scholarly journals The frequency of Raynaud’s phenomenon, very early diagnosis of systemic sclerosis, and systemic sclerosis in a large Veteran Health Administration database

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tracy M. Frech ◽  
Maureen A. Murtaugh ◽  
Megan Amuan ◽  
Mary Jo Pugh
Keyword(s):  
Systemic Sclerosis ◽  
Early Diagnosis ◽  
Medical Records ◽  
Military Service ◽  
Categorical Variables ◽  
Diagnostic Code ◽  
Health Administration ◽  
Job Classification ◽  
Chi Squared ◽  
The Military

Abstract Background We describe Raynauds phenomenon (RP), potential very early diagnosis of systemic sclerosis (VEDOSS), and systemic sclerosis (SSc) in Veterans deployed in support of Post-9/11 operations. We sought to describe the military occupation specialty, clinical features, and vasodilator use across the three diagnoses. Methods Individual Veterans medical records were assessed for RP (ICD-9443.0), VEDOSS with swelling of hands (ICD-9729.81) and RP (ICD-9443.0), and SSc (ICD-9710.1). The distribution of sociodemographic, military service branch, job classification, vasodilator use, and comorbidities were examined across the three classifications of disease. The chi-squared test and Fisher’s exact compared frequency of these categorical variables. Logistic regression assessed the likelihood of characteristics of the three classifications. Results In this population of 607,665 individual Veteran medical records, 857 had RP, 45 met possible VEDOSS criteria, and 71 had a diagnosis of SSc. The majority of RP, potential VEDOSS and SSc cases were white males. Those in craftworks, engineering or maintenance, and healthcare had a greater likelihood of RP. Less than half of RP and VEDOSS patients were on vasodilators. The most common comorbidities in this population were the diagnostic code for pain (highest in the potential VEDOSS group [81.6%]), followed by depression in all groups. Conclusion This is a unique Veteran population of predominately-male patients. Our data suggests that vasodilator medications are potentially being under-utilized for RP and potential VEDOSS. Our data highlights mood and pain management as an important aspect of SSc care.

scholarly journals Interstitial lung disease in a veterans affairs regional network; a retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247316
Author(s):  
Armando Bedoya ◽  
Roy A. Pleasants ◽  
Joel C. Boggan ◽  
Danielle Seaman ◽  
Anne Reihman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Research Question ◽  
Health Concern ◽  
Categorical Variables ◽  
Diagnostic Code ◽  
Health Administration ◽  
Incidence Prevalence

Background The epidemiology of Interstitial Lung Diseases (ILD) in the Veterans Health Administration (VHA) is presently unknown. Research question Describe the incidence/prevalence, clinical characteristics, and outcomes of ILD patients within the Veteran’s Administration Mid-Atlantic Health Care Network (VISN6). Study design and methods A multi-center retrospective cohort study was performed of veterans receiving hospital or outpatient ILD care from January 1, 2008 to December 31st, 2015 in six VISN6 facilities. Patients were identified by at least one visit encounter with a 515, 516, or other ILD ICD-9 code. Demographic and clinical characteristics were summarized using median, 25th and 75th percentile for continuous variables and count/percentage for categorical variables. Characteristics and incidence/prevalence rates were summarized, and stratified by ILD ICD-9 code. Kaplan Meier curves were generated to define overall survival. Results 3293 subjects met the inclusion criteria. 879 subjects (26%) had no evidence of ILD following manual medical record review. Overall estimated prevalence in verified ILD subjects was 256 per 100,000 people with a mean incidence across the years of 70 per 100,000 person-years (0.07%). The prevalence and mean incidence when focusing on people with an ILD diagnostic code who had a HRCT scan or a bronchoscopic or surgical lung biopsy was 237 per 100,000 people (0.237%) and 63 per 100,000 person-years respectively (0.063%). The median survival was 76.9 months for 515 codes, 103.4 months for 516 codes, and 83.6 months for 516.31. Interpretation This retrospective cohort study defines high ILD incidence/prevalence within the VA. Therefore, ILD is an important VA health concern.

