Office of Research & Development |
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VA ORD's ability to ensure innovations in healthcare for the benefit of our nation's Veterans is dependent upon fostering a pool of highly talented, motivated scientists from diverse backgrounds who will help to further VA's mission. The DEI Research Supplement awardees for FY 23 were announced on October 1, 2022. They are:
SUPPLEMENT AWARDEE |
VA MEDICAL CENTER / MENTOR |
TITLE OF MERIT AWARD / SUPPLEMENT DESCRIPTION |
Delisa Brown, PhD |
VA Finger Lakes / Lisham Ashrafioun, PhD |
Telehealth CBT to increase engagement in pain treatment among Veterans using prescription opioids |
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Disparities plague every facet of healthcare including the opioid crises among both Veteran and civilian populations. Racism (e.g. race-related stress [RSS]) is a key social determinant of health negatively impacting treatment seeking behaviors among minoritized populations. Cognitive-Behavioral Therapy for Treatment Seeking (CBT-TS) significantly increases treatment initiation among AA Veterans, but the mechanisms of action remain unknown. Serving toward Dr. Brown’s goal of becoming a VA Research Scientist, she will address this gap in understanding by examining the mechanisms of action in CBT-TS that increase initiation of psychosocial pain treatment among AA Veterans using opioid analgesics for chronic pain. This study will examine racial differences in the efficacy of this evidence-based intervention on increasing treatment initiation of and retention to psychosocial interventions for pain among AA Veterans, the mechanisms of action, and the impact of RRS on treatment initiation and retention. |
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Kevin Burt, PhD |
Philadelphia VA / Robert Mauck, PhD |
Tissue Engineered Total Disc Replacement in a Large Animal Model |
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Back pain is frequently associated with degeneration of the intervertebral discs (IVDs) of the spine and represents a significant health and economic burden, particularly to our active duty military and Veteran populations. Current treatments for disc degeneration, such as spinal fusion, are limited in that they do not restore healthy disc structure or function. The purpose of this supplemental award is to provide a more detailed analysis of the inflammatory milieu of the degenerating IVD and evaluate the immunomodulatory potential of a novel tissue engineered IVD replacement. This will be achieved via long term studies in a large animal model under clinically relevant conditions. Immunophenotyping of cells within the degenerated IVDs and engineered disc replacements will be used to evaluate the immunomodulatory effect of the engineered replacements and how loading impacts these features. This work will drive clinical translation of our tissue engineered disc, significantly improving treatment options for Veterans suffering from disc degeneration and back pain. |
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Miguel de la Flor, PhD |
South Texas VAHCS / Jason O’Connor PhD |
Role of Brain-Derived Neurotrophic Factor in Regulating Neuroinflammation in Mental Health |
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Exposure to risk factors such as stress or inflammation has been shown to be an important predisposing factor to psychiatric disorders and suicide. However, many individuals exposed to adversity maintain normal psychological functioning, and the factors underlying resistance to the deleterious effects of stress remain unknown. We propose that BDNF functions as a modulator of non-neuronal cells responsible for neuroinflammation and kynurenine metabolism in brain, and that it is through this mechanism that BDNF confers resilience to stress. |
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Andrew Flores, PhD |
San Diego VAHCS / Thomas Hnasko |
Midbrain neural circuit mechanisms underlying addiction |
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The opioid epidemic has enormous consequences on the health and well-being of Veterans, Veteran families, and Veteran communities. Opioid addiction is propelled by opioid-induced changes in brain circuits that control reward and aversion, and pharmacological or other neuromodulatory therapies that reverse opioid-induced changes are sorely needed. This proposal will systematically identify where and how the actions of opioids act on ventral pallidum and connected brain circuits to cause changes that underlie reward-seeking and punishment-avoidance behaviors. |
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Lily Lau, PhD |
VA Northern California HCS / Anthony Chen, MD |
Strengthening neuro-cognitive skills for success in school, work and beyond |
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Record numbers of Veterans are pursuing higher education. However, difficulties with attention, memory, irritability, and self-regulation often ‘derail’ Veterans with traumatic brain injury, post-traumatic stress and related issues as they pursue academic and life goals. Increasing engagement with rehabilitation amongst student Veterans is a top priority, as access, stigma, and competing life demands often limit their use of traditional VA services. Innovations in treatment formulation and delivery that cross gaps between healthcare and education may be required to better engage these Veterans. In this project, we will (a) assess the feasibility and acceptability of delivering remote cognitive interventions to improve cognitive-emotional regulation or education to optimize brain functioning for student Veterans; (b) characterize critical aspects of the training process, and (c) explore student insights on ways to further improve cognitive trainings to best meet their needs. |
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Roberto Mendez, PhD |
