WorldWideScience

Sample records for veterans experiencing illness

  1. Rural and urban supported employment programs in the Veterans Health Administration: Comparison of barriers and facilitators to vocational achievement for veterans experiencing mental illnesses.

    Science.gov (United States)

    Kukla, Marina; McGuire, Alan B; Salyers, Michelle P

    2016-06-01

    The purpose of this mixed-methods study was to compare urban and rural supported employment programs on barriers and facilitators with employment for veterans experiencing mental illnesses. A national sample of 114 supported employment staff, supervisors, and upper level managers employed by the Veteran's Health Administration were recruited. Participants completed an online survey of work barriers and facilitators, including open-ended questions regarding additional factors that impact the work success of veterans. Survey responses were compared between participants from rural (n = 28) and urban (n = 86) programs using independent groups t tests. Open-ended questions were analyzed using content analysis. Supported employment personnel from rural programs perceived significantly more barriers to work success compared with urban personnel, particularly in the areas of access to services and a range of job-related factors, including job match and interpersonal relationships at the work site. In contrast, participants from urban programs reported greater facilitators in the domain of mental health services. Qualitative findings add depth to the quantitative findings and highlight challenges in rural supported employment programs impacting job development and job fit. Both urban and rural programs experienced unique barriers related to geography and transportation. Findings from this nationwide mixed-methods survey provide a comprehensive picture of the obstacles to employment success for veterans living with mental illnesses and receiving supported employment services in rural areas. Suggestions for changes in policy related to services and resource allocation are presented to address these unique barriers, particularly in rural areas. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Diagnoses Treated in Ambulatory Care Among Homeless-Experienced Veterans: Does Supported Housing Matter?

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Gelberg, Lillian

    2016-10-01

    Little is known about how permanent supported housing influences ambulatory care received by homeless persons. To fill this gap, we compared diagnoses treated in VA Greater Los Angeles (VAGLA) ambulatory care between Veterans who are formerly homeless-now housed/case managed through VA Supported Housing ("VASH Veterans")-and currently homeless. We performed secondary database analyses of homeless-experienced Veterans (n = 3631) with VAGLA ambulatory care use from October 1, 2010 to September 30, 2011. We compared diagnoses treated-adjusting for demographics and need characteristics in regression analyses-between VASH Veterans (n = 1904) and currently homeless Veterans (n = 1727). On average, considering 26 studied diagnoses, VASH (vs currently homeless) Veterans received care for more (P Veterans were more likely (P homeless Veterans to receive treatment for diagnoses across categories: chronic physical illness, acute physical illness, mental illness, and substance use disorders. Specifically, VASH Veterans had 2.5, 1.7, 2.1, and 1.8 times greater odds of receiving treatment for at least 2 condition in these categories, respectively. Among participants treated for chronic illnesses, adjusting for predisposing and need characteristics, VASH (vs currently homeless) Veterans were 9%, 8%, and 11% more likely to have 2 or more visits for chronic physical illnesses, mental illnesses, and substance use disorder, respectively. Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care. © The Author(s) 2016.

  3. 77 FR 18307 - Gulf War Veterans' Illnesses Task Force Report

    Science.gov (United States)

    2012-03-27

    ... addressing 1990-1991 Gulf War Veterans' illnesses. The GWVI-TF published its first annual report in September... AFFAIRS Gulf War Veterans' Illnesses Task Force Report AGENCY: Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Secretary Department of Veterans Affairs (VA) established the Gulf War Veterans...

  4. Illness Among Persian Gulf War Veterans: Case Validation Studies

    National Research Council Canada - National Science Library

    Doebbeling, Bradley

    1999-01-01

    ..., and fibromyalgia were particularly elevated. The existence of a causal relationship between either military exposures or other risk factors and documented illness for most symptomatic PGW veterans remains to be demonstrated...

  5. Hearing Voices: Qualitative Research with Postsecondary Students Experiencing Mental Illness

    Science.gov (United States)

    Venville, Annie; Street, Annette F.

    2014-01-01

    Vocational Education and Training (VET) students experiencing mental illness have been described as one of the most vulnerable student groups in the Australian post-secondary sector. This vulnerability can be attributed to the impacts of illness, the oft-reported experiences of stigma and discrimination, and low educational outcomes. There is…

  6. Experiencing stigma as a nurse with mental illness.

    Science.gov (United States)

    Peterson, A L

    2017-06-01

    WHAT IS KNOWN ON THE SUBJECT?: Stigma involves connecting individuals with a particular label to negative characteristics; this is based not on the stigmatized condition itself, but cultural reactions to it. Stigma exists towards nurses with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a first-person account of experiencing stigma as a nurse with a mental illness. This paper incorporates the existing literature to offer a broader cultural perspective on the experiences of a nurse with a mental illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses are likely to encounter a nurse with a mental illness at some point in their practice. Nurses' reactions towards colleagues with mental illness can have significant implications for those colleague(s)' wellbeing. Nurses with mental illness will have to navigate their person and professional journey while giving consideration to the attitudes of their nursing peers and leaders. Limited research has been done on the stigma faced by nurses with mental illness from their nursing peers. Mental illness is not generally considered acceptable within the context of nursing culture, so when nurses do experience mental illness, their experiences in a professional context may be influenced by stereotypes, particularly those relating to dangerousness. Using autoethnography as a research method, the author examines her own subjective experiences of stigma as a nurse with a mental illness, and draws upon existing literature on stigma, deviance and the phenomenon of mental illness in nurses to analyse broader cultural implications for nursing. Assessment of suitability to return to work arises throughout the narratives, and consideration is given to the way that risk assessment by nursing leaders is impacted by negative stereotypes that surround mental illness. © 2017 John Wiley & Sons Ltd.

  7. 78 FR 36309 - Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting

    Science.gov (United States)

    2013-06-17

    ... diagnosing and treating Gulf War Veterans, and a drug treatment trial which is underway. On June 18, the... AFFAIRS Research Advisory Committee on Gulf War Veterans' Illnesses, Notice of Meeting The Department of... Research Advisory Committee on Gulf War Veterans' Illnesses will meet on June 17 and 18, 2013, in room 230...

  8. Racial Differences in Mental Health Recovery among Veterans with Serious Mental Illness.

    Science.gov (United States)

    Ali, Mana K; Hack, Samantha M; Brown, Clayton H; Medoff, Deborah; Fang, Lijuan; Klingaman, Elizabeth A; Park, Stephanie G; Dixon, Lisa B; Kreyenbuhl, Julie A

    2017-04-14

    Black consumers with serious mental illness (SMI) face significant challenges in obtaining quality mental health care and are at risk for experiencing significant disparities in mental health care outcomes, including recovery from mental illness. Patient-provider interactions may partly contribute to this disparity. The purpose of the current study was to understand the effects of race, psychosis, and therapeutic alliance on mental health recovery orientation among Veterans with SMI. Participants were Veterans who had an SMI being treated at two Veteran Affairs outpatient mental health clinics by a psychiatrist or nurse practitioner. Participants completed the Behavior and Symptom Identification Scale (BASIS-24), Mental Health Recovery Measure, and patient-report Scale to Assess the Therapeutic Relationship (STAR-P) which includes three subscales: positive collaboration, positive clinician input, and non-supportive clinician input. Regression analyses were used to determine interactive effects of race, psychosis severity, and therapeutic alliance variables. The sample was 226 Veterans (50% black, 50% white). Black participants were slightly older (p mental health recovery (p mental health recovery orientation for black participants. Conversely, for white participants, positive collaboration had little effect on the negative relationship between psychosis severity and mental health recovery orientation. Increased levels of psychosis may inhibit patients' perceptions of their ability to recover from SMI. However, for black participants, positive collaboration with mental health providers may moderate the effects of psychotic symptomatology.

  9. Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

    Science.gov (United States)

    Garrido, Melissa M; Prigerson, Holly G; Neupane, Suvam; Penrod, Joan D; Johnson, Christopher E; Boockvar, Kenneth S

    2017-03-01

    Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted. To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses. Design, Subjects, and Measurements: This was a retrospective study of 11,286 veterans hospitalized in a Veterans Health Administration acute care facility in fiscal year 2011 with diagnoses of advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, and/or advanced HIV/AIDS. Prevalent and incident mental illness diagnoses during and before hospitalization and rates of psychotherapy and psychotropic use among patients with incident depression and anxiety were measured. At least one-quarter of the patients in our sample had a mental illness or substance use disorder. The most common diagnoses at hospitalization were depression (11.4%), followed by alcohol abuse or dependence (5.5%), and post-traumatic stress disorder (4.9%). Of the 831 patients with incident past-year depression and 258 with incident past-year anxiety, nearly two-thirds received at least some psychotherapy or guideline-concordant medication within 90 days of diagnosis. Of 191 patients with incident depression and 47 with incident anxiety at time of hospitalization, fewer than half received mental healthcare before discharge. Many veterans hospitalized with serious physical illnesses have comorbid mental illnesses and may benefit from depression and anxiety treatment.

  10. Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

    Science.gov (United States)

    Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani

    2016-06-30

    We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery. Published by Elsevier Ireland Ltd.

  11. Persistent Super-Utilization of Acute Care Services Among Subgroups of Veterans Experiencing Homelessness.

    Science.gov (United States)

    Szymkowiak, Dorota; Montgomery, Ann Elizabeth; Johnson, Erin E; Manning, Todd; O'Toole, Thomas P

    2017-10-01

    Acute health care utilization often occurs among persons experiencing homelessness. However, knowing which individuals will be persistent super-utilizers of acute care is less well understood. The objective of the study was to identify those more likely to be persistent super-utilizers of acute care services. We conducted a latent class analysis of secondary data from the Veterans Health Administration Corporate Data Warehouse, and Homeless Operations Management and Evaluation System. The study sample included 16,912 veterans who experienced homelessness and met super-utilizer criteria in any quarter between July 1, 2014 and December 31, 2015. The latent class analysis included veterans' diagnoses and acute care utilization. Medical, mental health, and substance use morbidity rates were high. More than half of the sample utilized Veterans Health Administration Homeless Programs concurrently with their super-utilization of acute care. There were 7 subgroups of super-utilizers, which varied considerably on the degree to which their super-utilization persisted over time. Approximately a third of the sample met super-utilizer criteria for ≥3 quarters; this group was older and disproportionately male, non-Hispanic white, and unmarried, with lower rates of post-9/11 service and higher rates of rural residence and service-connected disability. They were much more likely to be currently homeless with more medical, mental health, and substance use morbidity. Only a subset of homeless veterans were persistent super-utilizers, suggesting the need for more targeted interventions.

  12. Growing Use of Mental and General Health Care Services Among Older Veterans With Mental Illness.

    Science.gov (United States)

    Wiechers, Ilse R; Karel, Michele J; Hoff, Rani; Karlin, Bradley E

    2015-11-01

    National data from Veterans Health Administration (VHA) electronic medical records were used to examine rates of mental illness and service use among older veterans since mental health care transformation efforts were implemented in 2005. Data were extracted from VHA electronic medical records for each fiscal year from 2005 through 2013 for veterans ages 65 and older. Among those receiving any health care services, the number and proportion treated for a confirmed mental illness and the utilization of non-mental health care services were identified. In 2013, 2.6 million older veterans utilized services in VHA, 14% of whom had a confirmed mental illness, which was a 57% increase from 2005. Older veterans with confirmed mental illness accounted for a sizable and growing proportion of non-mental health service utilization. Preparing the workforce to address the mental health needs of older veterans and nonveterans is essential.

  13. 78 FR 77205 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Science.gov (United States)

    2013-12-20

    ... related to Gulf War Veterans' illnesses and updates on relevant scientific research published since the... to Gulf War Veterans' illnesses and treatments guided by systems biology. There will also be Committee training and updates on the Department of Defense and VA Gulf War research initiatives. A...

  14. Chronic multisymptom illness complex in Gulf War I veterans 10 years later.

    Science.gov (United States)

    Blanchard, Melvin S; Eisen, Seth A; Alpern, Renee; Karlinsky, Joel; Toomey, Rosemary; Reda, Domenic J; Murphy, Frances M; Jackson, Leila W; Kang, Han K

    2006-01-01

    Prior research has demonstrated that shortly after the 1991 Gulf War (Gulf War I), chronic multisymptom illness (CMI) was more common among deployed veterans than among nondeployed veterans. The aims of the current study were to determine the prevalence of CMI among deployed and nondeployed veterans 10 years after Gulf War I, compare the distribution of comorbid conditions, and identify prewar factors associated with CMI. Cross-sectional data collected from 1,061 deployed veterans and 1,128 nondeployed veterans examined between 1999 and 2001 were analyzed. CMI prevalence was 28.9% among deployed veterans and 15.8% among nondeployed veterans (odds ratio = 2.16, 95% confidence interval: 1.61, 2.90). Deployed and nondeployed veterans with CMI had similarly poorer quality-of-life measures and higher prevalences of symptom-based medical conditions, metabolic syndrome, and psychiatric disorders. Diagnoses of prewar anxiety disorders (not related to post-traumatic stress disorder) and depression were associated with CMI among both deployed and nondeployed veterans. Nicotine dependence and veteran-reported physician-diagnosed infectious mononucleosis were associated with CMI among deployed veterans, and migraine headaches and gastritis were associated with CMI among nondeployed veterans. CMI continues to be substantially more prevalent among deployed veterans than among nondeployed veterans 10 years after Gulf War I, but it manifests similarly in both groups. It is likely to be a common, persistent problem among veterans returning from the current Gulf War.

  15. The Association between Toxic Exposures and Chronic Multisymptom Illness in Veterans of the Wars of Iraq and Afghanistan

    Science.gov (United States)

    DeBeer, Bryann B.; Davidson, Dena; Meyer, Eric C.; Kimbrel, Nathan A.; Gulliver, Suzy B.; Morissette, Sandra B.

    2017-01-01

    Objective The purpose of this study was to determine if post-9/11 veterans deployed to the Iraq and Afghanistan conflicts experienced toxic exposures and whether they are related to symptoms of Chronic Multisymptom Illness (CMI). Methods Data from 224 post-9/11 veterans who self-reported exposure to hazards in theater were analyzed using hierarchical regression. Results Of the sample, 97.2% endorsed experiencing one or more potentially toxic exposure. In a regression model, toxic exposures and CMI symptoms were significantly associated above and beyond covariates. Follow-up analyses revealed that pesticide exposures, but not smoke inhalation was associated with CMI symptoms. Conclusions These findings suggest that toxic exposures were common among military personnel deployed to the most recent conflicts, and appear to be associated with CMI symptoms. Additional research on the impact of toxic exposures on returning Iraq and Afghanistan Veterans’ health is needed. PMID:28045798

  16. The illness trajectory experienced by patients having spine fusion surgery

    DEFF Research Database (Denmark)

    Damsgaard, Janne Brammer; Bastrup, Lene; Norlyk, Annelise

    The illness trajectory of spine fusion patients. A feeling of being (in)visible Background Research shows that being a back patient is associated with great personal cost, and that back patients who undergo so-called spine fusion often experience particularly long and uncoordinated trajectories....... The patients describe a feeling of being mistrusted and thrown around in the system. It is the aim of this study to examine how spine fusion patients experience their illness trajectory and hospitalisation. Methods The study is based on qualitative interviews, and the data analysis is inspired by the French...... system and healthcare professionals are often dismissed as irrelevant. It is also evident that spine fusion patients are denied the opportunity to verbalise what it feels like to, for example, be ”a person in constant pain” or someone who ”holds back” to avoid being an inconvenience. These feelings...

  17. Gulf War Illness and the Health of Gulf War Veterans

    Science.gov (United States)

    2008-11-01

    sign. higher; retinol binding protein ns higher 2005: Serum uric acid ns lower Neurocognitive function 1997: Poorer accuracy on automated performance...with muscle metabolism and physical endurance in 49 Gulf War veterans and 61 nonveterans with chronic fatigue syndrome (CFS).1725 In Gulf War veterans...118. 120. Behan PO, Behan WM, Horrobin D. Effect of high doses of essential fatty acids on the postviral fatigue syndrome . Acta Neurol Scand. 1990;82

  18. Quality of life in veterans with alcohol dependence and co-occurring mental illness.

    Science.gov (United States)

    Ralevski, Elizabeth; Gianoli, Mayumi O; McCarthy, Elissa; Petrakis, Ismene

    2014-02-01

    Quality of life is negatively impacted by diagnosis of mental illness. Those with mental illness report problems in physical, psychological, cognitive, social, and occupational functioning. This study was designed to examine changes in quality of life in veterans with dual diagnoses. All veterans participated in a treatment study designed to treat alcohol dependence with naltrexone, disulfiram, and the combination of naltrexone/disulfiram or placebo for 12 weeks. Quality of life was assessed before treatment and at the end of treatment. Quality of life improved for all veterans and the improvement was more significant for those who abstained from alcohol throughout treatment. Severity of psychiatric symptom was associated with worse quality of life. This study demonstrates the importance of addressing social functioning in veterans with dual diagnosis. Copyright © 2013. Published by Elsevier Ltd.

  19. Multisymptom Illness in Gulf War Veterans: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Gwini, Stella M; Forbes, Andrew B; Sim, Malcolm R; Kelsall, Helen L

    2016-07-01

    The aim of this study was to conduct a systematic review and meta-analysis of multisymptom illness (MSI) in 1990 to 1991 Gulf/Afghanistan/Iraq War veterans. Electronic databases were searched from January 1990, June 2014 for studies on MSI prevalence in Gulf/Afghanistan/Iraq War veterans, based on the Centers for Disease Control and Prevention MSI case definition, and which included a military comparison group. Seven studies were identified among US, UK, and Australian Gulf War veterans; no studies were identified in Afghanistan/Iraq War veterans. MSI prevalence in Gulf War veterans and comparison groups ranged from 26 to 65% and from 12 to 37%, respectively. More recent studies were larger, with improved designs. The pooled odds ratio comparing Gulf War veterans to other military groups was 2.74 (95% confidence interval 2.15 to 3.51). The systematic review showed that MSI was most prevalent in Gulf War veterans, emphasizing the health burden of MSI in this veteran population.

  20. Racial and Ethnic Differences in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental Health Challenges.

    Science.gov (United States)

    Wong, Eunice C; Collins, Rebecca L; Cerully, Jennifer; Seelam, Rachana; Roth, Beth

    2017-01-01

    Reports racial and ethnic differences on the California Well-Being Survey, a surveillance tool that tracks mental illness stigma and discrimination among a sample of California adults experiencing psychological distress.

  1. Department of Veterans Affairs, Gulf War VeteransIllnesses Task Force to the Secretary of Veterans Affairs

    Science.gov (United States)

    2010-09-29

    overall exposure of troops to Leishmania tropica? 3. What were the exposure concentrations to various petroleum products, and their combustion products...have been identified in Veterans of the 1990 – 1991 Gulf War. 3. What were the exposure concentrations to various petroleum products, and their...Research Program within CDMRP (DoD). A clinical study to examine the effects of aspirin and Clopidogrel on biomarkers of Gulf War Veterans

  2. Access to and Use of the Internet by Veterans with Serious Mental Illness.

    Science.gov (United States)

    Record, Elizabeth J; Medoff, Deborah R; Dixon, Lisa B; Klingaman, Elizabeth A; Park, Stephanie G; Hack, Samantha; Brown, Clayton H; Fang, Li Juan; Kreyenbuhl, Julie

    2016-02-01

    This study evaluated internet use among 239 veterans with serious mental illness who completed questionnaires assessing demographics and internet use in 2010-2011. The majority of individuals (70 %) reported having accessed the internet and among those, 79 % had accessed it within the previous 30 days. Those who were younger and more educated were more likely to have accessed the internet, as were those with a schizophrenia spectrum disorder, bipolar disorder, or major depressive disorder, compared to individuals with PTSD. Veterans with serious mental illness commonly use the internet, including to obtain health information, though use varies across demographic characteristics and clinical diagnosis.

  3. The Stigma Experienced by Terminally Ill Patients: Evidence From a Portuguese Ethnographic Study

    OpenAIRE

    Hilário, Ana Patrícia

    2016-01-01

    The aim of this study was to offer an understanding of the ways in which terminally ill patients may face discrimination due to their visibly altered body. An ethnographic approach was adopted and fieldwork was conducted over 10 months in 2 inpatient hospice units in Portugal. Participant observation was complemented by 50 in-depth interviews with terminally ill patients, family members, and hospice staff. The stigma experienced by terminally ill patients derived mostly from the behavior of p...

  4. Health care utilization and costs after entry into an outreach program for homeless mentally ill veterans.

    Science.gov (United States)

    Rosenheck, R; Gallup, P; Frisman, L K

    1993-12-01

    This study evaluated the impact of a Department of Veterans Affairs outreach and residential treatment program for homeless mentally ill veterans on utilization and cost of health care services provided by the VA. Veterans at nine program sites (N = 1,748) were assessed with a standard intake instrument. Services provided by the outreach program were documented in quarterly clinical reports and in residential treatment discharge summaries. Data on nonprogram VA health service utilization and health care costs were obtained from national VA data bases. Changes in use of services and cost of services from the year before initial contact with the program to the year after were analyzed by t test. Multivariate analyses were used to examine the relationship of these changes to indicators of clinical need and to participation in the outreach program. Although utilization of inpatient service did not increase after veterans' initial contact with the program, use of domiciliary and outpatient services increased substantially. Total annual costs to the VA also increased by 35 percent, from $6,414 to $8,699 per veteran per year. Both clinical need and participation in the program were associated with increased use of health services and increased cost. Veterans with concomitant psychiatric and substance abuse problems used fewer health care services than others. Specialized programs to improve the access of homeless mentally ill persons to health care services appear to be effective, but costly. Dually diagnosed persons seem especially difficult to engage in treatment.

  5. 76 FR 31018 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Science.gov (United States)

    2011-05-27

    ... background information on the Gulf War and Gulf War Veterans' illnesses, immune function and system... at the end of each day. A sign-up sheet for five-minute comments will be available at the meeting.... Vivian Drake, Acting Committee Management Officer. BILLING CODE P ...

  6. Paternal history of mental illness associated with posttraumatic stress disorder among veterans.

    Science.gov (United States)

    Shepherd-Banigan, Megan; Kelley, Michelle L; Katon, Jodie G; Curry, John F; Goldstein, Karen M; Brancu, Mira; Wagner, H Ryan; Fecteau, Teresa E; Van Houtven, Courtney H

    2017-10-01

    This study examined the association between parent and family reported history of non-PTSD mental illness (MI), PTSD specifically, and substance use problems, and participant clinical diagnosis of PTSD. Participants were drawn from the US Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) Post-Deployment Mental Health (PDMH) study (n = 3191), an ongoing multi-site cohort study of US Afghanistan and Iraq conflict era veterans. Participants who recalled a father history of PTSD had a 26-percentage point higher likelihood of meeting criteria for PTSD; while participants reporting any family history of PTSD had a 15-percentage point higher probability of endorsing symptoms consistent with PTSD. Mother history of substance use problems was associated with Veteran current PTSD, but results were sensitive to model specification. Current PTSD was not associated with family/parent history of non-PTSD mental illness, mother history of PTSD, or family/father history of substance use problems. Family history of PTSD may increase PTSD risk among veterans exposed to trauma, particularly when a father history is reported. Knowledge of family history could improve clinical decision-making for trauma-exposed individuals and allow for more effective targeting of programs and clinical services. Published by Elsevier B.V.

  7. Associations of mental illness and substance use disorders with prescription contraception use among women veterans.

    Science.gov (United States)

    Callegari, Lisa S; Zhao, Xinhua; Nelson, Karin M; Lehavot, Keren; Bradley, Katharine A; Borrero, Sonya

    2014-07-01

    To investigate whether mental illness and substance use disorder (SUD) are associated with having a prescription contraceptive method among women veterans. We conducted a retrospective analysis of National Veterans Administration (VA) administrative and clinical data for women veterans aged 18-45 years who made at least one primary care visit in 2008. We assessed associations between mental illness (depression, posttraumatic stress disorder, anxiety, bipolar disorder, schizophrenia and adjustment disorder) and SUD (drug/alcohol use disorder) with having a prescription contraceptive method from VA (pill, patch, ring, injection, implant and intrauterine device) using multivariable logistic regression with random effects for VA facility, adjusting for confounders. Among 94,115 reproductive aged women, 36.5% had mental illness only, 0.6% had SUD only, 5.3% had both mental illness and SUD and 57.7% had neither diagnosis. In these groups, 22.1%, 14.6%, 18.2% and 17.7% (pcontraception. After adjusting for potential confounders, women with mental illness only were as likely as women with neither diagnosis to have a prescription method and were more likely to use a highly effective prescription method (implant or intrauterine device) if using contraception [adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) = 1.08-1.27]. Women with SUD (with or without mental illness) were significantly less likely to have a prescription method than women with neither diagnosis (aOR 0.73, 95% CI = 0.57-0.95 and aOR 0.79, 95% CI = 0.73-0.86, respectively). Women veterans with SUD are less likely to have prescription contraception compared to other women, which may increase their risk of unintended pregnancy. Published by Elsevier Inc.

  8. Experiencing Community: Perspectives of Individuals Diagnosed as Having Serious Mental Illness

    Science.gov (United States)

    Bromley, Elizabeth; Gabrielian, Sonya; Brekke, Benjamin; Pahwa, Rohini; Daly, Kathleen A.; Brekke, John S.; Braslow, Joel T.

    2013-01-01

    Objective Community integration is recognized as a crucial component of recovery from serious mental illness. Although the construct of community integration can be measured with structured instruments, little is known about the subjective and experiential meaning of community and community involvement for persons with serious mental illness. Methods In 2010, 30 individuals with serious mental illness treated in two public mental health clinics completed semistructured interviews that elicited the places and people that they associate with the experience of community and the larger meaning of community in their lives. Results Participants described four experiences as integral to their concepts of community: receiving help, minimizing risk, avoiding stigma, and giving back. Participants looked for communities that provide reliable support, and they described the need to manage community contact in order to protect themselves and others from their symptoms and from discrimination. Most participants experienced communities centered on mental health treatment or mentally ill peers as providing opportunities for positive engagement. Conclusions The experience of having a serious mental illness shapes preferences for and perceptions of community in pervasive ways. Participants describe community involvement not as a means to move away from illness experiences and identities but as a process that is substantially influenced by them. Mental health communities may help individuals with serious mental illness to both manage their illness and recognize and enjoy a sense of community. The findings indicate the need for further research on the relationship between community integration and outcome in serious mental illness. PMID:23545784

  9. Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness.

    Science.gov (United States)

    Paul, Sayani; Corneau, Simon; Boozary, Tanya; Stergiopoulos, Vicky

    2017-12-01

    The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. This study is an in-depth investigation of the personal perceived strengths, attitudes and coping behaviors of homeless adults of diverse ethnoracial backgrounds experiencing homelessness and mental illness in Toronto, Canada. Using qualitative methods, 36 in-depth semi-structured interviews were conducted to capture the perspectives of ethnoracial homeless participants with mental illness on coping and resilience. Transcripts were analyzed using thematic analysis. Similar to prior findings in the general homeless population, study participants recognized personal strengths and attitudes as great sources of coping and resilience, describing hope and optimism, self-esteem and confidence, insight into their challenges and spirituality as instrumental to overcoming current challenges. In addition, participants described several coping strategies, including seeking support from family, friends and professionals; socializing with peers; engaging in meaningful activities; distancing from overwhelming challenges; and finding an anchor. Findings suggest that homeless adults with mental illness from ethnoracial groups use similar coping strategies and sources of resilience with the general homeless population and highlight the need for existing services to foster hope, recognize and support individual coping strategies and sources of resilience of homeless individuals experiencing complex challenges.

  10. Recovery-Promoting Care as Experienced by Persons with Severe Mental Illness and Substance Misuse

    Science.gov (United States)

    Cruce, Gunilla; Ojehagen, Agneta; Nordstrom, Monica

    2012-01-01

    This paper explores recovery-promoting care as experienced by persons with concomitant severe mental illness and substance misuse. Sixteen in-depth interviews, based on an interview guide concerning their experiences of health, life situation and care, were held with eight participants in an outpatient treatment programme. The analysis aimed to…

  11. A comprehensive assessment of factors related to smoking and other cardiovascular disease risk factors among people experiencing severe mental illness

    OpenAIRE

    Filia, Sacha Louise

    2017-01-01

    The prevalence of smoking and the resultant impact on the health and well-being of people experiencing severe mental illness, is significantly disproportionate to smokers in the general population. Smokers experiencing severe mental illness are more likely to die, and at an earlier age, from smoking-related conditions, predominantly cardiovascular disease (CVD). Further, smoking among people experiencing severe mental illness is associated with a poorer clinical picture, and increases the f...

  12. Physical, psychological, and functional comorbidities of multisymptom illness in Australian male veterans of the 1991 Gulf War.

    Science.gov (United States)

    Kelsall, Helen L; McKenzie, Dean P; Sim, Malcolm R; Leder, Karin; Forbes, Andrew B; Dwyer, Terence

    2009-10-15

    Multisymptom illness is more prevalent in 1991 Gulf War veterans than in military comparison groups; less is known about comorbidities. The authors compared physical, psychological, and functional comorbidities in Australian male Gulf War I veterans with those in actively (non-Gulf) deployed and nondeployed military personnel by using a questionnaire and medical assessment in 2000-2002. Multisymptom illness was more common in male Gulf War veterans than in the comparison group (odds ratio (OR) = 1.80, 95% confidence interval (CI): 1.48, 2.19). Stratifying by deployment status in the comparison group made little difference in this association. Gulf War veterans with multisymptom illness had increased psychiatric disorders, including major depression (OR = 6.31, 95% CI: 4.19, 9.52) and posttraumatic stress disorder (OR = 9.77, 95% CI: 5.39, 18.59); increased unexplained chronic fatigue (OR = 13.32, 95% CI: 7.70, 23.05); and more reported functional impairment and poorer quality of life, but objective physical and laboratory outcomes were similar to those for veterans without multisymptom illness. Similar patterns were found in the comparison groups; differences across the 3 groups were statistically significant for only hospitalization, obstructive liver disease, and Epstein-Barr virus exposure. Multisymptom illness is more prevalent in Gulf War I veterans, but the pattern of comorbidities is similar for actively deployed and nondeployed military personnel.

  13. Socioeconomic Disparities and Metabolic Risk in Veterans with Serious Mental Illness.

    Science.gov (United States)

    Caroff, Stanley N; Leong, Shirley H; Ng-Mak, Daisy; Campbell, E Cabrina; Berkowitz, Rosalind M; Rajagopalan, Krithika; Chuang, Chien-Chia; Loebel, Antony

    2017-12-28

    Socioeconomic disparities were assessed in predicting metabolic risk among veterans with serious mental illness. Veterans with schizophrenia, schizoaffective, or bipolar disorders were identified in VISN 4 facilities from 10/1/2010 to 9/30/2012. Differences between patients with and without metabolic syndrome were compared using t-tests, Chi square tests and multivariate logistic regressions. Among 10,132 veterans with mental illness, 48.8% had metabolic syndrome. Multivariate logistic regression analysis confirmed that patients with metabolic syndrome were significantly more likely to be older, male, African-American, married, and receiving disability pensions but less likely to be homeless. They were more likely to receive antipsychotics, antidepressants, or anticonvulsants. Bivariate cross-sectional analysis revealed that patients with metabolic syndrome had higher rates of coronary artery disease, cerebrovascular disease, and mortality, and that metabolic syndrome was more often associated with emergency visits and psychiatric or medical hospitalizations. Demographics, socioeconomic status and medications are independent predictors of metabolic syndrome and should be considered in broader screening of risk factors in order to provide preventive interventions for metabolic syndrome.

  14. Alexithymia, Coping Styles and Traumatic Stress Symptoms in a Sample of Veterans Who Experienced Military Sexual Trauma.

    Science.gov (United States)

    Gaher, Raluca M; O'Brien, Carol; Smiley, Paul; Hahn, Austin M

    2016-02-01

    The current study examined the association between alexithymia and coping styles (planning, positive reinterpretation and growth, social-emotion coping, and denial), and trauma symptoms in a clinical sample of 170 male and female veterans who experienced sexual trauma during military service. Denial was the only coping style positively associated with trauma symptoms, and it mediated the relationship between alexithymia and trauma symptoms. Alexithymia was negatively associated with planning. Likewise, alexithymia was negatively associated with social-emotional coping and with positive reinterpretation and growth. The results speak to the significant role that alexithymia has in predicting individual coping styles. Copyright © 2014 John Wiley & Sons, Ltd.

  15. The Stigma Experienced by Terminally Ill Patients: Evidence From a Portuguese Ethnographic Study.

    Science.gov (United States)

    Hilário, Ana Patrícia

    2016-01-01

    The aim of this study was to offer an understanding of the ways in which terminally ill patients may face discrimination due to their visibly altered body. An ethnographic approach was adopted and fieldwork was conducted over 10 months in 2 inpatient hospice units in Portugal. Participant observation was complemented by 50 in-depth interviews with terminally ill patients, family members, and hospice staff. The stigma experienced by terminally ill patients derived mostly from the behavior of peers, extended family members, and friends toward their visibly altered body. There was no evidence that these patients were discredited by their immediate family when they became visibly unwell; unlike what has been reported in previous studies. This finding could be related to the strong familial culture of Portuguese society.

  16. Life, liberty, and the pursuit of happiness: reframing inequities experienced by people with severe mental illness.

    Science.gov (United States)

    Whitley, Rob; Henwood, Benjamin F

    2014-03-01

    In the Declaration of Independence, Thomas Jefferson stated that citizens of the new republic had fundamental and inalienable rights to "life, liberty and the pursuit of happiness." The purpose of this article is to reframe inequities experienced by people living with severe mental illnesses in terms of violations of Jeffersonian rights to "life, liberty and the pursuit of happiness." We simultaneously consider governmental and clinical efforts to address identified inequities and uphold these rights. The broad research literature on severe mental illnesses was examined. People with severe mental illnesses experience numerous inequities regarding "life, liberty and the pursuit of happiness." These inequities include diminished life expectancy, excessive involuntary commitment and elevated rates of unemployment and homelessness. Governmental and clinical responses to such inequities include the Affordable Care Act and the Olmstead Decision, as well as recovery-oriented interventions such as Supported Employment and Supported Housing.

  17. The challenges experienced by Iranian war veterans living with chemical warfare poisoning: a descriptive, exploratory study.

    Science.gov (United States)

    Hassankhani, Hadi; Taleghani, Fariba; Mills, Jane; Birks, Melanie; Francis, Karen; Ahmadi, Fazlolah

    2010-06-01

    This exploratory, descriptive study investigates the experiences of Iranian war veterans living with chronic disease acquired as a result of chemical warfare. Sulphur mustard (SM) is considered one of the most important agents of chemical warfare and was widely used during the Iran-Iraq conflict in 1980-1988. There are approximately 100 000 Iranian SM casualties who suffer from serious long-term progressive health problems involving their respiratory organs, eyes and skin. Seventeen male Iranian war veterans aged between 30 and 59 years and four victims' family members participated in the study. Data was generated during individual in-depth interviews that used open-ended questions. Grounded theory techniques, including the constant comparative method of concurrent data generation and analysis, were employed in the analysis of data. Preliminary results indicate two main thematic categories: social isolation and physical disability. It is argued that a lack of knowledge about the outcomes of SM poisoning, physical restrictions and difficulty in adjusting socially decreases war veterans' functional capacity and levels of independence.

  18. Social and existential alienation experienced by people with long-term mental illness.

    Science.gov (United States)

    Erdner, Anette; Magnusson, Annabella; Nyström, Maria; Lützén, Kim

    2005-12-01

    The aim of this study was to explore how people suffering from long-term mental illness and who live in the community experience their daily lives. The study was based on an ethnographic framework involving participant observations with 23 individuals from two rehabilitation centres and interviews with six women and two men. The observational notes and interviews were recorded, transcribed into the data and analysed based on the phases of hermeneutic interpretation. The process consisted of identifying tentative interpretations that highlighted various impediments that prevent people with long-term mental illness from having an active life. The impediments can also be interpreted as a form of alienation, an interpersonal phenomenon and a consequence due to of the lack of social acceptance towards mental illness. The participants expressed concern about the future and lack of hope. Viewing themselves as being 'odd' is not a symptom of mental illness, but rather evidence of experiencing existential and social alienation not only as a consequence of other people's reactions but also their own negative attitudes towards mental illness and effects of their cognitive dysfunction.

  19. Factors affecting implementation of an evidence-based practice in the Veterans Health Administration: Illness management and recovery.

    Science.gov (United States)

    McGuire, Alan B; Salyers, Michelle P; White, Dominique A; Gilbride, Daniel J; White, Laura M; Kean, Jacob; Kukla, Marina

    2015-12-01

    Illness management and recovery (IMR) is an evidence-based practice that assists consumers in managing their illnesses and pursuing personal recovery goals. Although research has examined factors affecting IMR implementation facilitated by multifaceted, active roll-outs, the current study attempted to elucidate factors affecting IMR implementation outside the context of a research-driven implementation. Semi-structured interviews with 20 local recovery coordinators and 18 local IMR experts were conducted at 23 VA medical centers. Interviews examined perceived and experienced barriers and facilitators to IMR implementation. Data were analyzed via thematic inductive/deductive analysis in the form of crystallization/immersion. Six factors differed between sites implementing IMR from those not providing IMR: awareness of IMR, importer-champions, autonomy-supporting leadership, veteran-centered care, presence of a sensitive period, and presence of a psychosocial rehabilitation and recovery center. Four factors were common in both groups: recovery orientation, evidence-based practices orientation, perceived IMR fit within program structure, and availability of staff time. IMR can be adopted in lieu of active implementation support; however, knowledge dissemination appears to be key. Future research should examine factors affecting the quality of implementation. (c) 2015 APA, all rights reserved).

  20. Emergency Department Registered Nurses' conceptualisation of recovery for people experiencing mental illness.

    Science.gov (United States)

    Marynowski-Traczyk, Donna; Moxham, Lorna; Broadbent, Marc

    2017-05-01

    The Emergency Department (ED) is an integral link to both mental health inpatient and community services and people experiencing mental health crisis often access mental healthcare through EDs. As such EDs have a significant role in enabling optimal transition of mental health consumers between services. The notion of recovery as it is understood by people who experience mental illness, and the delivery of recovery oriented mental healthcare services, are now embedded in mental health service provision in Australia and documented in policy. However, disparity exists in the meaning of recovery with the term meaning different things depending on the lens through which the concept is viewed. This research aimed to understand how Registered Nurses (RNs) working in the ED conceptualise recovery for people experiencing mental illness. Using a phenomenographic approach, individual semi structured interviews were undertaken with 14 RNs working in Australian EDs. A seven stage cycle of data analysis resulted in the identification of six categories of description. The categories were - recovery not occurring; seeking help from the ED; getting through the acute mental health crisis; referral to other areas of mental healthcare; implementing strategies for ongoing care, and living in the community. Findings conclude that ED RNs have limited cognisance of the meaning of recovery as it is understood by people with lived experience of mental illness. Their conceptualisation of recovery for mental health consumers predominantly remains bound to the dominant medical notion of recovery. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  1. Complex factors in the etiology of Gulf War illness: wartime exposures and risk factors in veteran subgroups.

    Science.gov (United States)

    Steele, Lea; Sastre, Antonio; Gerkovich, Mary M; Cook, Mary R

    2012-01-01

    At least one-fourth of U.S. veterans who served in the 1990-1991 Gulf War are affected by the chronic symptomatic illness known as Gulf War illness (GWI). Clear determination of the causes of GWI has been hindered by many factors, including limitations in how epidemiologic studies have assessed the impact of the complex deployment environment on veterans' health. We sought to address GWI etiologic questions by evaluating the association of symptomatic illness with characteristics of veterans' deployment. We compared veteran-reported wartime experiences in a population-based sample of 304 Gulf War veterans: 144 cases who met preestablished criteria for GWI and 160 controls. Veteran subgroups and confounding among deployment variables were considered in the analyses. Deployment experiences and the prevalence of GWI differed significantly by veterans' location in theater. Among personnel who were in Iraq or Kuwait, where all battles took place, GWI was most strongly associated with using pyridostigmine bromide pills [odds ratio (OR) = 3.5; 95% confidence interval (CI): 1.7, 7.4] and being within 1 mile of an exploding SCUD missile (OR = 3.1; 95% CI: 1.5, 6.1). For veterans who remained in support areas, GWI was significantly associated only with personal pesticide use, with increased prevalence (OR = 12.7; 95% CI: 2.6, 61.5) in the relatively small subgroup that wore pesticide-treated uniforms, nearly all of whom also used skin pesticides. Combat service was not significantly associated with GWI. Findings support a role for a limited number of wartime exposures in the etiology of GWI, which differed in importance with the deployment milieu in which veterans served.

  2. Predictors of smoking cessation group treatment engagement among veterans with serious mental illness.

    Science.gov (United States)

    Travaglini, Letitia E; Li, Lan; Brown, Clayton H; Bennett, Melanie E

    2017-12-01

    High prevalence rates of tobacco use, particularly cigarettes, pose a serious health threat for individuals with serious mental illness (SMI), and research has demonstrated the effectiveness of pharmacotherapy and psychosocial interventions to reduce tobacco use in this group. However, few studies have considered predictors of tobacco cessation treatment engagement among individuals with SMI. The current study examined predictors of engagement in smoking cessation groups among veterans with SMI engaged in mental health services at three VA medical centers. All veterans were participating in a smoking cessation treatment study. Of 178 veterans who completed baseline assessments, 127 (83.6%) engaged in treatment, defined as attending at least three group sessions. Forty-one (N=41) predictors across five domains (demographics, psychiatric concerns, medical concerns, smoking history, and self-efficacy to quit smoking) were identified based on previous research and clinical expertise. Using backward elimination to determine a final multivariable logistic regression model, three predictors were found to be significantly related to treatment engagement: marital status (never-married individuals more likely to engage); previous engagement in group smoking cessation services; and greater severity of positive symptoms on the Brief Psychiatric Rating Scale. When included in the multivariable logistic regression model, the full model discriminates between engagers and non-engagers reasonably well (c statistic=0.73). Major considerations based on these findings are: individuals with SMI appear to be interested in smoking cessation services; and serious psychiatric symptomatology should not discourage treatment providers from encouraging engagement in smoking cessation services. Published by Elsevier Ltd.

  3. Vagus Nerve Stimulation: A Non-Invasive Treatment to Improve the Health of Gulf Veterans with Gulf War Illness

    Science.gov (United States)

    2017-05-01

    Gulf War Illness (GWI) is a condition occurring in some veterans who served in the 1990-91 Gulf War . To date there is no specific treatment for it. A...major complaint of veteran subjects with GWI is widespread pain and achiness. Currently, some drugs are available to treat these symptoms, but these...complaint of Gulf War veterans with GWI using a hand-held neuro-stimulator device that activates a nerve in the neck called the vagus. This study will

  4. Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

    Science.gov (United States)

    Hermes, Eric; Rosenheck, Robert

    2016-02-01

    Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.

  5. Collective stories and well-being: using a dialogical narrative approach to understand peer relationships among combat veterans experiencing post-traumatic stress disorder.

    Science.gov (United States)

    Caddick, Nick; Phoenix, Cassandra; Smith, Brett

    2015-03-01

    Using a dialogical narrative approach, this original research explored how combat veterans experiencing post-traumatic stress disorder made sense of peer relationships with other veterans and what effects these relationships had on their well-being. Interviews and participant observations were conducted with 15 male combat veterans (aged 27-60 years) and one member of the civilian emergency services, the majority of whom were diagnosed with post-traumatic stress disorder following traumatic exposure in a range of armed conflicts. All participants were part of a surfing charity for veterans experiencing post-traumatic stress disorder. Data were rigorously analysed using a dialogical narrative analysis (DNA). Findings revealed the collective story that veterans used to make sense of peer relationships within the group. This collective story worked for the veterans to shape their experiences of well-being by fostering camaraderie, stimulating deeper connections and countering the negative effects of post-traumatic stress disorder. Potential therapeutic effects of the collective story were also identified. This article extends previous knowledge on combat veterans and social relationships and advances the field of narrative health psychology through the empirical application of a sophisticated dialogical narrative approach. © The Author(s) 2015.

  6. ELSiTO. a collaborative European initiative to foster social inclusion with persons experiencing mental illness.

    Science.gov (United States)

    Ammeraal, M; Kantartzis, S; Burger, M; Bogeas, T; van der Molen, C; Vercruysse, L

    2013-06-01

    ELSiTO (Empowering Learning for Social Inclusion Through Occupation), an international collaborative partnership, with over 30 members from Belgium, Greece and the Netherlands, aimed to explore the nature and processes of social inclusion for persons experiencing mental illness. Members included persons experiencing mental illness and health professionals. Four international visits and local activities enabled a knowledge creation process that combined the experience of social inclusion as we lived and worked together with exploration of the processes of community projects, narratives of experiences and reflective workshops. Outcomes included identification and description of the following: the nature of social inclusion as lived by the participants; the critical elements that support inclusion; and the competences that are developed by all stakeholders during this process. The complex process of social inclusion is facilitated by doing together in environments that enable equality, trust, risk taking and realignment of power. These conceptual understandings of inclusion are discussed in relation to the ongoing activities of the partners, to their potential contribution to the education of occupational therapists (and other professionals) and to the development of socially inclusive occupation-based projects in the community. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Confirming mental health care in acute psychiatric wards, as narrated by persons experiencing psychotic illness: an interview study.