The Perpetuation of Gender Norms and White Hegemonic Patriarchy in the South African Defence Force as Represented in André van der Merwe’s Moffie (2006)

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Bernard Nolen Fortuin
Keyword(s):  
South Africa ◽  
Military Service ◽  
Well Being ◽  
The Novel ◽  
White Family ◽  
White Children ◽  
White Masculinity ◽  
Party Government ◽  
Compulsory Military Service ◽  
The Military

With the institution of compulsory military service in South Africa in 1948 the National Party government effected a tool well shaped for the construction of hegemonic masculinities. Through this, and other structures like schools and families, white children were shaped into submissive abiding citizens. Due to the brutal nature of a militarised society, gender roles become strictly defined and perpetuated. As such, white men’s time served on the border also “toughened” them up and shaped them into hegemonic copies of each other, ready to enforce patriarchal and racist ideologies. In this article, I look at how the novel Moffie by André Carl van der Merwe (2006) illustrates hegemonic white masculinity in South Africa and how it has long been strictly regulated to perpetuate the well-being of the white family as representative of the capitalist state. I discuss the novel by looking at the ways in which the narrator is marked by service in the military, which functions as a socialising agent, but as importantly by the looming threat of the application of the term “moffie” to himself, by self or others.  

Religion and the Military

2018 ◽  
pp. 535-552
Author(s):  
Leana A. Bouffard ◽  
Haerim Jin
Keyword(s):  
Criminal Justice ◽  
Military Service ◽  
Criminal Justice Policy ◽  
Future Research ◽  
Period Effects ◽  
Offending Patterns ◽  
Role Of Religion ◽  
The Military ◽  
The Relationship

This chapter provides an overview of the literature examining the role of religion and military service in the desistance process. It also identifies outstanding issues and directions for future research. It first presents an overview of research examining the role of religion in desistance and highlights measurement issues, potential intervening mechanisms, and a consideration of faith-based programs as criminal justice policy. Next, this chapter covers the relationship between military service and offending patterns, including period effects that explain variation in the relationship, selection effects, and the incorporation of military factors in criminal justice policy and programming. The chapter concludes by highlighting general conclusions from these two bodies of research and questions to be considered in future research.

scholarly journals Patients’ Perceived Satisfaction Through Telephone-Assisted Tele-Consultation During the SARS-CoV-2 Pandemic Period: Observational Single-Centre Study at a Tertiary-Referral Colorectal Surgery Department

2021 ◽  
pp. 155335062110080
Author(s):  
Lara Blanco Terés ◽  
Carlos Cerdán Santacruz ◽  
Javier García Septiem ◽  
Rocío Maqueda González ◽  
José María Lopesino González ◽  
...  
Keyword(s):  
Categorical Variables ◽  
Average Score ◽  
Job Status ◽  
Perceived Satisfaction ◽  
The Future ◽  
Chi Squared ◽  
Single Centre Study ◽  
Set Up ◽  
Almost All ◽  
Surgery Department

Introduction: The pandemic produced by SARS-CoV-2 has obliged us to set up the tele-assistance to offer a continuity of care. This implies an innovation, being the degree of satisfaction of patients unknown. Methods: A telephonic survey was conducted with the validated in the Spanish tool Telehealth Usability Questionnaire (Telehealth Usability Questionnaire; rating from 1-7) of all candidate patients assisted consecutively in the Coloproctology Unit. We included demographic variables, education level, job status, diagnosis and consultation type. A descriptive study was done. The relationship between the willingness of consultation model in the future (telemedicine vs traditional) and the categorical variables was analysed through the chi-squared test. Results: A total of 115 patients were included. The average age was 59.9 years, being 60% women. The average score in each of the survey items was higher than 6 in all the questions but 1. 26.1% of the surveyed patients confessed being advocated to tele-assistance in the future. The only factors related to greater willingness to tele-assistance were male gender (37% vs 18.8%; P = .03) and a higher academic preparation level in favour of higher technical studies (35.9%) and university studies (32.4%) opposite to the rest ( P = .043). The rest of variables studied, job status, labour regimen, diagnostic group and consultation type did not show any relationship. Conclusions: A vast majority of patients answered favourably to almost all the items of the survey. However, only 26.1% of them would choose a model of tele-assistance without restrictions.

Health and Service-related Impact of Sexual and Stalking Victimization During United States Military Service on LGBT Service Members

2020 ◽  
pp. 088626052097031
Author(s):  
Cary Leonard Klemmer ◽  
Ashley C. Schuyler ◽  
Mary Rose Mamey ◽  
Sheree M. Schrager ◽  
Carl Andrew Castro ◽  
...  
Keyword(s):  
United States ◽  
Military Service ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
United States Military ◽  
Service Outcomes ◽  
Study Participants ◽  
The Military ◽  
Stalking Victimization

