmitted for each patient semiannually to the Duke Clinical Research Institute (DCRI) for warehousing, analysis, and distribution. Site-specific reports are produced with regional and national aggregate comparisons for unadjusted and adjusted surgical deaths and complications, as well as length of stay for coronary artery bypass grafting (CABG), valvular procedures, and valvular/CABG procedures. Both databases use the logistic regression modeling approach. Data for key processes of care are also captured in both databases. Research projects are frequently carried out using each database. Results More than 74,000 and 1.6 million cardiac surgical patients have been entered into the VA and STS databases

  4. Success of HIS DICOM interfaces in the integration of the healthcare enterprise at the Department of Veterans Affairs

    NASA Astrophysics Data System (ADS)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    1999-07-01

    The US Department of Veterans Affairs (VA) is integrating imaging into the healthcare enterprise using the Digital Imaging and Communication in Medicine (DICOM) standard protocols. Image management is directly integrated into the VistA Hospital Information System (HIS) software and the clinical database. Radiology images are acquired via DICOM, and are stored directly in the HIS database. Images can be displayed on low-cost clinician's workstations throughout the medical center. High-resolution diagnostic quality multi-monitor VistA workstations with specialized viewing software can be used for reading radiology images. Two approaches are used to acquire and handle imags within the radiology department. Some sties have a commercial Picture Archiving and Communications System (PACS) interfaced to the VistA HIS, while other sites use the direct image acquisition and integrated diagnostic reading capabilities of VistA itself. A small set of DICOM services have been implemented by VistA to allow patient and study text data to be transmitted to image producing modalities and the commercial PACS, and to enable images and study data to be transferred back. The VistA DICOM capabilities are now used to interface seven different commercial PACS products and over twenty different radiology modalities. The communications capabilities of DICOM and the VA wide area network are begin used to support reading of radiology images form remote sites. DICOM has been the cornerstone in the ability to integrate imaging functionality into the Healthcare Enterprise. Because of its openness, it allows the integration of system component from commercial and non- commercial sources to work together to provide functional cost-effective solutions. As DICOM expands to non-radiology devices, integration must occur with the specialty information subsystems that handle orders and reports, their associated DICOM image capture systems, and the computer- based patient record. The mode and concepts of

  5. Providers' Note-Writing Practices for Post-traumatic Stress Disorder at Five United States Veterans Affairs Facilities.

    PubMed

    Tuepker, Anaïs; Zickmund, Susan L; Nicolajski, Cara E; Hahm, Bridget; Butler, Jorie; Weir, Charlene; Post, Lori; Hickam, David H

    2016-07-01

    The capacity of electronic health records (EHRs) to capture desired information depends on the practices of health care providers. These practices have not been well studied in relation to post-traumatic stress disorder (PTSD). This qualitative study investigated how providers write EHR notes on PTSD through 38 interviews with providers working at five Veterans Affairs (VA) hospitals across the United States of America. Two overarching themes were prominent in the results. Providers used progress notes primarily to remember and access details for direct patient care, but only rarely for care coordination. Providers infrequently recorded information not judged to directly contribute to improved care, sometimes deliberately omitting information perceived to jeopardize patients' access to, or quality of, care. Omitted information frequently included sexual or non-military trauma. Understanding providers' thought processes can help clinicians be aware of the limitations of EHR notes as a tool for learning the histories of new patients. Similarly, researchers relying on EHR data for PTSD research should be aware of likely areas of missing data. PMID:26228929

  6. Information Communication Technology (ICT) Shaping Student Affairs.

    ERIC Educational Resources Information Center

    Broughton, Elizabeth

    This paper opens with the following questions: "How prepared are you as a student affairs professional for information communication technology (ICT)? Do you understand such concepts as portals, e-business, Napster, computer use policies, and wireless communication? Will student affairs be shaped by ICT or will student affairs help shape ICT on…

  7. A GUIDE TO UNDERSTANDING WORLD AFFAIRS.

    ERIC Educational Resources Information Center

    ROGERS, WILLIAM C.

    WRITTEN IN EVERYDAY ENGLISH, THIS READING BOOK PRESENTS MANY FACTS AND IDEAS ABOUT WORLD AFFAIRS. CHAPTERS COVER INTERNATIONAL LIFE, POWER IN WORLD AFFAIRS, WAR AS INTERNATIONAL CONFLICT, THE MEANS AND VARIETIES OF ARMED CONFLICT, INTERNATIONAL CONFLICT SHORT OF WAR, THE ACCOMMODATION OF CONFLICT IN WORLD AFFAIRS, AND PEACE--WHAT IT IS AND HOW TO…

  8. US Department of Veterans Affairs Disability Policies for Posttraumatic Stress Disorder: Administrative Trends and Implications for Treatment, Rehabilitation, and Research

    PubMed Central

    Frueh, B. Christopher; Grubaugh, Anouk L.; Elhai, Jon D.; Buckley, Todd C.

    2007-01-01

    An accumulating body of empirical data suggests that current Department of Veterans Affairs (VA) psychiatric disability and rehabilitation policies for combat-related posttraumatic stress disorder (PTSD) are problematic. In combination, recent administrative trends and data from epidemiological and clinical studies suggest theses policies are countertherapeutic and hinder research efforts to advance our knowledge regarding PTSD. Current VA disability policies require fundamental reform to bring them into line with modern science and medicine, including current empirically supported concepts of resilience and psychiatric rehabilitation. PMID:17971542

  9. High-density lipoprotein cholesterol as an independent risk factor in cardiovascular disease: assessing the data from Framingham to the Veterans Affairs High--Density Lipoprotein Intervention Trial.

    PubMed

    Boden, W E

    2000-12-21

    The Framingham Heart Study found that high-density lipoprotein cholesterol (HDL-C) was the most potent lipid predictor of coronary artery disease risk in men and women >49 years of age. The Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS), in which subjects were randomized to treatment with lovastatin or placebo, also reported a striking benefit of treatment, particularly in patients with HDL-C < or =35 mg/dL at baseline. Treatment with lovastatin was associated with a remarkable 45% reduction in events for this group. The Veterans Affairs HDL Intervention Trial (VA-HIT) randomized subjects to gemfibrozil or placebo. A high proportion of enrolled subjects with low HDL-C also had characteristics of the dysmetabolic syndrome. HDL-C likewise increased by 6% on treatment, total cholesterol was reduced by 4% and triglycerides by 31%. There was no change in low-density lipoprotein cholesterol (LDL-C) levels. These changes in lipid were associated with a cumulative 22% reduction in the trial primary endpoint of all-cause mortality and nonfatal myocardial infarction (MI). Additionally, significant reductions in secondary endpoints including death from coronary artery disease, nonfatal MI, stroke, transient ischemic attack, and carotid endarterectomy were associated with the increase in HDL-C. In VA-HIT, for every 1% increase in HDL-C, there was a 3% reduction in death or MI, a therapeutic benefit that eclipses the benefit associated with LDL-C reduction. PMID:11374850

  10. 'A one-sided affair': unilateral pulmonary oedema and the role of cardiac MRI in diagnosing premature coronary artery disease in a patient with Prader-Willi syndrome.

    PubMed

    Jabbar, Avais; Khan, Jamal N; Singh, Anvesha; McCann, Gerry P

    2013-01-01

    There is no formal association between premature coronary artery disease (CAD) and Prader-Willi syndrome despite its association with hyperlipidaemia, diabetes mellitus and hypertension. A 36-year-old man with Prader-Willi syndrome presented with acute breathlessness. Inflammatory markers were borderline elevated and chest radiography demonstrated unilateral diffuse alveolar shadowing. Bronchopneumonia was diagnosed and despite treatment with multiple courses of antimicrobial therapy, there was minimal symptomatic and radiographical improvement. A diagnosis of unilateral pulmonary oedema was suspected. Echocardiography was non-diagnostic due to body habitus and coronary angiography was deemed inappropriate due to uncertainty in diagnosis, invasiveness and pre-existing chronic kidney disease. Therefore, cardiac magnetic resonance was performed, confirming severe triple-vessel CAD. This case demonstrates a presentation of heart failure with unilateral chest radiograph changes in a young patient with Prader-Willi syndrome and severe premature CAD detected by multiparametric cardiac magnetic resonance imaging. PMID:23704427

  11. Perioperative Care of the Transgender Patient.

    PubMed

    Smith, Francis Duval

    2016-02-01

    Transgender patients are individuals whose gender identity is not related to their biological sex. Assuming a new gender identity that does not conform to societal norms often results in discrimination and barriers to health care. The exact number of transgender patients is unknown; however, these patients are increasingly seen in health care. Transgender individuals may experience provider-generated discrimination in health care facilities, including refusal of service, disrespect, and abuse, which contribute to depression and low self-esteem. Transgender therapies include mental health counseling for depression and low self-esteem, hormone therapy, and sex reassignment surgery. Health care professionals require cultural competence, an understanding of the different forms of patient identification, and adaptive approaches to care for transgender patients. VA (Veterans Affairs) hospitals provide a model for the care for transgender patients and staff. PMID:26849981

  12. Access to the US Department of Veterans Affairs health system: self-reported barriers to care among returnees of Operations Enduring Freedom and Iraqi Freedom

    PubMed Central

    2013-01-01

    Background The U.S. Department of Veterans Affairs (VA) implemented the Polytrauma System of Care to meet the health care needs of military and veterans with multiple injuries returning from combat operations in Afghanistan and Iraq. Studies are needed to systematically assess barriers to use of comprehensive and exclusive VA healthcare services from the perspective of veterans with polytrauma and with other complex health outcomes following their service in Afghanistan and Iraq. These perspectives can inform policy with regard to the optimal delivery of care to returning veterans. Methods We studied combat veterans (n = 359) from two polytrauma rehabilitation centers using structured clinical interviews and qualitative open-ended questions, augmented with data collected from electronic health records. Our outcomes included several measures of exclusive utilization of VA care with our primary exposure as reported access barriers to care. Results Nearly two thirds of the veterans reported one or more barriers to their exclusive use of VA healthcare services. These barriers predicted differences in exclusive use of VA healthcare services. Experiencing any barriers doubled the returnees’ odds of not using VA exclusively, the geographic distance to VA barrier resulted in a 7 fold increase in the returnees odds of not using VA, and reporting a wait time barrier doubled the returnee’s odds of not using VA. There were no striking differences in access barriers for veterans with polytrauma compared to other returning veterans, suggesting the barriers may be uniform barriers that predict differences in using the VA exclusively for health care. Conclusions This study provides an initial description of utilization of VA polytrauma rehabilitation and other medical care for veteran returnees from all military services who were involved in combat operations in Afghanistan or Iraq. Our findings indicate that these veterans reported important stigmatization and barriers to

  13. 78 FR 45454 - Patient Access to Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-29

    ...The Department of Veterans Affairs (VA) amends its regulation governing disclosure of information to veterans and other beneficiaries. The current regulation provides for a special procedure for evaluating sensitive records and determining whether an individual may gain access to his or her own records. The special procedure allows VA to prevent an individual's access to his or her own records......

  14. 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.

  15. 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.

