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Tampa, FL, United States

Lee M.,University of South Florida | Jim H.S.,Moffitt Cancer Center | Fishman M.,Moffitt Cancer Center | Zachariah B.,James A. Haley Veterans Hospital | And 3 more authors.
Psycho-Oncology | Year: 2015

Objective Prostate cancer patients who receive androgen deprivation therapy (ADT) often experience many physical and psychological side effects. ADT may be associated with increased risk for depression, but the relationship between ADT and depression is not fully understood. This study used a longitudinal design to assess depressive symptomatology in patients receiving ADT compared with two groups of matched controls. Methods Participants were men initiating ADT treatment (ADT+ group; n = 61) and their matched controls: prostate cancer patients treated with radical prostatectomy (ADT- group; n = 61), and no-cancer controls (CA- group; n = 61). Depressive symptomatology was assessed using the Center for Epidemiological Studies Depression Scale at ADT initiation and again 6 months later. Differences in depressive symptomatology and rates of clinically significant depressive symptomatology were analyzed between groups at each time point and within groups over time. Results Between baseline and follow-up, ADT+ participants demonstrated increased depressive symptomatology and increased rates of clinically significant depressive symptomatology (ps < 0.05). ADT+ participants also reported greater depressive symptomatology than both control groups at follow-up (ps < 0.001). Rates of clinically significant depressive symptomatology were higher in the ADT+ group than the ADT- and CA- groups at both time points (baseline: 28%, 5%, 12%; follow-up: 39%, 9%, 11%). Conclusions Findings support the hypothesis that ADT administration yields increases in depression and suggest that the mechanism behind ADT's association with depression should be explored and that prostate cancer patients treated with ADT should receive particular focus in depression screening and intervention. © 2014 John Wiley & Sons, Ltd. Source

Cowan L.J.,United Road Services | Cowan L.J.,Florida College | Stechmiller J.K.,Florida College | Rowe M.,James A. Haley Veterans Hospital | And 2 more authors.
Wound Repair and Regeneration | Year: 2012

This study sought to determine if a parsimonious pressure ulcer (PU) predictive model could be identified specific to acute care to enhance the current PU risk assessment tool (Braden Scale) utilized within veteran facilities. Factors investigated include: diagnosis of gangrene, anemia, diabetes, malnutrition, osteomyelitis, pneumonia/pneumonitis, septicemia, candidiasis, bacterial skin infection, device/implant/graft complications, urinary tract infection, paralysis, senility, respiratory failure, acute renal failure, cerebrovascular accident, or congestive heart failure during hospitalization; patient's age, race, smoking status, history of previous PU, surgery, hours in surgery; length of hospitalization, and intensive care unit days. Retrospective chart review and logistic regression analyses were used to examine Braden scores and other risk factors in 213 acutely ill veterans in North Florida with (n=100) and without (n=113) incident PU from January-July 2008. Findings indicate four medical factors (malnutrition, pneumonia/ pneumonitis, candidiasis, and surgery) have stronger predictive value (sensitivity 83%, specificity 72%, area under receiver operating characteristic [ROC] curve 0.82) for predicting PUs in acutely ill veterans than Braden Scale total scores alone (sensitivity 65%, specificity 70%, area under ROC curve 0.70). In addition, accounting for four medical factors plus two Braden subscores (activity and friction) demonstrates better overall model performance (sensitivity 80%, specificity 76%, area under ROC curve 0.88). © 2012 by the Wound Healing Society. Source

Chappell K.B.,American Nurses Credentialing Center | Richards K.C.,George Mason University | Barnett S.D.,James A. Haley Veterans Hospital
Journal of Nursing Administration | Year: 2014

