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Comparing strategies for United States veterans' mortality ascertainment

Comparing strategies for United States veterans' mortality ascertainment

Veterans' mortality ascertainment was significantly improved by using both VA and death certificates as source files. Our findings indicate that either single source approach for mortality ascertainment may misrepresent veteran mortality based on comparisons of race / ethnic- ity, marital status, severity of illness, and settings of care. Diagnoses associated with serious medical co-morbidity and the likelihood of receiving any inpatient services (e.g. hospital or long term care) were both significantly lower among veterans missed by either single source approach. Our findings are consistent with Washington State where the deaths of 25% of 533 veterans who only used outpa- tient services were only identified with death certificates, and 5% were only identified in BIRLS. [9] Using BIRLS only for mortality determination, it is unclear why gener- ally healthier, primarily outpatient users are less likely to be noted. Death notification is typically triggered by ben- efit claims (e.g., burial assistance, pension and related benefits). Affluent veterans whose families might be less likely to file benefit claims were drawn to the VA recently [27]. However, poverty or low social support might also make it harder to file claims. On the other hand, a death certificate only approach to ascertainment misses rela- tively fewer non-resident veterans. Such veterans may be homeless or mobile, retired veterans, and they may seek care transiently in California, or their deaths may be recorded elsewhere.
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Mending Invisible Wounds: The Efficacy and Legality of MDMA-Assisted Psychotherapy in United States' Veterans Suffering with Post-Traumatic Stress Disorder

Mending Invisible Wounds: The Efficacy and Legality of MDMA-Assisted Psychotherapy in United States' Veterans Suffering with Post-Traumatic Stress Disorder

In the last decade, scientific progress has elucidated the power of a stigmatized and illegalized substance with regard to its effective use in therapy. It is important to note that the Controlled Substances Act is open for rescheduling hearings on an annual basis. 270 As a result, the DEA will be presented with the opportunity to conform its legislation to the scientific understand regarding MDMA and its use in psychotherapy, and will have the opportunity to do so without frustrating congressional purpose. A rescheduling of the substance to Schedule III, as opposed to Schedule I, would provide physicians with the ability to administer MDMA in dispersed therapy sessions over a wide range of time, a technique with proven benefits unseen in the current antidepressant atmosphere. Making this change will allow outdated drug legislation to catch up with scientific progress, and in doing so, make a meaningful and necessary step toward addressing PTSD in American veterans.
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Clinical decisions surrounding genomic and proteomic testing among United States veterans treated for lung cancer within the Veterans Health Administration

Clinical decisions surrounding genomic and proteomic testing among United States veterans treated for lung cancer within the Veterans Health Administration

This study illustrates the significant complexity imposed by the use of precision medicine tools in clinical care of NSCLC patients. There are approximately 7600 veterans diagnosed with lung cancer each year. Over the period studied (18 months), based on histologic type (non- squamous NSCLC) and stage (IV), approximately 2280 patients were eligible for EGFR mutational testing. Only 69 patients (3%) underwent proteomic testing, which illustrates how rare this testing is within the VA. Yet, there are potentially many more patients who could benefit from proteomic testing. Our prior study of EGFR testing in the VA found that 64 (7%) out of 973 patients tested had sensitizing mutations [13]. Theoretically, all the EGFR-negative patients or those lacking tumor tissue are
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Characteristics of primary care office visits to nurse practitioners, physician assistants and physicians in United States Veterans Health Administration facilities, 2005 to 2010:a retrospective cross-sectional analysis

Characteristics of primary care office visits to nurse practitioners, physician assistants and physicians in United States Veterans Health Administration facilities, 2005 to 2010:a retrospective cross-sectional analysis

Background: Primary care, an essential determinant of health system equity, efficiency, and effectiveness, is threatened by inadequate supply and distribution of the provider workforce. The Veterans Health Administration (VHA) has been a frontrunner in the use of nurse practitioners (NPs) and physician assistants (PAs). Evaluation of the roles and impact of NPs and PAs in the VHA is critical to ensuring optimal care for veterans and may inform best practices for use of PAs and NPs in other settings around the world. The purpose of this study was to characterize the use of NPs and PAs in VHA primary care and to examine whether their patients and patient care activities were, on average, less medically complex than those of physicians.
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Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans

Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans

residual confounding. In our analyses, we defined drug exposure as having a prescription for it. Because PPIs (and H2 blockers) are available over the counter in the USA, it is possible that some patients in this cohort may have obtained and used PPI without prescription. However, owing to financial considerations, this is not highly likely, and if it occurred in some patients, it will have biased the results against the primary hypothesis and resulted in underestimation of risk. The cohort included mostly older white male US veterans, which may limit the generalisability of study results to a broader population. Our data sets did not include information on the cause of death. The study has a number of strengths, including the use of national large-scale data from a network of integrated health systems, which were captured during routine medical care that minimises selection bias. We employed a new user (incident user) approach and eval- uated the association between PPI use and risk of death using a number of analytical approaches where we consis- tently found a significant association between PPI use and increased risk of death. The consistency of study findings in our report and the growing body of evidence in the literature showing a host of adverse events associated with PPI use are compelling, and because of the high preva- lence of PPI use, it may have public health implications. Exercising pharmacovigilance and limiting PPI use to instances and durations where it is medically indicated may be warranted.
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PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice

PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice

We have adopted this position for a number of rea- sons, both experientially and empirically based. Tracing the history of facilitation as a concept in healthcare [5], there is a tradition of applying facilitator roles to support the implementation of changes in practice. From the introduction of facilitators to promote primary care prevention programmes in the 1980s [47], the use of fa- cilitators in primary care has become commonplace, par- ticularly supporting the implementation of change through quality improvement methods [48–51]. A 2012 systematic review of practice facilitation in primary care concluded that practices supported by a facilitator were 2.76 times more likely to adopt evidence-based clinical guidelines [52]. Within the 23 studies reviewed, facilita- tors employed a number of different facilitation strat- egies, in particular audit and feedback (used in 100 per cent of studies) and interactive consensus building and goal setting (91 per cent use), alongside reminders, tai- loring to context and quality improvement tools such as Plan-Do-Study-Act (PDSA) cycles. This concurs with our own experiences of applying facilitation to support the development of standards, audit and quality im- provement in nursing and health care [53, 54]. More re- cently, the use of facilitation has been evaluated in a number of other settings. For example, the NeoKIP (Neonatal Knowledge into Practice) trial evaluated the effectiveness of facilitation as a knowledge translation intervention for improved neonatal health and survival [55]. Using lay members of the community who received training in facilitation techniques such as PDSA and group consensus building, the study demonstrated a re- duced neonatal mortality of 49 % in the third year of the intervention [56]. In the United States Veterans Health Administration, a number of studies have demonstrated the benefits of using facilitation to support the imple- mentation of evidence into clinical practice (for example [57, 58]), whilst in the UK, facilitators have been employed to support the implementation of evidence- based vascular care [20, 21], as described in the CKD case study.
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An assessment of survey measures used across key epidemiologic studies of United States Gulf War I Era Veterans

An assessment of survey measures used across key epidemiologic studies of United States Gulf War I Era Veterans

We compared the survey tools used in keystone epide- miologic studies and registries of Gulf War Era veterans, with the intent of highlighting commonalities and differ- ences in efforts aimed at understanding health and risk factors. It is apparent that there are many areas of at least minimal concordance with respect to question and response format. We note that some investigators intentionally drew on the materials used by prior studies, establishing areas of commonality [1,12,60]. Among mental and physical health domains, there was moderate concordance among the measures used to assess medical history, symptoms, functional status, and the diagnoses of chronic fatigue syndrome and fibromyalgia. Most of the exposure assessment instruments also have response formats that can be reduced to the same binary frame- work. These similarities suggest that meta-analyses of study-level or individual-level data could be performed on several of the subdomains, with varying degrees of loss of detail.
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What has happened to construction labor in the united states?

What has happened to construction labor in the united states?