  16. 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:

  17. 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…

  18. The relationship between local area labor market conditions and the use of Veterans Affairs health services

    PubMed Central

    2013-01-01

    Background In the U.S., economic conditions are intertwined with labor market decisions, access to health care, health care utilization and health outcomes. The Veterans Affairs (VA) health care system has served as a safety net provider by supplying free or reduced cost care to qualifying veterans. This study examines whether local area labor market conditions, measured using county-level unemployment rates, influence whether veterans obtain health care from the VA. Methods We used survey data from the Behavioral Risk Factor Surveillance System in years 2000, 2003 and 2004 to construct a random sample of 73,964 respondents self-identified as veterans. VA health service utilization was defined as whether veterans received all, some or no care from the VA. Hierarchical ordered logistic regression was used to address unobserved state and county random effects while adjusting for individual characteristics. Local area labor market conditions were defined as the average 12-month unemployment rate in veterans’ county of residence. Results The mean unemployment rate for veterans receiving all, some and no care was 5.56%, 5.37% and 5.24%, respectively. After covariate adjustment, a one percentage point increase in the unemployment rate in a veteran’s county of residence was associated with an increase in the probability of receiving all care (0.34%, p-value = 0.056) or some care (0.29%, p-value = 0.023) from the VA. Conclusions Our findings suggest that the important role of the VA in providing health care services to veterans is magnified in locations with high unemployment. PMID:23496888

  19. 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

  20. 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. PMID:22285982

  1. Utilization of evidence-based psychotherapies in Veterans Affairs posttraumatic stress disorder outpatient clinics

    PubMed Central

    Finley, Erin P.; Garcia, Hector A.; Ketchum, Norma S.; McGeary, Donald D.; McGeary, Cindy A.; Stirman, Shannon Wiltsey; Peterson, Alan L.

    2014-01-01

    In response to the growing numbers of veterans with posttraumatic stress disorder (PTSD), the Department of Veterans Affairs (VA) has sought to make evidence-based psychotherapies for PTSD available at every VA facility. We conducted a national survey of providers within VA PTSD clinical teams (PCTs) to describe utilization of Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) and to identify individual and organizational factors associated with treatment uptake and adherence. Participants (N = 128) completed an electronic survey assessing reported utilization of PE and CPT treatments, adherence to treatment manuals, and characteristics of the provider and workplace environment. Participants reported conducting a weekly mean of 4.5 hours of PE, 3.9 hours of CPT (individual format), 1.3 hours of CPT (group format), and 13.4 hours of supportive care. Perceived effectiveness of PE and CPT were significantly associated with utilization of and adherence to those treatments. Reported number of hours conducting supportive care was positively associated with feeling the clinic was not sufficiently staffed (p = .05). Adherence to the PE treatment manual was positively associated with receiving emotional support from co-workers (p<.01). Provider attitudes and organizational factors such as staffing and work relationships may have an important impact on treatment selection and the quality of PTSD care provided in VA PCTs. PMID:25419915

  2. 76 FR 59741 - Bureau of International Labor Affairs; Office of Trade and Labor Affairs; National Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... through the Bureau of International Labor Affairs (ILAB) that will be included in the second Biennial... statements in response to this notice to Paula Church Albertson, Office of Trade and Labor Affairs, ILAB,...

  3. KENO V.a certification package

    SciTech Connect

    Niemer, K.A.

    1994-04-01

    KENO V.a has been certified. KENO V.a is a multigroup Monte Carlo criticality program used to calculate the k-effective of a 3-D system. It is part of the SCALE modular code system for performing Standardized Computer Analyses for Licensing Evaluation. SCALE was developed for the Nuclear Regulatory Commission to satisfy a need for a standardized method of analysis for the evaluation of nuclear fuel facility and package designs. In its present form, the system has the capability to perform criticality, shielding, and heat transfer analyses using well established functional modules tailored to the SCALE system. KENO V.a will be used at SRS to perform critical calculations related to nuclear criticality safety.

  4. 78 FR 13897 - Bureau of International Labor Affairs; Office of Trade and Labor Affairs; Labor Affairs Council...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ...: International Labor Affairs Bureau (ILAB), U.S. Department of Labor. ACTION: Notice of Public Session Meeting...), the International Labor Affairs Bureau (ILAB) of the U.S. Department of Labor gives notice of the..., 2013, from 9:00 a.m. to 11:30 a.m. ILAB requests those interested in attending provide their...

  5. VaRank: a simple and powerful tool for ranking genetic variants

    PubMed Central

    Geoffroy, Véronique; Pizot, Cécile; Redin, Claire; Piton, Amélie; Vasli, Nasim; Stoetzel, Corinne; Blavier, André; Laporte, Jocelyn

    2015-01-01

    Background. Most genetic disorders are caused by single nucleotide variations (SNVs) or small insertion/deletions (indels). High throughput sequencing has broadened the catalogue of human variation, including common polymorphisms, rare variations or disease causing mutations. However, identifying one variation among hundreds or thousands of others is still a complex task for biologists, geneticists and clinicians. Results. We have developed VaRank, a command-line tool for the ranking of genetic variants detected by high-throughput sequencing. VaRank scores and prioritizes variants annotated either by Alamut Batch or SnpEff. A barcode allows users to quickly view the presence/absence of variants (with homozygote/heterozygote status) in analyzed samples. VaRank supports the commonly used VCF input format for variants analysis thus allowing it to be easily integrated into NGS bioinformatics analysis pipelines. VaRank has been successfully applied to disease-gene identification as well as to molecular diagnostics setup for several hundred patients. Conclusions. VaRank is implemented in Tcl/Tk, a scripting language which is platform-independent but has been tested only on Unix environment. The source code is available under the GNU GPL, and together with sample data and detailed documentation can be downloaded from http://www.lbgi.fr/VaRank/. PMID:25780760

  6. VaRank: a simple and powerful tool for ranking genetic variants.

    PubMed

    Geoffroy, Véronique; Pizot, Cécile; Redin, Claire; Piton, Amélie; Vasli, Nasim; Stoetzel, Corinne; Blavier, André; Laporte, Jocelyn; Muller, Jean

    2015-01-01

    Background. Most genetic disorders are caused by single nucleotide variations (SNVs) or small insertion/deletions (indels). High throughput sequencing has broadened the catalogue of human variation, including common polymorphisms, rare variations or disease causing mutations. However, identifying one variation among hundreds or thousands of others is still a complex task for biologists, geneticists and clinicians. Results. We have developed VaRank, a command-line tool for the ranking of genetic variants detected by high-throughput sequencing. VaRank scores and prioritizes variants annotated either by Alamut Batch or SnpEff. A barcode allows users to quickly view the presence/absence of variants (with homozygote/heterozygote status) in analyzed samples. VaRank supports the commonly used VCF input format for variants analysis thus allowing it to be easily integrated into NGS bioinformatics analysis pipelines. VaRank has been successfully applied to disease-gene identification as well as to molecular diagnostics setup for several hundred patients. Conclusions. VaRank is implemented in Tcl/Tk, a scripting language which is platform-independent but has been tested only on Unix environment. The source code is available under the GNU GPL, and together with sample data and detailed documentation can be downloaded from http://www.lbgi.fr/VaRank/. PMID:25780760

  7. Reflections after the Diane affair.

    PubMed

    Kant, A; van Puijenbroek, E; van Hunsel, F

    2014-09-01

    The Pharmacovigilance Centre Lareb received 621 reports of possible adverse drugs reactions on Diane-35® . Of all reports, 388 were received after media attention. Of the 309 reports of thromboembolic adverse drugs reactions, 18 cases were fatal. In 31 cases the thromboembolic adverse drugs reaction was initially not recognized as such. The analysis and the turmoil of the 'Diane affair' gave rise to the following reflections: Reflection 1. Continuous awareness and attention of risk of medicines is needed, also for known risks, for timely recognition of adverse drugs reactions. Reflection 2. Reporting side effects should be part of the professional attitude. Reports play a pivotal role in the detection of new adverse drugs reactions and the conditions under which known adverse drugs reactions occur. Reflection 3. Improvement of adequate use of drugs. Pharmacovigilance not only has the aim to improve knowledge on risk of medicines, but also the aim of getting this knowledge into Health Care practice. PMID:24909698

  8. Role of HIS/RIS DICOM interfaces in the integration of imaging into the Department of Veterans Affairs healthcare enterprise

    NASA Astrophysics Data System (ADS)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    1998-07-01

    The U.S. Department of Veterans Affairs is integrating imaging into the healthcare enterprise using the Digital Imaging and Communication in Medicine (DICOM) standard protocols. Image management is directly integrated into the VistA Hospital Information System (HIS) software and clinical database. Radiology images are acquired via DICOM, and are stored directly in the HIS database. Images can be displayed on low- cost clinician's workstations throughout the medical center. High-resolution diagnostic quality multi-monitor VistA workstations with specialized viewing software can be used for reading radiology images. DICOM has played critical roles in the ability to integrate imaging functionality into the Healthcare Enterprise. Because of its openness, it allows the integration of system components from commercial and non- commercial sources to work together to provide functional cost-effective solutions (see Figure 1). Two approaches are used to acquire and handle images within the radiology department. At some VA Medical Centers, DICOM is used to interface a commercial Picture Archiving and Communications System (PACS) to the VistA HIS. At other medical centers, DICOM is used to interface the image producing modalities directly to the image acquisition and display capabilities of VistA itself. Both of these approaches use a small set of DICOM services that has been implemented by VistA to allow patient and study text data to be transmitted to image producing modalities and the commercial PACS, and to enable images and study data to be transferred back.

  9. Randomized trial of pragmatic education for low-risk COPD patients: impact on hospitalizations and emergency department visits

    PubMed Central

    Siddique, Haamid H; Olson, Raymond H; Parenti, Connie M; Rector, Thomas S; Caldwell, Michael; Dewan, Naresh A; Rice, Kathryn L

    2012-01-01

    Background: Most interventions aimed at reducing hospitalizations and emergency department (ED) visits in patients with chronic obstructive pulmonary disease (COPD) have employed resource-intense programs in high-risk individuals. Although COPD is a progressive disease, little is known about the effectiveness of proactive interventions aimed at preventing hospitalizations and ED visits in the much larger population of low-risk (no known COPD-related hospitalizations or ED visits in the prior year) patients, some of whom will eventually become high-risk. Methods: We tested the effect of a simple educational and self-efficacy intervention (n = 2243) versus usual care (n = 2182) on COPD/breathing-related ED visits and hospitalizations in a randomized study of low-risk patients at three Veterans Affairs (VA) medical centers in the upper Midwest. Administrative data was used to track VA admissions and ED visits. A patient survey was used to determine health-related events outside the VA. Results: Rates of COPD-related VA hospitalizations in the education and usual care group were not significantly different (3.4 versus 3.6 admissions per 100 person-years, respectively; 95% CI of difference −1.3 to 1.0, P = 0.77). The much higher patient-reported rates of non-VA hospitalizations for breathing-related problems were lower in the education group (14.0 versus 19.0 per 100 person-years; 95% CI −8.6 to −1.4, P = 0.006). Rates of COPD-related VA ED visits were not significantly different (6.8 versus 5.3; 95% CI −0.1 to 3.0, P = 0.07), nor were non-VA ED visits (32.4 versus 36.5; 95% CI −9.3 to 1.1, P = 0.12). All-cause VA admission and ED rates did not differ. Mortality rates (6.9 versus 8.3 per 100 person-years, respectively; 95% CI −3.0 to 0.4, P = 0.13) did not differ. Conclusion: An educational intervention that is practical for large numbers of low-risk patients with COPD may reduce the rate of breathing-related hospitalizations. Further research that more

  10. A Framework for Understanding Student Affairs Work.

    ERIC Educational Resources Information Center

    Kuh, George D.