    Science.gov (United States)

    Sebergsen, Karina; Norberg, Astrid; Talseth, Anne-Grethe

    2016-01-01

    It is important that mental health nurses meet the safety, security and care needs of persons suffering from psychotic illness to enhance these persons' likelihood of feeling better during their time in acute psychiatric wards. Certain persons in care describe nurses' mental health care as positive, whereas others report negative experiences and express a desire for improvements. There is limited research on how persons with psychotic illness experience nurses' mental health care acts and how such acts help these persons feel better. Therefore, the aim of this study was to explore, describe and understand how the mental health nurses in acute psychiatric wards provide care that helps persons who experienced psychotic illness to feel better, as narrated by these persons. This study had a qualitative design; 12 persons participated in qualitative interviews. The interviews were transcribed, content analysed and interpreted using Martin Buber's concept of confirmation. The results of this study show three categories of confirming mental health care that describe what helped the participants to feel better step-by-step: first, being confirmed as a person experiencing psychotic illness in need of endurance; second, being confirmed as a person experiencing psychotic illness in need of decreased psychotic symptoms; and third, being confirmed as a person experiencing psychotic illness in need of support in daily life. The underlying meaning of the categories and of subcategories were interpreted and formulated as the theme; confirming mental health care to persons experiencing psychotic illness. Confirming mental health care acts seem to help persons to feel better in a step-wise manner during psychotic illness. Nurses' openness and sensitivity to the changing care needs of persons who suffer from psychotic illness create moments of confirmation within caring acts that concretely help the persons to feel better and that may enhance their health. The results show the

  8. Benzodiazepine and sedative-hypnotic use among older seriously Ill veterans: choosing wisely?

    Science.gov (United States)

    Garrido, Melissa M; Prigerson, Holly G; Penrod, Joan D; Jones, Shatice C; Boockvar, Kenneth S

    2014-11-01

    The 2014 American Geriatrics Society's Choosing Wisely list cautions against the use of any benzodiazepines or other sedative-hypnotics (BSHs) as initial treatments for agitation, insomnia, or delirium in older adults. Because these symptoms are prevalent among hospitalized patients, seriously ill older adults are at risk of receiving these potentially inappropriate medications. The objectives of this study were to understand the extent to which potentially inappropriate BSHs are being used in hospitalized, seriously ill, older veterans and to understand what clinical and sociodemographic characteristics are associated with potentially inappropriate BSH use. We reviewed medical records of 222 veterans aged ≥65 years who were hospitalized in an acute care facility in the New York-New Jersey metropolitan region in fiscal years 2009 and 2010. Veterans had diagnoses of advanced cancer, chronic obstructive pulmonary disease, congestive heart failure, and/or HIV/AIDS and received inpatient palliative care. Associations among potentially inappropriate BSH use (BSHs for indications other than alcohol withdrawal and current generalized anxiety disorder or one-time use before a medical procedure) and clinical and sociodemographic characteristics were examined with multivariable logistic regression. One-fifth of the sample was prescribed a potentially inappropriate BSH during the index hospitalization during the study period (n = 47). The most commonly prescribed potentially inappropriate medications were zolpidem (n = 26 [11.7%]) and lorazepam (n = 19 [8.9%]). Hispanic ethnicity was significantly associated with prescription of potentially inappropriate BSHs among the entire sample (adjusted odds ratio [AOR] = 3.79; 95% CI, 1.32-10.88) and among patients who survived until discharge (n = 164; AOR = 5.28; 95% CI, 1.64-17.07). Among patients who survived until discharge, black patients were less likely to be prescribed potentially inappropriate BSHs than white patients (AOR

  9. An examination of sleep quality in veterans with a dual diagnosis of PTSD and severe mental illness.

    Science.gov (United States)

    Brown, Wilson J; Wilkerson, Allison K; Milanak, Melissa E; Tuerk, Peter W; Uhde, Thomas W; Cortese, Bernadette M; Grubaugh, Anouk L

    2017-01-01

    Poor sleep quality is one of the most frequently reported symptoms by veterans with Posttraumatic Stress Disorder (PTSD) and by veterans with severe mental illness (SMI; i.e., schizophrenia spectrum disorders, bipolar disorder, major depression with or without psychotic features). However, little is known about the compounding effects of co-occurring PTSD/SMI on sleep quality in this population. Given the high rates of comorbidity and poor functional outcomes associated with sleep dysfunction, there is a need to better understand patterns of poor sleep quality in this population. The present study provides a description of sleep quality in veterans with a dual diagnosis of PTSD/SMI relative to veterans with PTSD only. Results indicated that, despite similar reports of PTSD symptom severity between the groups, veterans with PTSD/SMI reported higher levels of poor sleep quality than veterans only diagnosed with PTSD. Specifically, veterans with PTSD/SMI reported significantly greater difficulties with sleep onset and overall more sleep disturbance than their non-SMI counterparts. Implications of the findings are discussed within the context of an existing model of insomnia and suggest that more comprehensive sleep assessment and the provision of targeted sleep interventions may be helpful for those with a dual diagnosis of PTSD/SMI. Copyright © 2016. Published by Elsevier Ireland Ltd.

  10. Differential experiences of discrimination among ethnoracially diverse persons experiencing mental illness and homelessness.

    Science.gov (United States)

    Zerger, Suzanne; Bacon, Sarah; Corneau, Simon; Skosireva, Anna; McKenzie, Kwame; Gapka, Susan; O'Campo, Patricia; Sarang, Aseefa; Stergiopoulos, Vicky

    2014-12-14

    This mixed methods study explored the characteristics of and experiences with perceived discrimination in an ethnically diverse urban sample of adults experiencing homelessness and mental illness. Data were collected in Toronto, Ontario, as part of a 4-year national randomized field trial of the Housing First treatment model. Rates of perceived discrimination were captured from survey questions regarding perceived discrimination among 231 ethnoracially diverse participants with moderate mental health needs. The qualitative component included thirty six in-depth interviews which explored how individuals who bear these multiple identities of oppression navigate stigma and discrimination, and what affects their capacity to do so. Quantitative analysis revealed very high rates of perceived discrimination related to: homelessness/poverty (61.5%), race/ethnicity/skin colour (50.6%) and mental illness/substance use (43.7%). Immigrants and those who had been homeless three or more years reported higher perceived discrimination on all three domains. Analysis of qualitative interviews revealed three common themes related to navigating these experiences of discrimination among participants: 1) social distancing; 2) old and new labels/identities; and, 3) 'homeland' cultures. These study findings underscore poverty and homelessness as major sources of perceived discrimination, and expose underlying complexities in the navigation of multiple identities in responding to stigma and discrimination. Current Controlled Trials ISRCTN42520374 . Registered 18 August 2009.

  11. Therapeutic Lifestyle Changes: Impact on Weight, Quality of Life, and Psychiatric Symptoms in Veterans With Mental Illness.

    Science.gov (United States)

    Tessier, Jillian M; Erickson, Zachary D; Meyer, Hilary B; Baker, Matthew R; Gelberg, Hollie A; Arnold, Irina Y; Kwan, Crystal; Chamberlin, Valery; Rosen, Jennifer A; Shah, Chandresh; Hellemann, Gerhard; Lewis, Melissa M; Nguyen, Charles; Sachinvala, Neena; Amrami, Binyamin; Pierre, Joseph M; Ames, Donna

    2017-09-01

    Veterans with mental illness tend to have shorter life spans and suboptimal physical health because of a variety of factors. These factors include poor nutrition, being overweight, and smoking cigarettes. Nonphysical contributors that may affect quality of life are the stigma associated with mental illness, social difficulties, and spiritual crises. Current mental health treatment focuses primarily on the delivery of medication and evidence-based psychotherapies, which may not affect all the above areas of a Veteran's life as they focus primarily on improving psychological symptoms. Clinicians may find greater success using integrative, comprehensive, multifaceted programs to treat these problems spanning the biological, psychological, social, and spiritual domains. These pilot studies test an adjunctive, holistic, behavioral approach to treat mental illness. This pilot work explores the hypotheses that engagement in a greater number of therapeutic lifestyle changes (TLCs) leads to improvement in quality of life, reduction of psychiatric symptoms, and weight loss. Institutional Review Boards for human subjects at the Veterans Affairs (VA) Greater Los Angeles and Long Beach Healthcare Systems approved pilot study activities at their sites. Pilot Study 1 was a prospective survey study of Veterans with mental illness, who gained weight on an atypical antipsychotic medication regimen, participating in a weight management study. At each session of the 1-year study, researchers asked a convenience sample of 55 Veterans in the treatment arm whether they engaged in each of the eight TLCs: exercise, nutrition/diet, stress management and relaxation, time in nature, relationships, service to others, religious or spiritual involvement, and recreation. Pilot Study 2 applied the TLC behavioral intervention and examined 19 Veterans with mental illness, who attended four classes about TLCs, received individual counseling over 9 weeks, and maintained journals to track TLC practice

  12. Veterans Crisis Line

    Data.gov (United States)

    Department of Veterans Affairs — The caring responders at the Veterans Crisis Line are specially trained and experienced in helping Veterans of all ages and circumstances. Some of the responders are...

  13. A Randomized, Controlled Multisite Study of Behavioral Interventions for Veterans with Mental Illness and Antipsychotic Medication-Associated Obesity.

    Science.gov (United States)

    Erickson, Zachary D; Kwan, Crystal L; Gelberg, Hollie A; Arnold, Irina Y; Chamberlin, Valery; Rosen, Jennifer A; Shah, Chandresh; Nguyen, Charles T; Hellemann, Gerhard; Aragaki, Dixie R; Kunkel, Charles F; Lewis, Melissa M; Sachinvala, Neena; Sonza, Patrick A; Pierre, Joseph M; Ames, Donna

    2017-04-01

    Weight gain and other metabolic sequelae of antipsychotic medications can lead to medication non-adherence, reduced quality of life, increased costs, and premature mortality. Of the approaches to address this, behavioral interventions are less invasive, cost less, and can result in sustained long-term benefits. We investigated behavioral weight management interventions for veterans with mental illness across four medical centers within the Veterans Affairs (VA) Healthcare System. We conducted a 12-month, multi-site extension of our previous randomized, controlled study, comparing treatment and control groups. Veterans (and some non-veteran women) diagnosed with mental illness, overweight (defined as having a BMI over 25), and required ongoing antipsychotic therapy. One group received "Lifestyle Balance" (LB; modified from the Diabetes Prevention Program) consisting of classes and individual nutritional counseling with a dietitian. A second group received less intensive "Usual Care" (UC) consisting of weight monitoring and provision of self-help. Participants completed anthropometric and nutrition assessments weekly for 8 weeks, then monthly. Psychiatric, behavioral, and physical assessments were conducted at baseline and months 2, 6, and 12. Metabolic and lipid laboratory tests were performed quarterly. Participants in both groups lost weight. LB participants had a greater decrease in average waist circumference [F(1,1244) = 11.9, p Behavioral interventions specifically designed for individuals with mental illness can be effective for weight loss and improve dietary behaviors. "Lifestyle Balance" integrates well with VA healthcare's patient-centered "Whole Health" approach. ClinicalTrials.gov identifier NCT01052714.

  14. Psychological ill-being experienced by first-time mothers and their partners in pregnancy after abortion: a cohort study.

    Science.gov (United States)

    Holmlund, Susanna; Kaljonen, Anne; Junttila, Niina; Räihä, Hannele; Mäkinen, Juha; Rautava, Päivi

    2014-12-01

    The psychological effects of abortion have been much discussed lately, with recently published studies indicating that induced abortion (IA) may, contrary to the general consensus, be contributing to psychological symptoms post-abortion. Using a cohort of first-time mothers, we assessed the likelihood of them experiencing psychological ill-being at the midpoint of their pregnancy, depending on their IA history. We also examined the psychological symptoms of their partners, the hypothesis being that ill-being in IA-experienced mothers might reflect onto their partners. Altogether 680 future first-time mothers (9.8% of whom had an IA history) and their partners were selected. Most mothers attended their 16 check-ups at maternity health clinics (MHC), where the family's physical and emotional well-being were checked. Several internationally validated questionnaires, which gauged psychological ill-being, were filled in at the 20th week of pregnancy. There were no significant differences between the study and the control group in terms of psychological ill-being during the pregnancy. The contribution of prior IA to psychological ill-being during the next pregnancy seems to be minimal. The availability of IA procedures, intensive MHC services in Finland, as well as this society's neutral attitude towards IA, may be among the reasons why the results are so positive for mothers who have previously undergone one or more IAs.

  15. Illness Symptoms Experienced by Children Exposed to Benzene After a Flaring Incident at the BP Refinery Facility in Texas City.

    Science.gov (United States)

    D'Andrea, Mark A; Reddy, G Kesava

    2016-10-01

    Objective To evaluate the illness symptoms experienced by children who were exposed to benzene following a flaring incident at the BP refinery in Texas City, Texas. Methods A total of 641 children, aged 5 year (P = .04). Conversely, urinary phenol levels were significantly lower in children 5 years (P = .00). Conclusion Together, these findings reveal that children exposed to benzene experience a range of illness symptoms and an altered profile of urinary phenol indicating their vulnerability to potentially increased health complications. © The Author(s) 2016.

  16. Monitoring and prevalence rates of metabolic syndrome in military veterans with serious mental illness.

    Directory of Open Access Journals (Sweden)

    Sameed Ahmed M Khatana

    Full Text Available BACKGROUND: Cardiovascular disease is the leading cause of mortality among patients with serious mental illness (SMI and the prevalence of metabolic syndrome--a constellation of cardiovascular risk factors--is significantly higher in these patients than in the general population. Metabolic monitoring among patients using second generation antipsychotics (SGAs--a risk factor for metabolic syndrome--has been shown to be inadequate despite the release of several guidelines. However, patients with SMI have several factors independent of medication use that predispose them to a higher prevalence of metabolic syndrome. Our study therefore examines monitoring and prevalence of metabolic syndrome in patients with SMI, including those not using SGAs. METHODS AND FINDINGS: We retrospectively identified all patients treated at a Veterans Affairs Medical Center with diagnoses of schizophrenia, schizoaffective disorder or bipolar disorder during 2005-2006 and obtained demographic and clinical data. Incomplete monitoring of metabolic syndrome was defined as being unable to determine the status of at least one of the syndrome components. Of the 1,401 patients included (bipolar disorder: 822; schizophrenia: 222; and schizoaffective disorder: 357, 21.4% were incompletely monitored. Only 54.8% of patients who were not prescribed SGAs and did not have previous diagnoses of hypertension or hypercholesterolemia were monitored for all metabolic syndrome components compared to 92.4% of patients who had all three of these characteristics. Among patients monitored for metabolic syndrome completely, age-adjusted prevalence of the syndrome was 48.4%, with no significant difference between the three psychiatric groups. CONCLUSIONS: Only one half of patients with SMI not using SGAs or previously diagnosed with hypertension and hypercholesterolemia were completely monitored for metabolic syndrome components compared to greater than 90% of those with these characteristics

  17. For Homeless Veterans

    Science.gov (United States)

    ... for VA health care services and are experiencing homelessness. VA case managers may connect these Veterans with ... Veterans who have experienced long-term or repeated homelessness. As of Sept. 30, 2015, HUD had allocated ...

  18. Biomarker Discovery in Gulf War Veterans: Development of a War Illness Diagnostic Panel

    Science.gov (United States)

    2016-12-01

    with GWI reflect a persistent disruption in central nervous system (CNS) proinflammatory and neuroendocrine parameters. These processes can...Immunol. 1999;6:6-13. 8. Vojdani A, Thrasher, JD. Cellular and humoral immune abnormalities in Gulf War veterans. Environ Health Perspect. 2004;112...in Gulf War veterans: relationships to posttraumatic stress disorder and health symptoms. Biol Psychiatry. 2007;62:1175-1178. 18. Sastre A, Cook MR

  19. Anxiety disorders, physical illnesses, and health care utilization in older male veterans with Parkinson disease and comorbid depression.

    Science.gov (United States)

    Qureshi, Salah U; Amspoker, Amber B; Calleo, Jessica S; Kunik, Mark E; Marsh, Laura

    2012-12-01

    This study examined the rates of anxiety and depressive disorders, physical illnesses, and health service use in male patients 55 years or older with a diagnosis of Parkinson disease who were seen at least twice at the 10 medical centers in the Veterans Affairs Healthcare Network of the South Central region of the United States. Of the 273 male patients diagnosed between October 1, 1997, and September 30, 2009, 62 (22.7%) had a depressive disorder. The overall prevalence of anxiety disorders was 12.8%; patients with comorbid depression had a 5-fold greater prevalence of anxiety disorders than those without depression (35.5% vs 6.2%, Pdisease and comorbid depression are more likely to have anxiety disorders and several physical illnesses, to be using antipsychotic and dementia medicines, and to have increased health service utilization than those without depression.

  20. Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings.

    Science.gov (United States)

    Ye, Jing; Chen, Timothy F; Paul, Diane; McCahon, Rebecca; Shankar, Sumitra; Rosen, Alan; O'Reilly, Claire L

    2016-09-01

    To describe the perceived experiences of stigma and discrimination among people living with severe and persistent mental illness in assertive community treatment (ACT teams) settings in New South Wales (NSW), Australia. The Discrimination and Stigma Scale (DISC) was used in this cross-sectional study with people living with severe and persistent mental illness. The DISC is a reliable and valid, quantitative and qualitative instrument used to explore and measure levels of negative, anticipated and positive discrimination. Relevant clinical history and socio-demographic information were also collected. A total of 50 clients participated, with 40 (80%) reporting experienced negative discrimination in at least one life area. Negative discrimination was most commonly experienced in being avoided or shunned (n=25, 50%), by neighbours (n=24, 48%) and family (n=23, 46%). Anticipated discrimination was common, with half of participants (n=25, 50%) feeling the need to conceal their mental health diagnosis. Discrimination was highly prevalent in everyday aspects of life. While healthcare professionals often tend to increase perceived stigma and discrimination, this was only experienced in interactions with general health professionals, while interactions with ACT team members decreased perceived stigma and increased positive discrimination. This indicates that healthcare professionals potentially have a significant role in reducing stigma and discrimination in mental health and that such an effect may be optimised in an ACT team setting. © The Author(s) 2016.

  1. Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial.

    Science.gov (United States)

    O'Campo, Patricia; Hwang, Stephen W; Gozdzik, Agnes; Schuler, Andrée; Kaufman-Shriqui, Vered; Poremski, Daniel; Lazgare, Luis Ivan Palma; Distasio, Jino; Belbraouet, Slimane; Addorisio, Sindi

    2017-08-01

    Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). Homeless adults with mental illness (n 2148). Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

  2. Characteristics of adherence to methadone maintenance treatment over a 15-year period among homeless adults experiencing mental illness

    Directory of Open Access Journals (Sweden)

    Milad Parpouchi

    2017-12-01

    Full Text Available Background: Methadone maintenance treatment (MMT has important protective effects related to reduced illicit opioid use, infectious disease transmission, and overdose mortality. Adherence to MMT has not been examined among homeless people. We measured MMT adherence and reported relevant characteristics among homeless adults experiencing mental illness in Vancouver, British Columbia, Canada. Material and methods: Homeless adults living with mental illness who had received MMT prior to the baseline interview of the Vancouver At Home study (n=78 were included in analyses. The medication possession ratio (MPR was used to estimate MMT adherence from retrospective administrative pharmacy and public health insurance data collected across 15years. Independent sample t tests and one-way ANOVA were used to test for significant differences in MMT MPR by participant characteristics. Results: Mean MMT MPR was 0.47. A large proportion of participants reported blood-borne infectious disease, three or more chronic physical health conditions, and substance use. Being single and never married was associated with significantly lower MMT MPR (0.40 vs. 0.55, p=0.036, while living with schizophrenia, bipolar disorder, or a mood disorder with psychotic features was associated with significantly higher MMT MPR (0.54 vs. 0.37, p=0.022. Daily drug use (excluding alcohol was associated with significantly lower MMT MPR (0.39 vs. 0.54, p=0.051. Conclusions: The level of adherence to MMT was very low among homeless adults experiencing mental illness. Efforts are needed to improve adherence to MMT as a means of reducing illicit substance use, preventing overdose deaths, and attenuating infectious disease transmission. Keywords: Adherence, Medication possession ratio, Methadone, Opioid dependence, Homeless, Mental illness

  3. Psychological responses of terminally ill patients who are experiencing suffering: A qualitative study.

    Science.gov (United States)

    Montoya-Juarez, Rafael; Garcia-Caro, María Paz; Campos-Calderon, Concepcion; Schmidt-RioValle, Jacqueline; Gomez-Chica, Antonio; Marti-García, Celia; Cruz-Quintana, Francisco

    2013-01-01

    Suffering is not only characterized by the feeling of being threatened, but also by the feeling of impotence to deal with such a threat. Literature identifies a terminal illness as a period during which several experiences implying an intense suffering are endured, but little attention has been paid to the psychological responses when reacting to threats. Identify the psychological responses that terminally ill patients put in place to face up to the demands of the end of life, as a foundation for future nursing interventions. Qualitative methodology with an interpretative phenomenological approach. Different hospitals health centers around the region of Granada (Spain). Twenty-four participants were finally chosen to take part in the research. The sampling procedure was intentional, and it was made taking into account exclusion and inclusion criteria. Patients with a cognitive impairment, who had been diagnosed with psychiatric alterations, who at that time suffered from uncontrollable symptoms such as intense pain were excluded from the sample. The patients were interviewed following a script (semistructured interview) carried out using the suggested theoretical framework. The interviews were analyzed using the sequence suggested by Strauss and Corbin: Open, axial and selective codification. The analysis of the participants' answers to the different questions of the semi-structured interview has allowed us to identify a main category "To realize that life is short". There are three categories where the different ways of facing up to the end of life concentrate: "Re-Evaluation of life", "Opportunity for growth", "Resignation/Acceptance". Nurses, have to try to alleviate the impact the terminal illness has on the subject, not only by controlling the symptoms but also encouraging the patients responses, by promoting the feeling of satisfaction in life, providing honest and sensitive information, establishing with the patient realistic goals, and facilitating a

  4. Increased generalization of learned associations is related to re-experiencing symptoms in veterans with symptoms of post-traumatic stress.

    Science.gov (United States)

    Anastasides, Nicole; Beck, Kevin D; Pang, Kevin C H; Servatius, Richard J; Gilbertson, Mark W; Orr, Scott P; Myers, Catherine E

    2015-01-01

    One interpretation of re-experiencing symptoms in post-traumatic stress disorder (PTSD) is that memories related to emotional information are stored strongly, but with insufficient specificity, so that stimuli which are minimally related to the traumatic event are sufficient to trigger recall. If so, re-experiencing symptoms may reflect a general bias against encoding background information during a learning experience, and this tendency might not be limited to learning about traumatic or even autobiographical events. To test this possibility, we administered a discrimination-and-transfer task to 60 Veterans (11.2% female, mean age 54.0 years) self-assessed for PTSD symptoms in order to examine whether re-experiencing symptoms were associated with increased generalization following associative learning. The discrimination task involved learning to choose the rewarded object from each of six object pairs; each pair differed in color or shape but not both. In the transfer phase, the irrelevant feature in each pair was altered. Regression analysis revealed no relationships between re-experiencing symptoms and initial discrimination learning. However, re-experiencing symptom scores contributed to the prediction of transfer performance. Other PTSD symptom clusters (avoidance/numbing, hyperarousal) did not account for significant additional variance. The results are consistent with an emerging interpretation of re-experiencing symptoms as reflecting a learning bias that favors generalization at the expense of specificity. Future studies will be needed to determine whether this learning bias may pre-date and confer risk for, re-experiencing symptoms in individuals subsequently exposed to trauma, or emerges only in the wake of trauma exposure and PTSD symptom development.

  5. A Study Of The Effects Of Illness Experienced By Families Of Oral And Oropharyngeal Cancer Patients

    Directory of Open Access Journals (Sweden)

    Bhagyalaxmi A

    2002-01-01

    Full Text Available Research question : What are the various areas and burden a family experiences due to presence of oral and oropharyngeal cancer patient. Objectives: 1. To identify the family burden like financial burden, disruption of routine activities and family leisure etc. 2. To study the severity of family burden experienced by the families of oral and oropharyngeal cancer patients. Study design: Case- control. Setting: Gujarat Cancer and Research Institute (G.C.R.I, Ahmedabad. Participants: 100 cases belonging to the diagnostic categories no. 140-46 of ICD â€"9 and 100 controls belonging to the diagnostic categories other than no. 140-46 of ICD-9 Statistical analysis: Proportions, Chi-square test and Z test. Results: Financial burden was observed in 36% of cases and 43% of controls had burden on the family. Out of 43% respondents reporting any burden, 36(83.72% were identified with severe burden.

  6. Novel Autoantibody Serum and Cerebrospinal Fluid Biomarkesin Veterans with Gulf War Illness

    Science.gov (United States)

    2016-10-01

    syndrome (CFS) and 50 irritable bowel syndrome (IBS) non-veterans) will be analyzed in this study from several current and prior studies using stored...central nervous system, biomarkers, irritable bowel syndrome , chronic fatigue syndrome 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT... syndrome , irritable bowel syndrome 3. Accomplishments • What were the major goals of the project? o The major goals of the project as stated in the

  7. Novel Autoantibody Serum and Cerebrospinal Fluid Biomarkers in Veterans with Gulf War Illness

    Science.gov (United States)

    2016-10-01

    GWI) and from 200 controls (100 healthy GW controls, 100 disease controls). Preliminary results using Western blot assay showed increased levels of...Department of Math and Computer Science, Menoufia University, Shebin ElKom, Egypt6, Department of Biostatistics & Bioinformatics, Duke University Medical...included. The results show significantly elevated levels of circulating Ig-G-class autoantibodies in the veterans with GWI, compared to controls. This

  8. Decomposing gender differences in low-density lipoprotein cholesterol among veterans with or at risk for cardiovascular illness.

    Science.gov (United States)

    Sambamoorthi, Usha; Mitra, Sophie; Findley, Patricia A; Pogach, Leonard M

    2012-03-01

    To measure the extent to which gender differences in poor lipid control among individuals at risk for cardiovascular diseases could be explained by patient-level characteristics. Cross-sectional analyses of merged Veteran Health Administration (VHA) and Medicare claims data for the fiscal years (FY) 2002 and 2003 consisting of veterans using VHA facilities and were diagnosed with diabetes or heart disease or hypertension during FY 2002 and had recorded LDL cholesterol values in FY2003 (N = 527,568). There were 10,582 women and 516,986 men veterans. Poor lipid control was defined as LDL cholesterol values ≥130 mg/dL. Multivariate techniques consisted of logistic regressions. Based on the parameter estimates and distribution of individual characteristics, we used a decomposition technique to analyze factors that contributed to the gender difference in poor lipid control. A significantly higher percent of women (27.4%) than men (17.1%) had LDL cholesterol values ≥130 mg/dL. Of the 10.3 percentage point difference in lipid control, 3.4 percentage points were explained by variables included in the model. The gender difference in poor lipid control was mostly explained by age, physical illnesses, use of lipid lowering medications and depression. Only one-third of the gender difference in poor lipid control could be explained by differences in individual characteristics, some of which are modifiable or could be used to identify groups at risk with poor lipid control. Our findings suggest that gender differences in lipid control could be partially reduced by increasing the prescription of lipid lowering drugs and treating depression among women. Interventions that improve lipid control in the non-elderly will also benefit women. However the largest part of the difference in lipid control between women and men remains unexplained and further research is needed to identify additional modifiable and unmodifiable factors. Copyright © 2012 Jacobs Institute of Women

  9. Chronic multisymptom illness: a comparison of Iraq and Afghanistan deployers with veterans of the 1991 Gulf War.

    Science.gov (United States)

    Smith, Tyler C; Powell, Teresa M; Jacobson, Isabel G; Smith, Besa; Hooper, Tomoko I; Boyko, Edward J; Gackstetter, Gary D

    2014-12-15

    Symptoms and illnesses reported by veterans of the 1991 Gulf War era are a cause of potential concern for those military members who have deployed to the Gulf region in support of more recent contingency operations in Iraq and Afghanistan. In the present study, we quantified self-reported symptoms from participants in the Millennium Cohort Study, a prospective study representing all US service branches, including both active duty and Reserve/National Guard components (2001-2008). Self-reported symptoms were uniquely compared with those in a cohort of subjects from the 1991 Gulf War to gain context for the present report. Symptoms were then aggregated to identify cases of chronic multisymptom illness (CMI) based on the case definition from the Centers for Disease Control and Prevention. The prevalence of self-reported CMI symptoms was compared with that collected in 1997-1999 from a study population of US Seabees from the 1991 Gulf War, as well as from deployed and nondeployed subgroups. Although overall symptom reporting was much less in the Millennium Cohort than in the 1991 Gulf War cohort, a higher prevalence of reported CMI was noted among deployed compared with nondeployed contemporary cohort members. An increased understanding of coping skills and resilience and development of well-designed screening instruments, along with appropriate clinical and psychological follow-up for returning veterans, might help to focus resources on early identification of potential long-term chronic disease manifestations. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Is There a Need for Early Palliative Care in Patients With Life-Limiting Illnesses? Interview Study With Patients About Experienced Care Needs From Diagnosis Onward.

    Science.gov (United States)

    Beernaert, Kim; Deliens, Luc; De Vleminck, Aline; Devroey, Dirk; Pardon, Koen; Block, Lieve Van den; Cohen, Joachim

    2016-06-01

    The early integration of specialist palliative care has been shown to benefit the quality of life of patients with advanced cancer. In order to explore whether other seriously ill people and people at even earlier phases would also benefit from early palliative care, we conducted 18 qualitative interviews with people having cancer, chronic obstructive lung disease, heart failure, or dementia at different phases of the illness trajectory about how they experienced care needs related to their disease from diagnosis onward. Respondents experienced needs within the different domains of palliative care at different stages of the illness and different illness types or duration of the illness. This study contributes to the understanding of primary care needs of patients for whom palliative care (not necessarily specialized palliative care) could be beneficial. © The Author(s) 2015.

  11. Retrospective Review of Critically Ill Patients Experiencing Alcohol Withdrawal: Dexmedetomidine Versus Propofol and/or Lorazepam Continuous Infusions.

    Science.gov (United States)

    Ludtke, Kimberly A; Stanley, Kevin S; Yount, Natalie L; Gerkin, Richard D

    2015-03-01

    Alcohol withdrawal symptoms can be difficult to manage and may lead to an intensive care unit (ICU) admission. Patients experiencing severe alcohol withdrawal often require high doses of sedatives, which can lead to respiratory depression and the need for endotracheal intubation. Dexmedetomidine, an alpha-2 adrenoreceptor agonist, provides adequate sedation with little effect on respiratory function when compared to other sedatives. To evaluate sedation with a continuous infusion of dexmedetomidine versus propofol and/or lorazepam in critically ill patients experiencing alcohol withdrawal. A retrospective chart review was conducted on ICU admissions between March 2002 and April 2009 for alcohol withdrawal patients who necessitated treatment with a continuous infusion of dexmedetomidine, propofol, and/or lorazepam. Primary outcomes included the incidence of mechanical ventilation, length of mechanical ventilation (if applicable), and ICU and hospital length of stay. Fifteen patients were treated with a continuous infusion of dexmedetomidine, and 17 were treated with an infusion of propofol and/or lorazepam. Two patients (13.3%) required intubation and mechanical ventilation in the dexmedetomidine group versus 10 (58.8%) in the propofol and/or lorazepam group (P = .006). Length of stay in the ICU was 53 hours for patients treated with dexmedetomidine versus 114.9 hours in the propofol and/or lorazepam group (P = .016). Hospital length of stay was less for the dexmedetomidine group, 135.8 hours versus 241.1 hours in the propofol and/or lorazepam group (P = .008). Dexmedetomidine use was associated with a decrease in the incidence of endotracheal intubation when used to sedate patients experiencing alcohol withdrawal. Patients transferred to a lower level of care faster and were discharged from the hospital sooner when treated with dexmedetomidine.

  12. Phospholipid profiling of plasma from GW veterans and rodent models to identify potential biomarkers of Gulf War Illness.

    Directory of Open Access Journals (Sweden)

    Tanja Emmerich

    Full Text Available Gulf War Illness (GWI, which affects at least one fourth of the 700,000 veterans deployed to the Gulf War (GW, is characterized by persistent and heterogeneous symptoms, including pain, fatigue and cognitive problems. As a consequence, this illness remains difficult to diagnose. Rodent models have been shown to exhibit different symptomatic features of GWI following exposure to particular GW agents (e.g. pyridostigmine bromide, permethrin and DEET and/or stress. Preclinical analyses have shown the activation of microglia and astroglia as a pathological hallmark in these mouse and rat models. Although much has been learned in recent years from these different rodent models and independent clinical studies, characterization studies to identify overlapping features of GWI in animals and humans have been missing. Thus, we aimed to identify biomarkers that co-occur in the plasma of rodent models of GWI and human GWI patients. We observed increases of multiple phospholipid (PL species across all studied cohorts. Furthermore, these data suggested dysfunction within ether and docosahexaenoic acid and arachidonic acid containing PL species in relation to GWI. As these PL species play a role in inflammatory processes, these findings suggest a possible role for inflammatory imbalance in GWI. Overall, we show that the peripheral lipid disturbances are present both in human GWI patients and in the preclinical rodent models of GWI, highlighting the importance of lipidomics as a potential platform for further biomarker discovery and supporting the value of GW agent exposed models of GWI.

  13. Predictors of patient communication in psychiatric medication encounters among veterans with serious mental illnesses.

    Science.gov (United States)

    Hack, Samantha M; Medoff, Deborah R; Brown, Clayton H; Fang, Lijuan; Dixon, Lisa B; Klingaman, Elizabeth A; Park, Stephanie G; Kreyenbuhl, Julie A

    2016-06-01

    Person-centered psychiatric services rely on consumers actively sharing personal information, opinions, and preferences with their providers. This research examined predictors of consumer communication during appointments for psychiatric medication prescriptions. The Roter Interaction Analysis System was used to code recorded Veterans Affairs psychiatric appointments with 175 consumers and 21 psychiatric medication prescribers and categorize communication by purpose: biomedical, psychosocial, facilitation, or rapport-building. Regression analyses found that greater provider communication, symptomology, orientation to psychiatric recovery, and functioning on the Repeatable Battery for the Assessment of Neuropsychological Status Attention and Language indices, as well as consumer diagnostic label, were positive predictors of consumer communication, though the types of communication impacted varied. Provider communication is the easiest variable to intervene on to create changes in consumer communication. Future research should also consider how cognitive and symptom factors may impact specific types of consumer communication in order to identify subgroups for targeted interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. 75 FR 8789 - Research Advisory Committee on Gulf War Veterans' Illnesses; Notice of Meeting

    Science.gov (United States)

    2010-02-25

    ... at the University of Texas Southwestern Medical Center and the VA War Related Illness and Injury... for the Committee's review to Dr. Roberta White, Chair, Department of Environmental Health, Boston... additional information should contact Dr. White, Scientific Director, at (617) 638-4620 or Dr. William...

  15. Sex Differences in Weight Loss among Veterans with Serious Mental Illness: Observational Study of a National Weight Management Program.

    Science.gov (United States)

    Goodrich, David E; Klingaman, Elizabeth A; Verchinina, Lilia; Goldberg, Richard W; Littman, Alyson J; Janney, Carol A; Kim, Hyungjin Myra; Maguen, Shira; Hoerster, Katherine D; Owen, Richard R; Holleman, Robert G; Roman, Pia; Lai, Zongshan; Bowersox, Nicholas W

    2016-01-01

    Obesity disproportionately burdens individuals with serious mental illness (SMI), especially women. This observational study investigated whether there were sex differences in weight loss and program participation among veterans with SMI enrolled in the Veterans Health Administration's (VHA) MOVE! weight management program. Participants were identified from a national cohort of 148,254 veterans enrolled in MOVE! during fiscal years 2008 through 2012 who attended two or more sessions within 12 months of enrollment. The cohort included those with International Classification of Disease, 9th Edition, Clinical Modification (ICD-9-CM) diagnoses for SMI, age less than 70 years, and weight data at baseline and one or more follow-up timepoints within approximately 1 year of enrollment (n = 8,943 men; n = 2,245 women). Linear mixed models assessed associations of sex with 6- and 12-month weight change from baseline, adjusting for demographic- and site-level variables. Both sexes averaged 6.4 (standard deviation, 4.6) sessions within 12 months; however, women with and without SMI participated at rates double their respective proportion rates among all VHA users. Participants averaged statistically significant weight loss at 6 months (men, -2.5 lb [95% CI, -2.8 to -2.1]; women, -2.4 lb [95% CI, -3.1 to -1.7]) and 12 months (men, -2.5 lb [95% CI, -2.8 to -2.2]; women, -2.9 lb [95% CI, -3.6 to -2.2]), but no sex-based difference in absolute weight loss at either timepoint. Slightly more women achieved 5% or greater (clinically significant) weight loss at the 12-month follow-up than did men (25.7% vs. 23.0%; p Women with SMI participated in MOVE! at rates equivalent to or greater than men with SMI, with comparable weight loss. More women were Black, single, had bipolar and posttraumatic stress disorder, and higher service-connected disability, suggesting areas for program customization. Published by Elsevier Inc.

  16. Lived-through past, experienced present, anticipated future: Understanding "existential loss" in the context of life-limiting illness.

    Science.gov (United States)

    Harris, Denise A

    2015-12-01

    Motor Neurone Disease (MND) is a rare, devastating neurodegenerative disease of middle/later life, usually presenting in the sixth and seventh decades (McDermot & Shaw, 2008). People have to wait many months to receive a diagnosis of MND (Donaghy et al., 2008), and during this period they have already experienced the degenerative nature that characterizes MND (Bolmsjö, 2001). However, information on the meaning of life with MND through time is limited. The aim of the present research was to answer the research question "What does it mean to be a person living through the illness trajectory of MND?" and to research the phenomenon of existence when given a diagnosis of MND and in the context of receiving healthcare. Hermeneutic phenomenology, inspired by the philosophers Heidegger and Gadamer, informed the methodological approach employed, which asked people to tell their story from when they first thought something untoward was happening to them. The hermeneutic analysis involved a five-stage process in order to understand (interpret) the lifeworld 1 of four people diagnosed with MND, and a lifeworld perspective helped to make sense of the meaning of existence when given a terminal diagnosis of MND. The concept of "existential loss" identified in relation to MND was the loss of past ways of being-in-the-world, and the loss of embodiment, spatiality, and the future. The concept of existential loss requires closer attention by healthcare professionals from the time of diagnosis and on through the illness trajectory. The study findings are conceptualized into a framework, which when used as a clinical tool may prompt healthcare professionals to focus on their patients' existential loss and existential concerns. This research adds to the existing literature calling for a lifeworld approach to healthcare.

  17. Military sexual trauma as a determinant in the development of mental and physical illness in male and female veterans.

    Science.gov (United States)

    O'Brien, Betsy S; Sher, Leo

    2013-01-01

    Military Sexual Trauma (MST) is defined as sexual harassment and or sexual assault experienced by a military service member. It is much more widespread and common than reported. It is associated with pre-combat traumatic experiences and pathologic sequelae including mental and medical illness. An electronic search of the major behavioral science databases was conducted to retrieve studies detailing the social, epidemiological and clinical characteristics of MST and its relationship to psychiatric and medical illness. Studies indicate that military sexual trauma is related to an increase in psychiatric pathology, including posttraumatic stress disorder (PTSD), substance abuse and dependence, depression, anxiety, eating disorders and suicidal behavior. MST is also related to an increase in medical illness, primarily pain-related symptoms involving multiple organ systems, including gastrointestinal, neurological, genitourinary and musculoskeletal. MST is associated with an increased prevalence of mental and physical illness. Although there are some gender differences in the reported rates of MST and there may be some variables, such as prior traumatic experiences, that may make an individual more vulnerable to the psychiatric and medical sequela of MST, it is clear that MST is a major healthcare issue that affects both sexes and warrants further attention and an increase in clinical resources devoted to it. Some preventive measures for decreasing the prevalence of MST may include increasing education and legal prosecution of perpetrators in the military, and increasing access to mental health services for individuals who have suffered from MST.

  18. Recent research on Gulf War illness and other health problems in veterans of the 1991 Gulf War: Effects of toxicant exposures during deployment

    Science.gov (United States)

    White, Roberta F.; Steele, Lea; O’Callaghan, James P.; Sullivan, Kimberly; Binns, James H.; Golomb, Beatrice A.; Bloom, Floyd E.; Bunker, James A.; Crawford, Fiona; Graves, Joel C.; Hardie, Anthony; Klimas, Nancy; Knox, Marguerite; Meggs, William J.; Melling, Jack; Philbert, Martin A.; Grashow, Rachel

    2015-01-01

    Veterans of Operation Desert Storm/Desert Shield – the 1991 Gulf War (GW) – are a unique population who returned from theater with multiple health complaints and disorders. Studies in the U.S. and elsewhere have consistently concluded that approximately 25–32% of this population suffers from a disorder characterized by symptoms that vary somewhat among individuals and include fatigue, headaches, cognitive dysfunction, musculoskeletal pain, and respiratory, gastrointestinal and dermatologic complaints. Gulf War illness (GWI) is the term used to describe this disorder. In addition, brain cancer occurs at increased rates in subgroups of GW veterans, as do neuropsychological and brain imaging abnormalities. Chemical exposures have become the focus of etiologic GWI research because nervous system symptoms are prominent and many neurotoxicants were present in theater, including organophosphates (OPs), carbamates, and other pesticides; sarin/cyclosarin nerve agents, and pyridostigmine bromide (PB) medications used as prophylaxis against chemical warfare attacks. Psychiatric etiologies have been ruled out. This paper reviews the recent literature on the health of 1991 GW veterans, focusing particularly on the central nervous system and on effects of toxicant exposures. In addition, it emphasizes research published since 2008, following on an exhaustive review that was published in that year that summarizes the prior literature (RACGWI, 2008). We conclude that exposure to pesticides and/or to PB are causally associated with GWI and the neurological dysfunction in GW veterans. Exposure to sarin and cyclosarin and to oil well fire emissions are also associated with neurologically based health effects, though their contribution to development of the disorder known as GWI is less clear. Gene-environment interactions are likely to have contributed to development of GWI in deployed veterans. The health consequences of chemical exposures in the GW and other conflicts have

  19. Multiple Mild Traumatic Brain Injuries Are Associated with Increased Rates of Health Symptoms and Gulf War Illness in a Cohort of 1990–1991 Gulf War Veterans

    Directory of Open Access Journals (Sweden)

    Megan K. Yee

    2017-07-01

    Full Text Available Recent research demonstrated a relation between traumatic brain injury (TBI, health symptoms and diagnosis of Gulf War Illness (GWI in Gulf War Veterans, but no study has examined the impact of multiple mild TBIs (mTBIs. A total of 229 male Gulf War Veterans from the Ft Devens Cohort were categorized by a number of mTBIs reported. One-way ANOVA and chi-square test of independence were used to test for differences in total reported health symptoms and diagnosis of chronic multisymptom illness (CMI or Kansas GWI criteria, two of the most common case definitions of GWI. A total of 72 veterans reported no mTBIs (31.4%, 26 reported one mTBI (11.4%, 25 reported two mTBIs (10.9%, and 106 veterans reported sustaining three or more mTBIs (46.3%. Veterans reporting two or more mTBIs (p < 0.01 or three or more mTBIs (p < 0.001 endorsed significantly higher rates of health symptoms than Veterans reporting no mTBIs. Significantly higher rates of CMI (p = 0.035 and Kansas GWI criteria (p < 0.001 were seen in the three or more mTBI group. Results suggest two mTBIs increase risk of health symptoms, but three mTBIs may be the threshold needed to sustain chronic symptom reporting needed for a formal diagnosis. These findings highlight the importance of implementing policies and procedures monitoring head injuries in military personnel.

  20. Trial of Naltrexone and Dextromethorphan for Gulf War VeteransIllnesses

    Science.gov (United States)

    2014-07-01

    low dose naltrexone have established benefits in syndromes related to Gulf War Illness such as fibromyalgia . We have successfully enrolled 41 subjects...encountered drop out. Nonetheless, as we enter the last year of the study, our initial power analysis based on the use of study drugs for syndromes ...Hom J. Is there a Gulf War Syndrome ? Searching for syndromes by factor analysis of symptoms. JAMA. 1997;277:215-22. Erratum in: JAMA 1997 Aug 6;278(5

  1. Trial of Naltrexone and Dextromethorphan for Gulf War VeteransIllness

    Science.gov (United States)

    2015-07-01

    sectional epidemiologic study. JAMA. 1997:15;277:231-7. Younger J, Noor N, McCue R, Mackey S. Low-dose naltrexone for the treatment of fibromyalgia ...Neither   treatment  had  a  significant  impact  on  pain.  The   authors  concluded  that  CBT  and/or   exercise  provided...ground breaking concept that could provide, both an enhanced understanding of, and beneficial treatment for, Gulf War Illnesses. Research at the National

  2. Clinical Holistic Medicine (Mindful,Short-Term Psychodynamic Psychotherapy Complemented with Bodywork in the Treatment of Experienced Mental Illness

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available Short-term psychodynamic psychotherapy (STPP complemented with bodywork improved 31 of 54 patients (57.4%, 95% CI: 43.21–70.77% who rated themselves mentally ill before treatment. Calculated from this we find 1.41 500. Of the 54 patients, 40% had already had traditional treatment that did not help them. Bodywork helped the patients to confront repressed painful feelings from childhood and this seemingly accelerated and improved the therapy. The patients received in average 20 sessions over 14 months at a cost of 1600 EURO. For the treatment responders, all measured aspects of life (on a five point Likert Scale improved significantly, simultaneously, and radically: somatic health (from 2.9 to 2.3, self-esteem/relationship to self (from 3.5 to 2.3, relationship to partner (from 4.7 to 2.9 [no partner was rated as “6”], relationship to friends (from 2.5 to 2.0, ability to love (from 3.8 to 2.4, self-assessed sexual ability (from 3.5 to 2.4, self-assessed social ability (from 3.2 to 2.1, self-assessed working ability (from 3.3 to 2.4, and self-assessed quality of life (from 4.0 to 2.3. Quality of life as measured with QOL5 improved (from 3.6 to 2.3 on a scale from 1 to 5; p < 0.001. This general improvement strongly indicated that the patient had healed existentially, i.e., had experienced what Aaron Antonovsky (1923–1994 called “salutogenesis”, defined as the process exactly the opposite of pathogenesis. For the treatment responders, the treatment provided lasting benefits, without the negative side effects of drugs. A lasting, positive effect might also prevent many different types of problems in the future.

