Articles: hospitals.
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Hospitalists working outside the Veterans Affairs (VA) system frequently will serve Veterans receiving care for acute conditions and/or awaiting transfer to VA facilities. ⋯ Most studied health conditions among Veterans of post-9/11 conflicts have focused on areas of particular importance to the VA. However, significant gaps remain, particularly in understanding the correlation between specific exposures and clinical outcomes currently observed and to be anticipated in the future in this population.
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To explore the association of socioeconomic status (SES) and race/ethnicity with perioperative metrics within the Enhanced Recovery After Surgery (ERAS) framework to identify gaps for equity-informed improvements. ⋯ Low SES was linked to lower compliance with important process measures, higher infectious and all in-hospital complication rates, and longer LOS. Despite high rates of protocol compliance, Black race/ethnicity showed an association with increased odds of respiratory complications and extended LOS. Adjustments to perioperative protocols could address such disparities, helping to improve postoperative outcomes of colorectal surgeries.
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Alcohol use disorder (AUD) is the most common substance use disorder in the United States. Despite availability of four FDA-approved medications, fewer than 10% of patients are prescribed medication. This study aimed to evaluate the impact and feasibility of emergency department (ED)-initiated oral naltrexone in patients with moderate to severe AUD. ⋯ ED-initiated oral naltrexone is feasible and acceptable for patients with moderate to severe AUD. While engagement in treatment was moderate, significant reductions in alcohol craving and improvements in quality of life suggest potential benefits. Further research is warranted to confirm these findings.
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Female sterilization is a common form of contraception in the United States. On June 24, 2022, the United States Supreme Court eliminated the federal standard protecting a woman's right to abortion via Dobbs v. Jackson Women's Health Organization. Since that time, there have been anecdotal increases in sterilization requests across the country, although there are no publications demonstrating this change. This study hypothesized that there would be increased female sterilization rates at a Texas military hospital post-Dobbs decision due to state restrictions as compared with a Washington military hospital. ⋯ The reproductive health of military medical beneficiaries at one military hospital was significantly impacted by the Dobbs v. Jackson Women's Health Organization decision. Rates of female sterilization increased significantly. In addition, patients choosing permanent sterilization were younger and were less likely to use alternative, reversible contraceptive methods prior to surgery. This study demonstrates a significant change in contraceptive choices toward methods that incur greater surgical risks and potential for regret, as well as greater financial costs to the military health system.