    1999-01-01

    Originally published in January 1984, describes a framework in which extant models and knowledge from selected disciplines applicable to student affairs work can be synthesized. Argues that a multiple perspectives framework is a logical extension of previous efforts to lend direction to the thinking about and practice of student affairs work.…

  11. 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 to gain…

  12. A Legal Guide for Student Affairs Professionals.

    ERIC Educational Resources Information Center

    Kaplin, William A.; Lee, Barbara A.

    Today's college campuses offer student affairs divisions a multitude of challenges. Ways in which student affairs professionals can develop the capacities they need to successfully meet a myriad of legal concerns are covered in this text. The book is divided into 12 chapters and covers approximately 200 topics. It organizes and conceptualizes the…

  13. 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…

  14. Intellectual and Political Hygiene: The "Sokal Affair."

    ERIC Educational Resources Information Center

    Slack, Jennifer Daryl; Semati, M. Mehdi

    1997-01-01

    Analyzes coverage of the "Sokal Affair", in which physicist Alan Sokal submitted a fraudulent article and then criticized the journal for publishing it. Examines the four currents that overdetermined the Sokal Affair: antliberalism, anti-intellectualism, debates among the left about what constitutes a legitimate left, and the often-perceived…

  15. 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…

  16. 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.…

  17. 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

  18. 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

  19. 76 FR 56861 - Virginia Disaster #VA-00038

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... ADMINISTRATION Virginia Disaster VA-00038 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... Commonwealth of Virginia (FEMA-4024-DR), dated 09/03/2011. Incident: Hurricane Irene. Incident Period: 08/26..., Southampton, Suffolk City, Sussex, Virginia Beach City, Westmoreland, Williamsburg City, York. The...

  20. 77 FR 73510 - Virginia Disaster #VA-00052

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00052 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... State of Virginia (FEMA- 4092-DR), dated 11/26/2012. Incident: Hurricane Sandy Incident Period:...

  1. 76 FR 70804 - Virginia Disaster #VA-00037

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... ADMINISTRATION Virginia Disaster VA-00037 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for the Commonwealth of Virginia... Economic Injury Loans): Louisa. Contiguous Counties (Economic Injury Loans Only): Virginia:...

  2. 75 FR 24757 - Virginia Disaster #VA-00029

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00029 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... Commonwealth of Virginia (FEMA-1905-DR), dated 04/27/2010. Incident: Severe Winter Storms and...

  3. 77 FR 47489 - Virginia Disaster #VA-00048

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-08

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00048 AGENCY: Small Business Administration. ACTION: Notice. SUMMARY: This is... State of Virginia (FEMA- 4072-DR), dated 07/27/2012. Incident: Severe Storms and Straight-line...

  4. 75 FR 9006 - Virginia Disaster #VA-00028

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-26

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00028 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... Commonwealth of Virginia (FEMA-1874-DR), dated 02/16/2010. Incident: Severe Winter Storm and...

  5. 76 FR 40766 - Virginia Disaster #VA-00032

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... ADMINISTRATION Virginia Disaster VA-00032 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated... determined to be adversely affected by the disaster: Primary Counties: Pulaski. Contiguous Counties:...

  6. 76 FR 72020 - Virginia Disaster #VA-00039

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... ADMINISTRATION Virginia Disaster VA-00039 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated... adversely affected by the disaster: Primary Counties: Fairfax, Prince William. Contiguous Counties:...

  7. 76 FR 59765 - Virginia Disaster # VA-00036

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... ADMINISTRATION Virginia Disaster VA-00036 AGENCY: U.S. Small Business Administration. ACTION: Notice SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated...: Virginia: Charles City, Chesterfield, Colonial Heights City, Dinwiddie, Hanover, Henrico, James City,...

  8. 76 FR 72022 - Virginia Disaster #VA-00040

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00040 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... State of Virginia (FEMA- 4042-DR), dated 11/10/2011. Incident: Earthquake. Incident Period:...

  9. 76 FR 40765 - Virginia Disaster #VA-00034

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... ADMINISTRATION Virginia Disaster VA-00034 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated...: Virginia: Bristol City, Grayson, Russell, Scott, Smyth. Tennessee: Johnson, Sullivan. The Interest...

  10. 77 FR 74908 - Virginia Disaster #VA-00051

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... ADMINISTRATION Virginia Disaster VA-00051 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated... adversely affected by the disaster: Primary Counties: Accomack. Contiguous Counties: Virginia:...

  11. 76 FR 72994 - Virginia Disaster #VA-00041

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00041 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... State of Virginia (FEMA- 4045-DR), dated 11/17/2011. Incident: Remnants of Tropical Storm Lee....

  12. 77 FR 38179 - Autopsies at VA Expense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... document published in the Federal Register on December 2, 2011 (76 FR 75509), VA proposed the above... abuse; Alcoholism; Claims; Day care; Dental health; Drug abuse; Government contracts; Grant programs... statute that previously authorized certain outpatient and ambulatory care, which included...

  13. 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. PMID:26554261

  14. Mental Health Disorders and Treatment Seeking Among Veterans in Non-VA Facilities: Results and Implications from the Veterans’ Health Study

    PubMed Central

    Boscarino, Joseph A.; Hoffman, Stuart N.; Pitcavage, James M.; Urosevich, Thomas G.

    2015-01-01

    We surveyed 700 veterans who were outpatients in a non–Veterans Affairs (VA) multihospital system. Our objective was to assess the prevalence of mental disorders and service use among these veterans. The majority were Vietnam veterans (72.0%), and male (95.9%), and 40.4% reported recently using the VA for care. The prevalence of lifetime post-traumatic stress disorder (PTSD) was 9.6%, lifetime depression 18.4%, and lifetime mental health service use 50.1%. In multivariate analyses, significant factors associated with PTSD, depression, and mental health service use were low self-esteem, use of alcohol/drugs to cope, history of childhood adversity, high combat exposure, and low psychological resilience. VA service use was associated with greater mental health service use and combat exposure. With the exception of alcohol misuse, the mental health status of veterans seen in non-VA facilities appeared to be better than reported in past studies. Because most veterans have access to both VA and non-VA services, these findings have implications for veterans and outcomes research. PMID:26640743

  15. Telephone Enrollment in the VA Healthcare System. Interim final rule.

    PubMed

    2016-03-16

    This rulemaking amends VA's medical regulations to allow veterans to complete applications for health care enrollment by telephone by providing application information to a VA employee, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided over the phone. This action will make it easier for veterans to apply to enroll and will speed VA processing of applications. PMID:26987128

  16. 48 CFR 819.7109 - VA review of application.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7109 VA review of application. (a) VA OSDBU will review the information to establish the mentor and protégé eligibility and to ensure... charge to apply for the Mentor-Protégé Program. (b) After OSDBU completes its review and provides...

  17. 48 CFR 819.7109 - VA review of application.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7109 VA review of application. (a) VA OSDBU will review the information to establish the mentor and protégé eligibility and to ensure... charge to apply for the Mentor-Protégé Program. (b) After OSDBU completes its review and provides...

  18. 48 CFR 819.7109 - VA review of application.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7109 VA review of application. (a) VA OSDBU will review the information to establish the mentor and protégé eligibility and to ensure... charge to apply for the Mentor-Protégé Program. (b) After OSDBU completes its review and provides...

  19. 48 CFR 819.7109 - VA review of application.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7109 VA review of application. (a) VA OSDBU will review the information to establish the mentor and protégé eligibility and to ensure... charge to apply for the Mentor-Protégé Program. (b) After OSDBU completes its review and provides...

  20. 48 CFR 819.7109 - VA review of application.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7109 VA review of application. (a) VA OSDBU will review the information to establish the mentor and protégé eligibility and to ensure... charge to apply for the Mentor-Protégé Program. (b) After OSDBU completes its review and provides...

  1. Educationally Sound Due Process in Academic Affairs.

    ERIC Educational Resources Information Center

    La Morte, Michael W.; Meadows, Robert B.

    1979-01-01

    This article examines the concept of educationally sound due process in higher education academic affairs in the light of the existing case law and the responsibility of public school officials to provide an educationally sound school program. (Author/IRT)

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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…

  8. Student Affairs as Formal Educators: When Rhetoric Meets Reality

    ERIC Educational Resources Information Center

    Virkus, Annie J.

    2013-01-01

    The Student Affairs literature contains numerous approaches and strategies for bridging the gap between Student and Academic Affairs on college campuses. The use of student affairs professionals as instructors of credit-bearing courses is one example of such collaborative efforts. The student affairs literature identifies student affairs…

  9. 38 CFR 17.251 - The Subcommittee on Academic Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Academic Affairs. 17.251 Section 17.251 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants for Exchange of Information § 17.251 The Subcommittee on Academic Affairs. There is... Subcommittee on Academic Affairs, and the Subcommittee shall advise the Secretary, through the Under...

  10. 38 CFR 17.251 - The Subcommittee on Academic Affairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Academic Affairs. 17.251 Section 17.251 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants for Exchange of Information § 17.251 The Subcommittee on Academic Affairs. There is... Subcommittee on Academic Affairs, and the Subcommittee shall advise the Secretary, through the Under...

  11. 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…

  12. 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…

  13. 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)…

  14. 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…

  15. 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…

  16. First six months of clinical usage of an ATM network link between two Veterans Affairs Medical Centers

    NASA Astrophysics Data System (ADS)

    Duerinckx, Andre J.; Gentili, Amilcare; El-Saden, Suzie; Harmon, Craig; Kenagy, John J.; Grant, Edward G.

    1998-07-01

    Purpose/Background: Asynchronous transfer mode (ATM) network technology has recently been used for high speed transmission of radiological images between hospitals and inside hospitals. However, the number of clinical sites which routinely use this technology is limited. The purpose of this study was to analyze the very early impact of an ATM link between a large tertiary referral center and small peripheral clinic on cost and clinical practice. Methodology: An ATM link using 155 bps (OC3) technology was installed between the West Los Angeles VA Medical Center and the Sepulveda VA, a large outpatient facility which provides full service radiological services. The West Los Angeles VA Medical Center is a large tertiary referral center with sub-specialist radiologist. The clinical impact of this ATM link between a large full-scale DICOM-3 compliant PACS system at the West LA VA on a smaller PACS system at the Sepulveda VA was evaluated. Results: The ability to freely exchange complicated MRI and CT studies between a tertiary referral center and a clinic could have a direct impact on patient care. Over the last six months, all and CT studies from Sepulveda VA were readily available via the ATM connection to all radiologists at the West LA VA. On average the workload at the Sepulveda VA in CT and MRI was about one tenth of the same workload at West LA VA, thus creating interesting possibilities for sharing or radiologist resources. Conclusions: Although our preliminary data and work loads have been too limited to draw any final conclusions yet, we feel that future results will show that the ability to provide immediate and fast interactive consultation between general radiologists in a large outpatient facility and sub- specialists at a tertiary referral center can have an impact upon the quality of patient care.