  3. Impairments, activity limitations and participation restrictions experienced in the first year following a critical illness: protocol for a systematic review.

    Science.gov (United States)

    Ohtake, Patricia J; Coffey Scott, Jacqueline; Hinman, Rana S; Lee, Alan Chong; Smith, James M

    2017-01-24

    Critical illness requiring intensive care unit (ICU) management is a life-altering event with ∼25% of ICU survivors experiencing persistent reductions in physical functioning, impairments in mental health, cognitive dysfunction and decreased quality of life. This constellation of problems is known as 'postintensive care syndrome' (PICS) and may persist for months and/or years. The purpose of this systematic review is to identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU, using the International Classification of Functioning, Disability and Health framework to elucidate the impairments of body functions and structures, activity limitations and participation restrictions. Medline (Ovid), Cochrane Database of Systematic Reviews (Ovid), Cochrane Central Register of Controlled Trials (Ovid), PubMed, CINAHL (EBSCO), Web of Science and EMBASE will be systematically searched for observational studies reporting the physical impairments of body functions and structures, activity limitations and participation restrictions associated with PICS. Two reviewers will assess the articles for eligibility according to prespecified selection criteria, after which an independent reviewer will perform data extraction which will be validated by a second independent reviewer. Quality appraisal will be performed by two independent reviewers. Outcomes of the included studies will be summarised in tables and in narrative format and meta-analyses will be conducted where appropriate. Formal ethical approval is not required as no primary data is collected. This systematic review will identify the scope and magnitude of physical problems associated with PICS during the first year after discharge from ICU and will be disseminated through a peer-reviewed publication and at conference meetings, to inform practice and future research on the physical problems associated with PICS. CRD42015023520. Published by the BMJ Publishing

  4. Illness experiences of diabetes in the context of malaria in settings experiencing double burden of disease in southeastern Tanzania.

    Directory of Open Access Journals (Sweden)

    Emmy Metta

    Full Text Available Tanzania is doubly burdened with both non-communicable and infectious diseases, but information on how Tanzanians experience the co-existence of these conditions is limited. Using Kleinman's eight prompting questions the study synthesizes explanatory models from patients to describe common illness experiences of diabetes in a rural setting where malaria is the predominant health threat.We conducted 17 focus group discussions with adult members of the general community, diabetes patients, neighbours and relatives of diabetes patients to gain insight into shared experiences. To gain in-depth understanding of the individual illness experiences, we conducted 41 in-depth interviews with malaria or diabetes patients and family members of diabetes patients. The analysis followed grounded theory principles and the illness experiences were derived from the emerging themes.The illness experiences showed that malaria and diabetes are both perceived to be severe and fatal conditions, but over the years people have learned to live with malaria and the condition is relatively manageable compared with diabetes. In contrast, diabetes was perceived as a relatively new disease, with serious life-long consequences. Uncertainty, fear of those consequences, and the increased risk for severe malaria and other illnesses impacted diabetes patients and their families' illness experiences. Unpredictable ailments and loss of consciousness, memory, libido, and functional incapability were common problems reported by diabetes patients. These problems had an effect on their psychological and emotional health and limited their social life. Direct and indirect costs of illness pushed individuals and their families further into poverty and were more pronounced for diabetes patients.The illness experiences revealed both malaria and diabetes as distressing conditions, however, diabetes showed a higher level of stress because of its chronicity. Strategies for supporting social

  5. Experiences of adults who as children lived with a parent experiencing mental illness in a small-scale society : A Qualitative study.

    Science.gov (United States)

    Dam, K; Joensen, D G; Hall, E O C

    2017-12-29

    WHAT IS KNOWN ON THE SUBJECT?: Children of parent with severe mental illness are often carrying a caring burden; they keep the illness in the family, are documented to be stigmatized, bullied and to take special attention to their mentally ill parent's health and well-being. Little is however known about these children's experiences when growing up in a small-scale society. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: Children's experiences of living with a parent with severe mental illness in the small-scale society (Faroe Islands) are paradoxical, life is often unreasonable and evidently contradictory but anyway connected. The results show that "everybody knows everybody" which refers to that, in the small-scale society, it is difficult to be anonymous. The children were familiar with that people talked and had a prejudiced attitude; this resulted that the participants were constantly reminded of their mental ill parent's difference, and they were feeling less worthy than their pals. Children of parents with severe mental illness in a small-scale society need to support from the close family as well as mental healthcare professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study adds knowledge about the challenges that children of mental ill parents have to go through. Dialogue among mental healthcare colleagues not only about caring for the sick parent but also about modes of caring for the children and the family at large would deepen the staff's knowing of the need for family-centred care within mental health care. Introduction An estimated 23% of children worldwide live with a parent experiencing mental illness. These children are exposed to emotional and psychosocial challenges. Little is known about these children when living in small-scale societies. Aim To explore how adults, who as children lived with parents experiencing mental illness in a small-scale society, recalled their childhood life. Method Individual interviews with 11 adults were

  6. Establishing a 1991 Veterans Research Network to Improve Characterization of Gulf War Illness and Provide a National Resource for Veterans and Investigators

    Science.gov (United States)

    2016-11-01

    data will be used to optimize a GWI case definition, based on current symptoms, and to provide insights concerning rates of other medical conditions... questionnaires by mail or online, and to participate in the 1991 Veterans Research and Information Network (91VetNet), a national research and information...be used to update and optimize a GWI case definition, based on veterans’ current health status, and to provide important insights concerning rates of

  7. Recent research on Gulf War illness and other health problems in veterans of the 1991 Gulf War: Effects of toxicant exposures during deployment.

    Science.gov (United States)

    White, Roberta F; Steele, Lea; O'Callaghan, James P; Sullivan, Kimberly; Binns, James H; Golomb, Beatrice A; Bloom, Floyd E; Bunker, James A; Crawford, Fiona; Graves, Joel C; Hardie, Anthony; Klimas, Nancy; Knox, Marguerite; Meggs, William J; Melling, Jack; Philbert, Martin A; Grashow, Rachel

    2016-01-01

    Veterans of Operation Desert Storm/Desert Shield - the 1991 Gulf War (GW) - are a unique population who returned from theater with multiple health complaints and disorders. Studies in the U.S. and elsewhere have consistently concluded that approximately 25-32% of this population suffers from a disorder characterized by symptoms that vary somewhat among individuals and include fatigue, headaches, cognitive dysfunction, musculoskeletal pain, and respiratory, gastrointestinal and dermatologic complaints. Gulf War illness (GWI) is the term used to describe this disorder. In addition, brain cancer occurs at increased rates in subgroups of GW veterans, as do neuropsychological and brain imaging abnormalities. Chemical exposures have become the focus of etiologic GWI research because nervous system symptoms are prominent and many neurotoxicants were present in theater, including organophosphates (OPs), carbamates, and other pesticides; sarin/cyclosarin nerve agents, and pyridostigmine bromide (PB) medications used as prophylaxis against chemical warfare attacks. Psychiatric etiologies have been ruled out. This paper reviews the recent literature on the health of 1991 GW veterans, focusing particularly on the central nervous system and on effects of toxicant exposures. In addition, it emphasizes research published since 2008, following on an exhaustive review that was published in that year that summarizes the prior literature (RACGWI, 2008). We conclude that exposure to pesticides and/or to PB are causally associated with GWI and the neurological dysfunction in GW veterans. Exposure to sarin and cyclosarin and to oil well fire emissions are also associated with neurologically based health effects, though their contribution to development of the disorder known as GWI is less clear. Gene-environment interactions are likely to have contributed to development of GWI in deployed veterans. The health consequences of chemical exposures in the GW and other conflicts have been

  8. Decision-making styles of seriously ill male Veterans for end-of-life care: Autonomists, Altruists, Authorizers, Absolute Trusters, and Avoiders.

    Science.gov (United States)

    Braun, Ursula K; Beyth, Rebecca J; Ford, Marvella E; Espadas, Donna; McCullough, Laurence B

    2014-03-01

    To describe self-reported decision-making styles and associated pathways through end-of-life (EOL) decision-making for African-American, Caucasian, and Hispanic seriously ill male Veterans, and to examine potential relationships of race/ethnicity on these styles. Forty-four African American, White, and Hispanic male Veterans with advanced serious illnesses participated in 8 racially/ethnically homogenous focus groups. Transcripts were qualitatively analyzed to identify major themes, with particular attention to themes that might be unique to each of the racial/ethnic groups. Patients described two main decision-making styles, deciding for oneself and letting others decide, leading to five variants that we labeled Autonomists, Altruists, Authorizers, Absolute Trusters, and Avoiders. These variants, with exception of avoiders (not found among White patients), were found across all racial/ethnic groups. The variants suggested different 'implementation strategies', i.e., how clear patients made decisions and whether or not they then effectively communicated them. These identified decision-making styles and variants generate strategies for clinicians to better address individualized advance care planning. Physicians should elicit seriously ill patients' decision-making styles and consider potential implementation strategies these styles may generate, thus tailoring individualized recommendations to assist patients in their advance care planning. Patient-centered EOL decision-making can ensure that patient preferences are upheld. Published by Elsevier Ireland Ltd.

  9. Illness experiences of diabetes in the context of malaria in settings experiencing double burden of disease in southeastern Tanzania

    National Research Council Canada - National Science Library

    Metta, Emmy; Bailey, Ajay; Kessy, Flora; Geubbels, Eveline; Haisma, Hinke

    2017-01-01

    .... Using Kleinman's eight prompting questions the study synthesizes explanatory models from patients to describe common illness experiences of diabetes in a rural setting where malaria is the predominant health threat. METHODS...

  10. Racial/Ethnic Differences in Contemporaneous Use of Mental Health and Substance Use Treatment Among Individuals Experiencing Both Mental Illness and Substance Use Disorders.

    Science.gov (United States)

    Nam, Eunji; Matejkowski, Jason; Lee, Sungkyu

    2017-03-01

    This study examined whether the well-established racial/ethnic differences in mental health service utilization among individuals with mental illness are reflected in the treatment utilization patterns of individuals experiencing both mental illness and substance use disorders, particularly in regards to the use of contemporaneous mental health and substance abuse treatment. Using pooled data from the National Survey on Drug Use and Health (2009-2013), the patterns of mental health and substance use treatment utilization of 8748 White, Black, or Latino individuals experiencing both mental illness and substance use disorders were analyzed. Multinomial logistic regression was conducted to test the relationships among racial/ethnic groups and the receipt of contemporaneous treatment, mental health treatment alone, and substance use treatment alone as compared with no treatment utilization. Results indicated that Black and Latino respondents were less likely to receive contemporaneous treatment than Whites respondents. Also, significantly associated with outcomes were several interactions between race/ethnicity and predisposing, need and enabling factors known to be associated with service utilization. The findings suggest that an underlying mechanism of racial/ethnic differences among individuals with co-occurring mental illness and substance use disorders in the treatment utilization may differ by the specific types of treatment and between Blacks and Latinos. Therefore, efforts to reduce these disparities should consider specialty in each treatment settings and heterogeneity within diverse racial/ethnic groups.

  11. A experiência da enfermidade: considerações teóricas Experiencing illness: theoretical considerations

    Directory of Open Access Journals (Sweden)

    Paulo César Alves

    1993-09-01

    Full Text Available O presente trabalho estabelece algumas definições e o tratamento de conceitos chaves e termos relevantes para a compreensão da experiência da enfermidade. Objetiva analisar, em um nível teórico, a determinação individual e coletiva desta experiência. A análise aponta para a relação entre o universo macroscópico de significados estabelecidos pela sociedade e o mundo subjetivo dos indivíduos. O trabalho parte do pressuposto de que a experiência da enfermidade é uma realidade subjetiva tanto como intersubjetiva.This paper intends to establish some definitions and deal with key concepts and terms related to the understanding of illness as an experience. At the theoretical level, it aims to analyze the individual and collective determination of the experience of illness as the mediation between the macroscopic universe of meaning established in society and the ways in which this universe is sujectively real to individuals. This inquiry starts with the supposition that illness as an experience is both a subjetive and intersubjetive reality.

  12. Stigma, career worry, and mental illness symptomatology: Factors influencing treatment-seeking for Operation Enduring Freedom and Operation Iraqi Freedom soldiers and veterans.

    Science.gov (United States)

    Brown, Nicholas B; Bruce, Steven E

    2016-05-01

    Mental health related stigma, as well as mental illness symptomatology, have been shown to negatively impact treatment-seeking within military populations. However, few studies have delineated the 2 forms of stigma (self-stigma and public stigma), and none have differentiated between stigma and career-related consequences (career worry). The aim of this study was to increase our understanding of low treatment-seeking rates among soldiers and veterans by expanding upon previous measurements of the stigma construct and examining factors influencing willingness to seek treatment. The sample consisted of 276 Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) soldiers and veterans. Individual levels of self-stigma, public stigma, and career worry were measured, as were levels of willingness to seek treatment. Symptoms of PTSD, depression, and substance abuse were also evaluated to account for the influence of mental illness on treatment-seeking. A confirmatory factor analysis indicated that a 3-factor model including self-stigma, public stigma, and career worry fit the data significantly better than a 1- or 2- factor model. A multiple regression analysis also revealed that these 3 factors, combined with mental illness symptomatology, significantly predicted individual levels of willingness to seek treatment. Career worry was the strongest predictor, particularly for individuals with no treatment history. This study confirmed that career worry is a factor independent of self-stigma and public stigma. Findings indicate that a fear of negatively affecting one's career is the most influential factor in determining willingness to seek mental health treatment for the military population. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  13. Supported employment among veterans with serious mental illness: the role of cognition and social cognition on work outcome

    Directory of Open Access Journals (Sweden)

    L. Felice Reddy

    2014-09-01

    Full Text Available Unemployment is a primary functional deficit for the majority of adults with schizophrenia. Research indicates that over two-thirds of adults living in the community with schizophrenia are unemployed. Despite effective programs to assist with job identification and placement, the ability to attain and maintain employment remains a pressing concern. Neurocognitive functioning is widely acknowledged to be a determinant of work outcome; however, effect sizes tend to be in the small to medium range. The present study sought to further understand the determinants of work outcome among a sample of 104 veterans with schizophrenia enrolled in a supported employment program. A small percentage of veterans in the study got competitive jobs; 53% who secured jobs maintained employment for longer than 6 months. Cognition, social cognition, and symptoms were unrelated to job attainment. However, speed of processing and social cognition were significant predictors of work outcomes such as wages and tenure. These findings suggest that cognitive abilities including processing speed and the ability to accurately interpret and respond to social cues are significant determinants of whether individuals with schizophrenia remain employed. The results are discussed in light of current available treatment options and domains to target in synergy with work rehabilitation efforts.

  14. Trauma experience among homeless female veterans: correlates and impact on housing, clinical, and psychosocial outcomes.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Decker, Suzanne E; Desai, Rani A; Harpaz-Rotem, Ilan

    2012-12-01

    This study examined lifetime exposure to traumatic events as reported by 581 homeless female veterans enrolled in a Homeless Women Veterans Program across 11 sites to characterize the types of trauma they experienced; their correlation with baseline characteristics; and their association with housing, clinical outcomes, and psychosocial functioning over a 1-year treatment period. Almost all participants endorsed multiple types and episodes of traumatic events. Among the most common were having someone close experience a serious or life-threatening illness (82%) and rape (67%). Exploratory factor analysis revealed 6 potential trauma categories: being robbed, experiencing accident or disasters, illness or death of others, combat, sexual assault, and physical assault. At baseline, trauma from sexual assault was associated with more days homeless (β = .18, p homeless women veterans can achieve through homeless services. Published © 2012. This article is a US Government work and is in the public domain in the USA.

  15. Novel Therapeutic Approaches for the Treatment of Depression and Cognitive Deficits in a Rodent Model of Gulf War Veterans Illness

    Science.gov (United States)

    2015-10-01

    in this cascade produces depressive symptoms and memory impairments, and inhibiting this system with pharmacological or genetic manipulation affords...1 AWARD NUMBER: W81XWH-14-1-0478 TITLE: Novel Therapeutic Approaches for the Treatment of Depression and Cognitive Deficits in a Rodent Model...the Treatment of Depression and Cognitive Deficits in a Rodent Model of Gulf War Veterans’ Illness 5b. GRANT NUMBER W81XWH-14-1-0478 5c

  16. Is the increased reporting of symptomatic ill health in Gulf War veterans related to how one asks the question?

    Science.gov (United States)

    Murphy, Dominic; Hooper, Richard; French, Claire; Jones, Margaret; Rona, Roberto; Wessely, Simon

    2006-08-01

    Following the 1991 Gulf War (GW) there was much controversy surrounding service-related health effects. Evidence from the Vietnam experience suggested that self-reported ill health following that conflict might be related to how service during the conflict is framed. The aim of this article is to determine if a GW health effect persisted when the same questions were asked in a "non-GW" context. Prevalence of physical and psychological health problems were ascertained in a study assessing health screening from a random sample of UK Armed Forces. Record linkage between the screening survey and service history was conducted to obtain information on participation in the GW. Differences in health outcomes were found between the GW and the non-GW groups. This difference existed for symptomatic measures (OR=1.84, 95% CI, 1.17-2.91) rather than psychological or behavioral measures. No differences were found in psychological measures such as PTSD or behavioral measures such as alcohol consumption. Those deployed to the GW had a poorer self-perception of health (OR=1.47, 95% CI 1.02-2.11). Even in the absence of framing, a Gulf-related ill health effect was found.

  17. ‘We experienced a lack of tools for strengthening coping and health in encounters with patients with chronic illness': bridging theory and practice through formative research

    Directory of Open Access Journals (Sweden)

    Kristen Heggdal

    2015-11-01

    Full Text Available Background: Healthcare personnel in specialist care in Norway took the initiative to develop their practice in order to improve follow-up of patients with chronic illness. A research project was constructed that involved a close collaboration between practice and research in the development of a new, complex intervention to strengthen patients' ability to live with long-term conditions. Aims and objectives: This paper seeks to describe a part of the research process that involved the first- stage development of the intervention. The first objective is to describe how clinicians, patients and a health researcher collaborated, and to discuss the benefits of this collaborative work for improving practice. The second objective is to outline the intervention's aspects and components. Method: Three clinical sites were chosen for developing the intervention: a rehabilitation unit, an outpatient clinic and a centre for patient education. An interdisciplinary team of nine healthcare personnel and four patients engaged with the researcher(s in the formative research. A list of criteria for reporting on the development of complex interventions was applied to elaborate on intervention components. Results: An intervention was developed that entailed a person-centred approach to facilitating overall health in chronic illness. This involved a change in practice as the professionals acquired a new approach to the use of patients' capacity for health, and as patients began to function as active partners in health promotion. Conclusions: A close collaboration between clinicians, former patients and researcher was necessary for developing a theory and a research-based intervention that improved the follow-up of individuals diagnosed with long-term conditions. The intervention was designed to be applicable across diagnostic categories and in a variety of clinical settings. These patients experience a multitude of challenges that require attention in health

  18. Attitudes about the VA health-care setting, mental illness, and mental health treatment and their relationship with VA mental health service use among female and male OEF/OIF veterans.

    Science.gov (United States)

    Fox, Annie B; Meyer, Eric C; Vogt, Dawne

    2015-02-01

    In the present study, the authors explored gender differences in attitudinal barriers to and facilitators of care for Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans and examined the relationship of those factors with VA mental health service use among female and male veterans with probable mental health conditions. Data were collected as part of a national cross-sectional survey of OEF/OIF veterans; the current sample was limited to participants with a probable diagnosis of posttraumatic stress disorder, depression, or alcohol abuse (N = 278). Although negligible gender differences were observed in attitudes about VA care and perceived fit in the VA setting, men reported slightly more negative beliefs about mental illness and mental health treatment than women. In addition, logistic regressions revealed different associations with VA mental health service use for women and men. For women only, positive perceptions of VA care were associated with increased likelihood of seeking mental health treatment. For men only, perceived similarity to other VA care users and negative beliefs about mental health treatment were associated with increased likelihood of service use, whereas negative beliefs about mental illness were associated with lower likelihood of service use. For both women and men, perceived entitlement to VA care was associated with increased likelihood of service use and negative beliefs about treatment-seeking were associated with a reduced likelihood of seeking mental health care in the past 6 months. Results support the need for tailored outreach to address unique barriers to mental health treatment for female and male OEF/OIF veterans.

  19. Military sexual trauma among homeless veterans.

    Science.gov (United States)

    Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-07-01

    Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

  20. The process of transformation experienced by the patients, their families, and nurses during critical illness in the intensive care unit: perspective from a phenomenological study.

    Science.gov (United States)

    Cypress, Brigitte S

    2015-01-01

    There are no studies in the literature that explore and describe the concept of transformation from the perspective of patients, family members, and nurses during critical illness in the intensive care unit (ICU). The purpose of this article is to explore and describe the concept of transformation among patients, their families, and nurses during critical illness in the ICU. The concept "transformation" is a theme illuminated from a qualitative phenomenological study conducted in the ICU in 2010. Fifteen participants were interviewed until data saturation was achieved. van Manen's holistic, selective, and detailed line-by-line approach was used to analyze the data until themes emerged. Processes of transformation related to ICU experience during critical illness were noted among the patients, family members, and nurses and presented in the following descriptors: (a) patients: a "wake-up call," "the longest days of my life," and "thankful to be alive"; (b) family members: "the experience made me emotionally empowered," and "the experience strengthened my faith"; (c) nurses: "the experience made me grow as a person," "the experience made me more enthusiastic for learning," and "realization that good care equals family satisfaction thus own personal satisfaction." The concept of transformation from the perspective of a triad of patients, their families, and nurses may be noted in other conditions other than critical illness; thus, replicating studies with different populations and settings is needed.

  1. Clinical Holistic Medicine (Mindful, Short-Term Psychodynamic Psychotherapy Complemented with Bodywork in the Treatment of Experienced Physical Illness and Chronic Pain

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available We investigated the treatment effect of psychodynamic short-term therapy complemented with bodywork on patients who presented with physical illness at the Research Clinic for Holistic Medicine in Copenhagen. Psychodynamic short-term therapy was complemented with bodywork (Marion Rosen to help patients confront old emotional pain from childhood trauma(s. Patients were measured with a five-item quality of life and health questionnaire (QOL5, a one-item questionnaire of self-assessed quality of life (QOL1, and four questions on self-rated ability to love and to function sexually, socially, and at work (ability to sustain a full-time job. Most of the patients had chronic pain that could not be alleviated with drugs. Results showed that 31 patients with the experience of being severely physically ill (mostly from chronic pain, in spite of having consulted their own general practitioner, entered the study. The holistic approach and body therapy accelerated the therapy dramatically and no significant side effects were detected. After the intervention, 38.7% did not feel ill (1.73 < NNT < 4.58 (p = 0.05. Psychodynamic short-term therapy complemented with bodywork can help patients. When the patients responded to the therapy, the self-assessed mental health, relationship with partner, ability to work, self-assessed quality of life, relationships in general, measured QOL (with the validated questionnaire QOL5, and life's total state (mean of health, QOL and ability were significantly improved, statistically and clinically. Most importantly, all aspects of life were improved simultaneously, due to induction of Antonovsky-salutogenesis. The patients received in average 20 sessions over 14 months at a cost of 1600 EURO. For the treatment responders, the treatment seemingly provided lasting benefits.

  2. Veterans' homecomings

    DEFF Research Database (Denmark)

    Sørensen, Birgitte Refslund

    2015-01-01

    social identity and find a meaningful life in the civilian world. When doing so, they need to navigate an ambiguous political environment and emergent public imaginaries of the veteran while also wrestling with their own military socialization and personal experiences of war. The certainty previously...... experiences, present conditions, and future ambitions are embedded in webs of concealment, disclosure, exposure, deception, lying, silence, and so forth, only partially controlled by the veterans themselves. The intricacies and anxieties associated with secrecy work are discussed in relation to three veteran...

  3. Experiencing control

    NARCIS (Netherlands)

    Monaci, G.; Braspenning, R.A.C.; Meerbeek, B.W.; Bingley, P.; Rajagopalan, R.; Triki, M.

    2009-01-01

    This report describes the activities carried out in the first part of the Experiencing Control project (2008-324). The guiding idea of the project is to make control part of the experience, exploring new interaction solutions for complex, engaging interactions with Philips devices in the living

  4. Experiencing variation

    DEFF Research Database (Denmark)

    Kobayashi, Sofie; Berge, Maria; Grout, Brian William Wilson

    2017-01-01

    This study contributes towards a better understanding of learning dynamics in doctoral supervision by analysing how learning opportunities are created in the interaction between supervisors and PhD students, using the notion of experiencing variation as a key to learning. Empirically, we have bas...... were discussed, created more complex patterns of variation. Both PhD students and supervisors can learn from this. Understanding of this mechanism that creates learning opportunities can help supervisors develop their competences in supervisory pedagogy....

  5. Women Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report summarizes the history of women Veterans in the military and as Veterans. It profiles the characteristics of women Veterans in 2015, and illustrates how...

  6. Veterans Health Administration

    Science.gov (United States)

    ... code here VA » Veterans Health Administration Veterans Health Administration Veterans – Here's how to Avoid Getting the Flu ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  7. Veterans and Homelessness

    Science.gov (United States)

    2013-11-29

    health care and rehabilitation services for homeless veterans (the Health Care for Homeless Veterans and Domiciliary Care for Homeless Veterans...Health Care for Homeless Veterans ................................................................................... 19 Domiciliary Care for Homeless...for Homeless Veterans (HCHV), Domiciliary Care for Homeless Veterans (DCHV), the Compensated Work Therapy/Therapeutic Residences Program, and the

  8. Novel Therapeutic Approaches for the Treatment of Depression and Cognitive Deficits in a Rodent Model of Gulf War VeteransIllness

    Science.gov (United States)

    2017-10-01

    Chronic exposure to organophosphates (OP) is among multiple causes for GWI, yet its pathobiology remains ill understood. The role of calcium (Ca2...ml poly-L-lysine followed by multiple rinses with distilled water and then further treated with Cell-Tak (BD-Biosciences, San Jose, CA...provided? The GWIRP grant has allowed me to engage high school and undergraduate students in research and spark an interest in GWI research. My laboratory

  9. Identifying US veterans who access services from health care for the homeless clinics.

    Science.gov (United States)

    Knopf-Amelung, Sarah M; Jenkins, Darlene M

    2013-12-01

    Research on veterans experiencing homelessness is predominantly focused on the US Department of Veterans Affairs setting, despite the fact that substantial numbers receive services from Health Care for the Homeless (HCH) clinics. We explored how HCH clinics identified veteran patients through a survey of administrators (49% response rate). The majority (98%) identified veterans but used varied language and approaches. Implementing a streamlined, culturally competent identification process is vital to collecting accurate data, connecting veterans with benefits, and informing treatment plans.

  10. Comparing life experiences in active addiction and recovery between veterans and non-veterans: a national study.

    Science.gov (United States)

    Laudet, Alexandre; Timko, Christine; Hill, Thomas

    2014-01-01

    The costs of addiction are well documented, but the potential benefits of recovery are less well known. Similarly, substance use issues among both active duty military personnel and veterans are well known but their recovery experiences remain underinvestigated. Furthermore, little is known about whether and how addiction and recovery experiences differ between veterans and non-veterans. This knowledge can help refine treatment and recovery support services. Capitalizing on a national study of individuals in recovery (N = 3,208), we compare addiction and recovery experiences among veterans (n = 481) and non-veterans. Veterans' addiction phase was 4 years longer than non-veterans and they experienced significantly more financial and legal problems. Dramatic improvements in functioning were observed across the board in recovery with subgroup differences leveling off. We discuss possible strategies to address the specific areas where veterans are most impaired in addiction and note study limitations including the cross-sectional design.

  11. Risk Factors for Homelessness Among US Veterans

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  12. Risk factors for homelessness among US veterans.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  13. Health Programs for Veterans

    Science.gov (United States)

    ... Health Administration » Health Programs for Veterans Veterans Health Administration Health Programs for Veterans Beyond the doctors and ... families of patients receiving medical care at major military and VA medical centers Geriatrics & Extended Care Geriatric ...

  14. A tale of two veterans: homeless vs domiciled veterans presenting to a psychiatric urgent care clinic.

    Science.gov (United States)

    Lee, Haoyu; Iglewicz, Alana; Golshan, Shah; Zisook, Sidney

    2013-11-01

    The relationship between homelessness among veterans and mental illness and suicidality has not been clearly defined. To further examine this relationship, we compared rates of mental illness and suicidality among homeless and domiciled veterans seeking urgent psychiatric care at a US Department of Veterans Affairs (VA) facility. Information was collected by survey from 482 consecutive veterans seeking care at the Psychiatric Emergency Clinic (PEC) at the VA San Diego Healthcare System. A total of 73 homeless veterans were designated the homeless group and 73 domiciled veterans were randomly selected as the domiciled group. Suicidality and mental illnesses were assessed by self-assessment questionnaires and chart review of diagnoses. The homeless group had significantly higher rates of past suicide attempts (47% vs 27%) and recent reckless or self-harming behavior (33% vs 18%) compared with the domiciled group but significantly lower rates of depressive disorder (25% vs 44%), as diagnosed by a PEC physician. There were no differences between groups on the questionnaires for posttraumatic stress disorder (PTSD), depression, or alcohol abuse. Nor were there differences in diagnoses of bipolar disorder, PTSD, anxiety disorder, schizophrenia/schizoaffective disorder, or alcohol abuse. Veterans seeking help from a VA-based urgent psychiatric care clinic often are burdened by substantial depression, alcohol use disorders, PTSD, and both past and present suicide risk.

  15. Center for Women Veterans

    Science.gov (United States)

    ... various organizations and individuals are doing to challenge perceptions about women Veterans. Learn more » #VeteranOfTheDay - Nominate a Veteran Today! Veteran of the Day has been a tradition on VA’s social media pages for more than two years now. This ...

  16. 2007 Veterans Employability Research Survey

    Data.gov (United States)

    Department of Veterans Affairs — The 2007 Veterans Employability Research Survey (VERS) was conducted to determine the factors that impact veterans' employability resulting from participation in the...

  17. Pittsburgh Student Veterans' Experience with Social Media in Higher Education

    Science.gov (United States)

    Marsilio, Kenneth

    2016-01-01

    This study sought to understand how student veteran's experienced using social media in the context of higher education. It also explored how they used it for peer bonding and how student veterans perceived the benefits of using social media. This was a qualitative research study that used a phenomenological approach to data collection and…

  18. 77 FR 64597 - Proposed Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf...

    Science.gov (United States)

    2012-10-22

    ... whether eradication of these bacteria reduces symptoms of chronic diarrhea. Affected Public: Individuals... AFFAIRS Proposed Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans (Irritable Bowel Syndrome--Diarrhea)) Activity: Comment Request AGENCY: Veterans Health...

  19. Honoring our Nation's Veterans

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-11-01

    Full Text Available No abstract available. Article truncated at 150 words. Today is Armistice Day, renamed Veterans Day in 1954, to honor our Nation's Veterans. In Washington the rhetoric from both the political right and left supports our Veterans. My cynical side reminds me that this might have something to do with Veterans voting in a higher percentage than the population as a whole, but let me give the politicians this one. Serving our Country in the military is something that deserves to be honored. I was proud to serve our Veterans over 30 years at the four Department of Veterans Affairs (VA hospitals. However, the VA has had a very bad year. First, in Washington there were the resignations of the Secretary of Veterans Affairs, Eric Shinseki; the undersecretary for the Veterans Health Administration, Robert Petzel; and the undersecretary for the Veterans Benefits Administration, Allison Hickey. Locally, in the light of the VA wait scandal there were the firing of ...

  20. The Health and Social Isolation of American Veterans Denied Veterans Affairs Disability Compensation.

    Science.gov (United States)

    Fried, Dennis Adrian; Passannante, Marian; Helmer, Drew; Holland, Bart K; Halperin, William E

    2017-02-01

    Authors comparatively analyzed health and social isolation between U.S. military veterans denied Veterans Affairs (VA) disability compensation and veterans awarded VA disability compensation. The 2001 National Survey of Veterans was used to create a sample of 4,522 veterans denied or awarded VA disability compensation. Using the Andersen health services utilization model as a conceptual framework, multivariate logistic regression was applied to assess relationships between VA disability compensation award status, three separate domains of health, and correlates of social isolation. Results indicate that denied applicants were more likely than those awarded to have poor overall health (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.23, 1.70), and limitations in activities of daily living (OR = 1.12, 95% CI: 1.03, 1.21). Denied applicants' physical functioning (40.3) and mental functioning (41.2) composite summary scores were not clinically different from those of awarded applicants (39.0 and 40.1, respectively), indicating that both were comparably impaired. Veterans denied VA disability compensation had poor health and functional impairments. They also experienced poverty and isolation, suggesting that they may be in need of additional supportive services. Connecting veterans to community resources could be a vital service to provide to all veterans applying for disability compensation. © 2016 National Association of Social Workers.

  1. Veterans and Homelessness

    National Research Council Canada - National Science Library

    Perl, Libby

    2007-01-01

    .... The Department of Veterans Affairs (VA) estimates that it has served approximately 300 returning veterans in its homeless programs and has identified over 1,000 more as being at risk of homelessness...

  2. Minority Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  3. Minority Veteran Report 2014

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  4. Paralyzed Veterans of America

    Science.gov (United States)

    ... Clothing Donate a Vehicle Matching Gifts Buy PVA Gear Donate Donate Now Give Monthly Planned Giving View ... PVA1946 National Veterans Wheelchair Games App Download Now TOP Contact Us Paralyzed Veterans of America 801 Eighteenth ...

  5. Master Veteran Index (MVI)

    Data.gov (United States)

    Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

  6. Perceived Stigma, Discrimination, and Disclosure of Sexual Orientation Among a Sample of Lesbian Veterans Receiving Care in the Department of Veterans Affairs.

    Science.gov (United States)

    Mattocks, Kristin M; Sullivan, J Cherry; Bertrand, Christina; Kinney, Rebecca L; Sherman, Michelle D; Gustason, Carolyn

    2015-06-01

    Many lesbian women experience stigma and discrimination from their healthcare providers as a result of their sexual orientation. Additionally, others avoid disclosure of their sexual orientation to their providers for fear of mistreatment. With the increasing number of lesbian, gay, bisexual, and transgender (LGBT) veterans seeking care from the Veterans Health Administration (VHA), it is important to understand lesbian veterans' experiences with stigma, discrimination, and disclosure of sexual orientation. This article examines lesbian veterans' experiences with perceived stigma and discrimination in VHA healthcare, their perspectives on disclosure of sexual orientation to VHA providers, and their recommendations for improvements in VHA healthcare to create a welcoming environment for lesbian veterans. This is a mixed methods study of twenty lesbian veterans at four VHA facilities. The women veterans participated in a one-hour interview and then completed an anonymous survey. Ten percent of lesbian veterans had experienced mistreatment from VHA staff or providers, but nearly 50% feared that their Veterans Affairs (VA) providers would mistreat them if they knew about their sexual orientation. A majority of lesbian veterans (70%) believed that VHA providers should never ask about sexual orientation or should only ask if the veteran wanted to discuss it. A majority (80%) believed the VHA had taken steps to create a welcoming environment for LBGT veterans. Though many lesbian veterans have fears of stigma and discrimination in the context of VHA care, few have experienced this. Most lesbian veterans believed the VHA was trying to create a welcoming environment for its LGBT veterans. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country.

  7. Alcohol Use and Trauma Exposure among Male and Female Veterans Before, During, and After Military Service

    Science.gov (United States)

    Kelley, Michelle L.; Runnals, Jennifer; Pearson, Matthew R.; Miller, Marinell; Fairbank, John A.; Brancu, Mira

    2017-01-01

    The present study examined lifespan and combat-related trauma exposure as predictors of alcohol use among male and female veterans. Posttraumatic stress and depressive symptoms were examined as mediators of the effects of trauma exposure on alcohol use. Data were examined from 1825 (1450 male, 375 female) veterans and active duty service members who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Centers (VISN 6 MIRECC). For both men and women, depressive symptoms significantly mediated the effects of non-combat trauma exposure experienced before, during and after the military, as well as combat- exposure, on alcohol use. With posttraumatic stress symptoms, the models for men and women differed. For men, the effects of non-combat trauma exposure during and after military service, and combat exposure, on alcohol use were mediated by PTSD symptoms; however, for women, PTSD symptoms did not mediate these relationships. Findings are discussed in the context of potential gender differences in response to trauma such as use of alcohol to cope with traumatic events. PMID:24054989

  8. The Role of Psychological Symptomatology and Social Support in the Academic Adjustment of Previously Deployed Student Veterans

    Science.gov (United States)

    Campbell, Robyn; Riggs, Shelley A.

    2015-01-01

    Context: Research has indicated that returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans are experiencing mental health concerns following deployment. Increasing numbers of veterans are enrolling in higher education institutions; there is a scarcity of empirical research investigating student veterans' experiences as…

  9. Health-related quality of life among individuals with long-standing spinal cord injury: a comparative study of veterans and non-veterans

    Directory of Open Access Journals (Sweden)

    Ghodsi Seyed

    2010-01-01

    Full Text Available Abstract Background Spinal cord-injured (SCI patients experience poor health-related quality of life (HRQOL and they usually report lower HRQOL than the general population or population subgroups in Iran and elsewhere. The aim of this study was to compare HRQOL between veterans and non-veterans with SCI in Iran. Methods This was a cross-sectional study. HRQOL was measured using the 36-item Short Form Health Survey (SF-36. Thirty-nine male veterans and 63 non-veteran males with SCI were included in the study. Regression analyses were applied to determine the variables affecting physical and mental health-related quality of life among the patients. Results The male veterans had a lower HRQOL than the non-veterans with SCI. The differences were significant for all measures except for physical and social functioning. The greatest difference was observed for bodily pain (P = 0.001. The regression analysis results indicated that a longer time since injury was associated (P = 0.01 with better physical health-related quality of life (PCS, while being a veteran (P Conclusion The study findings showed that veterans with SCI experienced lower HRQOL than their non-veteran counterparts. A qualitative study is recommended to evaluate why HRQOL was lower in veterans than in non-veterans with SCI although veterans had higher incomes as a result of their pensions and increased access to equipment, and medications. To improve quality of life in both veterans and non-veterans with spinal cord injuries, policy changes or implementation of new interventions may be essential so that veterans could receive additional support (e.g. counseling, recreation therapy, vocational therapy, etc. and non-veterans could meet their basic needs.

  10. National Coalition for Homeless Veterans

    Science.gov (United States)

    ... Continues Support of National Campaign to End Veteran Homelessness Nov. 14, 2017 This Veterans Day, Harbor Freight ... support of the national campaign to end veteran homelessness through generous contributions to the National Coalition for ...

  11. Korean War Veterans by State

    Data.gov (United States)

    Department of Veterans Affairs — The spreadsheet of Korean War Veterans by State includes the total Korean War Veteran population for each state and broken out by age and gender. It also includes...

  12. Veterans Administration Databases

    Science.gov (United States)

    The Veterans Administration Information Resource Center provides database and informatics experts, customer service, expert advice, information products, and web technology to VA researchers and others.

  13. Arthritis and Veterans

    Centers for Disease Control (CDC) Podcasts

    2015-11-09

    One in three veterans has arthritis. This podcast provides information on how veterans can improve their quality of life with physical activity and other arthritis management strategies.  Created: 11/9/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/9/2015.

  14. 78 FR 6404 - Agency Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf...

    Science.gov (United States)

    2013-01-30

    ... whether eradication of these bacteria reduces symptoms of chronic diarrhea. An agency may not conduct or... AFFAIRS Agency Information Collection (Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans....'' SUPPLEMENTAL INFORMATION: Titles: a. Survey of Chronic Gastrointestinal Illness in Persian Gulf Veterans, VA...

  15. Sculpting the Illness Experience

    Directory of Open Access Journals (Sweden)

    Molly Bathje MS, OTR/L

    2014-10-01

    Full Text Available Otto Kamensek provided the cover art for the Fall 2014 issue of the Open Journal of Occupational Therapy. “Glimmer of Hope” is part of Otto’s collection “Shard’s, Bone Deep,” which includes hand-built ceramic sculptures that portray his experiences with a lifelong chronic illness. Engaging in ceramic sculpture helps him process the experiences associated with Juvenile Rheumatoid Arthritis and provides a means to support others experiencing chronic illness.

  16. Differential impact of combat on postdeployment symptoms in female and male veterans of iraq and afghanistan.

    Science.gov (United States)

    Afari, Niloofar; Pittman, James; Floto, Elizabeth; Owen, Laura; Buttner, Melissa; Hossain, Nazia; Baker, Dewleen G; Lindamer, Laurie; Lohr, James B

    2015-03-01

    We aimed to describe differences in combat experience for male and female veterans and characterize differential effects on postdeployment physical and mental health symptoms, including aggression. Retrospective cross-sectional health screening data from 554 Operation Enduring Freedom and Operation Iraqi Freedom veterans who enrolled for Veterans Affairs health care in San Diego were examined including measures of combat experience, pain intensity, traumatic brain injury symptoms, military sexual trauma, post-traumatic stress disorder, depression, alcohol use, and aggression. Although male veterans (n = 458) experienced significantly higher rates of combat than female veterans (n = 96), both experienced similar levels of postdeployment post-traumatic stress disorder and depression symptoms as well self-reported aggressive behavior compared to male veterans. Female veterans had higher rates of military sexual trauma and lower alcohol consumption than male veterans. All Operation Enduring Freedom and Operation Iraqi Freedom veterans returning from deployment may benefit from broad-based screening of physical and mental health symptoms, beyond those currently mandated by Veterans Affairs, including anger and aggression. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  17. Veterans Affairs Suicide Prevention Synthetic Dataset

    Data.gov (United States)

    Department of Veterans Affairs — The VA's Veteran Health Administration, in support of the Open Data Initiative, is providing the Veterans Affairs Suicide Prevention Synthetic Dataset (VASPSD). The...

  18. Stopping the Brain Drain of Skilled Veteran Teachers: Retaining and Valuing Their Hard-Won Experience

    Science.gov (United States)

    Fibkins, William L.

    2011-01-01

    Veteran educators are being encouraged to take early retirement in order to create jobs for less-experienced, lower-paid novices. Veteran educators are not alone: early retirement promotions have become the norm for aging workers in America. Consequently, there is a brain-drain of skilled workers at the national, state, and local levels. The early…

  19. Foodborne Illness

    Science.gov (United States)

    ... as a high amount of pesticides. Symptoms of foodborne illness depend on the cause. They can be mild ... can help prevent foodborne illnesses. Most people with foodborne illness get better on their own. It is important ...

  20. Veterans’ Disability Compensation: Trends and Policy Options

    Science.gov (United States)

    2014-08-01

    disabling, such as a small scar, mild anxiety , or a minor limitation in the motion of a thumb. A veteran with a composite rating of zero does not...unexplained, chronic, multiple-symptom illnesses (such as chronic fatigue syndrome, fibromyalgia , and irritable bowel syndrome) are now presumptive conditions

  1. veteran athletes exercise at higher maximum heart rates than

    African Journals Online (AJOL)

    Maximal HR in veteran athletes during specific sporting activities was significantly higher than that attained ... false-positive results due to the athletic heart syndrome have been described,13 it is accepted that a positive test is a risk .... group (210 (21) v. 185. (18) mmHg, P < 0.05, Table ill). Exercise time to fatigue in the. lID I ...

  2. Veterans Health Administration (VHA)

    Data.gov (United States)

    Social Security Administration — The purpose of this agreement is for SSA to verify SSNs and other identifying information for the Department of Veterans Affairs, VHA. DVA will use the information...

  3. Veterans Choice Program

    Data.gov (United States)

    Department of Veterans Affairs — If you are already enrolled in VA health care, the Choice Program allows you to receive health care within your community. Using this program does NOT impact your...

  4. Rooted in the Community: Assessing the Reintegration Effects of Agriculture on Rural Veterans.

    Science.gov (United States)

    Besterman-Dahan, Karen; Chavez, Margeaux; Njoh, Eni

    2018-02-01

    To assess the effect of a veteran-oriented community agricultural initiative on transitioning rural veterans. Convergent mixed-method program evaluation. Veteran-oriented farm-to-market community agricultural initiative. Veterans (N=43) who were members of the community agricultural initiative. Health, well-being, and reintegration were assessed by self-reported data from interviews, a demographic survey, a validated health quality of life measure (Veterans RAND-12 [VR-12]), a validated reintegration measure (Military to Civilian Questionnaire), and a general satisfaction survey. Veteran participants were primarily white (88.4%, n=38) and men (74.4%, n=32), and most had a service-connected disability rating (58.2%, n=25). Qualitative and quantitative data revealed that the veterans participating in this community agricultural initiative experienced health and reintegration benefits. Results on the Military to Civilian Questionnaire, VR-12, and satisfaction survey suggest that participating in this community agricultural initiative contributed to improved mental, physical, and emotional health and vocational skills, community connectedness, and interpersonal communication. Qualitative interviews supported quantitative findings and revealed that participating in the community agricultural initiative provided veterans with a sense of satisfaction, a sense of belonging, and helped decrease the stigma surrounding their veteran status. Veterans who participate in this community agricultural initiative reported general improvements in physical and mental health, including improvements in sleep, nutrition, and exercise, and decreases in anxiety, pain, depression, and medication and substance use, all known factors which effect veteran reintegration. Copyright © 2017. Published by Elsevier Inc.