In order to understand what has been construction labor it is important to look happening with construction labor over time. will be looking at the population of the United 1950. Further the study will look at those people the construction trades during that same period once we have that data we will look at what industry, in terms of growth within the industry. The United States Census Bureau conducts and data on the citizens of the United States. They collection every ten years. This data is published on the internet. (United States Census Bureau, the data provided by the United States Census research the most accurate and impartial data of the United States. In order to determine who in the construction trades since the 1950’s depended on the United States Bureau of Labor Bureau of Labor Statistics keeps data on all types and who is working in them. (United States Labor, 2018) This is where the data on construction is kept which is vital for us to see in order to
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Journal of Hematology & Oncology reviewer acknowledgement 2012

Journal of Hematology & Oncology reviewer acknowledgement 2012

Heather Himburg United States of America. Jessica Hochberg United States of America[r]

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BMC Endocrine Disorders reviewer acknowledgement 2014

BMC Endocrine Disorders reviewer acknowledgement 2014

Mary Vouyiouklis United States of America. Xiangbing Wang United States of America[r]

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Reviewer acknowledgement 2012

Reviewer acknowledgement 2012

Eric Barklis United States of America.. Joel Blankson United States of America.[r]

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Essays on Electoral Accountability and Equalization Transfer under a Decentralized Context: The Case of Peruvian Municipalities

Essays on Electoral Accountability and Equalization Transfer under a Decentralized Context: The Case of Peruvian Municipalities

not deserve this success and, at other times, he feels like the unfortunate experiences of others are not deserved. David begins to become disenchanted, questioning why such troubles and horrible events must occur and who is responsible for such events. He also begins to question whether these events are caused by human agency or through some deterministic forces outside the realm of the human. This line of questioning leads David to the point of paranoia, fearing that some catastrophe will be sent his way to counter all of his successes. This fear is often seen as guilt toward capitalist culture. For example, in her essay, ““The Psychological Politics of the American Dream: Death of a Salesman and the Case for an Existential Dialectics,” Lois Tyson states that the main focus of Arthur Miller’s works is “the myth of the American dream, the belief that, because one's socioeconomic success in America is limited only by one's ability and ambition, socioeconomic success is the measure of one's value as a person” (Tyson 262). Tyson believes that Miller critiques this belief and shows that the myth only perpetuates amoral behavior. Even in Jane Dominik’s compilation of theatrical reviews of Arthur Miller’s works, aptly entitled “Critical Receptions of Arthur Miller’s Works,” Dominik reduces the nature of the critics’ reviews to Miller’s themes of “guilt, responsibility, illusions, dreams, family, betrayal, the "birds coming home to roost" (Bigsby, Company 49), and success and failure in capitalistic America” (Dominik 72). Other critics focus on the breadth of Miller’s topics and his
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Tuberculosis among children in the United States: 1978

Tuberculosis among children in the United States: 1978

Tuberculosis among children in the United States: 1978.. Tuberculosis mortality in the United States has.[r]

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The construction of "hegemony" in selected nuclear nonproliferation "regime" literature

The construction of "hegemony" in selected nuclear nonproliferation "regime" literature

Regarding political control, if less 'developed' states do lack the capacity to control nuclear weaponry, or do not have the same command, communication and intelligence facilities as more developed states^ 87 this m ay not necessarily lead to a greater likelihood of nuclear war than if decisions were being taken under the seignorage of a superpower. Many regional conflicts have been exacerbated by superpower involvement in the past, and to date threats to use nuclear weapons have been issued primarily by the U.S. and the S.U. Destabilising ethnic conflict also occurs in 'developed' states, such as the recent ethnic conflict amongst various Soviet nationalities, and the British race riots of the mid-eighties, but there nuclear resolution of the conflict is equally unlikely. Finally, the assumption that governments in the more 'developed' states are more stable and less prone to coups or revolutions must surely be questioned in the light of political unrest in France in 1968, and more recently by the social movements of the eighties which have toppled the governments of industrialised Eastern Europe. The argument that nuclear war may be more likely in 'Third World' states because of the comparatively tenuous control of the military by civilian governments also overlooks the fact that technological failings such as 'failed com puter chips, flocks of geese, even the rising of the moon, have triggered false alarms in America's high technology early warning system'288? ancj that autom ated technology m inim ises the need for human control. M oreover, some 'threshold' third world states such as Brazil, which until recently have been military dictatorships, have not been identified with irresponsible regional behaviour. The loss of sensitive nuclear material, such as a shipment of yellowcake allegedly intercepted by Israel, has also been a U.S. 'responsibility'.
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Backdrop of mexican immigrants in to united states of America