Providence VAMC / Alan Morrison, MD, PhD |
Reprogramming Macrophages to Improve Vascular Healing in Diabetes |
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Diabetes is a common chronic disease in the US Veteran population, and non-healing skin wounds are a major cause of loss of limb and debility for Veterans with diabetes. Current medical treatments have limited effectiveness at healing wounds because it is not entirely clear how diabetes impairs the healing process. The primary goal of these studies is to activate inflammation signals that direct the early growth of new blood vessels to help with healing. We believe these studies will lead to new therapies that promote more effective skin healing and limb salvage for Veterans and all patients with diabetes. |
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Diana Naranjo, PhD |
Salt Lake City VA / Susan Zickmund, PhD |
Disparities in Trust: COVID-19's Impact on Minority Veterans' Healthcare Experiences |
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Latinx Veterans are more likely to experience low trust and high perceived discrimination while receiving VA care compared to White Veterans. Medical distrust in providers, healthcare entities, and medical research has been proposed as a possible explanation for such disparities. Medical distrust is high in marginalized populations. Causes of medical distrust are understudied and not previously well validated, specifically among Latinx patients. This study will examine the relationship between medical distrust and health outcomes in a national sample of Latinx Veterans from the perspective that patient health disparities emerge from sequential and overlapping influences at the individual (patient) and interpersonal (social network) levels. |
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Luis Rodriguez, PhD |
Philadelphia VAMC / Michael Beers, MD |
Surfactant Protein C Mutations and Interstitial Lung Disease |
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Idiopathic Pulmonary Fibrosis (IPF) is a devastating lung disease of older adults marked by progressive respiratory failure for which there remains a significant unmet need for effective medical therapies. The proposed project represents a supplement to a funded VA Merit Review that studies the pathophysiologic origins of epithelial dysfunction in IPF using novel mouse models of spontaneous lung fibrosis. The proposed supplement focuses on the role of age dependent aberrant cell quality control and metabolic reprogramming in the disruption of lung progenitor cell function and promotion of cell senescence as drivers of IPF. |
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Linda Diem Tran, PhD |
VA Palo Alto HCS / Todd Wagner, PhD |
Developing a New Method to Improve Primary Care Workforce Management |
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Clinical preventive services such as routine screening and immunizations are lifesaving and help prevent or delay disease. These services are underutilized, particularly among non-White populations. Race concordance, when patients and their providers share a racial or ethnic identity, has been proposed as one solution for increasing use of preventive services. This study examines whether racial concordance in VA primary care increases use of preventive services, specifically COVID-19 and flu vaccinations. Study findings have implications for how Veterans experience care and may help address quality and access issues when seeing a primary care provider. |
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Geneva Wilson, PhD |
Edward Hines, Jr VAMC / Charlesnika Evans, PhD, MPH |
Dissemination and Implementation of a Videoconference Antimicrobial Stewardship Team (VAST) |
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Antimicrobial-resistant and healthcare-associated pathogens are a global health threat. Antimicrobial stewardship aims to reduce inappropriate use as an important means of combating antimicrobial resistance. The parent proposal Videoconference Antimicrobial Stewardship Team (VAST) (IIR 20-240 Jump/Evans) uses telehealth to connect clinicians at rural VAMCs to geographically distant infectious disease experts to improve antimicrobial stewardship at the rural facilities. The role of health disparities and their impact on antimicrobial stewardship efforts remains underexplored. This ORD diversity supplement will explore the patient and system level factors that contribute to disparities in antibiotic prescribing for two conditions in which inappropriate antibiotic use is common, urinary tract infections and acute respiratory infections. This work will contribute vital information to the topic of health disparities and their role in antimicrobial stewardship. |
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Julie Wu, MD, PhD |
VA Palo Alto HCS / Shipra Arya, MD |
PAtient-centered mUltidiSciplinary care for vEterans undergoing surgery (PAUSE): a hybrid 1 clinical effectiveness-implementation intervention trial |
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Improving lung cancer survivorship care is critical to Veteran health. Each year, 7700 Veterans are diagnosed with lung cancer. With advances in treatment and screening, the number of Veteran survivors of lung cancer are expected to increase. However, lung cancer survivors are at increased risk of dying from a second primary lung cancer. The proposed research will prevent death of Veteran lung cancer survivors by improving screening practices for second primary lung cancer. To do so, it will use predictive models tailored specifically to the unique cancer risk profiles of Veterans, achieved by using Veteran data. This project to prioritize screening to identify early-stage lung cancer in high-risk Veterans by putting VA data to work for Veterans intersects the missions of the VA National Precision Oncology Program and VA Health Services Research and Development Service. |