OBJECTIVE: The objective of this study was to determine predictors of clinical leadership skill (CLS) for RNs with 24 months of clinical experience or less.BACKGROUND: New graduate nurse transition programs (NGNTPs) have been proposed as a strategy to increase CLS. CLS is associated with positive patient outcomes.METHOD: Method used was hierarchical regression modeling to evaluate predictors of CLS among individual characteristics of RNs and characteristics of NGNTPs.RESULTS: Perceived overall quality of an NGNTP was the strongest predictor of CLS (R2 = 0.041, P G .01). Clinical experience and NGNTP characteristics accounted for 6.9% of the variance in CLS and 12.6% of the variance among RNs with assigned mentors (P G .01). RNs participating in NGNTPs for more than 24 weeks were 21 times more likely to remain employed within the organization when compared with NGNTPs of 12 weeks or less, a significant costbenefit to the organization.CONCLUSION: Although perceived overall quality of a NGNTP was the strongest predictor of CLS, much of the variance in CLS remains unexplained. Copyright © 2014 Wolters Kluwer Health. Source

Ruiz M.A.,James A. Haley Veterans Hospital | Ruiz M.A.,University of South Florida | Cox J.,Texas A&M University | Magyar M.S.,Texas A&M University | Edens J.F.,Texas A&M University
Psychological Assessment | Year: 2014

We examined the predictive validity of the Personality Assessment Inventory (PAI; Morey, 2007) for criminal reoffending over a 44-60 month follow-up period among incarcerated offenders (N = 124) who completed an addiction treatment program. With this study, we sought to test whether PAI scores conceptually relevant to Andrews and Bonta's (2010) central eight and responsiveness factors were predictive of general and specific reoffending in a sample with criminal involvement and substance-related impairment. PAI scores tapping antisocial personality style and the anger/hostile component of antisocial cognitions had the most robust relationships with the timing and occurrence of reoffending. Hostile dominance and discrepancy scores of observed versus predicted drug and alcohol problems were also predictive of reoffending. None of the other variables examined were consistently associated with reoffending. We discuss these results in relation to the use of the PAI to inform clinical decision making for individuals involved in the criminal justice system. © 2014 American Psychological Association. Source

Hattler B.,University of Denver | Messenger J.C.,University of Denver | Shroyer A.L.,Northport Veterans Affairs Medical Center | Collins J.F.,Cooperative Studies Program Coordinating Center | And 5 more authors.
Circulation | Year: 2012

Background-The Department of Veterans Affairs Randomized On/Off Bypass (ROOBY) trial compared clinical and angiographic outcomes in off-pump versus on-pump coronary artery bypass graft (CABG) surgery to ascertain the relative efficacy of the 2 techniques. Methods and Results-From February 2002 to May 2007, the ROOBY trial randomized 2203 patients to off-pump versus on-pump CABG. Follow-up angiography was obtained in 685 off-pump (62%) and 685 on-pump (62%) patients. Angiograms were analyzed (blinded to treatment) for FitzGibbon classification (A=widely patent, B=flow limited, O=occluded) and effective revascularization. Effective revascularization was defined as follows: All 3 major coronary territories with significant disease were revascularized by a FitzGibbon A-quality graft to the major diseased artery, and there were no new postanastomotic lesions. Off-pump CABG resulted in lower FitzGibbon A patency rates than on-pump CABG for arterial conduits (85.8% versus 91.4%; P=0.003) and saphenous vein grafts (72.7% versus 80.4%; P<0.001). Fewer off-pump patients were effectively revascularized (50.1% versus 63.9% on-pump; P<0.001). Within each major coronary territory, effective revascularization was worse off pump than on pump (all P≤0.001). The 1-year adverse cardiac event rate was 16.4% in patients with ineffective revascularization versus 5.9% in patients with effective revascularization (P<0.001). Conclusions-Off-pump CABG resulted in significantly lower FitzGibbon A patency for arterial and saphenous vein graft conduits and less effective revascularization than on-pump CABG. At 1 year, patients with less effective revascularization had higher adverse event rates. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00032630. © 2012 American Heart Association, Inc. Source

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