  17. Nurse Workforce Characteristics and Infection Risk in VA Community Living Centers: A Longitudinal Analysis

    PubMed Central

    Uchida-Nakakoji, Mayuko; Stone, Patricia W.; Schmitt, Susan K.; Phibbs, Ciaran S.

    2015-01-01

    Objective To examine effects of workforce characteristics on resident infections in Veterans Affairs (VA) Community Living Centers (CLCs). Data Sources A six-year panel of monthly, unit-specific data included workforce characteristics (from the VA Decision Support System and Payroll data) and characteristics of residents and outcome measures (from the Minimum Data Set). Study Design A resident infection composite was the dependent variable. Workforce characteristics of registered nurses (RN), licensed practical nurses (LPN), nurse aides (NA), and contract nurses included: staffing levels, skill mix and tenure. Descriptive statistics and unit-level fixed effects regressions were conducted. Robustness checks varying workforce and outcome parameters were examined. Principal Findings Average nursing hours per resident day was 4.59 hours (sd = 1.21). RN tenure averaged 4.7 years (sd = 1.64) and 4.2 years for both LPN (sd= 1.84) and NA (sd= 1.72). In multivariate analyses RN and LPN tenure were associated with decreased infections by 3.8% (IRR= 0.962 p<0.01) and 2% (IRR=0.98 p<0.01) respectively. Robustness checks consistently found RN and LPN tenure to be associated with decreased infections. Conclusions Increasing RN and LPN tenure are likely to reduce CLC resident infections. Administrators and policymakers need to focus on recruiting and retaining a skilled nursing workforce. PMID:25634087

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

    PubMed

    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

    2010-12-01

    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

  19. Effectiveness of a social robot, "Paro," in a VA long-term care setting.

    PubMed

    Lane, Geoffrey W; Noronha, Delilah; Rivera, Alexandra; Craig, Kathy; Yee, Christina; Mills, Brent; Villanueva, Eimee

    2016-08-01

    Interest in animal assisted interventions (AAI) has grown over the years, but acceptance of AAI by the clinical and research community has been hampered by safety, hygiene, and logistical concerns. Advances in the field of social robotics have provided a promising route to deliver AAI while avoiding these aforementioned obstacles. Although there has been promising initial research on social robotics in older adults, to date there has been no such research conducted with a veteran population. The present pilot study followed 23 veteran residents of a Veterans Affairs (VA) geropsychiatric long-term care facility over the span of approximately a year and a half. It was found that use of Paro, a social robot, resulted in increased observed positive affective and behavioral indicators, with concomitant decreases observed in negative affective and behavioral indicators. The authors concluded that Paro is likely an effective nonpharmacological approach for managing dementia-related mood and behavior problems with veterans in VA long term care facilities. They additionally observed that Paro is best presented to residents who are relatively calm and approachable, as opposed to actively exhibiting behavior or mood problems. Future research directions are discussed in light of both the positive results noted and the inherent limitations of our pilot study. (PsycINFO Database Record PMID:27195530

  20. 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 PMID:27214172

  1. Restructuring VA ambulatory care and medical education: the PACE model of primary care.

    PubMed

    Cope, D W; Sherman, S; Robbins, A S

    1996-07-01

    The Veterans Health Administration (VHA) Western Region and associated medical schools formulated a set of recommendations for an improved ambulatory health care delivery system during a 1988 strategic planning conference. As a result, the Department of Veterans Affairs (VA) Medical Center in Sepulveda, California, initiated the Pilot (now Primary) Ambulatory Care and Education (PACE) program in 1990 to implement and evaluate a model program. The PACE program represents a significant departure from traditional VA and non-VA academic medical center care, shifting the focus of care from the inpatient to the outpatient setting. From its inception, the PACE program has used an interdisciplinary team approach with three independent global care firms. Each firm is interdisciplinary in composition, with a matrix management structure that expands role function and empowers team members. Emphasis is on managed primary care, stressing a biopsychosocial approach and cost-effective comprehensive care emphasizing prevention and health maintenance. Information management is provided through a network of personal computers that serve as a front end to the VHA Decentralized Hospital Computer Program (DHCP) mainframe. In addition to providing comprehensive and cost-effective care, the PACE program educates trainees in all health care disciplines, conducts research, and disseminates information about important procedures and outcomes. Undergraduate and graduate trainees from 11 health care disciplines rotate through the PACE program to learn an integrated approach to managed ambulatory care delivery. All trainees are involved in a problem-based approach to learning that emphasizes shared training experiences among health care disciplines. This paper describes the transitional phases of the PACE program (strategic planning, reorganization, and quality improvement) that are relevant for other institutions that are shifting to training programs emphasizing primary and ambulatory care

  2. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the facility in possession of the records or documents for response. The procedures outlined in 38 CFR... and approved by an appropriate VA medical facility Research and Development Committee and then... addition to other applicable protections for the research. (e) Individually identified patient...

  3. 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

    ... supportive services program that guides resident Veterans toward attaining long-term independence and self-sufficiency. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management...

  4. 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

    ... services program that guides resident Veterans toward attaining long-term independence and self- sufficiency. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management...

  5. 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

    ... provide a supportive services program that guides resident Veterans toward attaining long-term self-sufficiency. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management...

  6. 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...

  7. 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

    ...--Togus in Augusta, Maine. The selected lessee will finance, design, develop, construct, manage, maintain... construct, renovate, operate, and maintain permanent housing facilities; provide preference and...

  8. 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 construct, renovate, operate and maintain a permanent supportive housing facility with priority placement... of a Permanent Supportive Housing Facility in Minneapolis, MN AGENCY: Department of Veterans...

  9. 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

    ..., renovate, operate, and maintain a transitional and permanent housing facility; provide preference and... of a Transitional and Permanent Housing Facility in Canandaigua, NY AGENCY: Department of Veterans... Canandaigua, New York. The selected lessees will finance, design, develop, construct, manage, maintain...

  10. 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 construct, operate, and maintain a permanent housing facility; provide preference and priority placement for... of a Permanent Supportive Housing Facility in Lyons, NJ AGENCY: Department of Veterans...

  11. 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 construct, renovate, operate, and maintain permanent housing facilities; provide preference and...

  12. 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...

  13. Student Employee Development in Student Affairs

    ERIC Educational Resources Information Center

    Athas, Christina; Oaks, D'Arcy John; Kennedy-Phillips, Lance

    2013-01-01

    Employment within student affairs divisions offers environments in which students can apply the knowledge they have gained, as well as acquire new competencies, helping them to build solid foundations for their futures. Researchers used an online survey to assess the outcomes associated with part-time student employment within the student affairs…

  14. Teaching the Iran-Contra Affair.

    ERIC Educational Resources Information Center

    Masker, John Scott

    1996-01-01

    Describes a six-week study unit that requires students to examine specific aspects of the Iran-Contra affair in light of models such as presidential leadership style. The combination of a case study, student-centered cooperative learning, and writing across the curriculum proved popular with both the students and teacher. (MJP)

  15. Affective Commitment among Student Affairs Professionals

    ERIC Educational Resources Information Center

    Boehman, Joseph

    2007-01-01

    Student affairs professionals in the United States were surveyed to determine the predictive value of overall job satisfaction, organizational support, organizational politics, and work/nonwork interaction on affective organizational commitment. Results indicate that a supportive work environment leads to increased affective attachment to the…

  16. 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…

  17. Office of Indian Affairs 1985 Annual Report.

    ERIC Educational Resources Information Center

    New Mexico State Commission on Indian Affairs, Santa Fe.

    The major goals of the New Mexico Office of Indian Affairs (OIA) in 1985 were to enhance Indian education concerns, aid tribes in economic development, and effectuate a smooth working relationship between state, local, and tribal governments in the spirit of and through the use of the Joint Powers Act. Advancement is reflected in all these areas.…

  18. Orienting Mid-Level Student Affairs Professionals

    ERIC Educational Resources Information Center

    Mather, Peter C.; Bryan, Stephen P.; Faulkner, William O.

    2009-01-01

    Mid-level managers comprise a large proportion of student affairs organizations. They are often the most overlooked when it comes to professional orientation and institutional introduction when entering new positions. Accordingly, information is presented from the professional literature that speaks to the characteristics and unique needs of this…

  19. Education for America's Role in World Affairs.

    ERIC Educational Resources Information Center

    Fonte, John, Ed.; Ryerson, Andre, Ed.

    This collection of essays by leading policy analysts and educators investigate the often contradictory claims of global, peace, multicultural and citizenship education and examines what U.S. students should know about world affairs in the post-cold war era. The essays suggest methods of change based on a strong academic core of history,…

  20. 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…

  1. Student Affairs and Services Stream: College Quarterly

    ERIC Educational Resources Information Center

    Buddel, Neil

    2015-01-01

    "College Quarterly" recently introduced a stream for academic and scholar-practitioner dialogue concerning student affairs and services. To contribute to the growth and enhancement of the field, scholars and scholar-practitioners are invited to contribute original pieces that advance scholarship and/or practice around facilitating…

  2. TQM: Finding a Place in Student Affairs.

    ERIC Educational Resources Information Center

    Holmes, Tyrone A.

    1996-01-01

    Critically examines Total Quality Management (TQM). Analyzes the concepts and practices of TQM and its failure to live up to expectations in higher education. Emphasizes the problems inherent with TQM initiatives in an educational environment and outlines ways that student affairs officials can proactively apply TQM to support universities'…

  3. Building American Competence in World Affairs.

    ERIC Educational Resources Information Center

    Hayden, Rose L.

    In order to build United States competence in world affairs a strengthening of foreign language and international studies programs is required. Few would argue that the United States should not possess an educational system which produces at least a minimal cadre of experts about other peoples and cultures. Our national security requires…

  4. Undergraduate Consumer Affairs Program Needs: Employers' Perspectives

    ERIC Educational Resources Information Center

    Morrison, Kathryn; Saboe-Wounded Head, Lorna; Cho, Soo Hyun

    2012-01-01

    Forty-six Consumer Affairs (CA) internship supervisors were surveyed to identify critical knowledge and skills demonstrated by interns and to examine the importance of knowledge and skills needed in the workplace from the supervisors' perspectives.The knowledge and skills measured were identified through program goals. Results revealed that CA…

  5. Excellence in Community College Student Affairs

    ERIC Educational Resources Information Center

    Knight, Ashley

    2014-01-01

    Student success, accountability, and educational outcomes have been strongly emphasized in U.S. community colleges in recent years. For those individuals serving in community college student affairs, intentional commitment to standards and competencies in professional practice is essential in order to achieve institutional expectations and to meet…

  6. Rethinking the Introduction to Student Affairs Course.

    ERIC Educational Resources Information Center

    Manning, Kathleen

    1993-01-01

    Discusses theoretical and philosophical foundations that can be used to structure Introduction to Student Affairs course within graduate program. Describes the model course as being divided into two segments: liberation theology and liberal arts. Sees liberal arts segment as being further subdivided into philosophy, history, psychology,…

  7. The Student Affairs Portfolio in Small Colleges

    ERIC Educational Resources Information Center

    Heida, Debbie E.

    2006-01-01

    This chapter provides an overview of functional areas included in the portfolio of the small college dean. Four examples of organizational charts are offered, as well as factors that will influence the small college student affairs portfolio in the future. (Contains 4 figures.)