  5. Increased Mortality Among Older Veterans Admitted to VA Homelessness Programs.

    Science.gov (United States)

    Schinka, John A; Bossarte, Robert M; Curtiss, Glenn; Lapcevic, William A; Casey, Roger J

    2016-04-01

    National Death Index data were examined to describe mortality patterns among older veterans who are homeless. Homelessness and health care records from the U.S. Department of Veterans Affairs were used to identify old (ages 55-59) and older (ages ≥60) veterans who were (N=4,475) or were not (N=20,071) homeless. Survival functions and causes of death of the two samples over an 11-year follow-up period were compared. Substantially more veterans who were homeless (34.9%) died compared with the control sample (18.2%). Veterans who were homeless were approximately 2.5 years younger at time of death compared with the control sample. Older veterans who were homeless had the lowest survival rate (58%). No disease category appeared to be critical in reducing survival time. Suicide was twice as frequent in the homeless (.4%) versus the control (.2%) sample. Older veterans who were homeless experienced excess mortality and increased suicide risk.

  6. Deserving Veterans' Disability Compensation: A Qualitative Study of Veterans' Perceptions.

    Science.gov (United States)

    MacGregor, Casey; Heilemann, MarySue V

    2017-05-01

    Veterans recently returned from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) experience many health and mental health problems after deployment. These OEF/OIF veterans are applying and appealing for veterans' disability compensation (VDC) at rapidly increasing rates, often for "invisible conditions" such as posttraumatic stress disorder. Little is known about how veterans experience the process of applying and receiving VDC. In-depth qualitative interviews were conducted with OEF/OIF veterans ages 35 and younger (N = 18). This article addresses how veterans perceive themselves, and other veterans, of being deserving and undeserving of VDC. Veterans' rationales can be categorized into four primary areas: (1) risking and suffering, (2) the cause of the condition, (3) intentions to become self-sufficient, and (4) putting VDC to "good use." © 2017 National Association of Social Workers.

  7. Male partner reproductive coercion among women veterans.

    Science.gov (United States)

    Rosenfeld, Elian A; Miller, Elizabeth; Zhao, Xinhua; Sileanu, Florentina E; Mor, Maria K; Borrero, Sonya

    2017-10-19

    Male partner reproductive coercion is defined as male partners' attempts to promote pregnancy through interference with women's contraceptive behaviors and reproductive decision-making. Male partners may try to promote pregnancy through birth control sabotage such as taking away or destroying their partners' contraceptives, refusing to wear condoms, and/or verbally pressuring their partners to abstain from contraceptive use. Reproductive coercion is associated with an elevated risk for unintended pregnancy. Women who experience intimate partner violence, who are in racial/ethnic minorities, and who are of lower socioeconomic status are more likely to experience reproductive coercion. Women veterans who use Veterans Affairs for health care may be particularly vulnerable to reproductive coercion because they are disproportionally from racial/ethnic minority groups and experience high rates of intimate partner violence. We sought to examine the prevalence, correlates, and impact of reproductive coercion among women veterans who are served by the Veterans Affairs healthcare system. We analyzed data from a national telephone survey of women veterans aged 18-44 years, with no history of sterilization or hysterectomy, who had received care within the Veterans Affairs system in the previous 12 months. Participants who had sex with men in the last year were asked if they experienced male partner reproductive coercion. Adjusted logistic regression was used to examine the relationship between participant characteristics and male partner reproductive coercion and the relationship between reproductive coercion and the outcomes of contraceptive method used at last sex and pregnancy and unintended pregnancy in the last year. Among the 1241 women veterans in our study cohort, 11% reported experiencing male partner reproductive coercion in the past year. Black women, younger women, and single women were more likely to report reproductive coercion than their white, older, and

  8. Rural Veterans by State (2014)

    Data.gov (United States)

    Department of Veterans Affairs — This speadsheet contains data from the 2014 American Community Survey and shows the demographic and socioeconomic characteristics of Veterans who live in rural and...

  9. The Veteran Population Projection 2014

    Data.gov (United States)

    Department of Veterans Affairs — VetPop2014 is an actuarial projection model developed by the Office of the Actuary (OACT) for Veteran population projection from Fiscal Year FY2014 to FY2043. Using...

  10. Veteran Religious Affiliation by State

    Data.gov (United States)

    Department of Veterans Affairs — This dataset provide a count of Veteran by their religious affiliation and state of residence. The dataset set covers all 50 states, District of Columbia and other...

  11. Rural Veterans by State (2015)

    Data.gov (United States)

    Department of Veterans Affairs — This spreadsheet contains data from the 2015 American Community Survey and shows the demographic and socioeconomic characteristics of Veterans who live in rural and...

  12. VA Is Here for the People Who Support Our Veterans

    Science.gov (United States)

    ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of ... word about the Veterans Crisis Line. Access confidential Homeless Veterans Chat and see resources for homeless Veterans . Network ...

  13. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of ...

  14. Veteran Parents in Child Protective Services: Theory and Implementation

    Science.gov (United States)

    Nilsen, Wendy J.; Affronti, Melissa L.; Coombes, Margaret L.

    2009-01-01

    "Veteran parents" (VPs), or parents who have experienced challenges concerning their children's health and then mentor other families through similar situations, are widely used for parent support. This model has been adopted by Child Protective Services (CPS) to increase parent engagement. Here, we expand the theoretical discussion of VPs in CPS…

  15. Health Care for Homeless Veterans program. Final rule.

    Science.gov (United States)

    2015-05-01

    The Department of Veterans Affairs (VA) amends its medical regulations concerning eligibility for the Health Care for Homeless Veterans (HCHV) program. The HCHV program provides per diem payments to non-VA community-based facilities that provide housing, outreach services, case management services, and rehabilitative services, and may provide care and/or treatment to homeless veterans who are enrolled in or eligible for VA health care. The rule modifies VA's HCHV regulations to conform to changes enacted in the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012. Specifically, the rule removes the requirement that homeless veterans be diagnosed with a serious mental illness or substance use disorder to qualify for the HCHV program. This change makes the program available to all homeless veterans who are enrolled in or eligible for VA health care. The rule also updates the definition of homeless to match in part the one used by the Department of Housing and Urban Development (HUD). The rule further clarifies that the services provided by the HCHV program through non-VA community-based providers must include case management services, including non-clinical case management, as appropriate.

  16. Psychosocial Equine Program for Veterans.

    Science.gov (United States)

    Ferruolo, David M

    2016-01-01

    Nearly half of all combat veterans suffer from serious psychological disorders and reintegration issues. Veterans shy away from typical talk therapy and are seeking alternative treatments. Equine-facilitated mental health therapy has shown promise in treating veterans with depressive and anxiety disorders and reintegration issues. This article reports on an institutional review board-approved pilot program designed to address the mental health needs of veterans. Furthermore, this article discusses future directions for evolving development of equine treatment programming.

  17. Health risk factors and differences in outcomes between younger and older veterans using VA transitional housing.

    Science.gov (United States)

    Brown, Lisa M; Barnett, Scott D; Frahm, Kathryn A; Schinka, John A; Schonfeld, Lawrence; Casey, Roger J

    2015-01-01

    This study examined age-related differences in general medical and mental health risk factors for veterans participating in the U.S. Department of Veterans Affairs (VA) Grant Per Diem (GPD) transitional supportive housing program. The subpopulation of older homeless veterans is growing, and little is known about the implications of this fact for health care providers and for supportive programs intended to meet homeless veterans' needs. Data were obtained from the VA records of all veterans (N=40,820) who used the GPD program during fiscal years 2003 to 2009. Unconditional adjusted and unadjusted odds ratios for general medical and psychiatric characteristics were calculated and were the primary study focus. Significant predictors of homeless program completion assessed from univariate models were then evaluated in multivariate models. Younger (homeless veterans reported an equal number of days homeless before enrollment. Younger veterans averaged 19 fewer days in GPD. Older veterans had more general medical problems and approximately $500 more in program costs. Findings from this study indicate that older homeless veterans are at increased risk of serious medical problems. This group is especially vulnerable to experiencing negative consequences related to homelessness. Addressing these complex needs will allow the VA to provide enhanced care to older homeless veterans.

  18. Mixed methods study examining work reintegration experiences from perspectives of Veterans with mental health disorders.

    Science.gov (United States)

    Kukla, Marina; Rattray, Nicholas A; Salyers, Michelle P

    2015-01-01

    Recent findings have demonstrated that reintegration for Veterans is often challenging. One difficult aspect of reintegration—transitioning into the civilian workplace—has not been fully explored in the literature. To address this gap and examine work reintegration, this mixed methods study examined the perspectives of Veterans with mental health disorders receiving Department of Veterans Affairs healthcare. Forty Veterans rated factors that affect work success; participants also provided narratives on their most and least successful work experiences. We used t-tests and qualitative analysis to compare participants who did and did not serve in combat. Several themes relevant to work reintegration emerged in the narratives, particularly for Veterans who served in combat. An array of work difficulties were reported in the months following military discharge. In addition, Veterans who served in combat reported significantly more work barriers than Veterans who did not serve in combat, particularly health-related barriers. In conclusion, Veterans with mental health disorders who served in combat experienced more work reintegration difficulty than their counterparts who did not serve in combat. The role of being a Veteran affected how combat Veterans formed their self-concept, which also shaped their work success and community reintegration, especially during the early transition period.

  19. The war veteran identity

    Directory of Open Access Journals (Sweden)

    Marković-Savić Olivera S.

    2015-01-01

    Full Text Available The paper discusses how war veterans perceive themselves and how they answer the question 'Who am I?'. War veterans face many challenges in the process of re-socialization from a state of war and war traumatization to a peacetime society. There are several reasons why their re-socialization is a slow process: the first one is that a war engagement is in itself a highly stressful situation which carries traumas of different degrees, the other reason is the changed system of values in relation to war engagement. Namely, at the time they went to war, they had a strong social support, but at the time of their return and today this support is lost to the point of judgment. And the third reason which limits their re-socialization is the situation of social transition they found on their return from war, which specifically means that a large percentage of the population in general, and thus the war veterans after returning from the war, lost their jobs, creating a large social group of 'transition losers'. Such a condition often generates an identity crisis. This set of socio-cultural circumstances together with the ontological insecurity carried by war trauma generate an identity crisis, which is manifested among the respondents in nihilistic answers when responding to questions about their own personality. Studying the identity of war veterans, it was found that a strong attachment to the veteran identity is dominant. In fact, this paper discusses the different ways in which this attachment is refracted in the personality and identity of subjects, from negative attitudes to the pride in belonging to a group of war veterans and personal fulfillment in the activism in associations of war participants.

  20. Mental Illness

    Science.gov (United States)

    ... leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include: Unhappiness and decreased enjoyment of life ...

  1. Lifetime Sexual Assault and Sexually Transmitted Infections Among Women Veterans.

    Science.gov (United States)

    Goyal, Vinita; Mengeling, Michelle A; Booth, Brenda M; Torner, James C; Syrop, Craig H; Sadler, Anne G

    2017-07-01

    Women veterans report a high prevalence of sexual assault. Unfortunately, there are limited data on the reproductive health sequelae faced by these women. Our objective was to evaluate the association between completed lifetime sexual assault (LSA) and sexually transmitted infections (STIs) among a cohort of women veterans, adjusting for sexual risk behaviors. We conducted a retrospective study among women veterans aged 51 years or younger who enrolled for care at two Veterans Administration (VA) healthcare sites between 2000 and 2008. Participants completed a telephone interview assessing reproductive health and sexual violence history. We compared the frequencies of past STI diagnoses among those who had and had not experienced LSA. We used logistic regression to assess the effect of sexual assault with history of an STI diagnosis after adjusting for age, sexual risk behaviors, and substance abuse treatment. Among 996 women veterans, a history of STIs was reported by 32%, including a lifetime history of gonorrhea (5%), chlamydia (15%), genital herpes infection (8%), and human papillomavirus infection (15%), not mutually exclusive; 51% reported LSA. Women with a history of LSA were significantly more likely to report a history of STIs (unadjusted odds ratio [OR] 1.91, 95% confidence interval [CI] 1.45-2.50; adjusted OR 1.49, 95% CI 1.07-2.08). Women veterans who have experienced LSA are at increased risk for lifetime STI diagnoses. To adequately address the reproductive health needs of the growing population of women veterans, STI risk assessments should include queries of military service and LSA histories.

  2. Quality of relationship between veterans with traumatic brain injury and their family members.

    Science.gov (United States)

    Winter, Laraine; Moriarty, Helene J

    2017-01-01

    The quality of the relationship between patients with many illnesses and their family members has been shown to affect the well-being of both. Yet, relationship quality has not been studied in traumatic brain injury (TBI), and giving and receiving aspects have not been distinguished. The present study of veterans with TBI examined associations between relationship quality and caregiver burden, satisfaction with caregiving, and veterans' competence in interpersonal functioning, rated by veterans and family members. In this cross-sectional study, 83 veterans and their family members were interviewed at home. Measures of quality of relationship, veterans' interpersonal competence and sociodemographics were collected for both, caregiver burden and satisfaction for family members only. As predicted, veteran-rated Qrel/Giving was associated with family-rated Qrel/Receiving, and veteran-rated Qrel/Receiving with family-rated Qrel/Giving. Lower caregiver burden and higher caregiving satisfaction were associated with higher Qrel/Receiving scores but not with Qrel/Giving scores. Veterans' interpersonal competence was associated with total Qrel as rated by either veterans or family members. Relationship quality should be included in family research in TBI, and giving and receiving aspects should be differentiated. Findings suggest that lower caregiver burden and greater satisfaction should be more achievable by increasing caregivers' sense of benefits received from the relationship.

  3. Experiences of mental illness stigma, prejudice and discrimination: a review of measures

    National Research Council Canada - National Science Library

    Brohan, Elaine; Slade, Mike; Clement, Sarah; Thornicroft, Graham

    2010-01-01

    .... This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness...

  4. Characteristics and Use of Services Among Literally Homeless and Unstably Housed U.S. Veterans With Custody of Minor Children.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; Kane, Vincent

    2015-10-01

    The study examined the number of homeless veterans with minor children in their custody ("children in custody"), compared sociodemographic and clinical characteristics among homeless veterans with and without children in custody, and observed differences in referral and admission patterns among veterans with and without children in custody for a variety of U.S. Department of Veterans Affairs (VA) programs for homeless veterans. Data were obtained from the VA Homeless Operations Management and Evaluation System for 89,142 literally homeless and unstably housed veterans. Sociodemographic, housing, health, and psychosocial characteristics of veterans were analyzed. Among literally homeless veterans, 9% of men and 30% of women had children in custody; among unstably housed veterans, 18% of men and 45% of women had children in custody. Both male and female veterans with children in custody were younger and less likely to have chronic general medical conditions and psychiatric disorders compared with other veterans, but, notably, 11% of homeless veterans with children in custody had psychotic disorders. Veterans with children in custody were more likely than other veterans to be referred and admitted to the VA's permanent supported housing program, and women were more likely than men to be admitted to the program. A substantial proportion of homeless veterans served by the VA have severe mental illness and children in custody, which raises concerns about the parenting environment for their children. Particular focus should be directed at VA's supported-housing program, and the practical and ethical implications of serving homeless parents and their children need to be considered.

  5. Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study.

    Science.gov (United States)

    Brown, George R; Jones, Kenneth T

    2016-04-01

    There are no large controlled studies of health disparities in transgender (TG) or gender dysphoric patients. The Veterans Health Administration (VHA) is the largest healthcare system in the United States and was an early adopter of electronic health records. We sought to determine whether medical and/or mental health disparities exist in VHA for clinically diagnosed TG veterans compared to matched veterans without a clinical diagnosis consistent with TG status. Using four ICD-9-CM codes consistent with TG identification, a cohort of 5135 TG veterans treated in VHA between 1996 and 2013 was identified. Veterans without one of these diagnoses were matched 1:3 in a case-control design to determine if medical and/or mental health disparities exist in the TG veteran population. In 2013, the prevalence of TG veterans with a qualifying clinical diagnosis was 58/100,000 patients. Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups. This is the first study to examine a large cohort of clinically diagnosed TG patients for psychiatric and medical health outcome disparities using longitudinal, retrospective medical chart data with a matched control group. TG veterans were found to have global disparities in psychiatric and medical diagnoses compared to matched non-TG veterans. These findings have significant implications for policy, healthcare screening, and service delivery in VHA and potentially other healthcare systems.

  6. National Cemetery Administration Summary of Veteran and Non-Veteran Interments: FY2000 to FY2012

    Data.gov (United States)

    Department of Veterans Affairs — Total Veteran and Non-Veteran Interments at National Cemetery, and shown by Interment Type of Casket or Cremain, FY2000 to FY2012. Non-Veteran includes dependents,...

  7. Factors associated with receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.

    Science.gov (United States)

    Chen, Joyce H; Rosenheck, Robert A; Greenberg, Greg A; Seibyl, Catherine

    2007-03-01

    Public support payments may facilitate exit from homelessness for persons with mental illness. We examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits. Those who were awarded benefits (22% of contacted veterans) were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past. Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort.

  8. Development and Validation of an Instrument to Assess Imminent Risk of Homelessness Among Veterans

    Science.gov (United States)

    Fargo, Jamison D.; Kane, Vincent; Culhane, Dennis P.

    2014-01-01

    Objectives Veterans are overrepresented within the homeless population compared with their non-veteran counterparts, particularly when controlling for poverty. The U.S. Department of Veterans Affairs (VA) aims to prevent new episodes of homelessness by targeting households at greatest risk; however, there are no instruments that systematically assess veterans' risk of homelessness. We developed and tested a brief screening instrument to identify imminent risk of homelessness among veterans accessing VA health care. Methods The study team developed initial assessment items, conducted cognitive interviews with veterans experiencing homelessness, refined pilot items based on veterans' and experts' feedback and results of psychometric analyses, and assigned weights to items in the final instrument to indicate a measure of homelessness risk. Results One-third of veterans who responded to the field instrument reported imminent risk of homelessness (i.e., housing instability in the previous 90 days or expected in the next 90 days). The reliability coefficient for the instrument was 0.85, indicating good internal consistency. Veterans who had a recent change in income, had unpaid housing expenses, were living temporarily with family and friends, needed help to get or keep housing, and had poor rental and credit histories were more likely to report a risk of homelessness than those who did not. Conclusion This study provides the field with an instrument to identify individuals and households at risk of or experiencing homelessness, which is necessary to prevent and end homelessness. In addition, it supports VA's investment in homelessness prevention and rapid rehousing services for veterans who are experiencing or are at risk for homelessness. PMID:25177054

  9. A Home-Based Palliative Care Consult Service for Veterans.

    Science.gov (United States)

    Golden, Adam G; Antoni, Charles; Gammonley, Denise

    2016-11-01

    We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians. © The Author(s) 2015.

  10. Are you experienced?

    DEFF Research Database (Denmark)

    Dahl, Michael Slavensky; Reichstein, Toke

    . We also find that spin-offs from parent companies that exit are less likely to survive than either spin-offs from surviving parents or other start-ups. These findings support the theoretical arguments that organizational heritage is important for the survival of new organizations. We found no similar...... ranked members of start-ups prior to their founding, and follow the fate of these firms. More specifically, we compare the survival of spin-offs from surviving parents, spin-offs from exiting parents, and other start-ups. Moreover, we investigate whether firms managed and founded by more experienced...... teams with higher levels of industry-specific experience are more likely to survive. Distinguishing between survivors and firms that have been acquired, we find that spin-offs from a surviving parent company combined with and industry-specific experience, positively affects the likelihood of survival...

  11. Services utilization among recently homeless veterans: a gender-based comparison.

    Science.gov (United States)

    Montgomery, Ann Elizabeth; Byrne, Thomas H

    2014-03-01

    As women emerge as a significant segment of the Veteran population, there is a need to understand how they enter the homeless system, the impact of homelessness on healthcare, and how this varies by gender. This study provides a gender-based comparison of Veterans' utilization of U.S. Department of Veterans Affairs (VA) health and behavioral health services following the onset of a homeless episode and assesses the relationship between services utilization and Veterans' entry into the homeless system. Male and female veterans were equally as likely to use mainstream and VA homeless services. There were few differences between genders in inpatient services use following a homeless episode. Men used more substance abuse outpatient treatment and emergency services whereas women used outpatient medical treatment. Veterans who sought non-VA homeless services were less likely to use outpatient services but more likely to access emergency services. Veterans experiencing homelessness who do not use VA homeless assistance services are less engaged with preventative VA health and behavioral healthcare. Veterans who are homeless but not identified as such by VA, particularly women, need additional engagement. Ongoing study of gender-based differences in services utilization among homeless and at-risk Veterans is needed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  12. Using Motivational Enhancement among OIF / OEF Veterans Returning to the Community

    Science.gov (United States)

    2015-12-25

    untreated mental illness can lead to many negative consequences and the stigmas associated with mental health use, veterans’ engagement and retention in...WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Detroit Wayne Mental Health Authority 640 Temple, 8th Floor Detroit, Michigan...motivational enhancement (ME) intervention to address barriers to engaging in mental health treatment for recently returned veterans of Operation Iraqi

  13. Veteran exposure to suicide: Prevalence and correlates.

    Science.gov (United States)

    Cerel, Julie; van de Venne, Judy G; Moore, Melinda M; Maple, Myfanwy J; Flaherty, Chris; Brown, Margaret M

    2015-07-01

    The aim of this study was to determine rates and consequences of suicide exposure in a veteran population and variables related to psychiatric morbidity. 931 veterans from a random digit dial survey conducted July 2012-June 2013 in the Commonwealth of Kentucky was utilized to examine associations between suicide exposure and depression and anxiety. For those with lifetime suicide exposure, perceptions of closeness to the decedent and additional traumatic death exposure were also examined. Almost half of veterans (47.1%, n=434) reported lifetime exposure to suicide. Suicide-exposed individuals were almost twice as likely to have diagnosable depression (OR=1.92, CI=1.31-2.8) and more than twice as likely to have diagnosable anxiety (OR=2.37, CI=1.55-3.61). Suicide-exposed were also more likely than non-exposed to report suicide ideation (9.9% vs. 4.3%). Perceived closeness to decedent increased the odds of depression (OR=1.38, CI=1.12-1.69), anxiety (OR=1.51, CI=1.21-1.89) and PTSD (OR=1.65, CI=1.27-2.16) and more than doubled the odds of Prolonged Grief (OR=2.47, CI=1.60-3.83). A model examined time sequence of suicide and traumatic death exposure. Experiencing a suicide exposure first and subsequent traumatic death exposure in their military career almost quadrupled the odds of suicide ideation (OR=3.56, p=.01, CI=1.34-9.46). Major study limitations include use of only one US state and random digit dial response rate. Suicide exposure confers psychiatric risks in veterans. Perceptions of closeness to decedents, which may extend beyond familial lines, may heighten these risks in the suicide exposed. Multiple exposures to suicide and traumatic death may lead to significant suicide risk. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Agent Orange exposure and attributed health effects in Vietnam veterans.

    Science.gov (United States)

    Young, Alvin L; Cecil, Paul F

    2011-07-01

    Serum dioxin studies of Vietnam (VN) veterans, military historical records of tactical herbicide use in Vietnam, and the compelling evidence of the photodegradation of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and other aspects of environmental fate and low bioavailability of TCDD are consistent with few, if any, ground troop veterans being exposed to Agent Orange. That conclusion, however, is contrary to the presumption by the Department of Veterans Affairs (DVA) that military service in Vietnam anytime from January 9, 1962 to May 7, 1975 is a proxy for exposure to Agent Orange. The DVA assumption is inconsistent with the scientific principles governing determinations of disease causation. The DVA has nonetheless awarded Agent Orange-related benefits and compensation to an increasing number of VN veterans based on the presumption of exposure and the published findings of the Institute of Medicine that there is sufficient evidence of a "statistical association" (a less stringent standard than "causal relationship") between exposure to tactical herbicides or TCDD and 15 different human diseases. A fairer and more valid approach for VN veterans would have been to enact a program of "Vietnam experience" benefits for those seriously ill, rather than benefits based on the dubious premise of injuries caused by Agent Orange.

  15. The Challenges of Afghanistan and Iraq Veterans' Transition from Military to Civilian Life and Approaches to Reconnection.

    Science.gov (United States)

    Ahern, Jennifer; Worthen, Miranda; Masters, Jackson; Lippman, Sheri A; Ozer, Emily J; Moos, Rudolf

    2015-01-01

    Afghanistan and Iraq veterans experienced traumas during deployment, and disrupted connections with friends and family. In this context, it is critical to understand the nature of veterans' transition to civilian life, the challenges navigated, and approaches to reconnection. We investigated these issues in a qualitative study, framed by homecoming theory, that comprised in-depth interviews with 24 veterans. Using an inductive thematic analysis approach, we developed three overarching themes. Military as family explored how many veterans experienced the military environment as a "family" that took care of them and provided structure. Normal is alien encompassed many veterans experiences of disconnection from people at home, lack of support from institutions, lack of structure, and loss of purpose upon return to civilian life. Searching for a new normal included strategies and supports veterans found to reconnect in the face of these challenges. A veteran who had successfully transitioned and provided support and advice as a peer navigator was frequently discussed as a key resource. A minority of respondents-those who were mistreated by the military system, women veterans, and veterans recovering from substance abuse problems-were less able to access peer support. Other reconnection strategies included becoming an ambassador to the military experience, and knowing transition challenges would ease with time. Results were consistent with and are discussed in the context of homecoming theory and social climate theory. Social support is known to be protective for veterans, but our findings add the nuance of substantial obstacles veterans face in locating and accessing support, due to disconnection and unsupportive institutions. Larger scale work is needed to better understand how to foster peer connection, build reconnection with family, and engage the broader community to understand and support veterans; interventions to support reconnection for veterans should be

  16. A Taxonomy of medical comorbidity for veterans who are homeless.

    Science.gov (United States)

    Goldstein, Gerald; Luther, James F; Jacoby, Aaron M; Haas, Gretchen L; Gordon, Adam J

    2008-08-01

    Homeless veterans have numerous medical and behavioral health problems. Grouping homeless people based on comorbidity patterns may assist in determining severity of illness and triaging health care more effectively. We sought to determine if a finite number of profiles could be identified related to demographic characteristics, living situation, length of homelessness, and referral areas using interview data from 2,733 veterans who were presently or recently homeless. We considered 12 disorders: eye problems, hypertension, cardiovascular problems, COPD/emphysema, tuberculosis, gastrointestinal problems, hepatic disease, neurologic disorders, orthopedic problems, skin problems, and trauma. Ratings were evaluated using cluster analysis. Comparison statistics were used to compare intercluster differences in demographics, homeless situation, and referral recommendations. A four-cluster solution is proposed: generalized illness, hepatic disease, lung disease, and neurologic disorder. Medical health problems are common and heterogeneous in homeless individuals. Classifications of these problems may be useful in planning treatment and predicting outcome.

  17. 2001 National Survey of Veterans (NSV)

    Data.gov (United States)

    Department of Veterans Affairs — The 2001 National Survey of Veterans (NSV) is the fifth in a series of comprehensivenationwide surveys designed to help the Department of Veterans Affairs (VA) plan...

  18. Profile of Vietnam War Veterans (2015).

    Data.gov (United States)

    Department of Veterans Affairs — The Profile of Vietnam War Veterans uses the 2015 ACS to provide a view into the demographic characteristics and socioeconomic conditions of the Vietnam War Veteran...

  19. 2015 Veteran Economic Opportunity Report

    Science.gov (United States)

    2015-01-01

    and data analysis to the VBA and stakeholders. PA&I developed the VBA Enterprise Data Warehouse to enable the generation of recurring and ad hoc...reports in response to VBA decision-making and business needs. PA&I will be a primary source of information on Veteran education, vocational...Servicemembers UI Unemployment Insurance URL Uniform Resource Locator USB Under Secretary for Benefits VA Department of Veterans Affairs VBA Veterans

  20. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... About About the Veterans Crisis Line FAQs Veteran Suicide Spread the Word Videos Homeless Resources Additional Information ... About About the Veterans Crisis Line FAQs Veteran Suicide The Veterans Crisis Line text-messaging service does ...

  1. Induced abortion among women veterans: data from the ECUUN study.

    Science.gov (United States)

    Schwarz, Eleanor Bimla; Sileanu, Florentina E; Zhao, Xinhua; Mor, Maria K; Callegari, Lisa S; Borrero, Sonya

    2018-01-01

    We compared rates of induced abortion among women veterans receiving Veterans Affairs (VA) healthcare to rates in the general US population, as current policy prohibits VA provision of abortion counseling or services even when pregnancy endangers a veteran's life. We analyzed data from 2298 women veterans younger than 45 years who completed a telephone-based, cross-sectional survey of randomly sampled English-speaking women from across the United States who had received VA healthcare. We compared lifetime, last-5-year and last-year rates of unintended pregnancy and abortion among participants to age-matched data from the National Survey of Family Growth. As few abortions were reported in the last year, we used multivariable logistic regression to examine associations between abortion in the last 5 years and age, race/ethnicity, income, education, religion, marital status, parity, geography, deployment history, housing instability, and past medical and mental health among VA patients. Women veterans were more likely than matched US women to report ever having an abortion [17.7%, 95% confidence interval (CI): 16.1%-19.3% vs. 15.2% of US women]. In the last 5 years, unintended pregnancy and abortion were reported by veterans at rates similar to US women. In multivariable models, VA patients were more likely to report abortion in the last 5 years if their annual income was less than $40,000 (adjusted odds ratio (OR) 2.95, 95% CI 1.30-6.70), they had experienced homelessness or housing instability (adjusted OR 1.91, 95% CI 1.01-3.62), they were single (adj. OR 2.46, 95% CI 1.23-4.91) and/or they had given birth (adjusted OR 2.29, 95% CI 1.19-4.40). Women veterans face unintended pregnancy and seek abortion as often as the larger US population. The Veterans Health Care Act, which prohibits provision of abortion services, increases vulnerable veterans' out-of-pocket healthcare costs and limits veterans' reproductive freedom. Copyright © 2017. Published by Elsevier Inc.

  2. Parental uncertainty in illness: managing uncertainty surrounding an "orphan" illness.

    Science.gov (United States)

    Kerr, Anna M; Haas, Stephen M

    2014-01-01

    Parents of children with complex chronic illnesses experience substantial uncertainty that is heightened when the condition is an "orphan" illness not belonging to one medical specialty. The current study explores uncertainty experienced by parents of children with "orphan" illnesses requiring multidisciplinary care. Participant-observations over 13 months (n=200) were combined with questionnaire data (n=55) to assess parental uncertainty at a multidisciplinary pediatric clinic. Five unique types of uncertainty emerged from a grounded analysis (Glaser & Strauss, 1967), revealing 11 interrelated uncertainties these parents experience. Findings can help providers understand parents' uncertainty and assist in family-centered decision-making. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. A hybrid intervention for challenging the stigma of mental illness

    Directory of Open Access Journals (Sweden)

    A. COMAN

    2016-11-01

    Full Text Available The stigma of mental illness has significant negative impact on people experiencing it, to an extent that it may lead to the avoidance of mental health services. Various strategies have been developed to change people’s negative and ill-founded attitudes towards the mental illness. This paper presents a novel strategy which builds innovatively on a robust model of attitude, while supporting both educational aims and access to the emotional world of people experiencing mental illness.

  4. A hybrid intervention for challenging the stigma of mental illness

    OpenAIRE

    Coman, Alina; Sas, Corina

    2016-01-01

    The stigma of mental illness has significant negative impact on people experiencing it, to an extent that it may lead to the avoidance of mental health services. Various strategies have been developed to change people’s negative and ill-founded attitudes towards the mental illness. This paper presents a novel strategy which builds innovatively on a robust model of attitude, while supporting both educational aims and access to the emotional world of people experiencing mental illness.

  5. Danish Gulf War Veterans Revisited

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Stoltenberg, Christian; Nielsen, Anni B Sternhagen

    2016-01-01

    OBJECTIVE: To examine the assumption that postdeployment incidence of sickness and other absence from work are higher among Gulf War Veterans compared with nonveterans. METHODS: A prospective registry study including a cohort of 721 Danish Gulf War Veterans and a control cohort of 3,629 nonvetera...

  6. College Is for Veterans, Too

    Science.gov (United States)

    Herrmann, Douglas; Raybeck, Douglas; Wilson, Roland

    2008-01-01

    Last summer Congress passed the new GI Bill, and the president signed it into law. Americans can take great pride in such a program, one that helps veterans attend college after they return home. However, few are aware that many of those veterans will also encounter a variety of non-financial problems that require substantial adjustment as they…

  7. Breast cancer: demands of illness.

    Science.gov (United States)

    Loveys, B J; Klaich, K

    1991-01-01

    This study explores the qualitative experience of illness demands from the woman's own perspective by asking, "What is the impact of breast cancer on the daily lives of women of childbearing age?" Semistructured interviews with 79 women newly diagnosed with breast cancer were transcribed and analyzed to discern illness demands. Content analysis yielded 14 domains of illness demands: treatment issues, change in life context or perspective, acceptance of the illness, social interaction or support, physical changes, reconstructing the self, uncertainty, loss, making comparisons, acquiring new knowledge, making choices, mortality issues, financial or occupational concerns, and making a contribution. Illness demands are experienced in every aspect of a woman's life, including her identity, daily routines, family and social experience, and her perception of the past, present, and future. This study details in the women's own language the considerable adjustments brought on by a diagnosis of breast cancer.

  8. Exploring Self-Reported Benefits of Auricular Acupuncture Among Veterans With Posttraumatic Stress Disorder.

    Science.gov (United States)

    King, Cdr Heather C; Moore, Lcdr Chad; Spence, Cdr Dennis L

    2016-09-01

    Auricular acupuncture treatments are becoming increasingly available within military treatment facilities, resulting in an expansion of nonpharmacologic treatment options available to veterans with posttraumatic stress disorder (PTSD). This study aimed to explore the self-reported benefits of auricular acupuncture treatments for veterans living with PTSD. A qualitative research methodology, thematic content analysis, was used to analyze data. Seventeen active duty veterans with PTSD provided written comments to describe their experiences and perceptions after receiving a standardized auricular acupuncture regimen for a 3-week period as part of a pilot feasibility study. A variety of symptoms experienced by veterans with PTSD were improved after receiving auricular acupuncture treatments. Additionally, veterans with PTSD were extremely receptive to auricular acupuncture treatments. Four themes emerged from the data: (1) improved sleep quality, (2) increased relaxation, (3) decreased pain, and (4) veterans liked/loved the auricular acupuncture treatments. Veterans with PTSD reported numerous benefits following auricular acupuncture treatments. These treatments may facilitate healing and recovery for veterans with combat-related PTSD, although further investigations are warranted into the mechanisms of action for auricular acupuncture in this population. © The Author(s) 2015.

  9. Heat Illness

    Science.gov (United States)

    ... humidity, sweating just isn't enough. Your body temperature can rise to dangerous levels and you can ... Heatstroke - a life-threatening illness in which body temperature may rise above 106° F in minutes; symptoms ...

  10. Foodborne Illnesses

    Science.gov (United States)

    ... symptoms of foodborne illnesses and prevent dehydration in adults: drinking plenty of liquids such as fruit juices, sports ... teeth, or using ice made from tap water drinking unpasteurized milk or milk products eating raw fruits and vegetables, ...

  11. Dual Diagnosis: Substance Abuse and Mental Illness

    Science.gov (United States)

    ... is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first. People experiencing a mental health ...

  12. 78 FR 59769 - Agency Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Science.gov (United States)

    2013-09-27

    ... AFFAIRS Agency Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...) of 1995 (44 U.S.C. 3501-21), this notice announces that the Veterans Benefits Administration (VBA...-0782.'' SUPPLEMENTARY INFORMATION: Title: Veterans Benefits Administration (VBA) Voice of the Veteran...

  13. 76 FR 20823 - Agency Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Science.gov (United States)

    2011-04-13

    ... AFFAIRS Agency Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV... U.S.C. 3501-21), this notice announces that the Veterans Benefits Administration (VBA), Department... INFORMATION: Title: Veterans Benefits Administration (VBA) Voice of the Veteran (VOV) Pilot Surveys. a...

  14. Suicide among War Veterans

    Directory of Open Access Journals (Sweden)

    Vsevolod Rozanov

    2012-07-01

    Full Text Available Studies aiming to identify if war veterans are at higher risk of suicide have often produced inconsistent results; this could be due to the complexity of comparisons and different methodological approaches. It should be noted that this contingent has many risk factors, such as stressful exposures, wounds, brain trauma and pain syndrome. Most recent observations confirm that veterans are really more likely to die of suicide as compared to the general population; they are also more likely to experience suicidal ideation and suffer from mental health problems. Suicides are more frequent in those who develop PTSD, depression and comorbid states due to war exposure. Combat stress and its’ frequency may be an important factor leading to suicide within the frame of the stress-vulnerability model. According to this model, the effects of stress may interact with social factors, interpersonal relations and psychological variables producing suicidal tendencies. Modern understanding of stress-vulnerability mechanisms based on genetic predispositions, early life development, level of exposure to stress and stress-reactivity together with interpersonal aspects may help to build more effective suicide prevention programs based on universal/selective/indicated prevention principles.

  15. Suicide among War Veterans

    Science.gov (United States)

    Rozanov, Vsevolod; Carli, Vladimir

    2012-01-01

    Studies aiming to identify if war veterans are at higher risk of suicide have often produced inconsistent results; this could be due to the complexity of comparisons and different methodological approaches. It should be noted that this contingent has many risk factors, such as stressful exposures, wounds, brain trauma and pain syndrome. Most recent observations confirm that veterans are really more likely to die of suicide as compared to the general population; they are also more likely to experience suicidal ideation and suffer from mental health problems. Suicides are more frequent in those who develop PTSD, depression and comorbid states due to war exposure. Combat stress and its’ frequency may be an important factor leading to suicide within the frame of the stress-vulnerability model. According to this model, the effects of stress may interact with social factors, interpersonal relations and psychological variables producing suicidal tendencies. Modern understanding of stress-vulnerability mechanisms based on genetic predispositions, early life development, level of exposure to stress and stress-reactivity together with interpersonal aspects may help to build more effective suicide prevention programs based on universal/selective/indicated prevention principles. PMID:22851956

  16. Military veteran mortality following a survived suicide attempt

    Directory of Open Access Journals (Sweden)

    Conigliaro Joseph

    2011-05-01

    Full Text Available Abstract Background Suicide is a global public health problem. Recently in the U.S., much attention has been given to preventing suicide and other premature mortality in veterans returning from Iraq and Afghanistan. A strong predictor of suicide is a past suicide attempt, and suicide attempters have multiple physical and mental comorbidities that put them at risk for additional causes of death. We examined mortality among U.S. military veterans after hospitalization for attempted suicide. Methods A retrospective cohort study was conducted with all military veterans receiving inpatient treatment during 1993-1998 at United States Veterans Affairs (VA medical facilities following a suicide attempt. Deaths occurring during 1993-2002, the most recent available year at the time, were identified through VA Beneficiary and Records Locator System data and National Death Index data. Mortality data for the general U.S. adult population were also obtained from the National Center for Health Statistics. Comparisons within the veteran cohort, between genders, and against the U.S. population were conducted with descriptive statistics and standardized mortality ratios. The actuarial method was used estimate the proportion of veterans in the cohort we expect would have survived through 2002 had they experienced the same rate of death that occurred over the study period in the U.S. population having the age and sex characteristics. Results During 1993-1998, 10,163 veterans were treated and discharged at a VA medical center after a suicide attempt (mean age = 44 years; 91% male. There was a high prevalence of diagnosed alcohol disorder or abuse (31.8%, drug dependence or abuse (21.8%, psychoses (21.2%, depression (18.5%, and hypertension (14.2%. A total of 1,836 (18.1% veterans died during follow up (2,941.4/100,000 person years. The cumulative survival probability after 10 years was 78.0% (95% CI = 72.9, 83.1. Hence the 10-year cumulative mortality risk was 22

  17. Health Correlates of Criminal Justice Involvement in 4,793 Transgender Veterans.

    Science.gov (United States)

    Brown, George R; Jones, Kenneth T

    2015-12-01

    Transgender (TG) persons are overrepresented in prison settings and in the U.S. veteran population. Health disparities studies of large populations of transgender people involved with the criminal justice system have not been published to date. We studied a large cohort of TG veterans who received care in Veterans Health Administration (VHA) facilities during 2007-2013 (n = 4,793) and a 3:1 matched control group of veterans without known TG identification (n = 13,625). Three hundred twenty six (n = 138 TG, 188 non-TG) had received VHA services in programs designed to address the needs of justice involved (JI) veterans. We linked patients in each of the three groups to their medical and administrative data. TG veterans were more likely to be justice involved than controls (2.88% vs. 1.38%; P history of homelessness (80% vs. 67%; P < .05) and to have reported sexual trauma while serving in the military (23% vs. 12%; P < .01). Significant health disparities were noted for TG JI veterans for depression, hypertension, obesity, posttraumatic stress disorder, serious mental illness, and suicidal ideation/attempts. These data suggest that TG veterans experience a number of health risks compared to non-TG veterans, including an increased likelihood of justice involvement. TG veterans involved with the criminal justice system are a particularly vulnerable group and services designed to address the health care needs of this population, both while incarcerated and when in the community, should take these findings into account in the development of health screenings and treatment plans.

  18. Experiencing the Meaning of Breathing | Edwards | Indo-Pacific ...

    African Journals Online (AJOL)

    The meaning of breathing is discussed in relation to consciousness, bodiliness, spirituality, illness prevention and health promotion. Experiencing the meaning of breathing is to experience more meaning in life itself. Experiential vignettes confirm that breathing skills may be regarded as an original method of survival, ...

  19. Mental Illness in the Peripartum Period

    Science.gov (United States)

    Ostler, Teresa

    2009-01-01

    Women are particularly vulnerable in the peripartum period for either developing a mental illness or suffering symptom exacerbation. These illnesses are often experienced covertly, however, and women may not seek out professional help, even though their symptoms may be seriously affecting their well-being and parenting. This article provides an…

  20. Traumatic war stressors and psychiatric symptoms among World War II, Korean, and Vietnam War veterans.

    Science.gov (United States)

    Fontana, A; Rosenheck, R

    1994-03-01

    Three hypotheses regarding symptoms of war-related posttraumatic stress disorder and general psychiatric distress were tested: that symptoms are more severe the more severe the traumatic exposure, regardless of the war in question; that symptoms are less severe the older the veterans' age; and that symptom levels differ across sociocultural cohorts. A total of 5,138 war zone veterans who were seeking treatment from specialized Veterans Affairs outpatient clinical teams made up the sample: 320 World War II, 199 Korean War, and 4,619 Vietnam War veterans. All hypotheses were supported significantly. The similarity of relationships between traumatic exposure and symptoms across wars testifies to the generality of these experiences. Furthermore, the results suggest the operation of significant effects due both to aging and to cohort differences in sociocultural attitudes toward the stigma of mental illness and the popularity of the wars.

  1. The role of resilience in rebuilding lives of injured veterans.

    Science.gov (United States)

    Edward, K-L; Ousey, K

    2016-10-02

    The aim of this commentary is to discuss potential clinical implications of introducing resilience-building interventions into care for veterans who are living with a war wound. Some war veterans are expected to live with a wound upon discharge from an active military role and also to fit into civilian life. These lifestyle adjustments can tax the person's coping abilities and in that context may hinder successful adaptation. The experience of living with a wound or wounds, either acute or chronic, is connected to losses, including loss of mobility, loss of financial capacity (unable to work at times) and losses attached to changed social roles. Psychological stress is also a common experience for veterans returning to civilian life. Psychological stress is associated with impaired wound healing. Modern health practice is centred on symptom reduction and working with pathology, however, working with people's adaptive behaviours such as resilience has not been considered. Using the resilience model as a conceptual framework health-care professionals can engage with veterans towards resilience within the context of their personal experience of ill health. Using this contemporary framework for considering these aspects of care has the potential to facilitate resistance to stressors associated with being injured, possibly preventing quality-of-life impairments. There are no declarations of interest.

  2. 38 CFR 12.21 - Action upon death of veteran.

    Science.gov (United States)

    2010-07-01

    ... veteran at a Department of Veterans Affairs hospital, center or domiciliary activity while receiving care... of the Department of Veterans Affairs hospital, center, or domiciliary activity having jurisdiction...

  3. Vascular and Skeletal Muscle Function in Gulf War Veterans Illness

    Science.gov (United States)

    2017-07-01

    intraarterial IVUS, intraaterial flow, cardiopulmonary test, and bone density scan. As successful endpoint evaluation is dependent on the data from 70...cardiopulmonary exercise testing and other muscle functions, (3) expression of genes relevant to endothelial function and mitochondrial function in muscle... Exercise and Cardiopulmonary Stress Testing Schedule Visit 2 ( Exercise and cardiopulmonary stress tests) 3-28 Scheduling for Visit 1 continues to

  4. Vascular and Skeletal Muscle Function in Gulf War Veterans Illness

    Science.gov (United States)

    2016-07-01

    Boston Healthcare System and Boston University School of Medicine on 09- Apr-2016. These quick initial responses give a good indication of the large...In particular, pyridostigmine and nerve gases are anticholinesterase agents that potentially have long term effects on the balance of

  5. Self-reported post-exertional fatigue in Gulf War veterans: roles of autonomic testing

    Directory of Open Access Journals (Sweden)

    Mian eLi

    2014-01-01

    Full Text Available To determine if objective evidence of autonomic dysfunction exists from a group of Gulf War veterans with self-reported post-exertional fatigue, we evaluated 16 Gulf War ill veterans and 12 Gulf War controls. Participants of the ill group had self- reported, unexplained chronic post-exertional fatigue and the illness symptoms had persisted for years until the current clinical study. The controls had no self-reported post-exertional fatigue either at the time of initial survey nor at the time of the current study. We intended to identify clinical autonomic disorders using autonomic and neurophysiologic testing in the clinical context. We compared the autonomic measures between the 2 groups on cardiovascular function at both baseline and head-up tilt, and sudomotor function. We identified 1 participant with orthostatic hypotension, 1 posture orthostatic tachycardia syndrome, 2 distal small fiber neuropathy, and 1 length dependent distal neuropathy affecting both large and small fiber in the ill group; whereas none of above definable diagnoses was noted in the controls. The ill group had a significantly higher baseline heart rate compared to controls. Compound autonomic scoring scale showed a significant higher score (95% CI of mean: 1.72 to 2.67 among ill group compared to controls (0.58 to 1.59. We conclude that objective autonomic testing is necessary for the evaluation of self-reported, unexplained post-exertional fatigue among some Gulf War veterans with multi-symptom illnesses. Our observation that ill veterans with self-reported post-exertional fatigue had objective autonomic measures that were worse than controls warrants validation in a larger clinical series.