Backdrop of mexican immigrants in to united states of America

The United States developed and grew from thirteen colonies to fifty states and has, gone through so many discoveries, explorations and settlements. The Immigration has played an important role in mmigration policy in the world. The extensive explorations from many lands like Spain, Great Britain, Holland and Sweden. In 1875 it was al responsibility. After that there was series of The national-origins quota system passed Walter Act of 1952, The immigration act of 1973, of 1986, 1990 Immigration Act, Illegal Immigrant the Border Protection, Anti-terrorism, Comprehensive Immigration Reform Act of 2006 ration Reform Act of 2007. The legislations passed from time to time by US government has controlled the level of migration into the country from Mexico both legal and illegal. Donald Trump for keeping a campaign promise, signed an executive order on ry 2017 which immediately but temporarily banned citizens from seven countries – Iran, Iraq, from entering the U.S. The Mexicans are the largest illegally in the country. During his first 100 days in office, President Trump has taken a sweeping set of actions on immigration, ranging from imposing a travel ban to cutting refugee admissions and travel ban. This policy affects mainly on Mexicans in US. The Chief made justification for Trum’s decision and has ndorsement of decision has constitutional ground. international terminals in U.S. airports nationwide, and behalf of refugees and other migrants.
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A Review on Agency Cost of Shariah Governance in Mutual Fund

A Review on Agency Cost of Shariah Governance in Mutual Fund

(1996) United States Duality function and firm performance Iyengar and Zampelli (2009) United States Duality function and firm performance Tufano and Sevick (1997) United States Board si[r]

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Grounds and Procedures Relating to Deportation

Grounds and Procedures Relating to Deportation

23. United States ex rel. United States ex rel.. 3 0 A lifelong alien resident of the United States who is convicted of smoking a marihuana cigarette is deportable ev[r]

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Origins in the USA in the 1980s of the warning that smokeless tobacco is not a safe alternative to cigarettes: a historical, documents-based assessment with implications for comparative warnings on less harmful tobacco/nicotine products

Origins in the USA in the 1980s of the warning that smokeless tobacco is not a safe alternative to cigarettes: a historical, documents-based assessment with implications for comparative warnings on less harmful tobacco/nicotine products

In March 1981, “Snuff dipping and oral cancer among women in the southern United States,” a study of 255 cases and 502 controls, [10] was featured in the New England Journal of Medicine by Winn and others from the National Cancer Institute (NCI). The abstract re- ported “The relative risk associated with snuff dipping among white nonsmokers was 4.2 (95% confidence limits, 2.6 to 5.7), and among chronic users this risk approached 50-fold for cancers of the gum and buccal mucosa...” (p. 745). The authors considered their study conclusive and “...the first to show a definite link” [11]. The results were widely publicized, including in January 1983 on national television [12]. The NCI issued a state- ment entitled, “In Answer to Your Questions About Smokeless Tobacco,” [13]. It treated the snuff-dipping study as if it were conclusive evidence against SLT.
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Ibm (international business machines), United States

Ibm (international business machines), United States

Accounting Grouping  Applicable only for inventory offset GBB, price difference PRD and consignment liabilityKON  Allows to subdivide number assignments for each transaction key in acc[r]

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Dr. Tichenor’s ‘Lost Cause’: The Rise of New Orleans’s Confederate Culture during the Gilded Age

Dr. Tichenor’s ‘Lost Cause’: The Rise of New Orleans’s Confederate Culture during the Gilded Age

The UDC’s political maneuvering on both the national and regional scale created a string of victories for the Lost Cause. During the turn of the twentieth-century a nostalgic celebration of Southern nationalism blossomed, and the growth of Southern populism meant that organizations like the UCV and UDC often found that they had free reign in Southern cities, especially New Orleans. The UDC’s stated objective was to honor the memory of those who served and died in the service of the Confederate States of America by collecting and preserving the material necessary for a truthful history of the Civil War. The UDC also aimed to protect, preserve, and mark the places made historic by those who fought to defend the Confederacy. Hence, it provided
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