  8. The Digital Age of Student Affairs

    ERIC Educational Resources Information Center

    Cabellon, Edmund T.; Junco, Reynol

    2015-01-01

    This chapter describes the student affairs profession in the digital age. The authors explore new challenges educators and professionals face as new areas are added and expanded, how social networks and digital technology tools continue to evolve, and what skills are needed to engage with students in person and online.

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  12. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  13. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  14. 12 CFR 3.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... portfolio of correlation trading positions that is modeled under § 3.209. A national bank or Federal savings... proxies are used. (b) Quantitative requirements for VaR-based measure. (1) The VaR-based measure must be... association's trading portfolio over a full business cycle. A national bank or Federal savings...

  15. 12 CFR 324.205 - VaR-based measure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of correlation trading positions that is modeled under § 324.209. An FDIC-supervised institution may.... (b) Quantitative requirements for VaR-based measure. (1) The VaR-based measure must be calculated on... of at least six months representing the volatility of the FDIC-supervised institution's...

  16. 38 CFR 17.71 - Revocation of VA approval.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... revocation of VA approval, VA health care personnel shall: (1) Cease referring veterans to the community residential care facility; and, (2) Notify any veteran residing in the community residential care facility of... health care personnel shall notify that person or entity of the community residential care...

  17. 38 CFR 17.71 - Revocation of VA approval.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... revocation of VA approval, VA health care personnel shall: (1) Cease referring veterans to the community residential care facility; and, (2) Notify any veteran residing in the community residential care facility of... health care personnel shall notify that person or entity of the community residential care...

  18. 38 CFR 17.71 - Revocation of VA approval.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... revocation of VA approval, VA health care personnel shall: (1) Cease referring veterans to the community residential care facility; and, (2) Notify any veteran residing in the community residential care facility of... health care personnel shall notify that person or entity of the community residential care...

  19. 38 CFR 17.71 - Revocation of VA approval.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... revocation of VA approval, VA health care personnel shall: (1) Cease referring veterans to the community residential care facility; and, (2) Notify any veteran residing in the community residential care facility of... health care personnel shall notify that person or entity of the community residential care...

  20. 76 FR 60713 - Establishment of Class E Airspace; Bumpass, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... Airspace at Bumpass, VA, to accommodate the new Standard Instrument Approach Procedures serving Lake Anna... establish Class E airspace at Bumpass, VA (76 FR 45479) Docket No. FAA-2011-0377. Interested parties were... for Lake Anna Airport. This action is necessary for the safety and management of IFR operations at...

  1. 78 FR 76061 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ..., Health professions, Health records, Homeless, Mental health programs, Nursing homes, Reporting and.... SUPPLEMENTARY INFORMATION: On November 28, 2012, VA proposed a rule in the Federal Register, at 77 FR 70967, to... for that disability. On the same date, VA published a companion direct final rule at 77 FR 70893...

  2. 76 FR 34576 - Amendment of Class E Airspace; Waynesboro, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ...) to amend Class E airspace at Eagle's Nest Airport, Waynesboro, VA (75 FR 14820) Docket No. FAA-2010..., 40113, 40120; E.O. 10854, 24 FR 9565, 3 CFR, 1959-1963 Comp., p. 389. Sec. 71.1 0 2. The incorporation... Federal Aviation Administration 14 CFR Part 71 Amendment of Class E Airspace; Waynesboro, VA...

  3. 77 FR 25592 - Drawbridge Operation Regulations; James River, Hopewell, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-01

    ... SECURITY Coast Guard 33 CFR Part 117 Drawbridge Operation Regulations; James River, Hopewell, VA AGENCY... Memorial Bridge, at mile 65.0, across the James River, at Hopewell, VA. This deviation is necessary to... schedule, the SR 156/Benjamin Harrison Memorial Bridge, at mile 65.0, across the James River, at...

  4. 76 FR 52230 - Establishment of Class E Airspace; Forest, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... Airspace at Forest, VA, to accommodate the new Area Navigation (RNAV) Global Positioning System (GPS..., VA (76 FR 34196) Docket No. FAA-2011-0378. Interested parties were invited to participate in this... Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a Regulatory...

  5. 33 CFR 80.510 - Chesapeake Bay Entrance, VA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA....

  6. 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…

  7. Graphical electrocardiogram waveforms as part of an integrated hospital system's patient record.

    PubMed Central

    Enison, E. J.; Dayhoff, R.; Fletcher, R. D.

    1993-01-01

    The U.S. Department of Veterans Affairs (VA) has an ongoing project to integrate diagnostic images into its existing text-based hospital information system. High-quality images from cardiology, pulmonary medicine, gastroenterology, endoscopy, pathology, radiology, hematology and nuclear medicine can be displayed for clinicians quickly and conveniently on workstations throughout the hospital. As a part of this endeavor, diagnostic-quality computer generated 12-lead electrocardiograms, including both median and rhythm data, can be viewed as a part of the on-line patient record of an integrated hospital information system. Now computer generated graphics can be included in the longitudinal patient record. Incorporating generated graphics and images into a text based patient record is another step towards the next generation of integrated hospital information system with multimedia patient records. PMID:8130498

  8. 76 FR 79067 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ...- connected conditions. As explained in a notice of proposed rulemaking published on June 11, 2010 (75 FR... with Non- VA Outpatient Care''. 75 FR 7218 (Feb. 18, 2010). Second, section 402(b)(3) made the... proposed rule published on June 11, 2010 (75 FR 33216), we proposed to amend the following VA...

  9. Student Affairs Practice in Higher Education. Second Edition.

    ERIC Educational Resources Information Center

    Rentz, Audrey L.; And Others

    This book describes significant issues and trends in the evolution of student affairs and reviews current methods and models of practice. The chapters are: (1) "The Philosophical Heritage of Student Affairs," by Stan Carpenter, reviewing the relationship between educational philosophy and student services; (2) "A History of Student Affairs," by…

  10. Student Affairs as Perceived Through Abraham Maslow's Hierarchy of Needs.

    ERIC Educational Resources Information Center

    Nowacki, Steven

    The needs of human behavior are explored and correlated to the various departments within Student Affairs in an effort to show how Student Affairs can satisfy those needs. Maslow's Hierarchy of needs is briefly explained and related to the following Student Affairs departments: Financial Aid, Student Management, Career Development and Placement,…

  11. 16 CFR 0.20 - Office of International Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Office of International Affairs. 0.20... ORGANIZATION § 0.20 Office of International Affairs. The Office of International Affairs (OIA) comprises international antitrust, international consumer protection, and international technical assistance. OIA...

  12. 16 CFR 0.20 - Office of International Affairs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Office of International Affairs. 0.20... ORGANIZATION § 0.20 Office of International Affairs. The Office of International Affairs (OIA) comprises international antitrust, international consumer protection, and international technical assistance. OIA...

  13. 16 CFR 0.20 - Office of International Affairs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Office of International Affairs. 0.20... ORGANIZATION § 0.20 Office of International Affairs. The Office of International Affairs (OIA) comprises international antitrust, international consumer protection, and international technical assistance. OIA...

  14. 16 CFR 0.20 - Office of International Affairs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Office of International Affairs. 0.20... ORGANIZATION § 0.20 Office of International Affairs. The Office of International Affairs (OIA) comprises international antitrust, international consumer protection, and international technical assistance. OIA...

  15. 16 CFR 0.20 - Office of International Affairs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Office of International Affairs. 0.20... ORGANIZATION § 0.20 Office of International Affairs. The Office of International Affairs (OIA) comprises international antitrust, international consumer protection, and international technical assistance. OIA...

  16. 75 FR 53007 - Advisory Committee on Veterans Business Affairs; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs; Meeting AGENCY: U.S. Small Business... Veterans Business Affairs. The meeting will be open to the public. DATES: Friday, September 24, 2010 from 9... the meeting of the Advisory Committee on Veterans Business Affairs. The Advisory Committee on...

  17. 76 FR 41553 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION... the location, date, time, and agenda for the next meeting of the Advisory Committee on Veterans... Committee on Veterans Business Affairs. The Advisory Committee on Veterans Business Affairs serves as...

  18. 76 FR 25400 - Advisory Committee on Veterans Business Affairs Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-04

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs Meeting AGENCY: U.S. Small Business Administration... announce the location, date, time, and agenda for the next meeting of the Advisory Committee on Veterans... Advisory Committee on Veterans Business Affairs. The Advisory Committee on Veterans Business Affairs...

  19. 77 FR 31420 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION... the location, date, time, and agenda for the next meeting of the Advisory Committee on Veterans... Committee on Veterans Business Affairs. The Advisory Committee on Veterans Business Affairs serves as...

  20. 77 FR 17562 - Advisory Committee on Veterans Business Affairs; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-26

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs; Meeting AGENCY: Small Business Administration... announce the location, date, time, and agenda for the next meeting of the Advisory Committee on Veterans... Advisory Committee on Veterans Business Affairs. The Advisory Committee on Veterans Business Affairs...

  1. 77 FR 52379 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION... the location, date, time, and agenda for the next meeting of the Advisory Committee on Veterans... Advisory Committee on Veterans Business Affairs. The Advisory Committee on Veterans Business Affairs...

  2. 48 CFR 952.204-75 - Public affairs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Public affairs. 952.204-75... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.204-75 Public affairs. As prescribed in 904.7201, insert the following clause: Public Affairs (DEC 2000) (a) The Contractor...

  3. 48 CFR 952.204-75 - Public affairs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Public affairs. 952.204-75... SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 952.204-75 Public affairs. As prescribed in 904.7201, insert the following clause: Public Affairs (DEC 2000) (a) The Contractor...

  4. Time to Treatment in Patients With Stage III Non-Small Cell Lung Cancer

    SciTech Connect

    Wang Li; Correa, Candace R.; Hayman, James A.; Zhao Lujun; Cease, Kemp; Brenner, Dean; Arenberg, Doug; Curtis, Jeffery; Kalemkerian, Gregory P.; Kong, F.-M.

    2009-07-01

    Purpose: To determine whether time to treatment (TTT) has an effect on overall survival (OS) in patients with unresectable or medically inoperable Stage III non-small cell lung cancer (NSCLC) and whether patient or treatment factors are associated with TTT. Methods and Materials: Included in the study were 237 consecutive patients with Stage III NSCLC treated at University of Michigan Hospital (UM) or the Veterans Affairs Ann Arbor Healthcare System (VA). Patients were treated with either palliative or definitive radiotherapy and radiotherapy alone (n = 106) or either sequential (n = 69) or concurrent chemoradiation (n = 62). The primary endpoint was OS. Results: Median follow-up was 69 months, and median TTT was 57 days. On univariate analysis, the risk of death did not increase significantly with longer TTT (p = 0.093). However, subset analysis showed that there was a higher risk of death with longer TTT in patients who survived {>=} 5 years (p = 0.029). Younger age (p = 0.027), male sex (p = 0.013), lower Karnofsky Performance Score (KPS) (p = 0.002), and treatment at the VA (p = 0.001) were significantly associated with longer TTT. However, on multivariate analysis, only lower KPS remained significantly associated with longer TTT (p = 0.003). Conclusion: Time to treatment is significantly associated with OS in patients with Stage III NSCLC who lived longer than 5 years, although it is not a significant factor in Stage III patients as a whole. Lower KPS is associated with longer TTT.