  6. Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness

    Science.gov (United States)

    2017-10-01

    selective attention). As this will be the first trial of intranasal insulin in Gulf War veterans, a dose-finding clinical trial is proposed using two...Award Number: W81XWH-12-1-0585 TITLE: Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness PRINCIPAL INVESTIGATOR: Dr. Julia...TITLE AND SUBTITLE Intranasal Insulin: A Novel Treatment for Gulf War Multisymptom Illness 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0585

  7. [Religious beliefs, illness and death: family's perspectives in illness experience].

    Science.gov (United States)

    Bousso, Regina Szylit; Poles, Kátia; Serafim, Taís de Souza; de Miranda, Mariana Gonçalves

    2011-04-01

    The objectives of this study were to identify predominant themes in religion, illness and death in the life histories of families and examine the relationship between religion creeds, illness and death in the discourse of families that have an ill person. The theoretical framework used in this study was Symbolic Interactionism and the method was Oral History. Participants were seventeen families with nine different religions, who had experienced the death of a relative. Data analysis showed that following a religion is a relevant part of the lives of many families and cannot be neglected in the illness context. Results point to the importance of understanding the meaning that religion has to the families in the health-disease process, so nurses can work on the promotion of health.

  8. Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

    Science.gov (United States)

    Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

    2018-02-06

    Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

  9. Veteran Student Persistence: The Lived Experiences of Veteran Students Coping with Post-Traumatic Stress Disorder While Enrolled in Online Degree Programs

    Science.gov (United States)

    Henderson-White, Mary

    2017-01-01

    Persistence as it pertained to traditional college students had been widely researched, but little was known about persistence and the role of resilience and engagement for veteran students experiencing post-traumatic stress disorder while enrolled in online degree programs. The focus of the study was to understand the lived experiences of veteran…

  10. Women Veterans and Mental Health

    Science.gov (United States)

    ... even make it worse. Return to top Military sexual trauma and women veterans Military sexual trauma (MST) is ... any lost self-esteem. Getting help for military sexual trauma If you've experience military sexual trauma (MST), ...

  11. VeteranOtherInformationService

    Data.gov (United States)

    Department of Veterans Affairs — This service is used to create, read, delete and update additional information captured during the EVSS Disability Compensation interview in an effort to align with...

  12. Veterans and Military Family Health

    Science.gov (United States)

    Service members and veterans face some different health issues from civilians. Their families also face some unique challenges. Families may have to cope with Separation from their loved ones Anxiety over loved ones' safety in combat ...

  13. The Stigma of Families with Mental Illness

    Science.gov (United States)

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  14. Assailant Identity and Self-Reported Nondisclosure of Military Sexual Trauma in Partnered Women Veterans.

    Science.gov (United States)

    Blais, Rebecca K; Brignone, Emily; Fargo, Jamison D; Galbreath, Nathan W; Gundlapalli, Adi V

    2017-10-09

    Department of Veterans Affairs estimates of military sexual trauma (MST) suggest 27% of female veterans have experienced MST. However, Department of Defense data (Department of Defense, 2014) show that a subgroup of active-duty women do not report sexual assaults to a military authority, suggesting barriers to disclosure exist among military samples. No study of female veterans has examined rates of nondisclosure among those with previous screens for MST; these data could inform screening efforts and establishment of safe havens for candid disclosures. Using an explanatory sequential mixed-methods survey, a history of MST, and postservice MST disclosures during screening and their associations with demographic, assault, and screening-setting characteristics were evaluated in 359 female veterans. Open-ended responses regarding barriers to disclosure were analyzed using editing analysis style. Eighty-one percent (n = 289) reported MST. Of these, 50% (n = 143) reported a prior screening and 25% (n = 35) reported they did not disclose their true MST status. Veterans who experienced MST by a unit-member assailant were significantly less likely to disclose (adjusted odds ratio = 4.75, 95% confidence interval = 1.20-18.30). Disclosure barriers included stigma, experiential avoidance, and discomfort with the screening setting. Creative interventions to reduce nondisclosure among female veterans, with specific attention to those assaulted by a unit member, are urgently needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Diarrheal Illness

    Centers for Disease Control (CDC) Podcasts

    2011-08-30

    Dr. Steve Monroe, director of CDC’s Division of High-Consequence Pathogens and Pathology, discusses diarrheal illness, its causes, and prevention.  Created: 8/30/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 8/31/2011.

  16. Lifetime Alcohol Abuse in Institutionalized World War II Veterans.

    Science.gov (United States)

    Herrmann, Nathan; Eryavec, Goran

    1996-01-01

    The authors document the lifetime prevalence and etiological correlates of alcohol abuse in a sample of elderly World War II veterans. Subjects (mean age 74.2 years), residing in a veterans' long-term care facility were given the Structured Clinical Interview for DSM-III-R. A second investigator gave the Modified Combat Exposure Scale and administered a checklist of pre-war and wartime variables. The lifetime prevalence of alcohol abuse was 53%. There was no correlation between alcohol abuse and any other psychiatric diagnosis. There was a significant correlation between the severity of combat stress and subsequent alcohol abuse. Veterans with alcohol abuse also had significantly more wartime head injuries. There was also a trend for the alcoholic group to have experienced more pre-war stressors. Examination of pre-war variables and the severity of the combat stress might help to identify veterans at risk for development of alcohol abuse. Copyright © 1996 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Growing up with an ill parent: An examination of family characteristics and parental illness features.

    Science.gov (United States)

    Stoeckel, Maggie; Weissbrod, Carol

    2015-12-01

    Existing literature suggests that the children of ill parents are vulnerable to a variety of psychosocial difficulties such as depression and anxiety. The purpose of the current study is to investigate the impact of family characteristics (parental involvement, familial support, stress experienced as a result of parental illness) and parental illness features (severity, duration, recovery status, frequency of symptoms, course) on the psychosocial functioning (depression, anxiety, life satisfaction) of late adolescents who have grown up with an ill parent but no longer live with their parents. Participants were 71 college students with a parent who experienced a chronic medical condition while they were growing up. Participants provided information regarding family characteristics, parental illness features, and the impact of parental illness. Impact of parental illness was assessed using the Impact of Illness Scale. Participants also completed measures of depression, anxiety, and life satisfaction. Participants' reported impact of parent illness was positively correlated with participant depression and anxiety. Several family characteristics and parental illness features were significantly associated with participant psychosocial functioning. In particular, lower parental involvement was correlated with greater participant depression and anxiety, as well as lower life satisfaction. These findings extend our understanding of the impact of parental illness on late adolescents' psychosocial functioning. Results could have clinical applications for psychosocial interventions in children and families coping with chronic illness. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  18. A Study of Interpersonal Intimacy and Meaning of Life Among Elderly Institutionalized Veterans.

    Science.gov (United States)

    Niu, Chen-Chun; Huang, Hui-Man; Hung, Yun-Ying; Lee, Hsiu-Li

    2016-12-01

    Most senior veterans who live in veterans' homes in Taiwan are single and have few intimate, interpersonal relationships. Aging is often accompanied by solitude and illness, which causes senior veterans to doubt the meaning of life and to lose confidence in the value of life. This study investigated the personal characteristics that influence interpersonal intimacy and the meaning of life as well as the relationship between interpersonal intimacy and the meaning of life among senior veterans living in veterans' homes. A cross-sectional design was used, and 120 senior male veterans were convenience sampled from three veterans' homes in southern Taiwan. Three structured questionnaires were used in this study: personal characteristics questionnaire, interpersonal intimacy scale, and purpose in life test. (a) Interpersonal intimacy was influenced by source of income or funds, type of residence institution, religious affiliation, and the quality of the participant's relationships with family, friends, and fellow residents. Educational level and self-perceived health status correlated positively with interpersonal intimacy, and period of residence correlated negatively with interpersonal intimacy. (b) Meaning of life was influenced by the quality of relationships with family and friends. Educational level and self-perceived health status correlated significantly and positively with meaning of life, and period of residence correlated negatively with meaning of life. (c) Significant, positive correlations were found among interpersonal intimacy, the four domains of interpersonal intimacy, and meaning of life. Health professionals involved in the care of senior veterans in institutions may use the results of this study to develop and implement interventions that promote a higher degree of interpersonal intimacy and a higher appreciation of the meaning of life, thus enabling senior veterans to confront old age in a more positive manner.

  19. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... listen? see more videos from Veterans Health Administration 1 Act see more videos from Veterans Health Administration ... videos from Veterans Health Administration The Power of 1 PSA see more videos from Veterans Health Administration ...

  20. Veterans Crisis Line: 1-800-273-8255

    Science.gov (United States)

    ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of ... Help NOW Take a Self-Check Quiz Confidential Homeless Veterans Chat Support for Deaf and Hard of Hearing ...

  1. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us ... Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us ...

  2. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... from Veterans Health Administration Be There: Help Save a Life see more videos from Veterans Health Administration ... more videos from Veterans Health Administration I am A Veteran Family/Friend Active Duty/Reserve and Guard ...

  3. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Help see more videos from Veterans Health Administration Suicide Prevention PSA for Military Families see more videos ... About About the Veterans Crisis Line FAQs Veteran Suicide The Veterans Crisis Line text-messaging service does ...

  4. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... listen? see more videos from Veterans Health Administration 1 Act see more videos from Veterans Health Administration ... from Veterans Health Administration Lost: The Power of One Connection see more videos from Veterans Health Administration ...

  5. Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care.

    Science.gov (United States)

    Kimerling, Rachel; Iverson, Katherine M; Dichter, Melissa E; Rodriguez, Allison L; Wong, Ava; Pavao, Joanne

    2016-08-01

    The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics. This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey. A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study. Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via self-report and VHA administrative data. The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% - 25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers. The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social

  6. Military Sexual Trauma Among Recent Veterans: Correlates of Sexual Assault and Sexual Harassment.

    Science.gov (United States)

    Barth, Shannon K; Kimerling, Rachel E; Pavao, Joanne; McCutcheon, Susan J; Batten, Sonja V; Dursa, Erin; Peterson, Michael R; Schneiderman, Aaron I

    2016-01-01

    Military sexual trauma (MST) includes sexual harassment or sexual assault that occurs during military service and is of increasing public health concern. The population prevalence of MST among female and male veterans who served during Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) has not been estimated to our knowledge. The purpose of this study is to assess the population prevalence and identify military correlates of MST, sexual harassment, and sexual assault among OEF/OIF veterans. MST was assessed in the 2009-2011 National Health Study for a New Generation of U.S. Veterans, a survey of 60,000 veterans who served during the OEF/OIF eras (response rate, 34%, n=20,563). Weighted prevalence estimates and AORs of MST, sexual harassment, and sexual assault among women and men were calculated. Gender-stratified logistic regression models controlled for military and demographic characteristics. Data analyses were conducted in 2013-2014. Approximately 41% of women and 4% of men reported experiencing MST. Deployed men had lower risk for MST compared with non-deployed men, though no difference was found among women. However, veterans reporting combat exposure during deployment had increased risk for MST compared with those without, while controlling for OEF/OIF deployment. Among women, Marines and Navy veterans had increased risk for MST compared with Air Force veterans. MST was significantly higher among veterans who reported using Veterans Affairs healthcare services. These prevalence estimates underscore the importance of public awareness and continued investigation of the public health impact of MST. Published by Elsevier Inc.

  7. Optimizing strategies to improve interprofessional practice for veterans, part 1

    Directory of Open Access Journals (Sweden)

    Bhattacharya SB

    2014-04-01

    Full Text Available Shelley B Bhattacharya,1–3 Michelle I Rossi,1,2 Jennifer M Mentz11Geriatric Research Education and Clinical Center (GRECC, Veteran's Affairs Pittsburgh Healthcare System, 2University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 3Albert Schweitzer Fellowship Program, Pittsburgh, PA, USAIntroduction: Interprofessional patient care is a well-recognized path that health care systems are striving toward. The Veteran's Affairs (VA system initiated interprofessional practice (IPP models with their Geriatric Evaluation and Management (GEM programs. GEM programs incorporate a range of specialties, including but not limited to, medicine, nursing, social work, physical therapy and pharmacy, to collaboratively evaluate veterans. Despite being a valuable resource, they are now faced with significant cut-backs, including closures. The primary goal of this project was to assess how the GEM model could be optimized at the Pittsburgh, Pennsylvania VA to allow for the sustainability of this important IPP assessment. Part 1 of the study evaluated the IPP process using program, patient, and family surveys. Part 2 examined how well the geriatrician matched patients to specialists in the GEM model. This paper describes Part 1 of our study.Methods: Three strategies were used: 1 a national GEM program survey; 2 a veteran/family satisfaction survey; and 3 an absentee assessment.Results: Twenty-six of 92 programs responded to the GEM IPP survey. Six strategies were shared to optimize IPP models throughout the country. Of the 34 satisfaction surveys, 80% stated the GEM clinic was beneficial, 79% stated their concerns were addressed, and 100% would recommend GEM to their friends. Of the 24 absentee assessments, the top three reasons for missing the appointments were transportation, medical illnesses, and not knowing/remembering about the appointment. Absentee rate diminished from 41% to 19% after instituting a reminder phone call policy.Discussion: Maintaining the

  8. 75 FR 78807 - Agency Information Collection (Notice to Department of Veterans Affairs of Veteran or Beneficiary...

    Science.gov (United States)

    2010-12-16

    ... Incarcerated in Penal Institution) Activity Under OMB Review AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the Paperwork Reduction Act (PRA... Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution, VA Form 21-4193. OMB Control...

  9. 76 FR 4152 - Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Science.gov (United States)

    2011-01-24

    ... AFFAIRS Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV... Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of... application and servicing processes for the VBA Compensation and Pension (C&P) Service, Education (EDU...

  10. 78 FR 37278 - Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Science.gov (United States)

    2013-06-20

    ... AFFAIRS Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV... Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of... application and servicing processes for the VBA Compensation Service (CS), Pension Service (P&F), Education...

  11. Veterans Affairs Central Cancer Registry (VACCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Affairs Central Cancer Registry (VACCR) receives and stores information on cancer diagnosis and treatment constraints compiled and sent in by the local...

  12. Benefits for Military Veterans with ALS

    Science.gov (United States)

    ... Advocate Get Involved Donate Military Veterans Resources for Military Veterans, Families & Survivors The ALS Association is working everyday to ... and Caregivers Newly Diagnosed Clinical Trials Familial ALS Military ... from families living with ALS ALS Registry Augmentative Communication Join ...

  13. Employment of Veterans in Executive Branch

    Data.gov (United States)

    Department of Veterans Affairs — This quick facts summarizes the Veteran new hires into the Federal government by disabled and by 30 percent and higher disabled groups for 2008 to 2015. It shows the...

  14. Dichotomous factor analysis of symptoms reported by UK and US veterans of the 1991 Gulf War

    Directory of Open Access Journals (Sweden)

    Hull Lisa

    2004-09-01

    Full Text Available Abstract Background Factor analysis is one of the most used statistical techniques to analyze the inter-relationships among symptoms reported by Gulf War veterans. The objective of this study was to apply factor analyses to binary symptom data from the UK study of Gulf War illness and the US Air Force study of Gulf War veterans, and to compare the symptom domains derived from the distinct samples. Methods UK veterans of the 1991 Gulf War (n = 3,454, individuals deployed to Bosnia on U.N. peacekeeping operations (n = 1,979 and Gulf War-era servicemen (n = 2,577 who were not deployed to the Gulf were surveyed in 1997–1998, and US 1991 Gulf War veterans from four Air Force units (n = 1,163 were surveyed in 1995 to collect health characteristics including symptoms. Each sample was randomly split in half for exploratory and confirmatory dichotomous factor analyses with promax oblique rotation. Results Four correlated factors were identified in each of the samples. Three factors (Respiratory, Mood-Cognition, Peripheral Nervous overlapped considerably across the UK cohorts. The Gastrointestinal/Urogenital factor in the UK Gulf cohort was noticeably different from the Gastrointestinal factor identified from the Bosnia and Era cohorts. Symptoms from Gulf War UK and U.S cohorts yielded similar Gastrointestinal, Respiratory and Mood-Cognition factors, despite differences in symptom inventories between the two surveys. A Musculoskeletal factor was only elicited from the US Gulf sample. Conclusion Findings of this report are consistent with those from other factor analysis studies that identified similar symptom dimensions between Gulf and non-Gulf War veterans, except that the Gastrointestinal factor in Gulf veterans included other symptom types. Correlations among factors raise the question as to whether there is a general illness, even if not unique to Gulf veterans, representing the common pathway underlying the identified factors. Hierarchical factor

  15. Access to Care Among Nonelderly Veterans.

    Science.gov (United States)

    Bernard, Didem M; Selden, Thomas M

    2016-03-01

    Veteran access to care is an important policy issue that has not previously been examined with population-based survey data. This study compares access to care for nonelderly adult Veterans versus comparable non-Veterans, overall and within subgroups defined by simulated eligibility for health care from the Veterans Health Administration and by insurance status. We use household survey data from the Medical Expenditure Panel Survey from 2006 to 2011. We use iterative proportional fitting to standardize (control for) differences in age, sex, income, medical conditions, disability, Census region, and Metropolitan Statistical Area. Nonelderly Veterans and comparable non-Veterans. For medical, dental, and prescription medicine treatments, we use 4 access measures: delaying care, inability to obtain care, perceiving delay as a big problem, and perceiving inability to obtain care as a big problem. We also examine having a usual source of care. Frequencies of access barriers are similar for nonelderly Veterans and comparable non-Veterans for dental and prescription medicine treatments. For medical treatment, we find that Veterans eligible for VA health care and Veterans with VA use who are uninsured report fewer access problems than the comparable non-Veteran populations for 2 measures: inability to obtain care and reporting inability to obtain care as a big problem. Our results show that uninsured Veterans, the most policy-relevant group, have better access to care than comparable non-Veterans. Our results highlight the importance of adjusting Veteran and non-Veteran comparisons to account for the higher than average health care needs of Veterans.

  16. Health care for homeless veterans. Final rule.

    Science.gov (United States)

    2011-08-23

    This final rule establishes regulations for contracting with community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program of the Department of Veterans Affairs (VA). The HCHV program assists certain homeless veterans in obtaining treatment from non-VA community-based providers. The final rule formalizes VA's policies and procedures in connection with this program and clarifies that veterans with substance use disorders may qualify for the program.

  17. Why Is Veteran Unemployment So High?

    Science.gov (United States)

    2014-01-01

    Population Survey (CPS), the difference between veteran and non-veteran youth unemployment increased substantially between 2008 and 2011, but then...the veteran youth unemployment rate averaged 10.7 percent compared to 8.0 percent among non-veteran youth . But the unemployment rates of older...Labor NLSY97 1997 National Longitudinal Survey of Youth PaYS U.S. Army Partnership for Youth Success TAP Transition Assistance Program UCX Unemployment

  18. Veterans Benefits: Burial Benefits and National Cemeteries

    Science.gov (United States)

    2010-10-18

    hospital, nursing home, or domiciliary care facility; and (2) a plot allowance for a veteran eligible for burial in a national cemetery who is not... domiciliary care . The VA was permitted to enter into contracts to provide the burial and funeral services for veterans who died in VA facilities...Veterans Affairs (VA) provides a range of benefits and services to veterans who meet certain eligibility rules; benefits include hospital and medical care

  19. Hysterectomy risk in premenopausal-aged military veterans: associations with sexual assault and gynecologic symptoms.

    Science.gov (United States)

    Ryan, Ginny L; Mengeling, Michelle A; Summers, Karen M; Booth, Brenda M; Torner, James C; Syrop, Craig H; Sadler, Anne G

    2016-03-01

    Several gynecological conditions associated with hysterectomy, including abnormal bleeding and pelvic pain, have been observed at increased rates in women who have experienced sexual assault. Previous findings have suggested that one of the unique health care needs for female military veterans may be an increased prevalence of hysterectomy and that this increase may partially be due to their higher risk of sexual assault history and posttraumatic stress disorder (PTSD). Although associations between trauma, PTSD, and gynecological symptoms have been identified, little work has been done to date to directly examine the relationship between sexual assault, PTSD, and hysterectomy within the rapidly growing female veteran population. The objective of the study was to assess the prevalence of hysterectomy in premenopausal-aged female veterans, compare with general population prevalence, and examine associations between hysterectomy and sexual assault, PTSD, and gynecological symptoms in this veteran population. We performed a computer-assisted telephone interview between July 2005 and August 2008 of 1004 female Veterans Affairs (VA)-enrolled veterans ≤ 52 years old from 2 Midwestern US Veterans Affairs medical centers and associated community-based outreach clinics. Within the veteran study population, associations between hysterectomy and sexual assault, PTSD, and gynecological symptoms were assessed with bivariate analyses using χ(2), Wilcoxon-Mann-Whitney, and Student t tests; multivariate logistic regression analyses were used to look for independent associations. Hysterectomy prevalence and ages were compared with large civilian populations represented in the Behavioral Risk Factor Surveillance System and American College of Surgeons National Surgical Quality Improvement Program databases from similar timeframes using χ(2) and Student t tests. Prevalence of hysterectomy was significantly higher (16.8% vs 13.3%, P = .0002), and mean age at hysterectomy was

  20. Mental illness in the nursing workplace: a collective autoethnography.

    Science.gov (United States)

    Kidd, Jacquie Dianne; Finlayson, Mary P

    2010-01-01

    Many nurses are burned out, exhausted and have a high intent to leave their jobs. These factors, when experienced over a period of time, are consistent with the development of mental illness. This study takes a collective autoethnographical approach to mental illness in the nursing workplace by focusing on the stories of nurses who have experienced mental illness in clinical practice. It highlights three ways in which nursing and mental illness are connected; the nurse who is vulnerable to mental illness prior to entering the profession, the nurse who develops mental illness that is independent of her work but is nevertheless impacted by it, and the nurse who develops mental illness as a result of her work and/or role. This paper explores the hyphenated lives and bullying these nurses experience, and recommends strategies that the profession, employing organisations, and individuals can adopt to reduce nurses' progression from stress to distress and mental illness.

  1. Randomized Controlled Trial of Online Expressive Writing to Address Readjustment Difficulties Among U.S. Afghanistan and Iraq War Veterans.

    Science.gov (United States)

    Sayer, Nina A; Noorbaloochi, Siamak; Frazier, Patricia A; Pennebaker, James W; Orazem, Robert J; Schnurr, Paula P; Murdoch, Maureen; Carlson, Kathleen F; Gravely, Amy; Litz, Brett T

    2015-10-01

    We examined the efficacy of a brief, accessible, nonstigmatizing online intervention-writing expressively about transitioning to civilian life. U.S. Afghanistan and Iraq war veterans with self-reported reintegration difficulty (N = 1,292, 39.3% female, M = 36.87, SD = 9.78 years) were randomly assigned to expressive writing (n = 508), factual control writing (n = 507), or no writing (n = 277). Using intention to treat, generalized linear mixed models demonstrated that 6-months postintervention, veterans who wrote expressively experienced greater reductions in physical complaints, anger, and distress compared with veterans who wrote factually (ds = 0.13 to 0.20; ps difficulty compared with veterans who did not write at all (ds = 0.22 to 0.35; ps ≤ .001). Veterans who wrote expressively also experienced greater improvement in social support compared to those who did not write (d = 0.17). Relative to both control conditions, expressive writing did not lead to improved life satisfaction. Secondary analyses also found beneficial effects of expressive writing on clinically significant distress, PTSD screening, and employment status. Online expressive writing holds promise for improving health and functioning among veterans experiencing reintegration difficulty, albeit with small effect sizes. Published 2015. This article is a US Government work and is in the public domain in the USA.

  2. Comparison Study of Memory Status in War-PTSD Veterans With Depression and Non- Veterans Depressed Patient

    Directory of Open Access Journals (Sweden)

    Anvari SS

    2012-03-01

    Full Text Available Background: Cognitive problems in patients with post-traumatic stress disorder (PTSD include poor concentration and impaired memory. Prevalence of PTSD in all aspects of life is 8% in USA. Regarding the importance of memory in functional levels, this study was performed to review memory status in these patients. Methods: Fifty male war veterans with PTSD and major depression and 50 male non-veterans with depression participated in this study performed at psychiatric outpatient ward in Baqiyatallah hospital during 2008-2009. The patients met the DSM-IV diagnostic criteria. Depression severity, sex, age, educational level, and marital status were matched in both groups. A psychologist completed demographic and Mississippi questionnaires, PTSD checklist (PCL, beck depression Inventory and wechsler memory scale. The collected data were analyzed using SPSS software (version 11.0. A P-value smaller than 0.05 was considered significant.Results: The mean age of the veterans and non-veterans was 43.9±4.7 and 42±9.4 years, respectively. Memory status did not differ between the two groups (P>0.05. There was no statistically significant correlation between duration and severity of PTSD with memory impairment (P>0.05. A negative correlation was found between personal and general information with re-experiencing in the veterans (P<0.05. Impaired memory was correlated with age greater than 45, educational level lower than high school diploma, severity of depression and longer participation in war. Conclusion: Although both PTSD and major depression affected memory, but memory status did not differ between patients with PTSD and depression and patients with chronic depression.

  3. 75 FR 69327 - Veterans Day, 2010

    Science.gov (United States)

    2010-11-10

    ... Proclamation 8598--Veterans Day, 2010 #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol... President ] Proclamation 8598 of November 5, 2010 Veterans Day, 2010 By the President of the United States of America A Proclamation On Veterans Day, we come together to pay tribute to the men and women who...

  4. Gender, race & the veteran wage gap.

    Science.gov (United States)

    Vick, Brandon; Fontanella, Gabrielle

    2017-01-01

    This paper analyzes earnings outcomes of Iraq/Afghanistan-era veterans. We utilize the 2009-2013 American Community Survey and a worker-matching methodology to decompose wage differences between veteran and non-veteran workers. Among fully-employed, 25-40 year-olds, veteran workers make 3% less than non-veteran workers. While male veterans make 9% less than non-veterans, female and black veterans experience a wage premium (2% and 7% respectively). Decomposition of the earnings gap identifies some of its sources. Relatively higher rates of disability and lower rates of educational attainment serve to increase the overall wage penalty against veterans. However, veterans work less in low-paying occupations than non-veterans, serving to reduce the wage penalty. Finally, among male and white subgroups, non-veterans earn more in the top quintile due largely to having higher educational attainment and greater representation in higher-paying occupations, such as management. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Science.gov (United States)

    2012-04-06

    ... Veterans' Reintegration Program AGENCY: Veterans' Employment and Training Service (VETS), Department of...: Section 2021 of Title 38 of the United States Code (U.S.C.) reauthorizes the Homeless Veterans Reintegration Program (HVRP) through fiscal year (FY) 2012 and indicates: ``the Secretary of Labor shall conduct...

  6. Medical Care Needs of Returning Veterans with PTSD: Their Other Burden

    Science.gov (United States)

    Chiu, Victor Y.; Iqbal, Samina; Berg, Eric A.; Laungani, Kaajal J.; Cronkite, Ruth C.; Pavao, Joanne; Kimerling, Rachel

    2010-01-01

    ABSTRACT BACKGROUND There has been considerable focus on the burden of mental illness (including post-traumatic stress disorder, PTSD) in returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, but little attention to the burden of medical illness in those with PTSD. OBJECTIVES (1) Determine whether the burden of medical illness is higher in women and men OEF/OIF veterans with PTSD than in those with No Mental Health Conditions (MHC). (2) Identify conditions common in those with PTSD. DESIGN Cross-sectional study using existing databases (Fiscal Year 2006–2007). SETTING Veterans Health Administration (VHA) patients nationally. PATIENTS All 90,558 OEF/OIF veterans using VHA outpatient care nationally, categorized into strata: PTSD, Stress-Related Disorders, Other MHCs, and No MHC. MEASUREMENTS (1) Count of medical conditions; (2) specific medical conditions (from ICD9 codes, using Agency for Health Research and Quality’s Clinical Classifications software framework). MAIN RESULTS The median number of medical conditions for women was 7.0 versus 4.5 for those with PTSD versus No MHC (p PTSD patients, the most frequent conditions among women were lumbosacral spine disorders, headache, and lower extremity joint disorders, and among men were lumbosacral spine disorders, lower extremity joint disorders, and hearing problems. These high frequency conditions were more common in those with PTSD than in those with No MHC. CONCLUSIONS Burden of medical illness is greater in women and men OEF/OIF veteran VHA users with PTSD than in those with No MHC. Health delivery systems serving them should align clinical program development with their medical care needs. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1497-4) contains supplementary material, which is available to authorized users. PMID:20853066

  7. A Dynamic Model of Post-Traumatic Stress Disorder for Military Personnel and Veterans

    Science.gov (United States)

    Ghaffarzadegan, Navid; Ebrahimvandi, Alireza; Jalali, Mohammad S.

    2016-01-01

    Post-traumatic stress disorder (PTSD) stands out as a major mental illness; however, little is known about effective policies for mitigating the problem. The importance and complexity of PTSD raise critical questions: What are the trends in the population of PTSD patients among military personnel and veterans in the postwar era? What policies can help mitigate PTSD? To address these questions, we developed a system dynamics simulation model of the population of military personnel and veterans affected by PTSD. The model includes both military personnel and veterans in a “system of systems.” This is a novel aspect of our model, since many policies implemented at the military level will potentially influence (and may have side effects on) veterans and the Department of Veterans Affairs. The model is first validated by replicating the historical data on PTSD prevalence among military personnel and veterans from 2000 to 2014 (datasets from the Department of Defense, the Institute of Medicine, the Department of Veterans Affairs, and other sources). The model is then used for health policy analysis. Our results show that, in an optimistic scenario based on the status quo of deployment to intense/combat zones, estimated PTSD prevalence among veterans will be at least 10% during the next decade. The model postulates that during wars, resiliency-related policies are the most effective for decreasing PTSD. In a postwar period, current health policy interventions (e.g., screening and treatment) have marginal effects on mitigating the problem of PTSD, that is, the current screening and treatment policies must be revolutionized to have any noticeable effect. Furthermore, the simulation results show that it takes a long time, on the order of 40 years, to mitigate the psychiatric consequences of a war. Policy and financial implications of the findings are discussed. PMID:27716776

  8. Military sexual assault and homeless women veterans: clinical correlates and treatment preferences.

    Science.gov (United States)

    Decker, Suzanne E; Rosenheck, Robert A; Tsai, Jack; Hoff, Rani; Harpaz-Rotem, Ilan

    2013-01-01

    Both homeless women and women who have experienced military sexual assault (MSA) are at high risk of serious psychological sequelae. However, little is known about the combined impact of MSA and current homelessness on psychological distress, or about distinctive treatment preferences among homeless female veterans affected by MSA. This observational study compared clinical symptoms, pre-military experiences, and treatment preferences among 509 female veterans with and without MSA who enrolled in 11 VA Homeless Women Veterans Programs. Over one third of participants (41.1%) reported MSA. In multivariate analyses, homeless female veterans who reported MSA endorsed greater severity of PTSD and other psychiatric symptoms. Those who had experienced MSA were more likely to report interest in treatment, and treatment focused on safety was reported as especially attractive. Among homeless female veterans, MSA is associated with greater mental health symptoms and greater interest in safety-focused treatment. Services targeting the needs of homeless MSA survivors should be encouraged. Published by Elsevier Inc.

  9. Voluntary and involuntary childlessness in female veterans: associations with sexual assault.

    Science.gov (United States)

    Ryan, Ginny L; Mengeling, Michelle A; Booth, Brenda M; Torner, James C; Syrop, Craig H; Sadler, Anne G

    2014-08-01

    To assess associations between lifetime sexual assault and childlessness in female veterans. Cross-sectional, computer-assisted telephone interview study. Two Midwestern Veterans Administration (VA) medical centers. A total of 1,004 women aged ≤52 years, VA-enrolled between 2000 and 2008. None. Sociodemographic variables, reproductive history and care utilization, and mental health. A total of 620 veterans (62%) reported at least one attempted or completed sexual assault in their lifetime (LSA). Veterans with LSA more often self-reported a history of pregnancy termination (31% vs. 19%) and infertility (23% vs. 12%), as well as sexually transmitted infection (42% vs. 27%), posttraumatic stress disorder (32% vs. 10%), and postpartum dysphoria (62% vs. 44%). Lifetime sexual assault was independently associated with termination and infertility in multivariate models; sexually transmitted infection, posttraumatic stress disorder, and postpartum dysphoria were not. The LSA by period of life was as follows: 41% of participants in childhood, 15% in adulthood before the military, 33% in military, and 13% after the military (not mutually exclusive). Among the 511 who experienced a completed LSA, 23% self-reported delaying or foregoing pregnancy because of their assault. This study demonstrated associations between sexual assault history and pregnancy termination, delay or avoidance (voluntary childlessness), and infertility (involuntary childlessness) among female veterans. Improved gender-specific veteran medical care must attend to these reproductive complexities. Copyright © 2014 American Society for Reproductive Medicine. All rights reserved.

  10. Sexual trauma in the military: Exploring PTSD and mental health care utilization in female veterans.

    Science.gov (United States)

    Kintzle, Sara; Schuyler, Ashley C; Ray-Letourneau, Diana; Ozuna, Sara M; Munch, Christopher; Xintarianos, Elizabeth; Hasson, Anthony M; Castro, Carl A

    2015-11-01

    Sexual trauma remains a pervasive problem in the military. The deleterious mental health outcomes related to incidents of sexual assault have been well-documented in the literature, with particular attention given to the development of posttraumatic stress disorder (PTSD) and utilization of mental health services. Much effort has focused on addressing issues of sexual trauma in the military. The purpose of this study was to examine the incidences of sexual assault in female veterans, the relationship to PTSD and mental health care utilization. The research explored differences in pre- and post-9/11 veterans. Data were collected using a 6-prong recruitment strategy to reach veterans living in Southern California. A total of 2,583 veterans completed online and in-person surveys, of which 325 female veterans were identified for inclusion in the analysis. Forty percent of the sample reported experiencing sexual assault during their military service. A history of military sexual trauma was found to be a substantial contributor to symptoms of PTSD. A majority of female veterans who indicated being sexually assaulted during their military service met the cutoff for a diagnosis of PTSD. Although only a minority of participants who indicated being a victim of sexual assault reported receiving immediate care after the incident, most had received mental health counseling within the past 12 months. Findings point to the need for additional prevention programs within the military and opportunities for care for victims of military sexual assault. (c) 2015 APA, all rights reserved).

  11. Psychosocial function and health in veteran families

    DEFF Research Database (Denmark)

    Jensen, Mai Tødsø; Karmsteen, Kirstine; Jørgensen, Anne-Marie Klint

    to the veteran or the mental health of the partner while relatively few publications deal with the veteran family as a whole or its members social relations outside the primary family. Furthermore, there are relatively few publications focusing on relatives to veterans deployed other places than Iraq...... and Afghanistan, publications focusing on relatives of veterans with physical injuries and few publications dealing with relatives to female veterans. The overall conclusion is that there is a potential need for addressing psychosocial functioning and health among these groups of relatives in research to provide...

  12. Implementing goals of care conversations with veterans in VA long-term care setting: a mixed methods protocol.

    Science.gov (United States)

    Sales, Anne E; Ersek, Mary; Intrator, Orna K; Levy, Cari; Carpenter, Joan G; Hogikyan, Robert; Kales, Helen C; Landis-Lewis, Zach; Olsan, Tobie; Miller, Susan C; Montagnini, Marcos; Periyakoil, Vyjeyanthi S; Reder, Sheri

    2016-09-29

    The program "Implementing Goals of Care Conversations with Veterans in VA LTC Settings" is proposed in partnership with the US Veterans Health Administration (VA) National Center for Ethics in Health Care and the Geriatrics and Extended Care Program Offices, together with the VA Office of Nursing Services. The three projects in this program are designed to support a new system-wide mandate requiring providers to conduct and systematically record conversations with veterans about their preferences for care, particularly life-sustaining treatments. These treatments include cardiac resuscitation, mechanical ventilation, and other forms of life support. However, veteran preferences for care go beyond whether or not they receive life-sustaining treatments to include issues such as whether or not they want to be hospitalized if they are acutely ill, and what kinds of comfort care they would like to receive. Three projects, all focused on improving the provision of veteran-centered care, are proposed. The projects will be conducted in Community Living Centers (VA-owned nursing homes) and VA Home-Based Primary Care programs in five regional networks in the Veterans Health Administration. In all the projects, we will use data from context and barrier and facilitator assessments to design feedback reports for staff to help them understand how well they are meeting the requirement to have conversations with veterans about their preferences and to document them appropriately. We will also use learning collaboratives-meetings in which staff teams come together and problem-solve issues they encounter in how to get veterans' preferences expressed and documented, and acted on-to support action planning to improve performance. We will use data over time to track implementation success, measured as the proportions of veterans in Community Living Centers (CLCs) and Home-Based Primary Care (HBPC) who have a documented goals of care conversation soon after admission. We will work with

  13. Mental health and health service use among post-national service veterans: results from the 2007 Adult Psychiatric Morbidity Survey of England.

    Science.gov (United States)

    Woodhead, C; Rona, R J; Iversen, A; MacManus, D; Hotopf, M; Dean, K; McManus, S; Meltzer, H; Brugha, T; Jenkins, R; Wessely, S; Fear, N T

    2011-02-01

    There is concern surrounding the psychological health and uptake of treatment services among veterans of the UK Armed Forces. Data from a cross-sectional, nationally representative sample were used to compare health outcomes and treatment seeking among 257 post-national service veterans aged 16-64 years and 504 age and sex frequency-matched non-veterans living in the community in England. Early leavers (<4 years service) were compared with longer serving veterans. Male veterans reported more childhood adversity and were more likely to have experienced a major trauma in adulthood than non-veterans. There was no association between any measure of mental health and veteran status in males, except reporting more violent behaviours [adjusted odds ratio (aOR) 1.44, 95% confidence interval (CI) 1.01-2.06]. In females, a significant association was found between veteran status and ever having suicidal thoughts (aOR 2.82, 95% CI 1.13-7.03). No differences in treatment-seeking behaviour were identified between veterans and non-veterans with any mental disorder. Early service leavers were more likely to be heavy drinkers (aOR 4.16, 95% CI 1.08-16.00), to have had suicidal thoughts (aOR 2.37, 95% CI 1.21-4.66) and to have self-harmed (aOR 12.36, 95% CI 1.61-94.68) than longer serving veterans. The findings of this study do not suggest that being a veteran is associated with adversity in terms of mental health, social disadvantage or reluctance to seek treatment compared with the general population. Some evidence implies that early service leavers may experience more mental health problems than longer-serving veterans.

  14. Trust is the basis for effective suicide risk screening and assessment in veterans.

    Science.gov (United States)

    Ganzini, Linda; Denneson, Lauren M; Press, Nancy; Bair, Matthew J; Helmer, Drew A; Poat, Jennifer; Dobscha, Steven K

    2013-09-01

    To reduce suicides among Veterans, the Department of Veterans Affairs (VA) has designated suicide risk assessments for Veterans who screen positive for depression or post-traumatic stress disorder as a national performance goal. Many VA Medical Centers (VAMCs) are using brief suicidal ideation screens, administered in non-mental health ambulatory care settings, as the first step in the assessment process. To explore Veterans' perceptions of the suicide screening and risk assessment process, the barriers and facilitators to disclosing suicidal thoughts, and perceptions of possible consequences of revealing suicidal thoughts. Investigators recorded one semi-structured interview with each Veteran. Transcripts were analyzed using a modified grounded theory approach. Thirty-four Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans who screened positive for suicidal ideation in non-mental health ambulatory care settings in 2009 and 2010. Veterans accepted the need to assess suicide risk. They increasingly experienced attempts to suppress and avoid thoughts of suicide as burdensome and exhausting. Despite this, Veterans often failed to disclose severe and pervasive suicidal thoughts when screened because: (1) they considered suicidal thoughts as shameful and a sign of weakness; (2) they believed suicidal thoughts were private and not to be divulged to strangers; (3) they worried that disclosure would lead to unwanted hospitalization or medication recommendations; and (4) the templated computer reminder process was perceived as perfunctory and disrespectful. In contrast, admitting and discussing thoughts of suicide with a health provider who focused on building a relationship, demonstrated genuineness and empathy, offered information on the rationale for suicide risk assessment, and used straightforward and understandable language, all promoted trust that resulted in more honest disclosure of suicidal thoughts. In ambulatory care settings, both provider

  15. Implementing and Evaluating a Telephone-Based Centralized Maternity Care Coordination Program for Pregnant Veterans in the Department of Veterans Affairs.

    Science.gov (United States)

    Mattocks, Kristin M; Kuzdeba, Judy; Baldor, Rebecca; Casares, Jose; Lombardini, Lisa; Gerber, Megan R

    The purpose of this study was to develop and evaluate a comprehensive, telephonic maternity care coordination (MCC) program for all pregnant veterans enrolled for care at New England Department of Veterans Affairs (VA) facilities that comprise the Veterans Integrated Service Network 1. Telephone interviews were conducted with postpartum women veterans who had participated in the MCC program during their pregnancies. The program evaluation instrument assessed satisfaction and use of MCC services, prenatal education classes, and infant and maternal outcomes (e.g., newborn birthweight, insurance status, maternal depression) using both closed-ended and open-ended questions. A substantial majority (95%) of women enrolled in the MCC program expressed satisfaction with the services they received in the program. Women were most satisfied with help understanding VA maternity benefits and acquiring VA services and equipment, such as breast pumps and pregnancy-related medications. More than one-third of women noted their infants had experienced health problems since delivery, including neonatal intensive care unit hospitalizations. A majority of women planned to return to VA care in the future. Our findings suggest that MCC services play an important role for women veterans as they navigate both VA and non-VA care systems. MCC staff members coordinated maternity, medical, and mental health care services for women veterans. Additionally, by maintaining contact with the veteran during the postpartum period, MCC staff were able to assess the health of the mother and the infant, and refer women and their infants to medical and psychosocial services in the community as needed. Published by Elsevier Inc.

  16. Residential treatment for homeless female veterans with psychiatric and substance use disorders: effect on 1-year clinical outcomes.

    Science.gov (United States)

    Harpaz-Rotem, Ilan; Rosenheck, Robert A; Desai, Rani

    2011-01-01

    Limited evidence shows that time-limited residential treatment (RT) is beneficial for homeless people with serious mental illness. The Department of Veterans Affairs has established 11 specialty programs for homeless female veterans. We present data comparing 1-year clinical outcomes in a group of veterans who did and did not receive at least 30 days of RT. Clients of the Homeless Women Veterans Programs were invited to participate in a follow-up study. They were interviewed every 3 months for 1 year. Those who received at least 30 days of RT in the 3 months after program entry (RT group) were compared with other program participants (no or homeless women. This study, in conjunction with others, suggests that provision of stable housing may be an important element of recovery for homeless women with psychiatric problems, excluding substance use.

  17. Meta-analysis of self-reported health symptoms in 1990-1991 Gulf War and Gulf War-era veterans.

    Science.gov (United States)

    Maule, Alexis L; Janulewicz, Patricia A; Sullivan, Kimberly A; Krengel, Maxine H; Yee, Megan K; McClean, Michael; White, Roberta F

    2018-02-13

    Across diverse groups of Gulf War (GW) veterans, reports of musculoskeletal pain, cognitive dysfunction, unexplained fatigue, chronic diarrhoea, rashes and respiratory problems are common. GW illness is a condition resulting from GW service in veterans who report a combination of these symptoms. This study integrated the GW literature using meta-analytical methods to characterise the most frequently reported symptoms occurring among veterans who deployed to the 1990-1991 GW and to better understand the magnitude of ill health among GW-deployed veterans compared with non-deployed GW-era veterans. Meta-analysis. Literature databases were searched for peer-reviewed studies published from January 1990 to May 2017 reporting health symptom frequencies in GW-deployed veterans and GW-era control veterans. Self-reported health symptom data were extracted from 21 published studies. A binomial-normal meta-analytical model was used to determine pooled prevalence of individual symptoms in GW-deployed veterans and GW-era control veterans and to calculate combined ORs of health symptoms comparing GW-deployed veterans and GW-era control veterans. GW-deployed veterans had higher odds of reporting all 56 analysed symptoms compared with GW-era controls. Odds of reporting irritability (OR 3.21, 95% CI 2.28 to 4.52), feeling detached (OR 3.59, 95% CI 1.83 to 7.03), muscle weakness (OR 3.19, 95% CI 2.73 to 3.74), diarrhoea (OR 3.24, 95% CI 2.51 to 4.17) and rash (OR 3.18, 95% CI 2.47 to 4.09) were more than three times higher among GW-deployed veterans compared with GW-era controls. The higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal and dermatological symptoms among GW-deployed veterans compared with GW-era controls indicates these symptoms are important when assessing GW veteran health status. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is

  18. 75 FR 24514 - Supportive Services for Veteran Families Program

    Science.gov (United States)

    2010-05-05

    ... eligible homeless veterans, such as the Health Care for Homeless Veterans (HCHV) Program, the Grant and Per... AFFAIRS 38 CFR Part 62 RIN 2900-AN53 Supportive Services for Veteran Families Program AGENCY: Department... concerning the Supportive Services for Veteran Families Program (SSVF Program) of the Department of Veterans...