Prior research among military personnel has indicated that sexual harassment, stalking, and sexual assault during military service are related to negative health sequelae. However, research specific to LGBT U.S. service members is limited. The current study aimed to explore the health, service utilization, and service-related impact of stalking and sexual victimization experiences in a sample of active-duty LGBT U.S. service members ( N = 248). Respondent-driven sampling was used to recruit study participants. U.S. service members were eligible to participate if they were 18 years or older and active-duty members of the U.S. Army, U.S. Navy, U.S. Marine Corps, or U.S. Air Force. This study included a sizeable portion of transgender service members ( N = 58, 23.4%). Sociodemographic characteristics, characteristics of military service, health, and sexual and stalking victimization in the military were assessed. Regression was used to examine relationships between health and service outcomes and sexual and stalking victimization during military service. Final adjusted models showed that experiencing multiple forms of victimization in the military increased the odds of visiting a mental health clinician and having elevated somatic symptoms, posttraumatic stress disorder symptomatology, anxiety, and suicidality. Sexual and stalking victimization during U.S. military service was statistically significantly related to the mental and physical health of LGBT U.S. service members. Interventions to reduce victimization experiences and support LGBT U.S. service members who experience these types of violence are indicated. Research that examines the role of LGBT individuals’ experiences and organizational and peer factors, including social support, leadership characteristics, and institutional policies in the United States military is needed.

scholarly journals POS0287 USE OF BIOLOGIC DISEASE MODIFYING ANTI-RHEUMATIC DRUGS IN RELATION TO THE RISK OF LYMPHOMA: A COHORT STUDY OF US VETERANS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 369.1-369
Author(s):  
N. Singh ◽  
A. Peterson ◽  
A. Baraff ◽  
A. Korpak ◽  
M. Vaughan-Sarrazin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Native American ◽  
Diagnostic Code ◽  
Health Administration ◽  
Inception Cohort ◽  
Regular User ◽  
Psoriatic Arthropathy ◽  
Disease Modifying ◽  
Us Veterans ◽  
Lymphoma Risk

Background:Epidemiologic studies suggest that disease duration and degree of inflammatory activity of rheumatoid arthritis (RA) contribute to lymphoma development. However, the association of the use of biologic disease modifying anti-rheumatic drugs (bDMARDs) in patients with RA on lymphoma risk needs further evaluation.Objectives:Examine the effect of administration of bDMARDS on the incidence of lymphoma in an inception cohort of RA.Methods:We identified patients diagnosed with RA in any US Veterans Affairs (VA) facility from 1/1/2002 and 12/31/2018 using the Veteran’s Health Administration (VHA) databases. To be included, each patient was required to meet the following criteria: 1) 2+ RA diagnostic codes at least 7 days apart but no more than 365 days apart 2) a prescription for a conventional synthetic DMARD (csDMARD) within 90 days of the first RA diagnosis 3) One inpatient or outpatient visit 30 days to 2 years preceding first RA diagnosis (indicating they are a regular user of the VHA). We excluded patients for any of the following if they preceded the first RA diagnosis: 1) a prior single RA diagnostic code 2) a prescription for any DMARD medication 3) a concomitant diagnosis of another inflammatory arthritis (e.g. psoriatic arthropathy) 4) a diagnosis of lymphoma. Index date for the study is the date of the first qualifying RA diagnosis. Lymphoma diagnoses were identified through VHA records using the International Classification of Diseases-Oncology codes.Results:We identified 27,536 veterans with RA in the study period meeting the inclusion and exclusion criteria. Of these, 53% (n=14,705) were in the age range 60 to 80 years. The cohort was 89% male, 75.5% White, 13.7% African American. Over the study period, 1.2% (n=332) of the study population developed a lymphoma.Conclusion:Using the nationwide VHA we have identified a large inception cohort of patients with RA of whom 1.2% developed lymphoma over study follow-up. This data will be used in future analyses to produce estimates of the effect of biologic medications on lymphoma risk, adjusting for confounding by indication and other variables.Table 1.Baseline characteristics of the cohort based on bDMARD exposure statusCharacteristicbDMARD-naive (n= 19,095)bDMARD-exposed (n=8,441)Overall Lymphomas Age (years)171161 18-4046 40-606378 60-8010074 >8043 Males17,206 (90%)7,270 (86%)Race White14,150 (74%)6,627 (76%) Black2,674 (14%)1,090 (13%) Asian96 (0.5%)46 (0.5%) Native American or Pacific Islander371 (2%)187 (2.2%) Missing1,804 (9%)491 (6%)Acknowledgements:The work in this abstract is supported by Investigator Award from the Rheumatology Research Foundation to Dr Singh.Disclosure of Interests:None declared

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