  5. Department of Veterans Affairs compensation and medical care benefits accorded to veterans with major limb loss.

    PubMed

    Maynard, Charles; Flohr, Brad; Guagliardo, Tony A; Martin, Chris H; McFarland, Lynne V; Pruden, Jonathan D; Reiber, Gayle E

    2010-01-01

    Veterans injured in theaters of combat operations are eligible for benefits, including medical care and compensation. This article describes veterans with service-connected disability for major lower- and/or upper-limb loss resulting from combat-field-associated injuries sustained in the Vietnam war, Operation Desert Shield/Operation Desert Storm, and Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). Using the Department of Veterans Affairs (VA) Compensation and Pension Mini-Master file, we identified 2,690 veterans who in August 2007 received compensation for loss of one or more limbs. More than 97% sustained their injuries in Vietnam; most were young men who served in the U.S. Army or Marine Corps. All but 5% had at least 50% combined service-connected disability and nearly half had a 100% rating. In addition to limb loss, one of the most prevalent compensable conditions was posttraumatic stress disorder, present in 46% of OIF/OEF and 20% of Vietnam veterans. Of these veterans, 82% visited VA outpatient clinics in 2007, although only 4% were hospitalized. A special obligation exists to those who have sustained serious injuries related to combat; this responsibility extends for the life of the servicemember and beyond to his or her spouse and dependents. PMID:20803407

  6. Mixed-Methods Research in a Complex Multisite VA Health Services Study: Variations in the Implementation and Characteristics of Chiropractic Services in VA.

    PubMed

    Khorsan, Raheleh; Cohen, Angela B; Lisi, Anthony J; Smith, Monica M; Delevan, Deborah; Armstrong, Courtney; Mittman, Brian S

    2013-01-01

    Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs' healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches-insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS). Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1) the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study's analysis plan and its data collection instruments and codebook and (2) ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis. PMID:24489589

  7. 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

  8. Technology-Assisted Patient Access to Clinical Information: An Evaluation Framework for Blue Button

    PubMed Central

    Nazi, Kim M; Luger, Tana M; Amante, Daniel J; Smith, Bridget M; Barker, Anna; Shimada, Stephanie L; Volkman, Julie E; Garvin, Lynn; Simon, Steven R; Houston, Thomas K

    2014-01-01

    Background Patient access to clinical information represents a means to improve the transparency and delivery of health care as well as interactions between patients and health care providers. We examine the movement toward augmenting patient access to clinical information using technology. Our analysis focuses on “Blue Button,” a tool that many health care organizations are implementing as part of their Web-based patient portals. Objective We present a framework for evaluating the effects that technology-assisted access to clinical information may have on stakeholder experiences, processes of care, and health outcomes. Methods A case study of the United States Department of Veterans Affairs' (VA) efforts to make increasing amounts of clinical information available to patients through Blue Button. Drawing on established collaborative relationships with researchers, clinicians, and operational partners who are engaged in the VA’s ongoing implementation and evaluation efforts related to Blue Button, we assessed existing evidence and organizational practices through key informant interviews, review of documents and other available materials, and an environmental scan of published literature and the websites of other health care organizations. Results Technology-assisted access to clinical information represents a significant advance for VA patients and marks a significant change for the VA as an organization. Evaluations of Blue Button should (1) consider both processes of care and outcomes, (2) clearly define constructs of focus, (3) examine influencing factors related to the patient population and clinical context, and (4) identify potential unintended consequences. Conclusions The proposed framework can serve as a roadmap to guide subsequent research and evaluation of technology-assisted patient access to clinical information. To that end, we offer a series of related recommendations. PMID:24675395

  9. Physical activity in postdeployment Operation Iraqi Freedom/Operation Enduring Freedom veterans using Department of Veterans Affairs services.

    PubMed

    Buis, Lorraine R; Kotagal, Lindsey V; Porcari, Carole E; Rauch, Sheila A M; Krein, Sarah L; Richardson, Caroline R

    2011-01-01

    Veteran activity levels may decrease between Active Duty and postdeployment. We examined attitudes and changes in self-reported activities between the two in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans using Department of Veterans Affairs (VA) services. We conducted an online cross-sectional survey (June-August 2008) of postdeployment OIF/OEF veterans registered with the VA Ann Arbor Healthcare System, Ann Arbor, Michigan. Descriptive statistics summarized demographic data and attitudes, while regression analyses compared physical activities during Active Duty with physical activities postdeployment. Participants (n = 319, 15.6% response rate) reported that they believe staying physically fit is important, they worry about gaining weight, and they believe exercise will keep them healthy (77%, 72%, and 90% agree or strongly agree, respectively). Running (30.0%), Exercise with Gym Equipment (21.5%), Occupational Activities (14.9%), and Walking (13.0%) were the most frequently reported Active Duty physical activities. The most frequently reported postdeployment physical activities included Walking (21.1%), Running (18.5%), and Exercise with Gym Equipment (17.9%). Health problems (39%) and chronic pain (52%) were common barriers to physical activity. Postdeployment OIF/OEF veterans using the VA believe physical activity is beneficial, yet many report health problems and/or chronic pain that makes exercise difficult. Physical activity promotes health, and strategies are needed to facilitate physical activity in this population. PMID:22068369

  10. Evaluation of an Implementation Model: A National Investigation of VA Residential Programs

    PubMed Central

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

    2014-01-01

    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. PMID:24817625

  11. Policy Recommendations to VA Leave NAS at Odds with Congress

    ERIC Educational Resources Information Center

    Walsh, John

    1978-01-01

    Describes adverse congressional reaction to a recent National Academy of Sciences (NAS) recommendation that the Veteran's Administration's (VA) health care system be phased into a general health care system. (SL)

  12. 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...

  13. 76 FR 72838 - Amendment of Class E Airspace; Luray, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... Luray, VA, to accommodate the new Area Navigation (RNAV) Global Positioning System (GPS) Standard... accommodate the new Area Navigation (RNAV) Global Positioning System (GPS) Standard Instrument Approach... FR 52292). Interested parties were invited to participate in this rulemaking effort by...

  14. 78 FR 42455 - Medications Prescribed by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse... section to read as follows: Sec. 17.96 Medication prescribed by non-VA physicians. * * * * * (a) * * *...

  15. Design and Implementation of a Perioperative Surgical Home at a Veterans Affairs Hospital.

    PubMed

    Walters, Tessa L; Howard, Steven K; Kou, Alex; Bertaccini, Edward J; Harrison, T Kyle; Kim, T Edward; Shafer, Audrey; Brun, Carlos; Funck, Natasha; Siegel, Lawrence C; Stary, Erica; Mariano, Edward R

    2016-06-01

    The innovative Perioperative Surgical Home model aims to optimize the outcomes of surgical patients by leveraging the expertise and leadership of physician anesthesiologists, but there is a paucity of practical examples to follow. Veterans Affairs health care, the largest integrated system in the United States, may be the ideal environment in which to explore this model. We present our experience implementing Perioperative Surgical Home at one tertiary care university-affiliated Veterans Affairs hospital. This process involved initiating consistent postoperative patient follow-up beyond the postanesthesia care unit, a focus on improving in-hospital acute pain management, creation of an accessible database to track outcomes, developing new clinical pathways, and recruiting additional staff. Today, our Perioperative Surgical Home facilitates communication between various services involved in the care of surgical patients, monitoring of patient outcomes, and continuous process improvement. PMID:26392388

  16. Female genital mutilation. Council on Scientific Affairs, American Medical Association.

    PubMed

    1995-12-01

    Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia. PMID:7474278

  17. Regulatory affairs administration as regulatory policy determinant

    SciTech Connect

    Forcier, J.R.

    1984-05-10

    It is the thesis of this article that the processing of a utility company's regulation-related work, the supporting tasks and the manner in which they are completed, can and does have a significant impact on the final results or work product of the regulatory affairs function, including even, potentially, the action of the regulatory agency. The article is therefore full of practical pointers on how the interface with the regulatory authority can best be organized, managed, and carried through to the attainment of optimum results for the utility. 2 references.

  18. Validity Assessment of Referral Decisions at a VA Health Care System Polytrauma System of Care

    PubMed Central

    Aguila, Fatima; Harris, Odette

    2015-01-01

    There has been intensive interest to ensure equitable and appropriate access to the specialized rehabilitative services of the VA Polytrauma System of Care (PSC) for patients sustaining polytrauma and traumatic brain injuries (TBI). A retrospective cohort study with prospective data acquisition was conducted to assess validity and objectivity of the acceptance decision algorithm to the VA Palo Alto Health Care System (VAPAHCS) PSC. Our hypotheses are (1) VAPAHCS PSC referral decisions were appropriate and without bias and (2) the identified needs of redirected referrals were addressed. This analysis included 1,025 referrals (906 patients); 813 patients (89.7%) were accepted, and 93 (10.3%) were redirected. Redirected cases were older, were more often active duty service members, and were not from the West Coast. There were more females redirected due to concomitant spinal cord injury. These are rationale differences. In redirected patients, the most commonly identified rehabilitation needs were psychological support, mobility/physical therapy, and communication/speech services; >75% of patients had these services offered elsewhere outside of the PSC resources. While balancing financial stewardship and meeting our mission to provide outstanding rehabilitative care to veterans and service members, we demonstrated that acceptance decisions were valid and without bias, and redirected patients received appropriate alternate resources. PMID:26180664

  19. Validity Assessment of Referral Decisions at a VA Health Care System Polytrauma System of Care.

    PubMed

    Chung, Joyce; Aguila, Fatima; Harris, Odette

    2015-01-01

    There has been intensive interest to ensure equitable and appropriate access to the specialized rehabilitative services of the VA Polytrauma System of Care (PSC) for patients sustaining polytrauma and traumatic brain injuries (TBI). A retrospective cohort study with prospective data acquisition was conducted to assess validity and objectivity of the acceptance decision algorithm to the VA Palo Alto Health Care System (VAPAHCS) PSC. Our hypotheses are (1) VAPAHCS PSC referral decisions were appropriate and without bias and (2) the identified needs of redirected referrals were addressed. This analysis included 1,025 referrals (906 patients); 813 patients (89.7%) were accepted, and 93 (10.3%) were redirected. Redirected cases were older, were more often active duty service members, and were not from the West Coast. There were more females redirected due to concomitant spinal cord injury. These are rationale differences. In redirected patients, the most commonly identified rehabilitation needs were psychological support, mobility/physical therapy, and communication/speech services; >75% of patients had these services offered elsewhere outside of the PSC resources. While balancing financial stewardship and meeting our mission to provide outstanding rehabilitative care to veterans and service members, we demonstrated that acceptance decisions were valid and without bias, and redirected patients received appropriate alternate resources. PMID:26180664

  20. Student Affairs Case Management: Merging Social Work Theory with Student Affairs Practice

    ERIC Educational Resources Information Center

    Adams, Sharrika D.; Hazelwood, Sherry; Hayden, Bruce

    2014-01-01

    Case management is a functional area in higher education and student affairs that emerged after the mass shootings at Virginia Tech in 2007. Although new to higher education, case management emerged from established social work practice. This article compares social work theory and case management standards with a new case management model for…

  1. Designing Student Affairs Organizational Structures: Perceptions of Senior Student Affairs Officers

    ERIC Educational Resources Information Center

    Kuk, Linda; Banning, James H.