  19. 38 CFR 3.454 - Veterans disability pension.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Veterans disability pension. 3.454 Section 3.454 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Apportionments § 3.454 Veterans...

  20. 38 CFR 21.272 - Veteran-student services.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Veteran-student services.... Chapter 31 Monetary Assistance Services § 21.272 Veteran-student services. (a) Eligibility. Veterans who.... Veteran-student services may be utilized in connection with: (1) VA outreach service program as carried...

  1. Differential impact of supported housing on selected subgroups of homeless veterans with substance abuse histories.

    Science.gov (United States)

    O'Connell, Maria J; Kasprow, Wesley J; Rosenheck, Robert A

    2012-12-01

    Studies have demonstrated that supported housing is an effective intervention for individuals who are homeless and have a mental illness or substance use disorder. This study examined data from an experimental trial of the U.S. Department of Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program to identify differences in the program's impact on subgroups defined by sociodemographic or clinical characteristics. Data were analyzed from 259 male homeless veterans with substance abuse problems who were randomly assigned to HUD-VASH (intensive case management [ICM] plus rent subsidy vouchers), ICM only, or treatment as usual between June 1992 and December 1995. Four subgroups were defined: African American versus Caucasian, younger versus older than 42.3 years, co-occurring diagnoses of mental illness versus diagnosis of a substance use disorder only, and active versus less active substance use upon program entry. Mixed models were used to identify significant interactions between HUD-VASH assignment and each subgroup. Compared with ICM alone, HUD-VASH was associated with more positive housing outcomes for Caucasians, veterans with co-occurring mental disorders, and veterans who were active substance users. HUD-VASH was associated with more positive socioclinical outcomes for African Americans. No differences were observed in housing or socioclinical outcomes as a function of age. Among homeless veterans with a substance use disorder, Caucasians and those with active substance use showed greater housing benefits than other veterans from HUD-VASH than from ICM alone. African Americans showed greater socioclinical benefit than Caucasians from HUD-VASH versus ICM. Interaction analysis deserves further study.

  2. Women experiencing the intergenerationality of conjugal violence

    Directory of Open Access Journals (Sweden)

    Gilvânia Patrícia do Nascimento Paixão

    2015-10-01

    Full Text Available Objective: to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence.Method: qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011.Results: the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed violence between their parents; they suffered repercussions from the violence between their parents: they were angry about the mother's submission to her partner; and they reproduced the conjugal violence. The discourse showed that the women witnessed, in childhood and adolescence, violence between their parents, and were injured both physically and psychologically. As a result of the mother's submission, feelings of anger arose in the children. However, in the adult phase of their own lives, they noticed that their conjugal life resembled that of their parents, reproducing the violence.Conclusion: investment is necessary in strategies designed to break inter-generational violence, and the health professionals are important in this process, as it is a phenomenon with repercussions in health. Because they work in the Family Health Strategy, which focuses on the prevention of harm and illness, health promotion and interdepartmentality, the nurses are essential in the process of preventing and confronting this phenomenon.

  3. Women experiencing the intergenerationality of conjugal violence.

    Science.gov (United States)

    Paixão, Gilvânia Patrícia do Nascimento; Gomes, Nadirlene Pereira; Diniz, Normélia Maria Freire; Carvalho e Lira, Margaret Ollinda de Souza; Carvalho, Milca Ramaiane da Silva; da Silva, Rudval Souza

    2015-01-01

    to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence. qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011). the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed violence between their parents; they suffered repercussions from the violence between their parents: they were angry about the mother's submission to her partner; and they reproduced the conjugal violence. The discourse showed that the women witnessed, in childhood and adolescence, violence between their parents, and were injured both physically and psychologically. As a result of the mother's submission, feelings of anger arose in the children. However, in the adult phase of their own lives, they noticed that their conjugal life resembled that of their parents, reproducing the violence. investment is necessary in strategies designed to break inter-generational violence, and the health professionals are important in this process, as it is a phenomenon with repercussions in health. Because they work in the Family Health Strategy, which focuses on the prevention of harm and illness, health promotion and interdepartmentality, the nurses are essential in the process of preventing and confronting this phenomenon.

  4. Intimate partner stalking: Contributions to PTSD symptomatology among a national sample of women veterans.

    Science.gov (United States)

    Dardis, Christina M; Amoroso, Timothy; Iverson, Katherine M

    2017-08-01

    Women veterans are at high risk for intimate partner violence (IPV), which has previously been defined as psychological, physical, or sexual violence from an intimate partner. The Centers for Disease Control and Prevention recently added stalking to its uniform definition of IPV, but little is known about the occurrence of stalking victimization among women veterans who experience IPV, its overlap with other forms of IPV, and its contribution to posttraumatic stress disorder (PTSD) symptomatology among this population. Lifetime intimate partner stalking, as well as physical, sexual, and psychological IPV, was assessed as part of a larger study of women veterans who completed a 2014 Web-based survey (75% participation rate). Women with a history of IPV or stalking (55%, n = 225) completed the PTSD Checklist-5 to assess PTSD symptoms related to IPV and items assessing military sexual trauma and combat exposure. Among 225 women veterans with a history of IPV, approximately 64% (n = 145) reported lifetime stalking by an intimate partner. Women who experienced both stalking and other forms of IPV were 4.2 times more likely to experience probable PTSD than were women who experienced IPV without stalking, odds ratio (OR) = 4.18, 95% confidence interval (CI) [1.91, 9.13]. After adjusting for military sexual trauma and lifetime sum of other types of IPV, women who experienced partner stalking remained 2.5 times more likely than women without a history of partner stalking to experience probable PTSD, OR = 2.49, 95% CI [1.07, 5.78]. Stalking from an intimate partner is a common form of IPV experienced by women veterans that strongly contributes to risk for probable PTSD. In addition to other forms of IPV, identification and treatment efforts should attend to stalking victimization among this rapidly growing population. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Lack of serological evidence for Mycoplasma fermentans infection in army Gulf War veterans: a large scale case-control study.

    Science.gov (United States)

    Lo, S C; Levin, L; Ribas, J; Chung, R; Wang, R Y; Wear, D; Shih, J W

    2000-12-01

    Mycoplasma firmentans is suspected in the development of 'Gulf War illness' in veterans of Operation Desert Storm. We conducted a matched case-control study for the prevalence of M. firmentans-specific antibodies before and after the operation, as well as seroconversion rates in veterans with and without complaints of 'Gulf War illness'. Cases consisted of Gulf War veterans, who complained of various illnesses and were enrolled in the second phase of the health evaluation by the Army Comprehensive Clinical Examination Program (CCEP). Controls were selected from Gulf War veterans who did not participate in the registry and did not request a health evaluation by the CCEP. Before operation deployment, 34 out of 718 of the cases (48%) and 116 out of 2233 of the controls (5.2%) tested positive for M. fermentans-specific antibodies. There was no difference in rates of seroconversion between cases and controls (1.1 vs. 1.2%) to M. fermentans during Operation Desert Storm. Thus, there is no serological evidence that suggests infectionby M. fermentans is associated with development of 'Gulf War illness'.

  6. Engagement in mental health treatment among veterans returning from Iraq

    Directory of Open Access Journals (Sweden)

    Tracy Stecker

    2010-03-01

    Full Text Available Tracy Stecker1,2, John Fortney3,4, Francis Hamilton1,2, Cathy D Sherbourne5, Icek Ajzen61Psychiatric Research Center, Dartmouth Medical School, Lebanon, NH, USA; 2VA Health Services Research and Development, White River Junction Veterans Administration, White River Junction, VT, USA; 3VA Health Services Research and Development (HR S&D, Center for Mental Health and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA; 4Division of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 5RAND, Santa Monica, CA, USA; 6Department of Psychology, University of Massachusetts, Amherst, MA, USAObjectives: Many veterans return from combat experiencing a variety of mental health concerns. Previous research has documented a stigma associated with seeking treatment that interferes with the decision to seek treatment. This study, conceptualized using the theory of planned behavior, assessed beliefs about mental health treatment in order to understand mental health treatment seeking behavior among a group of returning National Guard soldiers who served in the war in Iraq.Methods: Participants were one hundred and fifty Operation Iraqi Freedom National Guard soldiers who screened positive for depression, posttraumatic stress disorder, generalized anxiety disorder, panic disorder or alcohol abuse disorder on the Mini International Neuropsychiatric Interview (MINI. Participants were asked to complete a questionnaire assessing beliefs about mental health treatment and treatment-seeking behavior.Results: Beliefs related to symptom reduction and work were significantly related to mental health treatment-seeking behavior. Conclusions: Interventions developed to engage veterans into care must be directed toward cognitive factors that motivate treatment seeking in addition to traditionally targeted structural barriers.Keywords: treatment

  7. The Course and Correlates of Combat-Related PTSD in Australian Vietnam Veterans in the Three Decades After the War.

    Science.gov (United States)

    O'Toole, Brian I; Catts, Stanley V

    2017-02-01

    Australian male Vietnam veterans (N = 388) were assessed 22 and 36 years after their return to Australia using standardized diagnostic interviews, with added data from Army records and self-report questionnaires. Among veterans who ever had posttraumatic stress disorder (PTSD), 50.3% had a current diagnosis at the second assessment; of those who had a current diagnosis at Wave 1, 46.9% were also current at Wave 2. Late onset occurred for 19.0% of veterans, of whom 60.8% were current at Wave 2. Multivariate analysis compared veterans with no history of PTSD (n = 231) with veterans who had ever had PTSD (n = 157) to assess risk factors for PTSD incidence; and veterans with a history, but not current PTSD (n = 78) with veterans who had current PTSD at the second assessment (n = 79) to assess risk factors for failure to remit. Incidence was associated with lower education, shorter Army training predeployment, higher combat, excess drinking, and help-seeking after return to Australia. Prevalence was associated with having a father who saw combat in World War II, being injured in battle, having a lower intelligence test score, experiencing higher combat, and having a diagnosis of phobia at the first assessment. Only combat was common to incidence and prevalence. Copyright © 2017 International Society for Traumatic Stress Studies.

  8. Salt Lake Community College Veterans Services: A Model of Serving Veterans in Higher Education

    Science.gov (United States)

    Ahern, Aaron; Foster, Michael; Head, Darlene

    2015-01-01

    This chapter outlines the birth and growth of a veterans' program in Salt Lake City, Utah, and discusses next steps in spurring additional innovations and advancements to improve service for student veterans in community colleges.

  9. Increased risk among older veterans of prescribing psychotropic medication in the absence of psychiatric diagnoses.

    Science.gov (United States)

    Wiechers, Ilse R; Kirwin, Paul D; Rosenheck, Robert A

    2014-06-01

    This study uses Veterans Health Administration (VHA) pharmacy and encounter claims to evaluate the use of psychotropic medications without a psychiatric diagnosis across age groups. National VHA administrative data for fiscal year 2010 (FY2010) were used to identify all veterans who filled a prescription for at least one psychotropic medication from VHA (N = 1.85 million). Bivariate and multivariate analyses were used to compare the proportion of these veterans without any psychiatric diagnosis, across age groups, adjusting for possible medical indications. Analyses were repeated for six different classes of psychotropic medications and comparing mental health utilizers and non-mental health utilizers. Comparisons were made to prescribing of HIV and diabetes medications without an indicated diagnosis. Of all VHA patients prescribed a psychotropic medication in FY2010, 30% had no psychiatric diagnosis, with highest proportions among veterans ages 65-85. This practice was most frequent among nonmental health utilizers and far more prevalent for psychotropic medications than for HIV or diabetes medications. Logistic regression analysis found that age greater than 65 was the strongest predictor of being prescribed a psychotropic without a psychiatric diagnosis. Adjustment for possible medical use of psychotropics and overall medical comorbidity did not substantially alter these trends. Older veterans, especially those not using specialty mental healthcare, are more likely to be prescribed psychotropic medications in the absence of a psychiatric diagnosis, perhaps representing unnecessary use, under-diagnosis of mental illness, or incomplete documentation. Published by Elsevier Inc.

  10. Risk factors for homelessness among women veterans.

    Science.gov (United States)

    Washington, Donna L; Yano, Elizabeth M; McGuire, James; Hines, Vivian; Lee, Martin; Gelberg, Lillian

    2010-02-01

    Women veterans are three to four times more likely than non-veteran women to become homeless. However, their risk factors for homelessness have not been defined. Case-control study of non-institutionalized homeless women veterans (n533) and age-matched housed women veterans (n=165). Health, health care, and factors associated with homelessness were assessed using multiple logistic regression with a Monte Carlo algorithm to estimate exact standard errors of the model coefficients and p-values. Characteristics associated with homelessness were sexual assault during military service, being unemployed, being disabled, having worse overall health, and screening positive for an anxiety disorder or post-traumatic stress disorder. Protective factors were being a college graduate or married. Efforts to assess housed women veterans' risk factors for homelessness should be integrated into clinical care programs within and outside the Veterans Administration. Programs that work to ameliorate risk factors may prevent these women's living situations from deteriorating over time.

  11. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... listen? see more videos from Veterans Health Administration 1 Act see more videos from Veterans Health Administration Lost: The Power of One Connection see more videos from Veterans Health Administration ...

  12. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... Call see more videos from Veterans Health Administration I'm Good. But are you ready to listen? ... PSA see more videos from Veterans Health Administration I am A Veteran Family/Friend Active Duty/Reserve ...

  13. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... videos about getting help. Be There: Help Save a Life see more videos from Veterans Health Administration ... listen? see more videos from Veterans Health Administration 1 Act see more videos from Veterans Health Administration ...

  14. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... videos about getting help. Be There: Help Save a Life see more videos from Veterans Health Administration ... more videos from Veterans Health Administration I am A Veteran Family/Friend Active Duty/Reserve and Guard ...

  15. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... After the Call see more videos from Veterans Health Administration I'm Good. But are you ready to listen? see more videos from Veterans Health Administration 1 Act see more videos from Veterans ...

  16. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... Self-Check Quiz Resources Spread the Word Videos Homeless Resources Additional Information Make the Connection Get Help ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard ...

  17. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... from Veterans Health Administration Suicide Prevention PSA for Military Families see more videos from Blue Star Families These ... from Veterans Health Administration I am A ... Veterans Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us ...

  18. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... in crisis, find a facility near you. Spread the Word Download logos, Web ads, and materials and ... from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from Veterans Health Administration ...

  19. Employment of Veterans in the Federal Executive Branch

    Data.gov (United States)

    Department of Veterans Affairs — These quick facts use data from the 2011 Employment of Veterans in the Federal Executive Branch to compare Veteran employment in the Federal Government by agency,...

  20. Veterans Crisis Line: Videos About Reaching out for Help

    Science.gov (United States)

    Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  1. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... for help. Bittersweet More Videos from Veterans Health Administration Watch additional videos about getting help. Be There: ... a Life see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more ...

  2. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... out for help. Bittersweet More Videos from Veterans Health Administration Watch additional videos about getting help. Be ... Save a Life see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see ...

  3. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... Administration I'm Good. But are you ready to listen? see more videos from Veterans Health Administration ... videos from Veterans Health Administration Vet Centers: Here to Help see more videos from Veterans Health Administration ...

  4. Veterans Crisis Line: Videos About Reaching out for Help

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    Full Text Available ... More Videos from Veterans Health Administration Watch additional videos about getting help. Be There: Help Save a Life see more videos from Veterans Health Administration Veterans Crisis Line -- After ...

  5. Veterans Crisis Line: Videos About Reaching out for Help

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  6. Military Sexual Trauma Among Homeless Veterans

    OpenAIRE

    Pavao, Joanne; Turchik, Jessica A.; Hyun, Jenny K.; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-01-01

    ABSTRACT BACKGROUND Military sexual trauma (MST) is the Veteran Health Administration?s (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. OBJECTIVE To estimate the prevale...

  7. Experiencing Security in Interaction Design

    DEFF Research Database (Denmark)

    Mathiasen, Niels Raabjerg; Bødker, Susanne

    2011-01-01

    Security is experienced differently in different contexts. This paper argues that in everyday situations, users base their security decisions on a mix of prior experiences. When approaching security and interaction design from an experience approach, tools that help bring out such relevant...... experiences for design are needed. This paper reports on how Prompted exploration workshops and Acting out security were developed to target such experiences when iteratively designing a mobile digital signature solution in a participatory design process. We discuss how these tools helped the design process...... and illustrate how the tangibility of such tools matters. We further demonstrate how the approach grants access to non-trivial insights into people's security experience. We point out how the specific context is essential for exploring the space between experience and expectations, and we illustrate how people...

  8. Personal, Medical, and Healthcare Utilization Among Homeless Veterans Served by Metropolitan and Nonmetropolitan Veteran Facilities

    OpenAIRE

    Gordon, Adam J.; Haas, Gretchen L.; Luther, James F.; Hilton, Michael T.; Goldstein, Gerald

    2010-01-01

    This study assessed differences in personal, medical, and health care utilization characteristics of homeless veterans living in metropolitan versus nonmetropolitan environments. Data were obtained from a Veterans Health Administration (VHA) network sample of homeless veterans. Chi-square tests were used to assess differences in demographics, military history, living situation, medical history, employment status, and health care utilization. Moderator analyses determined whether predictors of...

  9. Validation of a research case definition of Gulf War illness in the 1991 US military population.

    Science.gov (United States)

    Iannacchione, Vincent G; Dever, Jill A; Bann, Carla M; Considine, Kathleen A; Creel, Darryl; Carson, Christopher P; Best, Heather; Haley, Robert W

    2011-01-01

    A case definition of Gulf War illness with 3 primary variants, previously developed by factor analysis of symptoms in a US Navy construction battalion and validated in clinic veterans, identified ill veterans with objective abnormalities of brain function. This study tests prestated hypotheses of its external validity. A stratified probability sample (n = 8,020), selected from a sampling frame of the 3.5 million Gulf War era US military veterans, completed a computer-assisted telephone interview survey. Application of the prior factor weights to the subjects' responses generated the case definition. The structural equation model of the case definition fit both random halves of the population sample well (root mean-square error of approximation = 0.015). The overall case definition was 3.87 times (95% confidence interval, 2.61-5.74) more prevalent in the deployed than the deployable nondeployed veterans: 3.33 (1.10-10.10) for syndrome variant 1; 5.11 (2.43-10.75) for variant 2, and 4.25 (2.33-7.74) for variant 3. Functional status on SF-12 was greatly reduced (effect sizes, 1.0-2.0) in veterans meeting the overall and variant case definitions. The factor case definition applies to the full Gulf War veteran population and has good characteristics for research. Copyright © 2011 S. Karger AG, Basel.

  10. Will the war for the Croatian Homeland War veterans ever end?

    Science.gov (United States)

    Rak, Davor; Matić, Aldenita; Rak, Benedict

    2014-12-01

    The aim of this paper is to show the psychological consequences of participation in the Homeland War and experienced trauma which can indirectly be seen through drawing even after more than 15 years after the war had ended. The research was conducted on a sample of 125 patients of both genders treated in the Daily Hospital program of University Hospital Dubrava, Psychiatry Clinics. All the tested had trauma in their medical history and all of them met the PTSD diagnostic criteria, 75 examinees participated in the Homeland War and they represent the veteran group, and 50 examinees went through a stressful situation during peacetime and they represent the civilian group. All the examinees had to make two individual drawings, and the task was to portray feelings of term "love" (first drawing) and term "hate" (second drawing). They could choose motifs and colors freely. When portraying the term love, choice of motifs between the civilian and the veteran group wasn't considerably different, and only a small number of male veteran population (6.6%) drawings hinted at the connection with the Homeland War. The results between two groups are completely different in portraying the term hate. As much as 76% examinees from the veteran group have unequivocally and directly decided to portray wartime motifs, unlike the civilian group whose use of wartime motifs was just 10%. When choosing color, nearly 90% of the veteran group used neutral and cool colors to portray the term hate.

  11. A National Study of Veterans Treatment Court Participants: Who Benefits and Who Recidivates.

    Science.gov (United States)

    Tsai, Jack; Finlay, Andrea; Flatley, Bessie; Kasprow, Wesley J; Clark, Sean

    2017-07-21

    Although there are now over 400 veterans treatment courts (VTCs) in the country, there have been few studies on participant outcomes in functional domains. Using national data on 7931 veterans in the Veterans Affairs (VA) Veterans Justice Outreach program across 115 VA sites who entered a VTC from 2011 to 2015, we examined the housing, employment, income, and criminal justice outcomes of VTC participants; and identified veteran characteristics predictive of outcomes. VTC participants spent an average of nearly a year in the program and 14% experienced a new incarceration. From program admission to exit, 10% more participants were in their own housing, 12% more were receiving VA benefits, but only 1% more were employed. Controlling for background characteristics, a history of incarceration predicted poor criminal justice, housing, and employment outcomes. Participants with property offenses or probation/parole violations and those with substance use disorders were more likely to experience a new incarceration. Participants with more mental health problems were more likely to be receiving VA benefits and less likely to be employed at program exit. Together, these findings highlight the importance of proper substance abuse treatment as well as employment services for VTC participants so that they can benefit from the diversion process.

  12. Depression in Gulf War veterans: a systematic review and meta-analysis.

    Science.gov (United States)

    Blore, J D; Sim, M R; Forbes, A B; Creamer, M C; Kelsall, H L

    2015-06-01

    Although post-traumatic stress disorder (PTSD) has been a focus of attention in 1990/1991 Gulf War veterans, the excess risk of depression has not been clearly identified. We investigated this through a systematic review and meta-analysis of studies comparing depression in Gulf War veterans to depression in a comparison group of non-deployed military personnel. Multiple electronic databases and grey literature were searched from 1990 to 2012. Studies were assessed for eligibility and risk of bias according to established criteria. Of 14 098 titles and abstracts assessed, 14 studies met the inclusion criteria. Gulf War veterans had over twice the odds of experiencing depression [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.88-2.76] and dysthymia or chronic dysphoria (OR 2.39, 95% CI 2.0-2.86) compared to non-deployed military personnel. This finding was robust in sensitivity analyses, and to differences in overall risk of bias and psychological measures used. Despite divergent methodologies between studies, depression and dysthymia were twice as common in Gulf War veterans and are important medical conditions for clinicians and policymakers to be aware of in managing Gulf War veterans' health.

  13. Marital quality and relationship satisfaction in war veterans and their wives in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Miro Klaric

    2011-12-01

    Full Text Available Posttraumatic stress disorder (PTSD in war veterans and its complex emotional and behavioral characteristics affect veterans’ partners and the quality of their relationships. Although most research focuses on the effects of veterans’ PTSD on their partners/wives and their relationships, not many findings have been established on partner adjustment and marriage quality when wives suffer from PTSD as well.The aim of the research was to examine the relationship between war-related posttraumatic stress symptoms and partner's marital satisfaction in couples where one or both partners suffer from PTSD.The Harvard Trauma Questionnaire and Dyadic Adjustment Scale encompassed 154 war veterans and their wives who had been treated at Mostar Clinical Hospital in Bosnia and Herzegovina for combat-related PTSD as well as 77 veterans who did not suffer from PTSD and their wives.Veterans’ PTSD is related to lower levels of marital adjustment of their wives. Marital adjustment was significantly lower in couples where both partners had PTSD compared with couples where only the veteran had PTSD or neither partner had PTSD. Female partner's marital adjustment is best explained by his avoidance symptoms and her own level of depressiveness and re-experiencing symptoms.The results highlight the importance of recognizing PTSD in wives of traumatized veterans as well as the importance of family approach in the treatment of PTSD.For the abstract or full text in other languages, please see Supplementary files under Reading Tools online

  14. Exploration of Individual and Family Factors Related to Community Reintegration in Veterans With Traumatic Brain Injury.

    Science.gov (United States)

    Moriarty, Helene; Winter, Laraine; Robinson, Keith; True, Gala; Piersol, Catherine; Vause-Earland, Tracey; Iacovone, Dolores Blazer; Holbert, Laura; Newhart, Brian; Fishman, Deborah; Short, Thomas H

    2015-01-01

    Community reintegration (CR) poses a major problem for military veterans who have experienced a traumatic brain injury (TBI). Factors contributing to CR after TBI are poorly understood. To address the gap in knowledge, an ecological framework was used to explore individual and family factors related to CR. Baseline data from an intervention study with 83 veterans with primarily mild to moderate TBI were analyzed. Instruments measured CR, depressive symptoms, physical health, quality of the relationship with the family member, and sociodemographics. Posttraumatic stress disorder and TBI characteristics were determined through record review. Five variables that exhibited significant bivariate relationships with CR (veteran rating of quality of relationship, physical functioning, bodily pain, posttraumatic stress disorder diagnosis, and depressive symptoms) were entered into hierarchical regression analysis. In the final analysis, the five variables together accounted for 35% of the variance, but only depression was a significant predictor of CR, with more depressed veterans exhibiting lower CR. Efforts to support CR of Veterans with TBI should carefully assess and target depression, a modifiable factor. © The Author(s) 2015.

  15. PTSD symptoms and suicide risk in veterans: Serial indirect effects via depression and anger.

    Science.gov (United States)

    McKinney, Jessica M; Hirsch, Jameson K; Britton, Peter C

    2017-05-01

    Suicide rates are higher in veterans compared to the general population, perhaps due to trauma exposure. Previous literature highlights depressive symptoms and anger as contributors to suicide risk. PTSD symptoms may indirectly affect suicide risk by increasing the severity of such cognitive-emotional factors. A sample of community dwelling veterans (N=545) completed online surveys, including the PTSD Checklist-Military Version, Suicidal Behaviors Questionnaire-Revised, Multidimensional Health Profile-Psychosocial Functioning, and Differential Emotions Scale -IV. Bivariate and serial mediation analyses were conducted to test for direct and indirect effects of PTSD symptoms on suicide risk. In bivariate analyses, PTSD symptoms, depression, anger, and internal hostility were positively related to suicide risk. In serial mediation analyses, there was a significant total effect of PTSD symptoms on suicide risk in both models. PTSD symptoms were also indirectly related to suicidal behavior via depression and internal hostility, and via internal hostility alone. Anger was not a significant mediator. Our cross-sectional sample was predominantly White and male; prospective studies with diverse veterans are needed. Our findings may have implications for veteran suicide prevention. The effects of PTSD and depression on anger, particularly internal hostility, are related to suicide risk, suggesting a potential mechanism of action for the PTSD-suicide linkage. A multi-faceted therapeutic approach, targeting depression and internal hostility, via cognitive-behavioral techniques such as behavioral activation and cognitive restructuring, may reduce suicide risk in veterans who have experienced trauma. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Addressing Mental Illness Stigma in the Psychology Classroom

    Science.gov (United States)

    Maranzan, K. Amanda

    2016-01-01

    A number of initiatives are aimed at reducing mental illness stigma, yet stigma remains a problem in the general population. A focus on stigma reduction with students is particularly relevant, as students often hold negative attitudes toward mental illness, have regular contact with persons experiencing mental health difficulties, and because…

  17. Veterans' use of Department of Veterans Affairs care and perceptions of outsourcing inpatient care.

    Science.gov (United States)

    Wakefield, Bonnie J; Tripp-Reimer, Toni; Rosenbaum, Marcy E; Rosenthal, Gary E

    2007-06-01

    The objective of the study was to examine veterans' perceptions of problems and benefits of outsourcing inpatient care from Veterans Affairs (VA) hospitals to private sector hospitals. Primary data were collected from a cross-section of 42 veterans who were VA users and nonusers using focus groups. Focus group discussion examined reasons patients use VA care, differences between VA and civilian care, positive and negative impacts of outsourcing, and special needs of veterans. Analyses revealed five domains related both to use of VA services and perceptions of outsourcing: costs, access, quality of care, contract (i.e., a covenant between veterans and the U.S. government), veteran milieu, and special needs. Participants identified a variety of potential positive and negative impacts. In general, veterans perceived more advantages than disadvantages to outsourcing VA care but still expressed significant concerns related to outsourcing. These issues should be considered in the development of future policy toward outsourcing VA care to the private sector.

  18. Experiencing sexuality after intestinal stoma

    Directory of Open Access Journals (Sweden)

    Maria Angela Boccara de Paula

    2012-06-01

    Full Text Available OBJECTIVE: Identify the Social Representations (SR of ostomized people in terms of sexuality after the stoma. METHODS: An exploratory, descriptive, qualitative study using the Social Representation Theory with 15 ostomized people (8 females, mean age of 57.9 years, between August and September 2005. Data obtained from transcribed interviews were submitted to content analysis, resulting in the thematic unit "Giving new meaning to sexuality" and subthemes. RESULTS: The study demonstrated that the intestinal stoma interferes in the sexuality experience, showing that the meanings attributed to this experience are based on individual life stories, quality of personal relationships established in practice and perception of sexuality, despite the stoma. CONCLUSIONS: The Social Representations, in terms of experiencing sexuality after the stoma, are based on meanings attributed to the body, associated with daily life and present in the social imaginary. It is influenced by other factors, such as physiological changes resulting from the surgery and the fact of having or not a partner. Care taken during sexual practices provide greater security and comfort in moments of intimacy, resembling the closest to what ostomized people experienced before the stoma. The self-irrigation technique associated or not with the use of artificial occluder, has been attested by its users as a positive element that makes a difference in sexual practice after the stoma. The support to ostomized people should be comprehensive, not limited to technical care and disease, which are important, but not sufficient. The interdisciplinary health team should consider all aspects of the person, seeking a real meeting between subjects.OBJETIVO: Identificar as Representações Sociais (RS da pessoa estomizada intestinal sobre vivência da sexualidade após confecção do estoma. MÉTODOS: Estudo exploratório, descritivo, qualitativo do ponto de vista do referencial da Representa

  19. 75 FR 14633 - Veterans Workforce Investment Program

    Science.gov (United States)

    2010-03-26

    ...' Employment and Training Service Veterans Workforce Investment Program AGENCY: Veterans' Employment and...' Workforce Investment Program (VWIP) for Program Year (PY) 2010, as authorized under section 168 of the Workforce Investment Act (WIA) of 1998. This Solicitation for Grant Applications (SGA) notice contains all...

  20. Which Vietnam Veterans Develop Posttraumatic Stress Disorders?

    Science.gov (United States)

    Solkoff, Norman; And Others

    1986-01-01

    Vietnam combat veterans diagnosed as having Postraumatic Stress Disorder (PTSD) differed significantly in the intensity of their combat experiences and their perceptions of their homecoming experiences from controls who were also combat veterans. Neither early history nor immediate preservice factors differentiated the two groups. (Author/KS)

  1. 77 FR 67533 - Veterans Day, 2012

    Science.gov (United States)

    2012-11-13

    ... Documents#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8902 of November 7, 2012 Veterans Day, 2012... of men and women who have served our country with honor and distinction. On Veterans Day, we show... challenge we cannot overcome, and our best days are still ahead. This year, we marked the 200th anniversary...

  2. Veterans Education Outreach Program. Exemplary Projects.

    Science.gov (United States)

    Amon, Ronald D.

    As a result of a review of performance reports submitted by almost 400 colleges and universities receiving Veterans Education Outreach Program (VEOP) grants, 37 exemplary programs were identified by a panel of 5 professionals in veterans' education and government administration. The exemplary programs selected showed consistency in staff efforts…

  3. Defining "Rural" for Veterans' Health Care Planning

    Science.gov (United States)

    West, Alan N.; Lee, Richard E.; Shambaugh-Miller, Michael D.; Bair, Byron D.; Mueller, Keith J.; Lilly, Ryan S.; Kaboli, Peter J.; Hawthorne, Kara

    2010-01-01

    Purpose: The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of the VHA scheme, we compared its categories to 3 Office of Management and Budget (OMB) and 4 Rural-Urban Commuting Area (RUCA) geographical categories. Method: Using…

  4. Veterans Medical Care: FY2011 Appropriations

    Science.gov (United States)

    2011-03-21

    services to veterans who meet certain eligibility rules including hospital and medical care , disability compensation and pensions,3 education ,4...prosthetic and orthotic devices, including eyeglasses and hearing aids; home health services, hospice care , palliative care , and institutional respite care ...CRS Report for Congress Prepared for Members and Committees of Congress Veterans Medical Care : FY2011 Appropriations Sidath Viranga

  5. Unemployment, earnings and enrollment among post 9/11 veterans.

    Science.gov (United States)

    Kleykamp, Meredith

    2013-05-01

    This paper examines three outcomes characterizing different aspects of post 9/11 veterans' economic reintegration to civilian life: unemployment, earnings and college enrollment, using Current Population Survey data from 2005 to 2011. Analyses include interactions of veteran status with sex, race/ethnicity and educational attainment to evaluate whether diverse veterans experience diverse consequences of service. In brief, I find that the basic unemployment differences between veterans and non-veterans often reported in the media understate the effect of military service on unemployment for men, since veterans have other characteristics that are associated with higher employment rates. Female veterans appear to suffer a steeper employment penalty than male veterans, but black veterans appear to suffer less of a penalty than white veterans. But on two other measures, earnings and college enrollment, veterans appear to be doing better than their civilian peers. Veterans with a high school education or less outearn their civilian peers, but veterans with at least some college education appear to lose some or all of the veteran earnings advantage compared to veterans with a high school degree, suggesting the greatest wage returns to military service accrue among the least educated. Veterans with at least a high school education are more likely to be enrolled in college than their civilian peers. Treating veterans as a monolithic block obscures differences in the consequences of military service across diverse groups. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Systematic Review of Sexual Dysfunction Among Veterans with Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Bentsen, Ida L; Giraldi, Annamaria G E; Kristensen, Ellids; Andersen, Henrik S

    2015-04-01

    The clinical observations that many Vietnam veterans complained of sexual problems after returning from active duty have led to the question of a correlation between post-traumatic stress disorder (PTSD) and sexual dysfunction (SD). The purpose of this review is to systematically review the current literature regarding SD in male veterans with PTSD. A systematic literature search, primarily in PubMed, the Cochrane database, and PsycINFO, was conducted. The keywords Sexual Dysfunction, Psychological OR Sexual Dysfunction, Physiological AND Stress Disorders, and Post-Traumatic were used. All manuscripts with relevance to the aim of the review were reviewed and considered. A total of 123 results were generated from the search. There were 11 publications regarding SD in veterans with PTSD included in the review. The included studies are described in detail in the Results section. All but one study found an increased and significant prevalence of SD among male veterans with PTSD, especially erectile dysfunction and decreased sexual desire. SD increased in patients with PTSD, with a prevalence between 8.4% and 88.6%; the large prevalence range were partly the result of methodological differences. Only two studies have examined the correlation between the severity of PTSD symptoms and SD, with conflicting results. Samples were of relatively moderate size. Only a few confounding factors were accounted for in the included studies. Increasing evidence suggests a correlation between PTSD and SD, but still, relatively few studies have addressed these questions. Further investigation is needed into the correlation between PTSD and SD, preferably taking severity of PTSD symptoms into account, along with confounders such as use of psychotropic medication, somatic illness, drug and alcohol abuse, and comorbid psychiatric illness. Bentsen IL, Giraldi AGE, Kristensen E, and Andersen HS. Systematic review of sexual dysfunction among veterans with post-traumatic stress disorder. Sex

  7. Joint replacement surgery in homeless veterans

    Directory of Open Access Journals (Sweden)

    Chase G. Bennett, MD

    2017-12-01

    Full Text Available Total joint arthroplasty (TJA in a homeless patient is generally considered contraindicated. Here, we report our known medical and social (housing and employment results of homeless veterans who had TJA. Thirty-seven TJAs were performed on 33 homeless patients (31 men at our hospital between November 2000 and March 2014. This was 1.2% of all TJAs. Average age was 54 years. Average hospital stay was 4.1 days. There were no major inpatient complications. Thirty-four cases had at least 1-year follow-up in any clinic within the Veterans Affairs health care system. There were no known surgery-related reoperations or readmissions. At final follow-up, 24 patients had stable housing and 9 were employed. The extensive and coordinated medical and social services that were provided to veterans from the Department of Veterans Affairs contributed to our positive results. Keywords: Homeless, Veteran, Joint replacement, Total hip, Total knee, Employment

  8. Faith-Based Organizations and Veteran Reintegration

    Science.gov (United States)

    Werber, Laura; Derose, Kathryn Pitkin; Rudnick, Mollie; Harrell, Margaret C.; Naranjo, Diana

    2015-01-01

    Abstract Faith-based organizations (FBOs) are an important community-based resource for veterans as they readjust to civilian life. Through interviews with both national-level and smaller, local FBOs, the authors sought to understand better the current and potential roles for FBOs in veteran reintegration. Interviewees suggested that veterans may look to FBOs for support because they offer privacy and confidentiality, two features that may be especially critical when a potential stigma is involved. Some FBOs have also developed a reputation as safe places for veterans, providing supportive, judgment-free environments. FBOs not only help veterans with spiritual matters but address diverse areas of veteran health and wellness, including vocation, education, financial and legal stability, shelter, access to goods and services, mental health, access to health care, physical health, family, and social networks. In some cases, the support is offered to veterans directly; in other instances, the support is indirect, via training individuals to help veterans or educating the public about them. In the process of providing support, FBOs interact with varied organizations, including government entities, private nonprofits, and one another, for training, outreach, referrals, information exchange, obtaining donations, and collaboration. Yet challenges exist, including insufficient connections with chaplains working in different settings and others in the web of support, resource and capacity constraints, lack of awareness of experience with veterans, issues related to religious philosophy or orientation, and characteristics of veterans themselves. To move forward, the authors offer recommendations for policymakers, organizations that interact with FBOs, and FBOs themselves to help FBOs engage fully in the web of reintegration support. PMID:28083391

  9. 76 FR 21099 - Determinations Concerning Illnesses Discussed In National Academy of Sciences Reports on Gulf War...

    Science.gov (United States)

    2011-04-14

    ... Veterans are entitled to compensation for chronic disabilities associated with signs or symptoms of disabilities such as those described above or associated with chronic multisymptom illness. The findings in... and scientific evidence provides support for the theory that the increased symptomatology reported by...

  10. The Role of Th1/Th2 Cytokine Balance in Gulf War-Related Illness

    Science.gov (United States)

    2002-02-01

    helper 2 type immune activation in Gulf War veterans with multi-symptom illness Anna Skowera, Matthew Hotopf, EI2bieta Sawicka, Ruben Varela- Calvino ...Ruben Varela- Calvino 1, PhD, Post-doctoral Fellow Catherine Unwin2 , MSc, Study co-ordinator Vasilis Nikolaou 3, MSc, Bio-statistician Lisa Hlull 2

  11. Do homeless veterans have the same needs and outcomes as non-veterans?

    Science.gov (United States)

    Tsai, Jack; Mares, Alvin S; Rosenheck, Robert A

    2012-01-01

    Although veterans have been found to be at increased risk for homelessness as compared to non-veterans, it is not clear whether those who are homeless have more severe health problems or poorer outcomes in community-based supported housing. This observational study compared 162 chronically homeless veterans to 388 non-veterans enrolled in a national-supported housing initiative over a 1-year period. Results showed that veterans tended to be older, were more likely to be in the Vietnam era age group, to be male, and were more likely to have completed high school than other chronically homeless adults. There were no differences between veterans and non-veterans on housing or clinical status at baseline or at follow-up, but both groups showed significant improvement over time. These findings suggest that the greater risk of homelessness among veterans does not translate into more severe problems or treatment outcomes. Supported housing programs are similarly effective for veterans and non-veterans.

  12. Adverse Childhood Experiences and Adult Health Outcomes Among Veteran and Non-Veteran Women.

    Science.gov (United States)

    McCauley, Heather L; Blosnich, John R; Dichter, Melissa E

    2015-09-01

    Women veterans represent a vulnerable population with unique health needs and disparities in access to care. One constellation of exposures related to subsequent poor health includes adverse childhood experiences (ACEs; e.g., physical and sexual child abuse), though research on impacts of ACEs among women veterans is limited. Data were drawn from the 2010 Behavioral Risk Factor Surveillance System for the 11 states that included the ACE module (n=36,485). Weighted chi-squared tests and multivariable logistic regression were used to assess the prevalence of ACEs among women veterans compared with women non-veterans and differences in the following outcomes, controlling for ACEs: social support, inadequate sleep, life satisfaction, mental distress, smoking, heavy alcohol use, obesity, diabetes, cardiovascular disease symptoms, asthma, and disability. Women veterans (1.6% of the total sample) reported a higher prevalence of 7 out of 11 childhood adversities and higher mean ACE score than women non-veterans. Women veterans were more likely to be current smokers and report a disability, associations which were attenuated when controlling for ACE. Despite women veterans' higher prevalence of ACE, their health outcomes did not differ substantially from non-veterans. Further research is needed to understand the intersections of traumatic experiences and sources of resilience over the lifecourse among women veterans.

  13. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There Show You ... more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from Veterans ...

  14. 38 CFR 11.84 - Redemption because of veteran's death.

    Science.gov (United States)

    2010-07-01

    ... veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS...'s death. If the veteran dies before the maturity of the loan, the amount of the unpaid principal and... day the loan matures or within six months thereafter, the bank holding the note and certificate shall...

  15. 38 CFR 21.400 - Veterans' Advisory Committee on Rehabilitation.

    Science.gov (United States)

    2010-07-01

    ... Committee on Rehabilitation. 21.400 Section 21.400 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Veterans' Advisory Committee on Rehabilitation § 21.400 Veterans...

  16. Illness as Teacher: Learning from Illness

    Science.gov (United States)

    Yoo, Joanne

    2017-01-01

    This article is a conceptual exploration into the value of illness, bodies and embodied practice in teacher education. It draws on my reflections and practitioner accounts of poor health to investigate the potential to learn from illness. I position myself in this discussion as a non-tenured academic who experiences the challenges of her uncertain…

  17. Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas Viviendo el accidente cerebrovascular agudo: significado de la enfermedad para personas hospitalizadas Experiencing acute stroke: the meaning of the illness for hospitalized patients

    Directory of Open Access Journals (Sweden)

    Samia Jardelle Costa de Freitas Maniva

    2013-04-01

    . Se aprendió que la experiencia del padecimiento de accidente cerebrovascular es compleja; en ella, los significados son elaborados en base a sentimientos, acciones y comportamientos de los sujetos.The aim was to understand the meaning of the experience of the acute stroke patient. This was a qualitative study, based on the conceptual theory of symbolic interaction. It was conducted in a unit specialized in the treatment of stroke at a tertiary hospital in Fortaleza-CE and the ethical aspects were respected. The study included ten patients and data were collected through open interviews. The data were organized and analyzed according to enunciation techniques. The meaning of the illness experience was constructed based on the perception of the feelings that arose during the hospitalization and was characterized by fear of death and the sequelae of the disease; sorrow for the distance from home; relief, when a patient perceived an improved clinical course; and a desire to change one´s lifestyle. The experience of illness due to stroke is complex, as meanings are elaborated ​​from the feelings, actions and behaviors of the subjects.

  18. Mental illness stigma, secrecy and suicidal ideation.

    Science.gov (United States)

    Oexle, N; Ajdacic-Gross, V; Kilian, R; Müller, M; Rodgers, S; Xu, Z; Rössler, W; Rüsch, N

    2017-02-01

    secrecy, which introduces negative emotional consequences. If our findings are replicated, they would suggest that programmes empowering people in treatment for mental illness to cope with anticipated and experienced discrimination as well as interventions to reduce public stigma within society could improve suicide prevention.

  19. Depression and dementias among military veterans.

    Science.gov (United States)

    Byers, Amy L; Yaffe, Kristine

    2014-06-01

    Depression is very common throughout the course of veterans' lives, and dementia is common in late life. Previous studies suggest an association between depression and dementia in military veterans. The most likely biologic mechanisms that may link depression and dementia among military veterans include vascular disease, changes in glucocorticoid steroids and hippocampal atrophy, deposition of β-amyloid plaques, inflammatory changes, and alterations of nerve growth factors. In addition, military veterans often have depression comorbid with posttraumatic stress disorder or traumatic brain injury. Therefore, in military veterans, these hypothesized biologic pathways going from depression to dementia are more than likely influenced by trauma-related processes. Treatment strategies for depression, posttraumatic stress disorder, or traumatic brain injury could alter these pathways and as a result decrease the risk for dementia. Given the projected increase of dementia, as well as the projected increase in the older segment of the veteran population, in the future, it is critically important that we understand whether treatment for depression alone or combined with other regimens improves cognition. In this review, we summarize the principal mechanisms of this relationship and discuss treatment implications in military veterans. Copyright © 2014 The Alzheimer's Association. All rights reserved.

  20. Intimate Partner Violence Victimization and Associated Implications for Health and Functioning Among Male and Female Post-9/11 Veterans.

    Science.gov (United States)

    Iverson, Katherine M; Vogt, Dawne; Maskin, Rachel M; Smith, Brian N

    2017-09-01

    There is increased emphasis on identifying patients who experience intimate partner violence (IPV) in Department of Veterans Affairs and other health care settings. A better understanding of IPV's implications for health and functioning is needed among post-911 Veterans, and especially male Veterans, to inform IPV screening and response. To identify past 6-month IPV experienced among partnered post-9/11 Veterans and examine sex-based associations between IPV and health. A national sample of Veterans completed a survey that included measures of IPV victimization and health. Types of IPV and relationships with health and functioning were examined separately for male and female Veterans. In total, 407 post-9/11 Veterans (52% women) in intimate relationships. IPV victimization was assessed with the Conflict Tactics Scales-Revised. Health and functioning indicators included posttraumatic stress disorder (PCL-5) and depression (Beck Depression Inventory-Primary Care) symptoms, physical health-related quality of life (Short-Form 12-item Health Survey), and occupational functioning (Inventory of Psychosocial Functioning). Nearly two thirds of both men and women reported past 6-month IPV, with greatest endorsement of psychological aggression (65% of men, 59% of women). A total of 8% of men and 7% of women reported physical IPV and 4% of men and 7% of women reported sexual IPV. Psychological aggression was strongly linked with mental health for both sexes and greater occupational impairment for men. Physical and sexual IPV were associated with more severe mental health symptoms for women while physical IPV was negatively associated with physical health-related quality of life for men. Recent IPV victimization, especially psychological aggression, is a key health issue for partnered male and female post-9/11 Veterans. Practice and research implications are discussed.

  1. Variation in Veteran Identity as a Factor in Veteran-Targeted Interventions.

    Science.gov (United States)

    Hack, Samantha M; DeForge, Bruce R; Lucksted, Alicia

    2017-07-01

    The sociocultural identities that people self-assign or accept influence their interpersonal interactions and decision making. Identity-based interventions attempt to influence individuals by associating healthy behaviors with in-group membership. Outreach and educational efforts aimed at veterans may rely on "typical" veteran identity stereotypes. However, as discussed in this Open Forum, there is evidence that veteran identity is not monolithic but rather fluctuates on the basis of personal characteristics and individual military service experiences. Overall, the impact of veteran identity on veterans' health behaviors and use of health care is not known and has been understudied. A major limiting factor is the lack of a standardized measure of veteran identity that can assess variations in salience, prominence, and emotional valence.

  2. Homeless Aging Veterans in Transition: A Life-Span Perspective

    OpenAIRE

    Thompson, Carla J.; Bridier, Nancy L.

    2013-01-01

    The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative...

  3. Barriers to Psychosocial Services among Homeless Women Veterans

    OpenAIRE

    HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

    2012-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to se...

  4. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share ... Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can ...

  5. Surgery and Adjuvant Chemotherapy Use Among Veterans With Colon Cancer: Insights From a California Study

    Science.gov (United States)

    Hynes, Denise M.; Tarlov, Elizabeth; Durazo-Arvizu, Ramon; Perrin, Ruth; Zhang, Qiuying; Weichle, Thomas; Ferreira, M. Rosario; Lee, Todd; Benson, Al B.; Bhoopalam, Nirmala; Bennett, Charles L.

    2010-01-01

    Purpose US veterans have been shown to be a vulnerable population with high cancer rates, and cancer care quality in Veterans Affairs (VA) hospitals is the focus of a congressionally mandated review. We examined rates of surgery and chemotherapy use among veterans with colon cancer at VA and non-VA facilities in California to gain insight into factors associated with quality of cancer care. Methods A retrospective cohort of incident colon cancer patients from the California Cancer Registry, who were ≥ 66 years old and eligible to use VA and Medicare between 1999 and 2001, were observed for 6 months after diagnosis. Results Among 601 veterans with colon cancer, 72% were initially diagnosed and treated in non-VA facilities. Among veterans with stage I to III cancer, those diagnosed and initially treated in VA facilities experienced similar colectomy rates as those at non-VA facilities. Stage III patients diagnosed and initially treated in VA versus non-VA facilities had similar odds of receiving adjuvant chemotherapy. In both settings, older patients had lower odds of receiving chemotherapy than their younger counterparts even when race and comorbidity were considered (age 76 to 85 years: odds ratio [OR] = 0.18; 95% CI, 0.07 to 0.46; age ≥ 86 years: OR = 0.17; 95% CI, 0.04 to 0.73). Conclusion In California, older veterans with colon cancer used both VA and non-VA facilities for cancer treatment, and odds of receiving cancer-directed surgery and chemotherapy were similar in both systems. Among stage III patients, older age lowered odds of receiving adjuvant chemotherapy in both systems. Further studies should continue to explore potential health system effects on quality of colon cancer care across the United States. PMID:20406940

  6. Alcohol and Drug Abuse Among U.S. Veterans: Comparing Associations with Intimate Partner Substance Abuse and Veteran Psychopathology

    Science.gov (United States)

    Miller, Mark W.; Reardon, Annemarie F.; Wolf, Erika J.; Prince, Lauren B.; Hein, Christina L.

    2013-01-01

    This study examined the relative influences of PTSD, other psychopathology, and intimate partner alcohol and drug use on substance-related problems in U.S. veterans (242 couples, N = 484). Hierarchical regression analyses revealed that partner alcohol and drug use severity explained more variance in veteran alcohol use and drug use (20% and 13%, respectively) than did veteran PTSD, adult antisocial behavior, or depression symptoms combined (6% for veteran alcohol use; 7% for veteran drug use). Findings shed new light on the influence of relationship factors on veteran alcohol and drug use and underscore the importance of couples-oriented approaches to treating veterans with comorbid PTSD and substance abuse. PMID:23325433

  7. A randomized controlled trial of supported employment among veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Davis, Lori L; Leon, Andrew C; Toscano, Richard; Drebing, Charles E; Ward, L Charles; Parker, Pamela E; Kashner, T Michael; Drake, Robert E

    2012-01-01

    Posttraumatic stress disorder (PTSD) is a potentially disabling mental illness that can cause occupational dysfunction. Although vocational rehabilitation is often prescribed for patients with PTSD, standard vocational services are far from adequate in helping them obtain and maintain competitive employment. This study is the first to examine the outcome of evidence-based supported employment for veterans with PTSD. Unemployed veterans with PTSD were randomly assigned to either individual placement and support (IPS) supported employment (N = 42) or a Veterans Health Administration Vocational Rehabilitation Program (VRP) treatment as usual (N = 43). Employment rates and occupational outcomes were followed for 12 months. During the 12-month study, 76% of the IPS participants gained competitive employment, compared with 28% of the VRP participants (number needed to treat = 2.07; χ(2) = 19.84, df = 1, pVRP (42% versus 16% of the eligible weeks, respectively; Mann-Whitney z test pVRP; Mann-Whitney z test pVRP. Because work is central to recovery, these results should assist stakeholders in planning improved services for veterans with PTSD.

  8. Veterans Integrated Services Networks (VISN), Markets, Submarkets, Sectors and Counties by Geographic Location

    Data.gov (United States)

    Department of Veterans Affairs — The Department of Veterans Affairs (VA) provides healthcare services to its veterans across the USA including territories and possessions. Healthcare services are...

  9. Psychiatric disorder in male veterans and nonveterans.

    Science.gov (United States)

    Norquist, G S; Hough, R L; Golding, J M; Escobar, J I

    1990-05-01

    Prevalences of Diagnostic Interview Schedule/DSM-III psychiatric disorders for male veterans and nonveterans from four war eras were estimated using data from over 7500 male community respondents interviewed by the Epidemiologic Catchment Area program at five geographic areas across the country. Veterans serving after Vietnam (Post-Vietnam era) had greater lifetime and 6-month prevalences of psychiatric disorder than their nonveteran counterparts, whereas the reverse tended to be the case for the Vietnam, Korean, and World War II war eras. Comparisons across war eras revealed a trend for more psychiatric disorder, especially substance abuse, in younger veterans and nonveterans than in older respondents.

  10. The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder.

    Science.gov (United States)

    O'Toole, Brian I; Catts, Stanley V; Outram, Sue; Pierse, Katherine R; Cockburn, Jill

    2009-08-01

    The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectations. Of 67 long-term conditions, the prevalences of 47 were higher and the prevalences of 4 were lower when compared with population expectations. Half of all veterans took some form of medication for mental well-being. The prevalence of psychiatric diagnoses exceeded Australian population expectations. Military and war service characteristics and age were the most frequent predictors of physical health endpoints, while PTSD was most strongly associated with psychiatric diagnoses. Draftees had better physical health than regular enlistees but no better mental health. Army service and war-related PTSD are associated with risk of illness in later life among Australian Vietnam veterans.

  11. Life satisfaction post stroke: The role of illness cognitions.

    Science.gov (United States)

    van Mierlo, M L; van Heugten, C M; Post, Mwm; de Kort, Plm; Visser-Meily, Jma

    2015-08-01

    To describe illness cognitions two months and two years post stroke and to investigate changes in illness cognitions over time. We also examined the associations between illness cognitions and life satisfaction at two months and two years post stroke and investigated if changes in illness cognitions predicted life satisfaction two years post stroke, taking demographic and stroke-related factors and emotional symptoms into account. Prospective cohort study in which 287 patients were assessed at two months and two years post stroke. The illness cognitions helplessness (maladaptive), acceptance (adaptive) and perceiving benefits (adaptive) were measured with the Illness Cognition Questionnaire. Life satisfaction was assessed with two life satisfaction questions. Correlational and regression analyses were performed. Patients experienced both maladaptive and adaptive illness cognitions two months and two years post stroke. Only acceptance increased significantly from two months to two years post stroke (p≤0.01). Helplessness, acceptance and perceiving benefits were significantly associated with life satisfaction at two months (R2=0.42) and two years (R2=0.57) post stroke. Furthermore, illness cognitions two months post stroke and changes in illness cognitions predicted life satisfaction two years post stroke (R2=0.57). Illness cognitions and changes in illness cognitions were independently associated with life satisfaction two years post stroke. It is therefore important during rehabilitation to focus on reducing maladaptive behavior and feelings to promote life satisfaction, and on promoting adaptive illness cognitions. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. More Research on Veteran Employment Would Show What’s Good for Business and for Veterans

    Science.gov (United States)

    2016-01-01

    beginnings of a reversal in the employer-employee dynamic. This shift also has the potential to promote sustained attention around veteran employment...empirical data to confirm this assertion. Building the business case for hiring veterans is critical to sustaining veteran employment efforts over...industries and available resources for entrepreneurship . These events are hosted by the U.S. Chamber of Commerce in partnership with DoD, other

  13. Treatment-seeking veterans of Iraq and Afghanistan: comparison with veterans of previous wars.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert

    2008-07-01

    Differences in the characteristics and mental health needs of veterans of the Iraq/Afghanistan war when compared with those of veterans who served in the Persian Gulf war and in the Vietnam war may have important implications for Veterans Affairs (VA) program and treatment planning. Subjects were drawn from administrative data bases of veterans who sought treatment from specialized VA programs for treatment of posttraumatic stress disorder (PTSD). Current Iraq/Afghanistan veterans were compared with 4 samples of outpatient and inpatient Persian Gulf and Vietnam veterans whose admission to treatment was either contemporaneous or noncontemporaneous with their admission. A series of analyses of covariance was used hierachically to control for program site and age. In analyses of contemporaneous veterans uncontrolled for age, Iraq/Afghanistan veterans differed most notably from Vietnam veterans by being younger, more likely to be female, less likely to be either married or separated/divorced, more often working, less likely to have ever been incarcerated, and less likely to report exposure to atrocities in the military. Regarding clinical status, Iraq/Afghanistan veterans were less often diagnosed with substance abuse disorders, manifested more violent behavior, and had lower rates of VA disability compensation because of PTSD. Differences are more muted in comparisons with Persian Gulf veterans, particularly in those involving noncontemporaneous samples, or those that controlled for age differences. Among recent war veterans with PTSD, social functioning has largely been left intact. There is a window of opportunity, therefore, for developing and focusing on treatment interventions that emphasize the preservation of these social assets.

  14. Engagement in mental health treatment among veterans returning from Iraq.

    Science.gov (United States)

    Stecker, Tracy; Fortney, John; Hamilton, Francis; Sherbourne, Cathy D; Ajzen, Icek

    2010-03-24

    Many veterans return from combat experiencing a variety of mental health concerns. Previous research has documented a stigma associated with seeking treatment that interferes with the decision to seek treatment. This study, conceptualized using the theory of planned behavior, assessed beliefs about mental health treatment in order to understand mental health treatment seeking behavior among a group of returning National Guard soldiers who served in the war in Iraq. Participants were one hundred and fifty Operation Iraqi Freedom National Guard soldiers who screened positive for depression, posttraumatic stress disorder, generalized anxiety disorder, panic disorder or alcohol abuse disorder on the Mini International Neuropsychiatric Interview (MINI). Participants were asked to complete a questionnaire assessing beliefs about mental health treatment and treatment-seeking behavior. Beliefs related to symptom reduction and work were significantly related to mental health treatment-seeking behavior. Interventions developed to engage veterans into care must be directed toward cognitive factors that motivate treatment seeking in addition to traditionally targeted structural barriers.

  15. Evaluation of brief treatment of symptoms of psychological trauma among veterans residing in a homeless shelter by use of Accelerated Resolution Therapy.

    Science.gov (United States)

    Kip, Kevin E; D'Aoust, Rita F; Hernandez, Diego F; Girling, Sue Ann; Cuttino, Barrett; Long, Mary Kathryn; Rojas, Paola; Wittenberg, Trudy; Abhayakumar, Alisha; Rosenzweig, Laney

    2016-01-01

    Posttraumatic stress disorder (PTSD) is prevalent in both homeless and nonhomeless veterans. To examine unique characteristics of being homeless that may influence PTSD treatment completion and clinical success. Twenty-three veterans who were homeless and residing in a homeless shelter, along with 94 veterans from the community, were enrolled to receive one to five sessions of Accelerated Resolution Therapy (ART), an emerging trauma-focused therapy for symptoms of PTSD. Rates of treatment completion with ART and acute and 6-month change in symptoms of PTSD were compared in an observational (nonrandomized) manner by housing status. Compared to veterans recruited from the community, veterans residing in the homeless shelter were older and presented with more extensive psychopathology yet had less combat exposure while being more likely to have experienced sexual assault. Rates of treatment completion were 52.2% (12 of 23) among homeless veterans compared to 81.9% (77 of 94) among veterans from the community (p = .005). Among treatment completers, both groups received an average of four sessions of ART. Reduction of symptoms of PTSD was substantial and nonsignificantly greater among homeless veterans vs. those treated from the community (p = .14), as were comorbidity reductions in depression, anxiety, sleep quality, pain, and improved quality of life. Results at 6-month posttreatment follow-up were similar. Although limited by small sample size and a nonrandomized design, ART appears to be an effective, brief treatment for symptoms of PTSD among veterans residing in a homeless shelter. However, development of effective strategies to maximize treatment completion among homeless veterans is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Criminal offending and distinguishing features of offenders among persons experiencing a first episode of psychosis.

    LENUS (Irish Health Repository)

    Hodgins, Sheilagh

    2011-02-01

    Persons with severe mental illness (SMI) are at increased risk of criminal offending, particularly violent offending, as compared with the general population. Most offenders with SMI acquire convictions prior to contact with mental health services. This study examined offending among 301 individuals experiencing their first episode of psychosis.

  17. Mental Health Among Military Personnel and Veterans

    National Research Council Canada - National Science Library

    Pickett, Treven; Rothman, David; Crawford, Eric F; Brancu, Mira; Fairbank, John A; Kudler, Harold S

    2015-01-01

    This commentary describes the prevalence of mental health problems affecting military service members and veterans in North Carolina and the rest of the nation, with a special emphasis on those who...

  18. Helping Veterans and Their Families Fight On!

    Directory of Open Access Journals (Sweden)

    Megan Hazle

    2012-04-01

    Full Text Available This new generation of veterans is coming home to families, friends, employers, and communities that likely do not understand military culture, nor the effects that military service and reintegration have on a veteran’s life, leading to the next war – the Reintegration War. Military servicemembers, veterans, and their families face challenges within the Reintegration War that are different from their civilian counterparts and are complicated by military-specific circumstances. In order to more effectively and efficiently address the challenges servicemembers, veterans, and their families face, we need to work together in a comprehensive effort. Strategies are presented to help win the Reintegration War and ease the transition for servicemembers, veterans, and their families.

  19. Sexual Trauma: Women Veterans Health Care

    Science.gov (United States)

    ... Enter ZIP code here Health Awareness Campaigns: Sexual Trauma Sexual Trauma Women Veterans Health Care has created materials to ... 10-320LG Dimensions: 11" x 17" Effects of Sexual Trauma One in five women in the United States ...

  20. 78 FR 67285 - Veterans Day, 2013

    Science.gov (United States)

    2013-11-08

    ... women should have the chance to power our economic engine, both because their talents demand it and... most demanding of circumstances and in the most dangerous corners of the earth, America's veterans have...

  1. Firearm Ownership Among Military Veterans With PTSD: A Profile of Demographic and Psychosocial Correlates.

    Science.gov (United States)

    Heinz, Adrienne J; Cohen, Nicole L; Holleran, Lori; Alvarez, Jennifer A; Bonn-Miller, Marcel O

    2016-10-01

    Post-traumatic stress disorder (PTSD), a condition that disproportionately affects military veterans, is associated with heightened rates of aggression and suicide. Although experience with firearms is common among this population, virtually nothing is known regarding who is more likely to own a firearm and whether firearm ownership is differentially associated with psychological and behavioral risk factors among veterans with PTSD. Of 465 veterans (79% male) entering PTSD treatment, 28% owned a firearm (median number of firearms among owners = 3, range = 1-40). Firearm owners reported higher income were less likely to be unemployed, and were more likely to be male, Caucasian, married, and living in permanent housing. Ownership was associated with higher combat exposure and driving aggression, yet lower rates of childhood and military sexual trauma, suicidal ideation, and incarceration. Ownership was not associated with previous suicide attempt, arrest history, number of traumas experienced, PTSD symptoms, or depression. Together, among a sample of treatment-seeking military veterans with PTSD, those who owned a firearm appeared to demonstrate greater stability across a number of domains of functioning. Importantly though, routine firearm safety discussions (e.g., accessibility restrictions; violence risk assessments) and bolstering of anger management skills remain critical when working with this high-risk population. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  2. A new generation of women veterans: stressors faced by women deployed to Iraq and Afghanistan.

    Science.gov (United States)

    Street, Amy E; Vogt, Dawne; Dutra, Lissa

    2009-12-01

    The extent of female service members' involvement in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), in terms of both the number of women deployed and the scope of their involvement, is unprecedented. While many of the mental health readjustment issues of female service members are likely to mirror those of the majority male Veteran population, this newest generation of women Veterans may also face unique threats to their mental health. The goal of this review it to highlight emerging issues relevant to the development of posttraumatic stress disorder (PTSD) among women deployed to Iraq and Afghanistan by reviewing the existing literature on gender-relevant issues among this cohort, as well as raising theoretically important issues that are worthy of further empirical investigation. Topics addressed include gender differences in combat experiences and in PTSD following combat exposure; sexual assault, sexual harassment and other interpersonal stressors experienced during deployment; women Veterans' experiences of premilitary trauma exposure; and unique stressors faced by women Veterans during the homecoming readjustment period. Given that most models of the impact of war zone deployment on PTSD are predicated on the experiences of male service members, women's expanding role in combat operations presents both an opportunity and a challenge to adapt these models to more effectively capture the experiences of female service members.

  3. Identity adjustment among Afghanistan and Iraq war veterans with reintegration difficulty.

    Science.gov (United States)

    Orazem, Robert J; Frazier, Patricia A; Schnurr, Paula P; Oleson, Heather E; Carlson, Kathleen F; Litz, Brett T; Sayer, Nina A

    2017-08-01

    To examine perceptions of identity adjustment in a diverse, national sample of U.S. veterans of the wars in Afghanistan and Iraq. The authors conducted a planned thematic analysis of text written by Afghanistan and Iraq war veterans when they were asked to describe their reintegration difficulties as part of a randomized controlled trial (RCT) of online expressive writing (Sayer et al., 2015). Participants were 100 randomly selected veterans from the larger study (42 women and 58 men, 60 active duty and 38 reserves or National Guard). Nearly 2/3s of participants wrote about their identity adjustment. The 5 interrelated areas of identity adjustment difficulty were (a) feeling like one does not belong in civilian society, (b) missing the military's culture and structured lifestyle, (c) holding negative views of civilian society, (d) feeling left behind compared to civilian counterparts due to military service, and (e) having difficulty finding meaning in the civilian world. The authors did not observe differences by gender. However, those deployed from active duty were particularly likely to feel as if they did not belong in civilian society and that they had not acquired needed skills, whereas those deployed from the reserves or National Guard experienced difficulty in reestablishing former civilian identities. Identity adjustment is a critical yet understudied aspect of veteran reintegration into community life following combat deployment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Neuropsychological Functioning, Coping, and Quality of Life among Returning War Veterans

    Science.gov (United States)

    Martindale, Sarah L.; Morissette, Sandra B.; Kimbrel, Nathan A.; Meyer, Eric C.; Kruse, Marc I.; Gulliver, Suzy B.; Dolan, Sara L.

    2016-01-01

    Purpose The present research tested the hypothesis that action- and emotion-focused coping strategies would mediate the relationship between neuropsychological functioning and quality of life among a sample of returning Iraq/Afghanistan veterans. Method Veterans (N = 130) who served as part of the wars in Iraq and Afghanistan, completed a diagnostic assessment of PTSD, a battery of questionnaires assessing coping style, traumatic brain injury (TBI), and quality of life, and neuropsychological tests measuring attention, learning and memory, working memory, inhibition, executive control, and visual motor coordination. Results Executive control, immediate and delayed verbal recall, and visual motor coordination were associated with quality of life. However, after controlling for the effects of combat exposure, PTSD, and probable TBI, no measure of neuropsychological functioning was directly associated with quality of life. Mediation analyses indicated that delayed verbal recall influenced quality of life through its effect on action-focused coping. Conclusions Although replication is needed, these findings indicate that delayed verbal recall may indirectly influence quality of life among Iraq/Afghanistan veterans through its association with action-focused coping strategies. Psychologists who are working with veterans that are experiencing memory difficulties and poor quality of life may consider focusing on improving coping skills prior to rehabilitation of memory deficits. PMID:26891248

  5. Barriers to Psychosocial Services among Homeless Women Veterans

    Science.gov (United States)

    HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

    2015-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety. PMID:26617471

  6. Barriers to Psychosocial Services among Homeless Women Veterans.

    Science.gov (United States)

    Hamilton, Alison B; Poza, Ines; Hines, Vivian; Washington, Donna L

    2012-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety.

  7. Being closely connected to health care providers experiencing burnout: putting one's life on hold to help.

    Science.gov (United States)

    Ericson-Lidman, Eva; Strandberg, Gunilla

    2010-02-01

    Being closely connected to a person experiencing illness may be a trying experience.This study aimed to illuminate meanings of being closely connected to health care providers experiencing burnout. Ten interviews were conducted with five people closely connected (i.e., family members or supportive friends) to health care providers recovering from burnout. The interviews were tape-recorded and transcribed verbatim, and the resulting text was interpreted using a phenomenological-hermeneutic method. One consequence of being closely connected to health care providers experiencing burnout is putting one's life on hold to help. In facing an almost unmanageable burden, those closely connected revealed their own suffering, emphasizing their need for support. Health care professionals need to be aware that those who are closely connected to a person experiencing burnout may lack knowledge about burnout and its related challenges. It is to be hoped such knowledge would allow significant others to better support the person experiencing burnout and promote their own health.

  8. Medical costs of war in 2035: long-term care challenges for veterans of Iraq and Afghanistan.

    Science.gov (United States)

    Geiling, James; Rosen, Joseph M; Edwards, Ryan D

    2012-11-01

    War-related medical costs for U.S. veterans of Iraq and Afghanistan may be enormous because of differences between these wars and previous conflicts: (1) Many veterans survive injuries that would have killed them in past wars, and (2) improvised explosive device attacks have caused "polytraumatic" injuries (multiple amputations; brain injury; severe facial trauma or blindness) that require decades of costly rehabilitation. In 2035, today's veterans will be middle-aged, with health issues like those seen in aging Vietnam veterans, complicated by comorbidities of posttraumatic stress disorder, traumatic brain injury, and polytrauma. This article cites emerging knowledge about best practices that have demonstrated cost-effectiveness in mitigating the medical costs of war. We propose that clinicians employ early interventions (trauma care, physical therapy, early post-traumatic stress disorder diagnosis) and preventive health programs (smoking cessation, alcohol-abuse counseling, weight control, stress reduction) to treat primary medical conditions now so that we can avoid treating costly secondary and tertiary complications in 2035. (We should help an amputee reduce his cholesterol and maintain his weight at age 30, rather than treating his heart disease or diabetes at age 50.) Appropriate early interventions for primary illness should preserve veterans' functional status, ensure quality clinical care, and reduce the potentially enormous cost burden of their future health care.

  9. 'Everything just seems much more right in nature': How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden.

    Science.gov (United States)

    Poulsen, Dorthe Varning; Stigsdotter, Ulrika K; Djernis, Dorthe; Sidenius, Ulrik

    2016-01-01

    Available evidence shows that an increasing number of soldiers are seeking help for post-traumatic stress disorder. The post-traumatic stress disorder condition has big emotional and psychological consequences for the individual, his/her family and the society. Little research has been done to explore the impact of nature-based therapy for veterans with post-traumatic stress disorder although there is a growing amount of evidence pointing towards positive outcome. This qualitative study aims to achieve a deeper understanding of this relationship from the veteran's perspective. Eight Danish veterans participated in a 10-week nature-based therapy. Qualitative interviews were conducted and analysed using the interpretative phenomenological method. The results indicated that the veterans have achieved tools to use in stressful situations and experienced an improvement in their post-traumatic stress disorder symptoms.

  10. 78 FR 65452 - Proposed Information Collection (Veterans, Researchers, and IRB Members Experiences With...

    Science.gov (United States)

    2013-10-31

    ... understand Veterans' preferences on research recruitment methods. The data will be published in peer-review... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... Recruitment Restrictions); Comment Request AGENCY: Veterans Health Administration, Department of Veterans...

  11. 75 FR 68040 - Proposed Information Collection (Veterans Mortgage Life Insurance Statement) Activity: Comment...

    Science.gov (United States)

    2010-11-04

    ... Collection (Veterans Mortgage Life Insurance Statement) Activity: Comment Request AGENCY: Veterans Benefits... to decline Veterans Mortgage Life Insurance. DATES: Written comments and recommendations on the... techniques or the use of other forms of information technology. Title: Veterans Mortgage Life Insurance...

  12. Experienced General Music Teachers' Instructional Decision Making

    Science.gov (United States)

    Johnson, Daniel C.; Matthews, Wendy K.

    2017-01-01

    The purpose of this descriptive study was to explore experienced general music teachers' decision-making processes. Participants included seven experienced, American general music teachers who contributed their views during two phases of data collection: (1) responses to three classroom scenarios; and (2) in-depth, semi-structured, follow-up…

  13. Experienced discrimination amongst European old citizens

    NARCIS (Netherlands)

    van den Heuvel, Wim J. A.; van Santvoort, Marc M.

    2011-01-01

    This study analyses the experienced age discrimination of old European citizens and the factors related to this discrimination. Differences in experienced discrimination between old citizens of different European countries are explored. Data from the 2008 ESS survey are used. Old age is defined as

  14. How war veterans with post-traumatic stress disorder experience nature-based therapy in a forest therapy garden

    DEFF Research Database (Denmark)

    Poulsen, Dorthe Varning

    treatments. The objective of this Ph.D. project was to explore the impact of nature-based therapy (NBT) from the perspective of veterans suffering from PTSD. The thesis consists of two studies: A systematic literature review and a qualitative single-case study. The review aims to describe state......-of-the-art research within the area of NBT, the evidence for treatment offered to veterans with PTSD, nature-assisted therapy (therapy that uses nature with the purpose of recovery), and the nature setting in which the therapy was conducted. The results pointed towards a positive benefit of nature-assisted therapy...... in the University of Copenhagen’s therapy garden Nacadia®, located in the Hoersholm Arboretum. The aim was to explore how eight veterans experienced the NBT, the garden and the arboretum and the NBA in relation to living with PTSD. The data was collected through four individual in-depth interview rounds, which were...

  15. Using Structured and Unstructured Data to Refine Estimates of Military Sexual Trauma Status Among US Military Veterans.

    Science.gov (United States)

    Gundlapalli, Adi V; Brignone, Emily; Divita, Guy; Jones, Audrey L; Redd, Andrew; Suo, Ying; Pettey, Warren B P; Mohanty, April; Gawron, Lori; Blais, Rebecca; Samore, Matthew H; Fargo, Jamison D

    2017-01-01

    Sexual trauma survivors are reluctant to disclose such a history due to stigma. This is likely the case when estimating the prevalence of sexual trauma experienced in the military. The Veterans Health Administration has a program by which all former US military service members (Veterans) are screened for military sexual trauma (MST) using a questionnaire. Administrative data on MST screens and a change of status from an initial negative answer to positive and natural language processing (NLP) on electronic medical notes to extract concepts related to MST were used to refine initial estimates of MST among a random sample of 20,000 Veterans. The initial MST positive screen of 15.4% among women was revised upward to 21.8% using administrative data and further to 24.5% by adding NLP results. The overall estimate of MST status in women and men in this sample was revised from 8.1% to 13.1% using both data elements.

  16. Effects of low-level sarin and cyclosarin exposure on white matter integrity in Gulf War Veterans.

    Science.gov (United States)

    Chao, Linda L; Zhang, Yu; Buckley, Shannon

    2015-05-01

    We previously found evidence of reduced gray and white matter volume in Gulf War (GW) veterans with predicted low-level exposure to sarin (GB) and cyclosarin (GF). Because loss of white matter tissue integrity has been linked to both gray and white matter atrophy, the current study sought to test the hypothesis that GW veterans with predicted GB/GF exposure have evidence of disrupted white matter microstructural integrity. Measures of fractional anisotropy and directional (i.e., axial and radial) diffusivity were assessed from the 4T diffusion tensor images (DTI) of 59 GW veterans with predicted GB/GF exposure and 59 "matched" unexposed GW veterans (mean age: 48 ± 7 years). The DTI data were analyzed using regions of interest (ROI) analyses that accounted for age, sex, total brain gray and white matter volume, trauma exposure, posttraumatic stress disorder, current major depression, and chronic multisymptom illness status. There were no significant group differences in fractional anisotropy or radial diffusivity. However, there was increased axial diffusivity in GW veterans with predicted GB/GF exposure compared to matched, unexposed veterans throughout the brain, including the temporal stem, corona radiata, superior and inferior (hippocampal) cingulum, inferior and superior fronto-occipital fasciculus, internal and external capsule, and superficial cortical white matter blades. Post hoc analysis revealed significant correlations between higher fractional anisotropy and lower radial diffusivity with better neurobehavioral performance in unexposed GW veterans. In contrast, only increased axial diffusivity in posterior limb of the internal capsule was associated with better psychomotor function in GW veterans with predicted GB/GF exposure. The finding that increased axial diffusivity in a region of the brain that contains descending corticospinal fibers was associated with better psychomotor function and the lack of significant neurobehavioral deficits in veterans

  17. Assessment of psychological pain in suicidal veterans.

    Directory of Open Access Journals (Sweden)

    Christopher Reist

    Full Text Available Psychological pain is a relatively understudied and potentially important construct in the evaluation of suicidal risk. Psychological pain also referred to as 'mental pain' or 'psychache' can be defined as an adverse emotional reaction to a severe trauma (e.g., the loss of a child or may be associated with an illness such as depression. When psychological pain levels reach intolerable levels, some individuals may view suicide as the only and final means of escape. To better understand psychological pain, we previously developed and validated a brief self-rating 10-item scale, Mee-Bunney Psychological Pain Assessment Scale [MBP] in depressed patients and non-psychiatric controls. Our results showed a significant increase in psychological pain in the depressed patients compared to controls. We also observed a significant linear correlation between psychological pain and suicidality in the depressed patient cohort. The current investigation extends our study of psychological pain to a diagnostically heterogeneous population of 57 US Veterans enrolled in a suicide prevention program. In addition to the MBP, we administered the Columbia Suicide Severity Rating Scale (C-SSRS, Beck Depression Inventory (BDI-II, Beck Hopelessness Scale (BHS, and the Barratt Impulsiveness Scale (BIS-11. Suicidal patients scoring above a predetermined threshold for high psychological pain also had significantly elevated scores on all the other assessments. Among all of the evaluations, psychological pain accounted for the most shared variance for suicidality (C-SSRS. Stepwise regression analyses showed that impulsiveness (BIS and psychological pain (MBP contributed more to suicidality than any of the other combined assessments. We followed patients for 15 months and identified a subgroup (24/57 with serious suicide events. Within this subgroup, 29% (7/24 had a serious suicidal event (determined by the lethality subscale of the C-SSRS, including one completed suicide. Our

  18. National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

    Science.gov (United States)

    Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

    2017-12-01

    To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  19. Gender disparities in Veterans Health Administration care: importance of accounting for veteran status.

    Science.gov (United States)

    Frayne, Susan M; Yano, Elizabeth M; Nguyen, Vu Q; Yu, Wei; Ananth, Lakshmi; Chiu, Victor Y; Phibbs, Ciaran S

    2008-05-01

    In an effort to assess and reduce gender-related quality gaps, the Veterans Health Administration (VHA) has promoted gender-based research. Historically, such appraisals have often relied on secondary databases, with little attention to methodological implications of the fact that VHA provides care to some nonveteran patients. To determine whether conclusions about gender differences in utilization and cost of VHA care change after accounting for veteran status. Cross-sectional. All users of VHA in 2002 (N = 4,429,414). Veteran status, outpatient/inpatient utilization and cost, from centralized 2002 administrative files. Nonveterans accounted for 50.7% of women (the majority employees) but only 3.0% of men. Among all users, outpatient and inpatient utilization and cost were far lower in women than in men, but in the veteran subgroup these differences decreased substantially or, in the case of use and cost of outpatient care, reversed. Utilization and cost were very low among women employees; women spouses of fully disabled veterans had utilization and costs similar to those of women veterans. By gender, nonveterans represent a higher proportion of women than of men in VHA, and some large nonveteran groups have low utilization and costs; therefore, conclusions about gender disparities change substantially when veteran status is taken into account. Researchers seeking to characterize gender disparities in VHA care should address this methodological issue, to minimize risk of underestimating health care needs of women veterans and other women eligible for primary care services.

  20. National study of discontinuation of long-term opioid therapy among veterans.

    Science.gov (United States)

    Vanderlip, Erik R; Sullivan, Mark D; Edlund, Mark J; Martin, Bradley C; Fortney, John; Austen, Mark; Williams, James S; Hudson, Teresa

    2014-12-01

    Veterans have high rates of chronic pain and long-term opioid therapy (LTOT). Understanding predictors of discontinuation from LTOT will clarify the risks for prolonged opioid use and dependence among this population. All veterans with at least 90 days of opioid use within a 180-day period were identified using national Veteran's Health Affairs (VHA) data between 2009 and 2011. Discontinuation was defined as 6 months with no opioid prescriptions. We used Cox proportional hazards analysis to determine clinical and demographic correlates for discontinuation. A total of 550,616 veterans met criteria for LTOT. The sample was primarily male (93%) and white (74%), with a mean age of 57.8 years. The median daily morphine equivalent dose was 26 mg, and 7% received high-dose (>100mg MED) therapy. At 1 year after initiation, 7.5% (n=41,197) of the LTOT sample had discontinued opioids. Among those who discontinued (20%, n=108,601), the median time to discontinuation was 317 days. Factors significantly associated with discontinuation included both younger and older age, lower average dosage, and having received less than 90 days of opioids in the previous year. Although tobacco use disorders decreased the likelihood of discontinuation, co-morbid mental illness and substance use disorders increased the likelihood of discontinuation. LTOT is common in the VHA system and is marked by extended duration of use at relatively low daily doses with few discontinuation events. Opioid discontinuation is more likely in veterans with mental health and substance use disorders. Further research is needed to delineate causes and consequences of opioid discontinuation. Published by Elsevier B.V.

  1. Violence against woman: psychic and mental illness

    OpenAIRE

    Eliany Nazaré Oliveira; Maria Salete Bessa Jorge

    2012-01-01

    The reflection tries to make explicit the existing interfaces between violence and mental illness, more specifically, inwomen experiencing daily mistreatment. Violence weakens women’s mental health. Psychological consequences of abuse are even more serious than their physical effects. Abuse suffering often destroys woman’s self esteem and exposes her to much higher risk of suffering mental disorders, including depression, post-traumatic stress, tendency towards suicide and consumption of drug...

  2. Examining the bidirectional association between veteran homelessness and incarceration within the context of permanent supportive housing.

    Science.gov (United States)

    Cusack, Meagan; Montgomery, Ann Elizabeth

    2017-05-01

    Homelessness and incarceration share a bidirectional association: individuals experiencing homelessness are more likely to be incarcerated and former inmates are more likely to become homeless. Permanent supportive housing (PSH) programs have demonstrated positive outcomes for participants with criminal histories, yet participants continue to exit to jail or prison and experience subsequent homelessness. Using data on Veterans participating in a PSH program at 4 locations between 2011 and 2014 (N = 1,060), logistic regression was used to examine the risk factors for exiting PSH because of incarceration and returning to homelessness. Though exiting because of incarceration was uncommon, Veterans with a drug use disorder who decreased the frequency of related care over time had an increased risk for this outcome, and a history of incarceration increased Veterans' risk of experiencing ongoing homelessness. Findings can inform housing and reentry interventions which should account for participant risk factors and service needs in an effort to end the cycle of homelessness and incarceration. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Medical, psychiatric and demographic factors associated with suicidal behavior in homeless veterans.

    Science.gov (United States)

    Goldstein, Gerald; Luther, James Francis; Haas, Gretchen Louise

    2012-08-30

    This study assessed potential for suicidal behaviors associated with sociodemographic, predisposing physical and mental health factors and self-reported psychological problems among homeless veterans in a large northeastern region. Data were obtained from a demographic and clinical history interview conducted with 3595 homeless veterans. Odds-ratio (OR) statistics were used to assess potential for suicidal behavior. Statistically significant ratios were similar for ideation and attempts. The highest ratios were for self-report of depression and difficulty controlling violence, but statistically significant ratios were found for reporting sleeping in a treatment facility the night before the interview, receiving VA support for a psychiatric condition, and the diagnoses of Alcoholism, Mood Disorder and Post Traumatic Stress Disorder (PTSD). Low but statistically significant odds-ratios were obtained for most of the physical health items. A negative odds-ratio was obtained for African-American ethnicity. Logistic regression results indicated that for ideation and attempts items entered first involved subjective report of trouble controlling violent behavior and experiencing depression. High odds ratios for the interview items concerning experiencing serious depression and having difficulties controlling violence may have strong implications for treatment and management of homeless veterans. There may be up to 14-1 odds that an individual who reports being seriously depressed or having difficulty inhibiting aggression may have a serious potential for suicidal behaviors. Published by Elsevier Ireland Ltd.

  4. Distance to Veterans Administration Medical Centers as a Barrier to Specialty Care for Homeless Women Veterans.

    Science.gov (United States)

    Gawron, Lori M; Pettey, Warren B P; Redd, Andrew M; Suo, Ying; Gundlapalli, Adi V

    2017-01-01

    Homeless women Veterans have a high prevalence of chronic mental and physical conditions that necessitate frequent healthcare visits, but travel burdens to specialty services may be overwhelming to navigate for this population, especially for those in rural settings. Access to specialty care is a key priority in the Veterans Health Administration (VHA) and understanding the geographic distribution and rural designation of this population in relation to medical centers (VAMC) can assist in care coordination. We identified 41,747 women Veterans age 18-44y with administrative evidence of homelessness in the VHA anytime during 2002-2015. We found 7% live in rural settings and 29% live >40miles from a VAMC. The mean travel distance for homeless women Veterans with a rural designation to a VAMC specialty center was 107 miles. Developing interventions to overcome this travel burden and engage vulnerable Veterans in necessary care can improve overall health outcomes for this high-risk population.

  5. Low Income as a Multiplicative Risk Factor for Oral Pain and Dental Problems Among U.S. Veteran Smokers.

    Science.gov (United States)

    Hicks, Terrell A; Wilson, Sarah M; Thomas, Shaun P; Dennis, Paul A; Neal, Julia M; Calhoun, Patrick S

    2017-05-19

    Compared to the United States (U.S.) general population, military veterans are at an increased risk of experiencing dental problems. This study documented associations between cigarette use and measures of dental/oral concern in a population of U.S. veterans who served in Iraq and Afghanistan. A cross-sectional analysis of survey data from the Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans Health and Needs Study, a study of U.S. military veterans. Out of 5000 surveys mailed to a random sample of OEF/OIF veterans, 1161 surveys were completed and returned. Among study respondents, N = 1114 had non-missing dental/oral pain data and were included for analysis. The survey also included smoking history and demographic information. Univariate and multivariate logistic regression analyses were used to cross-sectionally model the odds of experiencing dental/oral concerns as a function of smoking status. We also examined moderating effects of income and gender on the association between smoking and dental/oral concerns. In univariate and multivariate models, current smoking was associated with risk for dental/oral concerns. However, this association was qualified by a Smoking × Income interaction. For those earning above US$20,000, smoking was not associated with dental/oral concerns. Among veterans with low income, smoking was associated with three times higher odds of increased dental/oral concerns. There was no significant Gender × Smoking interaction. These findings underscore the relevance of factors that moderate the association between smoking and dental/oral concern, namely income. Findings also underscore the importance of interventions to mitigate income disparities in oral healthcare.

  6. Feelings of children when witnessing parents' illness

    Directory of Open Access Journals (Sweden)

    Julia Wakiuchi

    2016-12-01

    Full Text Available This study aimed to learn the experiences of children who witness their parents' illness due to cancer. This is a descriptive, qualitative study, with six children between 10 and 12 years of age, children of cancer patients assisted by a support institution. The data were collected from July to August 2015, based on the guiding question:    "How do you feel about your father/mother's illness?" From the analysis, two categories emerged: Recognizing the disease and the possibility of the parents 'death and, Growing as a child and living as an adult: the repercussions of parents with cancer in their children's lives, which reveal that children understand cancer and the possibility of death of their parents, being also affected by the disease. By experiencing the fears and repercussions of cancer, children need assistance by the family and health team during their parents' illness.

  7. Internet Use and Technology-Related Attitudes of Veterans and Informal Caregivers of Veterans.

    Science.gov (United States)

    Duan-Porter, Wei; Van Houtven, Courtney H; Mahanna, Elizabeth P; Chapman, Jennifer G; Stechuchak, Karen M; Coffman, Cynthia J; Hastings, Susan Nicole

    2017-12-18

    Healthcare systems are interested in technology-enhanced interventions to improve patient access and outcomes. However, there is uncertainty about feasibility and acceptability for groups who may benefit but are at risk for disparities in technology use. Thus, we sought to describe characteristics of Internet use and technology-related attitudes for two such groups: (1) Veterans with multi-morbidity and high acute care utilization and (2) informal caregivers of Veterans with substantial care needs at home. We used survey data from two ongoing trials, for 423 Veteran and 169 caregiver participants, respectively. Questions examined Internet use in the past year, willingness to communicate via videoconferencing, and comfort with new technology devices. Most participants used Internet in the past year (81% of Veterans, 82% of caregivers); the majority of users (83% of Veterans, 92% of caregivers) accessed Internet at least a few times a week, and used a private laptop or computer (81% of Veterans, 89% of caregivers). Most were willing to use videoconferencing via private devices (77-83%). A majority of participants were comfortable attempting to use new devices with in-person assistance (80% of Veterans, 85% of caregivers), whereas lower proportions were comfortable "on your own" (58-59% for Veterans and caregivers). Internet use was associated with comfort with new technology devices (odds ratio 2.76, 95% confidence interval 1.70-4.53). Findings suggest that technology-enhanced healthcare interventions are feasible and acceptable for Veterans with multi-morbidity and high healthcare utilization, and informal caregivers of Veterans. In-person assistance may be important for those with no recent Internet use.

  8. Will Veterans Answer Sexual Orientation and Gender Identity Questions?

    Science.gov (United States)

    Ruben, Mollie A; Blosnich, John R; Dichter, Melissa E; Luscri, Lorry; Shipherd, Jillian C

    2017-09-01

    The Veterans Health Administration does not routinely collect and document sexual orientation and gender identity (SOGI) data, despite existing health disparities among sexual and gender minority Veterans. Because of the legacy of previous Department of Defense (DoD) policies that prohibited disclosure of sexual or gender minority identities among active duty personnel, Veterans may be reluctant to respond to SOGI questions. This population-based study assesses item nonresponse to SOGI questions by Veteran status. This is a secondary analysis of data from a population-based sample of adults in 20 US states that elected to administer a SOGI module in the 2014 Behavioral Risk Factor Surveillance System survey. Prevalence of SOGI refusals and responses of "don't know" were compared for Veterans and non-Veterans. Veterans (n=22,587) and non-Veterans (n=146,475) were surveyed. Nearly all Veteran respondents (≥98%) completed the SOGI questions, with 95.4% identifying as heterosexual, 1.2% as gay or lesbian, 1.2% as bisexual, and 0.59% as transgender. A significantly lower proportion of Veterans than non-Veterans refuse to answer sexual orientation (1.5% vs. 1.9%). There was no difference between Veterans and non-Veterans in responses for gender identity. Veterans are just as likely as non-Veterans to complete SOGI items in survey research. Asking Veterans about SOGI is unlikely to yield significant nonresponse. These data suggest that future research should investigate Veterans' perspectives on being asked about SOGI in research settings and as part of routine clinical care.

  9. Young adult veteran perceptions of peers' drinking behavior and attitudes.

    Science.gov (United States)

    Pedersen, Eric R; Marshall, Grant N; Schell, Terry L; Neighbors, Clayton

    2016-02-01

    Social norms-based interventions have shown promise in reducing drinking behavior and the resulting consequences in young adults. Although most research has focused on young civilians (i.e., college students), some studies have investigated social norms-based interventions with active-duty military and veteran samples. Yet, research has not yet determined how to maximize the effectiveness of social norms-based interventions in this heavy-drinking population. As an initial step toward this goal, the current study utilized a community sample of 1,023 young adult veterans to examine (a) whether veteran perceptions of the drinking behavior of their veteran peers differ from their perceptions of civilian drinking behavior, (b) whether perceptions of specific veteran groups differ from the actual drinking behavior of veterans within those groups, (c) what levels of specificity in reference groups (same-gender civilians, same-branch veterans, same-gender veterans, or same-branch-and-gender veterans) are most strongly associated with veterans' own drinking, and (d) whether perceptions about others' attitudes toward drinking also contribute independently of perceived behavioral norms to veteran drinking. Findings indicated that participants perceived that other veterans drank more than civilians and that veteran groups drank more than veterans in the sample actually drank. Veteran-specific perceived behavioral norms were similar in their associations with drinking outcomes, whereas same-gender civilian perceived behavioral norms exhibited little or no associations with drinking. Veteran-specific perceived attitudinal norms exhibited little or no association with drinking behavior after controlling for perceived behavioral norms. These findings can be used to inform the development of social norms interventions for young adult veterans. (c) 2016 APA, all rights reserved).