    2009-01-01

    Student affairs organizations have become complex entities and serve as a critical link to student success and the quality of the overall educational experience in collegiate institutions. Over time, new programs and services have been added to the array of existing programs and services with little attention focused on how these organizations…

  2. Building a Better Bridge: Creating Effective Partnerships between Academic Affairs and Student Affairs. Invited Paper.

    ERIC Educational Resources Information Center

    Martin, James; Murphy, Sheila

    A new model among student affairs professionals, faculty, and academic administrators is emerging at colleges and universities across the country. This "partnership model" or "partnership movement" is characterized by collaborations and connections. These partnerships can serve as a transformational tool to enhance the quality of the students'…

  3. 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. PMID:15310045

  4. 76 FR 48204 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... availability of funds for currently operational fiscal year (FY) 2009 VA Grant and Per Diem Special Need Grant Recipients in conjunction with their collaborative VA Special Need partners and currently operational VA... under VA's Homeless Providers Grant and Per Diem Program for FY 2009 operational Grant and Per...

  5. Telephone care coordination for smokers in VA mental health clinics: protocol for a hybrid type-2 effectiveness-implementation trial

    PubMed Central

    2013-01-01

    Background This paper describes an innovative protocol for a type-II hybrid effectiveness-implementation trial that is evaluating a smoking cessation telephone care coordination program for Veterans Health Administration (VA) mental-health clinic patients. As a hybrid trial, the protocol combines implementation science and clinical trial methods and outcomes that can inform future cessation studies and the implementation of tobacco cessation programs into routine care. The primary objectives of the trial are (1) to evaluate the process of adapting, implementing, and sustaining a smoking cessation telephone care coordination program in VA mental health clinics, (2) to determine the effectiveness of the program in promoting long-term abstinence from smoking among mental health patients, and (3) to compare the effectiveness of telephone counseling delivered by VA staff with that delivered by state quitlines. Methods/design The care coordination program is being implemented at six VA facilities. VA mental health providers refer patients to the program via an electronic medical record consult. Program staff call referred patients to offer enrollment. All patients who enroll receive a self-help booklet, mailed smoking cessation medications, and proactive multi-call telephone counseling. Participants are randomized to receive this counseling from VA staff or their state’s quitline. Four primary implementation strategies are being used to optimize program implementation and sustainability: blended facilitation, provider training, informatics support, and provider feedback. A three-phase formative evaluation is being conducted to identify barriers to, and facilitators for, program implementation and sustainability. A mixed-methods approach is being used to collect quantitative clinical effectiveness data (e.g., self-reported abstinence at six months) and both quantitative and qualitative implementation data (e.g., provider referral rates, coded interviews with providers

  6. "To care for him who shall have borne the battle and for his widow and his orphan" (Abraham Lincoln): the Department of Veterans Affairs polytrauma system of care.

    PubMed

    Sigford, Barbara J

    2008-01-01

    The initiation of combat in Iraq and Afghanistan has resulted in a new cohort of active-duty service members and veterans seeking rehabilitation care through the U.S. Department of Veterans Affairs (VA). Service members injured in combat most often sustain multiple injuries (polytrauma) and require a unique service delivery model to meet their needs. The VA recognized this need and responded with the development of the Polytrauma System of Care (PSC). This national system of care balances access and expertise to provide specialized life-long care to the combat injured. The PSC is comprised of: 4 specialized regional rehabilitation centers that are accredited in brain injury by the Commission on Accreditation of Rehabilitation Facilities; 21 specialized outpatient and subacute rehabilitation programs; designated polytrauma teams at smaller, more remote VA facilities; and a point of contact at all other VA facilities. In addition, the PSC has developed a proactive case-management model, a specialized telehealth network, guidelines for long-term follow-up, and services for those individuals who are unable to return home. The following commentary and articles provide additional detail on this new and unique system of care. PMID:18164348

  7. Hemorrhagin VaH4, a covalent heterodimeric P-III metalloproteinase from Vipera ammodytes ammodytes with a potential antitumour activity.

    PubMed

    Leonardi, Adrijana; Sajevic, Tamara; Kovačič, Lidija; Pungerčar, Jože; Lang Balija, Maja; Halassy, Beata; Trampuš Bakija, Alenka; Križaj, Igor

    2014-01-01

    In the envenomation caused by a bite of Vipera ammodytes ammodytes, the most venomous snake in Europe, hemorrhage is usually the most severe consequence in man. Identifying and understanding the hemorrhagic components of its venom is therefore particularly important in optimizing medical treatment of patients. We describe a novel high molecular mass hemorrhagin, VaH4. The isolated molecule is a covalent dimer of two homologous subunits, VaH4-A and VaH4-B. Complete structural characterization of A and partial characterization of B revealed that both belong to the P-III class of snake venom metalloproteinases (SVMPs), comprising a metalloproteinase, a disintegrin-like domain and a cysteine-rich domain. However, neither VaH4-A nor VaH4-B possess the Cys174 involved in the inter-subunit disulphide bond of P-III SVMPs. A three-dimensional model of the VaH4 dimer suggests that Cys132 serves this function. This implies that dimers in the P-III class of SVMPs can be formed either between their Cys132 or Cys174 residues. The proteolytic activity and stability of VaH4 depend on Zn²⁺ and Ca²⁺ ions and the presence of glycosaminoglycans, which indicates physiological interaction of VaH4 with the latter element of the extracellular matrix (ECM). The molecular mass of VaH4, determined by MALDI/TOF mass spectrometry, is 110.2 kDa. N-deglycosylation reduced the mass of each monomer by 8.7 kDa. The two possible N-glycosylation sites in VaH4-A are located at completely different positions from those in homodimeric P-IIIc VaH3 from the same venom, however, without any evident functional implications. The hemorrhagic activity of this slightly acidic SVMP is ascribed to its hydrolysis of components of the ECM, particularly fibronectin and nidogen, and of some blood coagulation proteins, in particular the α-chain of fibrinogen. VaH4 is also significant medically as we found it cytotoxic against cancer cells and due to its substantial sequence similarity to ADAM/ADAMTS family of

  8. VA Accountability First and Appeals Modernization Act of 2016

    THOMAS, 113th Congress

    Rep. Miller, Jeff [R-FL-1

    2016-07-05

    09/15/2016 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:

  9. Well-managed companies public affairs is participative

    SciTech Connect

    Darcy, G.R.

    1984-03-29

    The working relationship between government and business has often been adversarial, especially during periods of major business reform movements. A positive approach to public affairs by business leaders, emphasizing cooperation with all levels of government, is suggested in this article as one means of improving the business regulatory environment. The author describes a progressive public affairs program with a broad socioeconomic focus undertaken by one utility. Developed over more than a decade, the program incorporates public affairs as part of every manager's responsibilities. Highlighted are the structure of the present public affairs department and the scope of its activities.

  10. Suppression of Antifolate Resistance by Targeting the Myosin Va Trafficking Pathway in Melanoma12

    PubMed Central

    Fernández-Pérez, María Piedad; Montenegro, María F; Sáez-Ayala, Magalí; Sánchez-del-Campo, Luis; Piñero-Madrona, Antonio; Cabezas-Herrera, Juan; Rodríguez-López, José Neptuno

    2013-01-01

    Human melanoma is a significant clinical problem. As most melanoma patients relapse with lethal drug-resistant disease, understanding and preventing mechanism(s) of resistance is one of the highest priorities to improve melanoma therapy. Melanosomal sequestration and the cellular exportation of cytotoxic drugs have been proposed to be important melanoma-specific mechanisms that contribute to multidrug resistance in melanoma. Concretely, we found that treatment of melanoma with methotrexate (MTX) altered melanogenesis and accelerated the exportation of melanosomes; however, the cellular and molecular processes by which MTX is trapped into melanosomes and exported out of cells have not been elucidated. In this study, we identified myosin Va (MyoVa) as a possible mediator of these cellular processes. The results demonstrated that melanoma treatment with MTX leads to Akt2-dependent MyoVa phosphorylation, which enhances its ability to interact with melanosomes and accelerates their exportation. To understand the mechanism(s) by which MTX activates Akt2, we examined the effects of this drug on the activity of protein phosphatase 2A, an Akt inhibitor activated by the methylation of its catalytic subunit. Taken together, this study identified a novel trafficking pathway in melanoma that promotes tumor resistance through Akt2/MyoVa activation. Because of these findings, we explored several MTX combination therapies to increase the susceptibility of melanoma to this drug. By avoiding MTX exportation, we observed that the E2F1 apoptotic pathway is functional in melanoma, and its induction activates p73 and apoptosis protease-activating factor 1 following a p53-autonomous proapoptotic signaling event. PMID:23814494

  11. Patient complexity in quality comparisons for glycemic control: An observational study

    PubMed Central

    Safford, Monika M; Brimacombe, Michael; Zhang, Quanwu; Rajan, Mangala; Xie, Minge; Thompson, Wesley; Kolassa, John; Maney, Miriam; Pogach, Leonard

    2009-01-01

    Background Patient complexity is not incorporated into quality of care comparisons for glycemic control. We developed a method to adjust hemoglobin A1c levels for patient characteristics that reflect complexity, and examined the effect of using adjusted A1c values on quality comparisons. Methods This cross-sectional observational study used 1999 national VA (US Department of Veterans Affairs) pharmacy, inpatient and outpatient utilization, and laboratory data on diabetic veterans. We adjusted individual A1c levels for available domains of complexity: age, social support (marital status), comorbid illnesses, and severity of disease (insulin use). We used adjusted A1c values to generate VA medical center level performance measures, and compared medical center ranks using adjusted versus unadjusted A1c levels across several thresholds of A1c (8.0%, 8.5%, 9.0%, and 9.5%). Results The adjustment model had R2 = 8.3% with stable parameter estimates on thirty random 50% resamples. Adjustment for patient complexity resulted in the greatest rank differences in the best and worst performing deciles, with similar patterns across all tested thresholds. Conclusion Adjustment for complexity resulted in large differences in identified best and worst performers at all tested thresholds. Current performance measures of glycemic control may not be reliably identifying quality problems, and tying reimbursements to such measures may compromise the care of complex patients. PMID:19126229

  12. Anticoagulant dysfunction of human Arg352Trp-activated protein C caused by defective factor Va inactivation.

    PubMed

    Rintelen, C; Yegneswaran, S; Griffin, J H

    2001-02-01

    The dysfunctional mutant R352W-protein C was found in two patients with venous thrombosis. The mutant R352A-protein C was constructed to define the contribution of charge/size of the residue at 352 on protein C (chymotrypsin numbering 187). Compared with wild type-protein C, R352W-protein C showed no difference in activation by thrombin-thrombomodulin or alpha-thrombin. However, R352W-activated protein C (APC) anticoagulant activity (aPTT assay) was reduced to approximately 65%. Although the catalytic efficiency of R352W-APC towards the oligopeptide substrate S-2366 was unperturbed, factor Va and R506Q-factor Va were not efficiently inactivated by R352W-APC compared with wild type-APC. R352A-APC showed reduced anticoagulant activity and reduced efficiency in factor Va inactivation and in factor VIIIa-inactivation in the presence of protein S. These observations suggest that the dysfunction of R352W-APC in factor Va inactivation may be one of the mechanisms leading to venous thrombosis in affected patients and that R352 plays an important role in the physiological functioning of APC. PMID:11246547

  13. 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. PMID:26579624

  14. Qualitative Analysis of Workflow Modifications Used to Generate the Reference Standard for the 2010 i2b2/VA Challenge

    PubMed Central

    South, Brett R; Shen, Shuying; Barrus, Robyn; DuVall, Scott L.; Uzuner, Ozlem; Weir, Charlene

    2011-01-01

    The Department of Veterans Affairs (VA) and the Informatics for Integrating Biology and the Bedside (i2b2) team partnered to generate the reference standard for the 2010 i2b2/VA challenge task on concept extraction, assertion classification, and relation classification. The purpose of this paper is to report an in-depth qualitative analysis of the experience and perceptions of human annotators for these tasks. Transcripts of semi-structured interviews were analyzed using qualitative methods to identify key constructs and themes related to these annotation tasks. Interventions were embedded with these tasks using pre-annotation of clinical concepts and a modified annotation workflow. From the human perspective, annotation tasks involve an inherent conflict between bias, accuracy, and efficiency. This analysis deepens understanding of the biases, complexities and impact of variations in the annotation process that may affect annotation task reliability and reference standard validity that are generalizable for other similar large-scale clinical corpus annotation projects. PMID:22195185

  15. VA opsin-based photoreceptors in the hypothalamus of birds.

    PubMed

    Halford, Stephanie; Pires, Susana S; Turton, Michael; Zheng, Lei; González-Menéndez, Irene; Davies, Wayne L; Peirson, Stuart N; García-Fernández, José M; Hankins, Mark W; Foster, Russell G

    2009-08-25

    Studies in the 1930s demonstrated that birds possess photoreceptors that are located within the hypothalamus and regulate photoperiodic responses to day length. Most recently, photoperiod has been shown to alter the activity of the pars tuberalis to release thyrotrophin, which ultimately drives a reproductive response. Despite these significant findings, the cellular and molecular identity of the hypothalamic photoreceptors has remained a mystery. Action spectra implicated an opsin-based photopigment system, but further identification based on rod- or cone-opsin probes failed, suggesting the utilization of a novel opsin. The vertebrate ancient (VA) opsin photopigments were isolated in 1997 but were thought to have a restricted taxonomic distribution, confined to the agnatha and teleost fish. Here, we report the isolation of VA opsin from chicken and show that the two isoforms spliced from this gene (cVAL and cVA) are capable of forming functional photopigments. Further, we show that VA opsin is expressed within a population of hypothalamic neurons with extensive projections to the median eminence. These results provide the most complete cellular and molecular description of a deep brain photoreceptor in any vertebrate and strongly implicate VA opsin in mediating the avian photoperiodic response. PMID:19664923

  16. 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. PMID:25355082

  17. Appreciative Inquiry and Student Affairs: A Positive Approach to Change

    ERIC Educational Resources Information Center

    Lehner, Rachelle; Hight, Donna L.

    2006-01-01

    Appreciative Inquiry (AI) is an organization development (OD) philosophy that utilizes and builds on past successes, using these as positive momentum for future change. AI provides student affairs with an alternative and generative approach to improving their organizations' processes and culture. As student affairs professionals look to the future…

  18. Factors That Influence Attrition of New Professionals in Student Affairs

    ERIC Educational Resources Information Center

    Buchanan, Jenine

    2012-01-01

    The purpose of this dissertation was to identify factors that contribute to the attrition of new professionals in the field of student affairs. Student affairs professionals report low levels of commitment to the field and depart from the field at rates ranging from 32% to 61% (Holmes, Verrier, & Chrisholm, 1983; Rosen et al., 1980; Rosser…

  19. The Student Affairs Committee. Effective Committees. Board Basics.

    ERIC Educational Resources Information Center

    Goodale, Thomas G.

    1997-01-01

    Responsibilities of the college or university governing board's student affairs committee include representing students' interests in all policy decisions, ensuring provision of adequate financial resources to support a comprehensive student affairs program, ensuring that board policies keep pace with students' diverse and changing needs, and…

  20. Leadership Development in Student Affairs Graduate Preparatory Programs

    ERIC Educational Resources Information Center

    Nelson, Kelly Anne

    2010-01-01

    As colleges and universities increase in complexity, so do the leadership demands of student affairs professionals. Today, entry-level professionals are expected to be competent leaders. As a result, student affairs graduate preparatory programs (SAGPPs) have an obligation to foster the leadership development of their enrolled students. This…

  1. Overview of Student Affairs Research Methods: Qualitative and Quantitative.

    ERIC Educational Resources Information Center

    Perl, Emily J.; Noldon, Denise F.

    2000-01-01

    Reviews the strengths and weaknesses of quantitative and qualitative research in student affairs research, noting that many student affairs professionals question the value of more traditional quantitative approaches to research, though they typically have very good people skills that they have applied to being good qualitative researchers.…

  2. Preserving the History of a Student Affairs Association

    ERIC Educational Resources Information Center

    Mann, B. J.

    2010-01-01

    The following is a brief overview regarding: the history and development of Student Affairs as it pertains to (a) preserving the history of a professional association, (b) value and benefits of a professional Student Affairs association, (c) establishing and assessing goals and (d) organizational development/change within a professional…

  3. Efficacy of Orientation for New Student Affairs Professionals

    ERIC Educational Resources Information Center

    Dean, Laura A.; Saunders, Sue A.; Thompson, George F.; Cooper, Dianne L.

    2011-01-01

    New staff orientation is a strategy that can positively affect job satisfaction and productivity, especially for those beginning careers in student affairs. In this study, new student affairs professionals were surveyed to determine their perceptions about the content and efficacy of their orientation experiences. Despite literature encouraging…

  4. 78 FR 34702 - Foreign Affairs Policy Board Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-10

    ... From the Federal Register Online via the Government Publishing Office STATE DEPARTMENT Foreign..., 5 U.S.C. App., the Department of State announces a meeting of the Foreign Affairs Policy Board to take place on July 15, 2013, at the Department of State, Washington, DC. The Foreign Affairs...

  5. 78 FR 51266 - Foreign Affairs Policy Board Meeting Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Foreign..., 5 U.S.C. App., the Department of State announces a meeting of the Foreign Affairs Policy Board to take place on September 9, 2013, at the Department of State, Washington, DC. The Foreign Affairs...

  6. Academic Affairs Committee. AGB Standing Committee Series [No. 2].

    ERIC Educational Resources Information Center

    Chait, Richard P.; Taylor, Barbara E.

    1983-01-01

    The responsibilities and functioning of an academic affairs committee of a college governing board are described. It is noted that the responsibilities of the academic affairs committee involve monitoring the relationship between mission and strategy in the academic realm. The following responsibilities of the committee are discussed: the…

  7. Decision to Enter the Profession of Student Affairs

    ERIC Educational Resources Information Center

    Taub, Deborah J.; McEwen, Marylu K.

    2006-01-01

    The purpose of this study was to consider factors that graduate students in master's degree programs in student affairs identify as influential to their decisions to enter the student affairs profession. A total of 300 master's students from 24 randomly selected graduate programs participated in the study. Relatively few differences were found…

  8. A Case Study of Student Affairs in Professional Schools

    ERIC Educational Resources Information Center

    Overly, Kathleen B.

    2012-01-01

    The purpose of conducting this study is to explore how student affairs professionals in professional schools acquire the knowledge and skill set to be effective in such positions. The need for such research arose after a review of the literature revealed inattention to the practice of student affairs in professional schools. Qualitative…

  9. Perceptions of Assessment Competency among New Student Affairs Professionals

    ERIC Educational Resources Information Center

    Hoffman, Jaimie Louise

    2010-01-01

    Due to the declining state of the current economy, a greater demand is being placed on student affairs professionals to provide evidence of the success of their programs, their impact on student learning and development and overall contributions to the undergraduate learning experience. It is a growing imperative that student affairs professionals…

  10. Rentz's Student Affairs Practice in Higher Education. 3rd Edition

    ERIC Educational Resources Information Center

    MacKinnon, Fiona J. D.

    2004-01-01

    Students in the field, as well as experienced practitioners and administrators, will herein find an up-to-date and in-depth study of the major student affairs functions of a comprehensive campus program. Within its covers, the graduate student will find chapters describing everything the person new to student affairs needs to know about the major…

  11. Improving Leadership in Student Affairs Administration: A Case Approach.

    ERIC Educational Resources Information Center

    Sandeen, Arthur

    The case approach to improving leadership in student affairs is offered as a key component of the process of learning how to become an effective leader. The 18 cases on diverse issues offered in this book are intended to provide learning opportunities for those who aspire to become student affairs leaders. The book contains an introduction about…

  12. 40 CFR 1.37 - Office of External Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Office of External Affairs. 1.37 Section 1.37 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL STATEMENT OF ORGANIZATION AND GENERAL INFORMATION Headquarters § 1.37 Office of External Affairs. (a) Office of Federal Activities. The Office of Federal Activities is headed...

  13. 17 CFR 200.15 - Office of International Affairs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Office of International... Organization § 200.15 Office of International Affairs. (a) The Office of International Affairs (“OIA”) is... activities relating to the Commission's international cooperation programs and develops initiatives...

  14. 17 CFR 200.15 - Office of International Affairs.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Office of International... Organization § 200.15 Office of International Affairs. (a) The Office of International Affairs (“OIA”) is... activities relating to the Commission's international cooperation programs and develops initiatives...

  15. 17 CFR 200.15 - Office of International Affairs.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 3 2014-04-01 2014-04-01 false Office of International... Organization § 200.15 Office of International Affairs. (a) The Office of International Affairs (“OIA”) is... activities relating to the Commission's international cooperation programs and develops initiatives...

  16. 17 CFR 200.15 - Office of International Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Office of International... Organization § 200.15 Office of International Affairs. (a) The Office of International Affairs (“OIA”) is... activities relating to the Commission's international cooperation programs and develops initiatives...

  17. 17 CFR 200.15 - Office of International Affairs.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Office of International... Organization § 200.15 Office of International Affairs. (a) The Office of International Affairs (“OIA”) is... activities relating to the Commission's international cooperation programs and develops initiatives...

  18. 75 FR 6227 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-08

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION... the location, date, time, and agenda for the next meeting of the Advisory Committee on Veterans... announces the meeting of the Advisory Committee on Veterans Business Affairs. The Advisory Committee...

  19. 75 FR 22434 - Advisory Committee on Veterans Business Affairs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... ADMINISTRATION Advisory Committee on Veterans Business Affairs AGENCY: U.S. Small Business Administration. ACTION... the location, date, time, and agenda for the next meeting of the Advisory Committee on Veterans... announces the meeting of the Advisory Committee on Veterans Business Affairs. The Advisory Committee...

  20. Doctoral Programs for Student Affairs Professionals: A Status Report.

    ERIC Educational Resources Information Center

    Coomes, Michael D.; And Others

    1991-01-01

    Conducted assessment of current status of doctoral education opportunities for student affairs professionals, drawn from data from the Doctoral Programs for Student Affairs Practitioners Questionnaire completed by 36 program directors, the Student Characteristics Questionnaire completed by 48 respondents, and a survey of 775 doctoral students.…