  10. War veterans as peace builders

    Directory of Open Access Journals (Sweden)

    Kostić Novica

    2010-01-01

    Full Text Available In the period from 1991. to 1999. over 1500000 people in former Yugoslavia were members of dozens military formations that participated in the war in different manners and with various motives. These persons have actively contributed to the tragedy caused by war, that was and for some time will be the most important factor of social and personal relationships between individuals and the nations in the member states of former Yugoslavia. They are now left on their own and exposed to manipulation by nationalist centers and certain politicians. Because of their wartime past, they are usually depicted as the carriers of nationalistic and warmongering ideas on the 'other' side. However, viewed from the aspect of peace-building, ex-soldiers represent a significant potential, because many of them, in fact, have a need to contribute to building a more just society and feel responsible for what happened. In this paper it is discussed how some war veterans decided to join forces and contribute to the reconciliation in the former Yugoslavia by their joint activities.

  11. Mental illness disclosure in Chinese immigrant communities.

    Science.gov (United States)

    Chen, Fang-Pei; Lai, Grace Ying-Chi; Yang, Lawrence

    2013-07-01

    Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person's participation in networks due to mental illness stigma, especially in Chinese immigrant communities where social networks (the guanxi network) have specific social-cultural significance. This study focused on mental illness disclosure in Chinese immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from 2 Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semistructured interview, including 6 questions on mental illness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants' consideration of 3 critical elements of social relationships. Ganqing, affection associated with relationship building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network, involuntary disclosure could happen without participants' permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations in which they experienced little discriminatory treatment, and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mental illness disclosure among Chinese immigrants were discussed. PsycINFO Database Record (c) 2013 APA, all

  12. Discovering foodborne illness in online restaurant reviews.

    Science.gov (United States)

    Effland, Thomas; Lawson, Anna; Balter, Sharon; Devinney, Katelynn; Reddy, Vasudha; Waechter, HaeNa; Gravano, Luis; Hsu, Daniel

    2018-01-10

    We developed a system for the discovery of foodborne illness mentioned in online Yelp restaurant reviews using text classification. The system is used by the New York City Department of Health and Mental Hygiene (DOHMH) to monitor Yelp for foodborne illness complaints. We built classifiers for 2 tasks: (1) determining if a review indicated a person experiencing foodborne illness and (2) determining if a review indicated multiple people experiencing foodborne illness. We first developed a prototype classifier in 2012 for both tasks using a small labeled dataset. Over years of system deployment, DOHMH epidemiologists labeled 13 526 reviews selected by this classifier. We used these biased data and a sample of complementary reviews in a principled bias-adjusted training scheme to develop significantly improved classifiers. Finally, we performed an error analysis of the best resulting classifiers. We found that logistic regression trained with bias-adjusted augmented data performed best for both classification tasks, with F1-scores of 87% and 66% for tasks 1 and 2, respectively. Our error analysis revealed that the inability of our models to account for long phrases caused the most errors. Our bias-adjusted training scheme illustrates how to improve a classification system iteratively by exploiting available biased labeled data. Our system has been instrumental in the identification of 10 outbreaks and 8523 complaints of foodborne illness associated with New York City restaurants since July 2012. Our evaluation has identified strong classifiers for both tasks, whose deployment will allow DOHMH epidemiologists to more effectively monitor Yelp for foodborne illness investigations.

  13. Mental illness disclosure in Chinese immigrant communities

    Science.gov (United States)

    Chen, Fang-pei; Ying-Chi Lai, Grace; Yang, Lawrence

    2014-01-01

    Support from social networks is imperative to mental health recovery of persons with mental illness. However, disclosing mental illness may damage a person’s participation in networks due to mental illness stigma, especially in Chinese-immigrant communities where social networks (the guanxi network) has specific social-cultural significance. This study focused on mental illness disclosure in Chinese-immigrant communities in New York City. Fifty-three Chinese psychiatric patients were recruited consecutively from two Chinese bilingual psychiatric inpatient units from 2006 to 2010. Two bilingual psychologists interviewed each participant once in a semi-structured interview, including 6 questions on mental illness disclosure. Conventional content analysis was applied to conceptualize the phenomenon. Results showed that participants voluntarily disclosed to a circle of people composed primarily of family and relatives. The decisions and strategies to disclose depended on participants’ consideration of three critical elements of social relationships. Ganqing, affection associated with relationship-building, ultimately determined who had the privilege to know. Renqing, the moral code of reciprocal kindness, further influenced disclosure decisions and what participants anticipated as responses to disclosure. Lastly, concerns over preserving face (lian), a construct representing personal and familial dignity, oftentimes prohibited disclosure. Additionally, in this tight-knit network involuntary disclosure could happen without participants’ permission or knowledge. Participants commonly suffered from stigma after disclosure. However, half of our participants reported situations where they experienced little discriminatory treatment and some experienced support and care as a result of cultural dynamics. Recommendations for culturally sensitive practice to facilitate mental illness disclosure among Chinese immigrants were discussed. PMID:23647389

  14. Perceived Burdensomeness, Thwarted Belongingness, and Fearlessness about Death: Associations With Suicidal Ideation among Female Veterans Exposed to Military Sexual Trauma.

    Science.gov (United States)

    Monteith, Lindsey L; Bahraini, Nazanin H; Menefee, Deleene S

    2017-12-01

    Military sexual trauma (MST) is prevalent among female Veterans and is associated with increased risk for suicidal self-directed violence. Yet research examining processes which contribute to suicidal ideation and attempts among MST survivors has been sparse, focusing primarily on psychiatric symptoms or diagnoses, rather than employing a theory-driven approach. The interpersonal-psychological theory (Joiner, 2005) is a leading theory of suicide that may be particularly relevant for understanding suicidal ideation among female Veterans who have experienced MST. We examined whether constructs derived from the interpersonal-psychological theory of suicide (perceived burdensomeness, thwarted belongingness, and fearlessness about death; Joiner, 2005) were associated with suicidal ideation among female Veterans who had experienced MST, when adjusting for known risk factors for suicide. Ninety-two female Veterans with a history of MST completed the Interpersonal Needs Questionnaire, Acquired Capability for Suicide Scale - Fearlessness about Death Scale, and Beck Scale for Suicide Ideation. Perceived burdensomeness, thwarted belongingness, and fearlessness about death were each associated with suicidal ideation in the past week, adjusting for prior suicide attempts, current depressive symptoms, and current symptoms of posttraumatic stress disorder. When including all three interpersonal-psychological constructs in the model, only perceived burdensomeness and fearlessness about death were significantly associated with suicidal ideation. These findings provide knowledge regarding interpersonal processes that may contribute to suicidal ideation among this high-risk, yet understudied, population. These results also underscore the importance of assessing for interpersonal-psychological constructs-particularly perceived burdensomeness and fearlessness about death-when working with female Veterans who have experienced MST. © 2017 Wiley Periodicals, Inc.

  15. Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide.

    Science.gov (United States)

    Omalu, Bennet; Hammers, Jennifer L; Bailes, Julian; Hamilton, Ronald L; Kamboh, M Ilyas; Webster, Garrett; Fitzsimmons, Robert P

    2011-11-01

    Following his discovery of chronic traumatic encephalopathy (CTE) in football players in 2002, Dr. Bennet Omalu hypothesized that posttraumatic stress disorder (PTSD) in military veterans may belong to the CTE spectrum of diseases. The CTE surveillance at the Brain Injury Research Institute was therefore expanded to include deceased military veterans diagnosed with PTSD. The authors report the case of a 27-year-old United States Marine Corps (USMC) Iraqi war veteran, an amphibious assault vehicle crewman, who committed suicide by hanging after two deployments to Fallujah and Ramadi. He experienced combat and was exposed to mortar blasts and improvised explosive device blasts less than 50 m away. Following his second deployment he developed a progressive history of cognitive impairment, impaired memory, behavioral and mood disorders, and alcohol abuse. Neuropsychiatric assessment revealed a diagnosis of PTSD with hyperarousal (irritability and insomnia) and numbing. He committed suicide approximately 8 months after his honorable discharge from the USMC. His brain at autopsy appeared grossly unremarkable except for congestive brain swelling. There was no atrophy or remote focal traumatic brain injury such as contusional necrosis or hemorrhage. Histochemical and immunohistochemical brain tissue analysis revealed CTE changes comprising multifocal, neocortical, and subcortical neurofibrillary tangles and neuritic threads (ranging from none, to sparse, to frequent) with the skip phenomenon, accentuated in the depths of sulci and in the frontal cortex. The subcortical white matter showed mild rarefaction, sparse perivascular and neuropil infiltration by histiocytes, and mild fibrillary astrogliosis. Apolipoprotein E genotype was 3/4. The authors report this case as a sentinel case of CTE in an Iraqi war veteran diagnosed with PTSD to possibly stimulate new lines of thought and research in the possible pathoetiology and pathogenesis of PTSD in military veterans as part of

  16. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... out for help. Bittersweet More Videos from Veterans Health Administration Watch additional videos about getting help. Behind the Scenes see more videos from Veterans Health Administration Be There: Help Save a Life see ...

  17. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us About About the Veterans Crisis Line ... Live Chat Military Live Chat Deaf - Hard of Hearing Contact Us About About the Veterans Crisis Line ...

  18. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... for help. Bittersweet More Videos from Veterans Health Administration Embedded YouTube video: https://www.youtube.com/v/ ... the Scenes see more videos from Veterans Health Administration Be There: Help Save a Life see more ...

  19. Federal Benefits for Veterans, Dependents and Survivors: 2016 Online Edition

    Science.gov (United States)

    ... AM A... Menu Menu For Veterans Benefit Information Agent Orange Post Traumatic Stress Disorder (PTSD) eBenefits Benefit & Claim ... DVI) Veterans' Mortgage Life Insurance (VMLI) Health Resources Agent Orange Post Traumatic Stress Disorder (PTSD) Dental Care Blue ...

  20. Service Utilization of Veterans Dually Eligible for VA...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service, 1999-2004 According to findings in Service Utilization of Veterans Dually...

  1. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... for help. Bittersweet More Videos from Veterans Health Administration Watch additional videos about getting help. Behind the Scenes see more videos from Veterans Health Administration Be There: Help Save a Life see more ...

  2. For-Profit Institutions and Student Veteran Data

    Science.gov (United States)

    Jones, Kevin C.; Fox Garrity, Bonnie K.

    2017-01-01

    This chapter explores the lack of data about student veterans and reasons this lack of data raises particular concerns about for-profit institutions, which enroll a large percentage of student veterans.

  3. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... facility near you. Spread the Word Download logos, Web ads, and materials and help get the word ... Veteran Suicide The Veterans Crisis Line text-messaging service does not store mobile phone numbers of users ...

  4. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... out for help. Bittersweet More Videos from Veterans Health Administration Embedded YouTube video: https://www.youtube.com/ ... Behind the Scenes see more videos from Veterans Health Administration Be There: Help Save a Life see ...

  5. Genome-Wide Association Study of a Validated Case Definition of Gulf War Illness in a Population-Representative Sample

    Science.gov (United States)

    2013-09-01

    exposed agricultural workers3 and in survivors of the 1995 sub- way sarin attack in Tokyo, Japan.4 Amongthemost troubling reportsof the ill veterans...Version 2.0 and mouse genome set, version 2.0 (Qiagen, Valencia , CA). All data of recent years were obtained with the use of Affimetrix U133 Plus 2.0

  6. Young Adult Veteran Perceptions of Peers’ Drinking Behavior and Attitudes

    Science.gov (United States)

    Pedersen, Eric R.; Marshall, Grant N.; Schell, Terry L.; Neighbors, Clayton

    2015-01-01

    Social norms-based interventions have shown promise in reducing drinking behavior and resulting consequences in young adults. Although most research has focused on young civilians (i.e., college students), some studies have investigated social norms-based interventions with active duty military and veteran samples. Yet, research has not yet determined how to maximize the effectiveness of social norms-based intervention in this heavy drinking population. As an initial step toward this goal, the current study utilized a community sample of 1,023 young adult veterans to examine: (1) whether veteran perceptions of the drinking behavior of their veteran peers differ from their perceptions of civilian drinking behavior, (2) whether perceptions of specific veteran groups differ from actual drinking behavior of veterans within those groups, (3) what levels of specificity in reference groups (same-gender civilians, same-branch veterans, same-gender veterans, or same-branch-and-same-gender veterans) are most strongly associated with veterans’ own drinking, and (4) whether perceptions about others’ attitudes toward drinking also contribute independently of perceived behavioral norms to veteran drinking. Findings indicated that participants perceived that other veterans drank more than civilians and that veteran groups drank more than veterans in the sample actually drank. Veteran-specific perceived behavioral norms were similar in their associations with drinking outcomes, whereas same-gender civilian perceived behavioral norms exhibited little or no associations with drinking. Veteran-specific perceived attitudinal norms exhibited little or no association on drinking behavior after controlling for perceived behavioral norms. These findings can be used to inform the development of social norms interventions for young adult veterans. PMID:26415056

  7. Use of Veterans Affairs and Medicaid Services for Dually Enrolled Veterans.

    Science.gov (United States)

    Yoon, Jean; Vanneman, Megan E; Dally, Sharon K; Trivedi, Amal N; Phibbs, Ciaran S

    2017-06-13

    To examine how dual coverage for nonelderly, low-income veterans by Veterans Affairs (VA) and Medicaid affects their demand for care. Veterans Affairs utilization data and Medicaid Analytic Extract Files. A retrospective, longitudinal study of VA users prior to and following enrollment in Medicaid 2006-2010. Veterans Affairs reliance, or proportion of care provided by VA, was estimated with beta-binomial models, adjusting for patient and state Medicaid program factors. In a cohort of 19,890 nonelderly veterans, VA utilization levels were similar before and after enrolling in Medicaid. VA outpatient reliance was 0.65, and VA inpatient reliance was 0.53 after Medicaid enrollment. Factors significantly associated with greater VA reliance included sociodemographic factors, having a service-connected disability, comorbidity, and higher state Medicaid reimbursement. Factors significantly associated with less VA reliance included months enrolled in Medicaid, managed care enrollment, Medicaid eligibility type, longer drive time to VA care, greater Medicaid eligibility generosity, and better Medicaid quality. Veterans Affairs utilization following new Medicaid enrollment remained relatively unchanged, and the VA continued to provide the large majority of care for dually enrolled veterans. There was variation among patients as Medicaid eligibility and other program factors influenced their use of Medicaid services. © Health Research and Educational Trust.

  8. Stigma experienced by people using mental health services in San Diego County.

    Science.gov (United States)

    Sarkin, Andrew; Lale, Rachel; Sklar, Marisa; Center, Kimberly C; Gilmer, Todd; Fowler, Chris; Heller, Richard; Ojeda, Victoria D

    2015-05-01

    This paper describes how individuals struggling with severe mental illness experience stigma along multiple dimensions including their experiences of discrimination by others, their unwillingness to disclose information about their mental health, and their internalization or rejection of the negative and positive aspects of having mental health problems. This cross-sectional study employs descriptive analyses and linear regression to assess the relationship between demographics, mental health diagnoses and self-reported stigma among people receiving mental health services in a large and ethnically diverse county public mental health system (n = 1,237) in 2009. We used the King Stigma Scale to measure three factors related to stigma: discrimination, disclosure, and positive aspects of mental illness. Most people (89.7 %) reported experiencing some discrimination from having mental health problems. Regression analyses revealed that younger people in treatment experienced more stigma related to mental health problems. Women reported experiencing more stigma than men, but men were less likely to endorse the potentially positive aspects of facing mental health challenges than women. Although people with mood disorders reported more discomfort with disclosing mental illness than people with schizophrenia, they did not report experiencing more discrimination than people with schizophrenia. Study findings suggest that the multidimensional experiences of stigma differ as a function of age, gender, and diagnosis. Importantly, these findings should inform anti-stigma efforts by describing different potential treatment barriers due to experiences of stigma among people using mental health services, especially among younger people and women who may be more susceptible to stigma.

  9. Heat-Related Illnesses

    Science.gov (United States)

    ... this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or any situation that involves extreme heat. Young children and the elderly are most at risk, ...

  10. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or any situation that involves extreme heat. Young children and the elderly are most at risk, ...

  11. MRI in decompression illness

    Energy Technology Data Exchange (ETDEWEB)

    Hierholzer, J.; Stroszczynski, C.; Hosten, N.; Felix, R. [Dept. of Radiology, Charite Campus Virchow-Klinikum, Humboldt Univ. Berlin (Germany); Tempka, A. [Dept. of Traumatology, Charite Campus Virchow-Klinikum, Humboldt Univ. Berlin (Germany); Amodio, F. [Dept. of Radiology, Univ. Federico II di Napoli, Naples (Italy); Haas, J. [Dept. of Neurology, Juedisches Krankenhaus Berlin, Berlin (Germany)

    2000-05-01

    We report a case of decompression illness in which the patient developed paraparesis during scuba diving after rapid ascent. MRI of the spine revealed a focal intramedullary lesion consistent with the symptoms. The pathophysiological and radiological aspects of spinal decompression illness are discussed. (orig.)

  12. Trauma-related dreams of Australian veterans with PTSD: content, affect and phenomenology.

    Science.gov (United States)

    Phelps, Andrea J; Forbes, David; Hopwood, Malcolm; Creamer, Mark

    2011-10-01

    Consensus on the parameters of trauma-related dreams required to meet criteria for post-traumatic stress disorder (PTSD) is critical when: (i) the diagnosis requires a single re-experiencing symptom; and (ii) trauma dreams are prevalent in survivors without PTSD. This study investigated the phenomenology of PTSD dreams in 40 veterans, using structured interview and self-report measures. Dream content varied between replay, non-replay, and mixed, but affect was largely the same as that experienced at the time of trauma across all dream types. ANOVA indicated no difference between dream types on PTSD severity or nightmare distress. The findings provide preliminary support for non-replay dreams to satisfy the DSM B2 diagnostic criterion when the affect associated with those dreams is the same as that experienced at the time of the traumatic event.

  13. 32 CFR 644.405 - Transfers to Veterans Administration.

    Science.gov (United States)

    2010-07-01

    ... Transfers to Veterans Administration. 38 U.S.C. 5003 authorizes the Secretaries of the military departments to transfer, without reimbursement, to the Veterans Administration, facilities, supplies, equipment... 32 National Defense 4 2010-07-01 2010-07-01 true Transfers to Veterans Administration. 644.405...

  14. Leadership Tenets of Military Veterans Working as School Administrators

    Science.gov (United States)

    Bolles, Elliot; Patrizio, Kami

    2016-01-01

    This study investigates the leadership tenets informing veterans' work as school leaders. Drawing on 15 interviews and surveys with military veterans working as educational leaders, the study relies on Stake's (2006) case study method to substantiate assertions that veterans: 1) come into education without the support of a transitional program, 2)…

  15. Marital Adjustment, Parental Functioning, and Emotional Sharing in War Veterans

    Science.gov (United States)

    Solomon, Zahava; Debby-Aharon, Shimrit; Zerach, Gadi; Horesh, Danny

    2011-01-01

    The current study aimed to examine the implications of posttraumatic stress disorder symptoms and emotional sharing in marital adjustment and parental functioning among Israeli veterans of the 1982 Lebanon War. The sample consisted of combat stress reaction (CSR) veterans (n = 264) and non-CSR veterans (n = 209). Results show that traumatized…

  16. Writing with Veterans in a Community Writing Group

    Science.gov (United States)

    Schell, Eileen E.

    2013-01-01

    This article provides an analysis of the growing phenomenon of community writing groups for military veterans. Drawing on the scholarship on literacy studies, community literacy, and veterans' writing groups, the author profiles three veterans' writing groups and provides strategies for starting up, conducting, and sustaining such groups. The…

  17. An Interprofessional Education Project to Address Veterans' Healthcare Needs

    Science.gov (United States)

    Peterson, Jane; Brommelsiek, Margaret; Amelung, Sarah Knopf

    2017-01-01

    Background/Objective: The number of veterans and their families seeking healthcare and support within civilian communities is increasing worldwide. There is a need for healthcare providers to provide sensitive, comprehensive care for veterans with both physical and behavioral health conditions. Many civilian providers are unfamiliar with veterans'…

  18. Searching the Soul: Veterans and Their Arts and Crafts

    Science.gov (United States)

    Hasio, Cindy

    2011-01-01

    For military veterans suffering from the long-term trauma of warfare, arts and crafts become much more than the fabrication of relics; they can literally save the spirit. Dialogue and interaction between the veterans, volunteers, and staff are crucial to the success of veterans' arts and crafts program. The purpose of this research was threefold.…

  19. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available Veterans Crisis Line Skip to Main Content SuicidePreventionLifeline.org Get Help Materials Get Involved Crisis Centers About Be There ... see more videos from Veterans Health Administration Veterans Crisis Line -- After the Call see more videos from ...

  20. Colleges' Experiences: Integrating Support Services for Military Veterans

    Science.gov (United States)

    Karp, Melinda Mechur; Klempin, Serena

    2017-01-01

    To improve the educational experiences and outcomes of student veterans, the Kisco Foundation developed the Kohlberg Prize in 2015. Two cohorts of colleges were awarded competitive grants to enhance their veterans services. This piece examines the process of creating integrated services for student veterans through the institutionalization of…

  1. Military Veterans' Midlife Career Transition and Life Satisfaction

    Science.gov (United States)

    Robertson, Heather C.; Brott, Pamelia E.

    2014-01-01

    Many military veterans face the challenging transition to civilian employment. Military veteran members of a national program, Troops to Teachers, were surveyed regarding life satisfaction and related internal/external career transition variables. Participants included military veterans who were currently or had previously transitioned to K-12…

  2. The Earnings of Veterans: Effects of Military Service

    Science.gov (United States)

    2015-03-01

    Hirsch & Mehay, 2003, p. 681). Then, the authors use a logit model that predicts the selection sample are likely veterans serving on active duty using...veteran data, veteran regression model 17. SECURITY 18. SECURITY CLASSIFICATION OF CLASSIFICATION OF TffiS REPORT PAGE Unclassified Unclassified NSN...3 B. RESEARCH MODELS

  3. Latent Classes of PTSD Symptoms in Vietnam Veterans

    Science.gov (United States)

    Steenkamp, Maria M.; Nickerson, Angela; Maguen, Shira; Dickstein, Benjamin D.; Nash, William P.; Litz, Brett T.

    2012-01-01

    The authors examined heterogeneity in posttraumatic stress disorder (PTSD) symptom presentation among veterans (n = 335) participating in the clinical interview subsample of the National Vietnam Veterans Readjustment Study. Latent class analysis was used to identify clinically homogeneous subgroups of Vietnam War combat veterans. Consistent with…

  4. Palliative Care: The Relief You Need When You're Experiencing Symptoms of Serious Illness

    Science.gov (United States)

    ... from this type of care. What is palliative care? Palliative care is comprehensive treatment of the discomfort, symptoms ... of life. Palliative care is different from hospice care. Palliative care is available to you at any time ...

  5. Caring with Honor: A Grounded Theory of Caring for Veterans within the Veterans Health Administration

    Directory of Open Access Journals (Sweden)

    Alvita K. Nathaniel

    2017-06-01

    Full Text Available Veterans comprise a unique culture. Through their military experience, Veterans become ingrained with shared values, beliefs and attitudes that characterize their everyday existence. Health care providers must take into consideration that culture impacts health care seeking behaviors. The theory of Caring with Honor is emerging through the classic GT method. A team of investigators within the VA health care system gathered data from 19 health care professionals via one-on-one interviews. The emerging theory, Caring with Honor, represents an amplifying process whereby health care professionals engage with Veterans through a process of enculturating, witnessing, connecting, honoring, and caring with purpose.

  6. Three Generations, Three Wars: African American Veterans.

    Science.gov (United States)

    Black, Helen K

    2016-02-01

    This article emerged from pilot research exploring experiences of war and suffering among African American veterans who served in World War II, Korean War, and Vietnam War. Men's experiences as soldiers reflected both racism and the social change that occurred in the Unites States while they served. We used techniques of narrative elicitation, conducting qualitative, ethnographic interviews with each of five veterans in his home. Interviews focused on unique and shared experiences as an African American man and a soldier. Three important themes emerged: (a) Expectations related to War--Although men viewed service to country as an expected part of life, they also expected equal treatment in war, which did not occur; (b) Suffering as an African American--Informants interpreted experiences of suffering in war as related to the lower status of African American servicemen; and (c) Perception of present identity--Each man was honed by the sum of his experiences, including those of combat, racism, and postwar opportunities and obstacles. From 40 to 70 years after the wars were fought, there are few scholarly narrative studies on African American veterans, despite the fact that Korean War Veterans are entering old-old age and few World War II Veterans are alive. The value of pilot research that offers narratives of unheard voices is significant; larger studies can interview more African American veterans to advance knowledge that might soon be lost. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Veterans health administration vocational services for operation iraqi freedom/operation enduring freedom veterans with mental health conditions

    OpenAIRE

    Elizabeth W. Twamley, PhD; Dewleen G. Baker, MD; Sonya B. Norman, PhD; James O. E. Pittman, MSW; James B. Lohr, MD; Sandra G. Resnick, PhD

    2013-01-01

    High rates of mental health conditions and unemployment are significant problems facing Veterans of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). We examined two national Veterans Health Administration (VHA) databases from fiscal years 2008–2009: a larger database (n = 75,607) of OIF/OEF Veterans with posttraumatic stress disorder, depression, substance use disorder, or traumatic brain injury (TBI) and a smaller subset (n = 1,010) of those Veterans whose employment was tracked...

  8. History of guide dog use by veterans.

    Science.gov (United States)

    Ostermeier, Mark

    2010-08-01

    The first guide dog school was established in Germany during World War I to care for German soldiers blinded in that war. Other schools in Germany followed. Observation by an American at one of the schools led to the creation of the first guide dog school in the United States in 1929, "The Seeing Eye." Additional U.S. schools were opened during and after World War II. This article discusses the history of guide dog use by veterans, including the formation of the first guide dog schools in response to aiding blinded servicemen, and the involvement of federal agencies and guide dog schools in providing assistance to blinded veterans.

  9. Chronic disease management for recently homeless veterans: a clinical practice improvement program to apply home telehealth technology to a vulnerable population.

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita; Andersen, Ronald M; McGuire, James; Rubenstein, Lisa; Sapir, Negar; Gelberg, Lillian

    2013-03-01

    Although vulnerable populations may benefit from in-home health information technologies (HIT) that promote disease self-management, there is a "digital divide" in which these groups are often unlikely to use such programs. We describe the early phases of applying and testing an existing Veterans Affairs (VA) HIT-care management program, Care Coordination Home Telehealth (CCHT), to recently homeless Veterans in the US Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) program. Peers were used to support patient participation. CCHT uses in-home messaging devices to provide health education and daily questions about clinical indicators from chronic illness care guidelines, with patient responses reviewed by VHA nurses. Patients could also receive adjunctive peer support. We used medical record review, Veteran interviews, and staff surveys to "diagnose" barriers to CCHT use, assess program acceptability, explore the role of peer support, and inform future quality improvement. Fourteen eligible Veterans in HUD-VASH agreed to CCHT participation. Ten of these Veterans opted to have adjunctive peer support and the other 4 enrolled in CCHT usual care. Although barriers to enrollment/engagement must be addressed, this subset of Veterans in HUD-VASH was satisfied with CCHT. Most Veterans did not require support from peers to engage in CCHT but valued peer social assistance amidst the isolation felt in their scattered-site homes. HIT tools hold promise for in-home care management for recently housed Veterans. Patient-level barriers to enrollment must be addressed in the next steps of quality improvement, testing and evaluating peer-driven CCHT recruitment.

  10. The Post-9/11 GI Bill: Insights from Veterans Using Department of Veterans Affairs Educational Benefits

    Science.gov (United States)

    Bell, Geri L.; Boland, Elizabeth A.; Dudgeon, Brian; Johnson, Kurt

    2013-01-01

    Because the Post-9/11 GI Bill was implemented in August of 2009, increasing numbers of veterans returning from the Global War on Terror (GWT) have drawn on Department of Veterans Affairs (VA) educational benefits. Based on the findings of a mixed-methods study, quantitative and qualitative survey responses from veterans enrolled at a major…

  11. Student service members/veterans on campus: Challenges for reintegration.

    Science.gov (United States)

    Borsari, Brian; Yurasek, Ali; Miller, Mary Beth; Murphy, James G; McDevitt-Murphy, Meghan E; Martens, Matthew P; Darcy, Monica G; Carey, Kate B

    2017-01-01

    Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a meaningful career and financial stability. Evidence suggests that student service members/veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts to facilitate their retention and academic performance. With a focus on SSM/Vs attending colleges and universities, we obtained 57 peer-reviewed and 73 gray literature records published between 2001 and 2015. The current SSM/V literature contains an abundance of gray literature, and the empirical research tends to be limited by cross-sectional design and small sample sizes. SSM/Vs encounter significant personal and environmental challenges when transitioning from the military to college campuses. A variety of services have been developed to address the needs of the SSM/V population, but the efficacy of these services remains largely unknown. In conclusion, there is a clear need to provide education to faculty, students, and staff regarding the experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engagement in mental health services would also be beneficial, as would improved availability of and SSM/V access to academic support. All future programs designed to address the unique challenges of SSM/Vs in the academic environment should also be systematically implemented and evaluated. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Statistical modelling studies examining the dimensional structure of psychopathology experienced by adults with intellectual disabilities: Systematic review

    OpenAIRE

    Melville, Craig A.; Johnson, Paul; Smiley, E.; Simpson, N; McConnachie, A.; Purves, D.; Osugo, M.; Cooper, S.-A.

    2016-01-01

    Diagnosing mental ill-health using categorical classification systems has limited validity for clinical practice and research. Dimensions of psychopathology have greater validity than categorical diagnoses in the general population, but dimensional models have not had a significant impact on our understanding of mental ill-health and problem behaviours experienced by adults with intellectual disabilities. This paper systematically reviews the methods and findings from intellectual disabilitie...

  13. Factor structure and risk factors for the health status of homeless veterans.

    Science.gov (United States)

    Goldstein, Gerald; Luther, James F; Haas, Gretchen L; Appelt, Cathleen J; Gordon, Adam J

    2010-12-01

    Homeless veterans have numerous health problems that have been previously characterized as falling into four major subgroups; addiction, psychosis, vascular disorders, and generalized medical and psychiatric illness. Comorbid conditions are common, often involving a combination of psychiatric and medical disorders. Using data from the same survey of homeless veterans that was used to establish these subgroups with cluster analysis, the present study examined the structure of these subgroup patterns through the use of factor analysis. This analysis yielded a five factor solution. They were named "Cardiac", Mood, Stress, Addiction, and Psychosis factors. Factor scores were computed and an odds ratio analysis was accomplished to determine the association between obtaining a high score on a given factor with a number of sociodemographic and homelessness related variables. It was concluded that health status of homeless veterans is a complex condition, but has a clear latent structure demonstrated by factor analysis. Scoring high or low on a particular factor is associated with numerous historical and sociodemographic considerations, notably age, ethnicity, and employment status.

  14. Increasing Prevalence of Chronic Lung Disease in Veterans of the Wars in Iraq and Afghanistan.

    Science.gov (United States)

    Pugh, Mary Jo; Jaramillo, Carlos A; Leung, Kar-Wei; Faverio, Paola; Fleming, Nicholas; Mortensen, Eric; Amuan, Megan E; Wang, Chen-Pin; Eapen, Blessen; Restrepo, Marcos; Morris, Michael J

    2016-05-01

    Research from the wars in Afghanistan and Iraq have focused on traumatic brain injury (TBI) and mental health conditions; however, it is becoming clear that other health concerns, such as respiratory illnesses, warrant further scientific inquiry. Early reports from theater and postdeployment health assessments suggested an association with deployment-related exposures (e.g., sand, burn pits, chemical, etc.) and new-onset respiratory symptoms. We used data from Veterans Affairs medical encounters between fiscal years 2003 and 2011 to identify trends in chronic obstructive pulmonary disease, asthma, and interstitial lung disease in veterans. We used data from Veterans Affairs and Department of Defense sources to identify sociodemographic (age, sex, race), military (e.g., service branch, multiple deployments) and clinical characteristics (TBI, smoking) of individuals with and without chronic lung diseases. Generalized estimating equations found significant increases over time for chronic obstructive pulmonary disease and asthma in both unadjusted and adjusted analyses. Trends for interstitial lung disease were significant only in adjusted analyses. Age, smoking, and TBI were also significantly associated with chronic lung diseases; however, multiple deployments were not associated. Research is needed to identify which characteristics of deployment-related exposures are linked with chronic lung disease. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  15. Do Alcohol Misuse, Service Utilisation, and Demographic Characteristics Differ between UK Veterans and Members of the General Public Attending an NHS General Hospital?

    Directory of Open Access Journals (Sweden)

    Dominic Murphy

    2016-11-01

    Full Text Available The aim of this paper was to provide insights into alcohol misuse within UK veterans to inform as to whether their presentations differ from the general public. This was done by exploring differences in the severity of alcohol misuse between UK veterans and the general public admitted to a general NHS hospital over an 18 month period using retrospective data. All patients admitted to the hospital were screened for alcohol misuse. Those deemed as experiencing problems were referred for specialist nurse-led support. A total of 2331 individuals were referred for this supported and administered with a standardised assessment that included measures of the severity of alcohol difficulties (AUDIT, dependency levels (LDQ, and assessed for the presence of withdrawal symptoms (CIWA-Ar. In addition, information was collected on service utilisation, referral category (medical or mental health, other substance misuse, and demographic characteristics. No differences were found between the severity of reported alcohol difficulties between veterans and non-veterans. Evidence was found to suggest that veterans were more likely to be referred for support with alcohol difficulties at an older age and to be admitted to hospital for longer periods of time. This could have considerable cost implications for the NHS. It was more common for veterans to present at hospital with physical health difficulties prior to being referred for support for alcohol.

  16. Nutrition in critical illness.

    Science.gov (United States)

    Chan, Daniel L; Freeman, Lisa M

    2006-11-01

    Malnutrition associated with critical illness has been unequivocally associated with increased morbidity and mortality in humans. Because malnutrition may similarly affect veterinary patients, the nutritional requirements of hospitalized critically ill animals must be properly addressed. Proper nutritional support is increasingly being recognized as an important therapeutic intervention in the care of critically ill patients. The current focus of veterinary critical care nutrition, and the major focus of this article, is on carefully selecting the patients most likely to benefit from nutritional support, deciding when to intervene, and optimizing nutritional support to individual patients.

  17. Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention.

    Science.gov (United States)

    Johnson, Sara S; Levesque, Deborah A; Broderick, Lynne E; Bailey, Dustin G; Kerns, Robert D

    2017-10-17

    -day post assessment, there were statistically significant pre-post reductions in pain (Pmanagement (P=.01) and for managing stress (Pchange measure showed that a majority had experienced some level of improvement. User ratings of acceptability were quite high; ratings of usability fell slightly below the mean for digital programs. Preliminary data demonstrate the potential impact of the Health eRide program for chronic musculoskeletal pain for veterans. The results underscore that simultaneously addressing other behaviors may be a promising approach to managing pain and comorbid conditions. Additional formative research is required to complete development of the Health eRide program and to address areas of usability requiring improvement. A randomized trial with longer follow-up is needed to demonstrate the program's long-term effects on pain and pain self-management.

  18. Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study.

    Science.gov (United States)

    Farrelly, Simone; Clement, Sarah; Gabbidon, Jheanell; Jeffery, Debra; Dockery, Lisa; Lassman, Francesca; Brohan, Elaine; Henderson, R Claire; Williams, Paul; Howard, Louise M; Thornicroft, Graham

    2014-05-29

    The unfair treatment of individuals with severe mental illness has been linked to poorer physical and mental health outcomes. Additionally, anticipation of discrimination may lead some individuals to avoid participation in particular life areas, leading to greater isolation and social marginalisation. This study aimed to establish the levels and clinical and socio-demographic associations of anticipated and experienced discrimination amongst those diagnosed with a schizophrenia and comparator severe mental illnesses (bipolar and major depressive disorders). This study was a cross-sectional analysis of anticipated and experienced discrimination from 202 individuals in South London (47% with schizophrenia, 32% with depression and 20% with bipolar disorder). 93% of the sample anticipated discrimination and 87% of participants had experienced discrimination in at least one area of life in the previous year. There was a significant association between the anticipation and the experience of discrimination. Higher levels of experienced discrimination were reported by those of a mixed ethnicity, and those with higher levels of education. Women anticipated more discrimination than men. Neither diagnosis nor levels of functioning were associated with the extent of discrimination. Clinical symptoms of anxiety, depression and suspiciousness were associated with more experienced and anticipated discrimination respectively. The unfair treatment of individuals with severe mental illnesses remains unacceptably common. Population level interventions are needed to reduce levels of discrimination and to safeguard individuals. Interventions are also required to assist those with severe mental illness to reduce internalised stigma and social avoidance.

  19. Adolescent construction of mental illness: implication for engagement and treatment.

    Science.gov (United States)

    Chisholm, Katharine; Patterson, Paul; Greenfield, Sheila; Turner, Erin; Birchwood, Max

    2016-05-11

    Understanding how adolescents perceive mental illness is important for clinicians wishing to improve engagement, and for the development of educational programmes and health-behaviour directed policies. The current research aimed to develop a preliminary model of how adolescents perceive mental illness and construct their understanding of mental health. Forty-six participants aged 11-18 from six schools in Birmingham, UK, took part in one of 12 group interviews. A thematic analysis highlighted a dual perception of mental illness. Adolescents discussed stereotypes and extreme examples of illness, but also displayed an insightful understanding of mental distress which had developed through participants' own experiences. Participants attempted to reconcile and negotiate these conflicting perceptions by creating distinctions between concepts of 'craziness' and 'normality', and reported experiencing negative emotions relating to both perceptions of illness. The findings suggest that once media stereotypes have been acknowledged, adolescents demonstrate a relatively sophisticated understanding of mental illness, although one which differed at times from the diagnostic medical model of mental illness. Focusing on individual symptoms, prevalence rates and prior contact adolescents have had with individuals with mental illnesses provides a framework to discuss mental health and ill-health with adolescents. John Wiley & Sons Australia, Ltd.

  20. Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

    Science.gov (United States)

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-01-01

    Background An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. Methods We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)—Contingency Tracking System Deployment file of military discharges from October 1, 2001–December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Results Less than 2% (n = 1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Conclusions Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women’s use of VA infertility services is an important component of understanding VA

  1. Gender and the use of Veterans Health Administration homeless services programs among Iraq/Afghanistan veterans.

    Science.gov (United States)

    Blackstock, Oni J; Haskell, Sally G; Brandt, Cynthia A; Desai, Rani A

    2012-04-01

    Female Veterans comprise 12% of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, the largest proportion of women to serve of any prior cohort. We sought to determine the sex-specific risk of using a Veterans Health Administration (VHA) homeless program among OEF/OIF Veterans and to identify factors associated with increased risk of program use for women compared with men. We included OEF/OIF Veterans with at least 1 VHA clinical visit between October 1, 2001, and September 30, 2009. The study's outcome was the time to first use of a VHA homeless program. Cox proportional-hazards regression was used to estimate the relative risk of using a homeless program by sex, adjusting for relevant sociodemographic and clinical variables. Exploratory analyses examined interactions between sex and all covariates. Of 445,319 Veterans, 7431 (1.7%) used a VHA homeless program, of which 961 were females (1.8%), and 6470 were males (1.7%) during a median follow-up period of 3.20 years. Women were as likely as men to use a homeless program (adjusted hazard ratio, 1.02; 95% confidence interval, 0.95-1.09); median time to first use was similar for female and male Veterans (1.88 vs. 1.88 y, respectively, P=0.53). In exploratory analyses, we found increased risk of program use for women compared with men for the following subgroups: ages 26-35 years, 100% service-connected disability rating, posttraumatic stress disorder diagnosis, and northeast location. Overall, there was no substantial difference in the sex-specific risk of using a VHA homeless program. In light of this finding, VHA homeless programs must be prepared to recognize and address the unique needs of female OEF/OIF Veterans.

  2. Infertility care among OEF/OIF/OND women Veterans in the Department of Veterans Affairs.

    Science.gov (United States)

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-04-01

    An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)-Contingency Tracking System Deployment file of military discharges from October 1, 2001-December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Less than 2% (n=1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women's use of VA infertility services is an important component of understanding VA's commitment to comprehensive medical care for

  3. Caring with Honor: A Grounded Theory of Caring for Veterans within the Veterans Health Administration

    OpenAIRE

    Alvita K. Nathaniel; Lisa Hardman

    2017-01-01

    Veterans comprise a unique culture. Through their military experience, Veterans become ingrained with shared values, beliefs and attitudes that characterize their everyday existence. Health care providers must take into consideration that culture impacts health care seeking behaviors. The theory of Caring with Honor is emerging through the classic GT method. A team of investigators within the VA health care system gathered data from 19 health care professionals via one-on-one interviews. T...

  4. Soccer kick kinematic differences between experienced and non-experienced soccer players

    Directory of Open Access Journals (Sweden)

    Muñoz López, Alejandro

    2012-01-01

    Full Text Available Purpose: to examine kinematic differences of instep soccer kick between experienced and non-experienced soccer players. Subjects: 17 men between 17 and 21 years old. Methodology: a 3D film system with 4 cameras was used. Maximum power instep kicks were executed. It was analyzed feet velocity in the impact, maximum hip extension, maximum knee flexion and kick phases duration. Results: were found significant differences in feet velocity with non-dominant leg in the impact moment (m/s (Experienced: 14.5±.52, Non-experienced: 12.5±.5; p<.001 and maximum hip extension (degrees (Experienced: 39.2 ± 1.3, Non-experienced: 34.28±3.2; p<.001. Also were significant differences in the second phase duration in both legs (p<.05. Conclusions: Maximum instep soccer kick show significant differences between groups of different level only in non-dominant leg.

  5. Prevalence of probable mental disorders and help-seeking behaviors among veteran and non-veteran community college students.

    Science.gov (United States)

    Fortney, John C; Curran, Geoffrey M; Hunt, Justin B; Cheney, Ann M; Lu, Liya; Valenstein, Marcia; Eisenberg, Daniel

    2016-01-01

    Millions of disadvantaged youth and returning veterans are enrolled in community colleges. Our objective was to determine the prevalence of mental disorders and help-seeking behaviors among community college students. Veterans (n=211) and non-veterans (n=554) were recruited from 11 community colleges and administered screeners for depression (PHQ-9), generalized anxiety (GAD-7), posttraumatic stress disorder (PC-PTSD), non-lethal self-injury, suicide ideation and suicide intent. The survey also asked about the perceived need for, barriers to and utilization of services. Regression analysis was used to compare prevalence between non-veterans and veterans adjusting for non-modifiable factors (age, gender and race/ethnicity). A large proportion of student veterans and non-veterans screened positive and unadjusted bivariate comparisons indicated that student veterans had a significantly higher prevalence of positive depression screens (33.1% versus 19.5%, Pdepression (OR=2.10, P=.01) and suicide ideation (OR=2.31, P=.03). Student veterans had significantly higher odds of perceiving a need for treatment than non-veterans (OR=1.93, P=.02) but were more likely to perceive stigma (beta=0.28, P=.02). Despite greater need among veterans, there were no significant differences between veterans and non-veterans in use of psychotropic medications, although veterans were more likely to receive psychotherapy (OR=2.35, P=.046). Findings highlight the substantial gap between the prevalence of probable mental health disorders and treatment seeking among community college students. Interventions are needed to link community college students to services, especially for student veterans. Copyright © 2016. Published by Elsevier Inc.

  6. Migration by Veterans Who Received Homeless Services From the Department of Veterans Affairs.

    Science.gov (United States)

    Metraux, Stephen; Treglia, Dan; O'Toole, Thomas P

    2016-10-01

    We examined migration patterns among 113,400 homeless veterans, focusing on the prevalence and the basic geographic patterns of this migration. Data were for all veterans who initiated use of Veterans Affairs homeless services in 2011 or 2012; and we followed them using Veterans Affairs administrative records for up to 2 years following this initial contact. Results showed that 15.3% of the veterans migrated across regions while homeless. Those who were homeless for longer periods were more likely to migrate, and migration, were it to occur, was most likely earlier on in veterans' homelessness episodes. There were no clear geographic correlates that explained the dynamics of this migration as, overall, in-migration tended to roughly balance out-migration in a region. These findings suggest that concerns about the extent of migration and its impact on localities are exaggerated, but also sets forth an agenda for more in-depth study of these data to gain a deeper and more expansive understanding of this phenomenon. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  7. 38 CFR 3.501 - Veterans.

    Science.gov (United States)

    2010-07-01

    ...) Disappearance of veteran. See § 3.656. (d) Divorce or annulment (38 U.S.C. 5112(b)(2)): (1) Divorce or annulment prior to October 1, 1982: last day of the calendar year in which divorce or annulment occurred. (2) Divorce or annulment on or after October 1, 1982: last day of the month in which divorce or annulment...

  8. The Veterans Choice Program (VCP): Program Implementation

    Science.gov (United States)

    2017-01-05

    to VACAA and challenges encountered during implantation of the law. Table 1 provides major highlights pertaining to the Veterans Choice Program (VCP...outpatient medical, surgical, and mental healthcare; pharmaceuticals; pregnancy and delivery services; dental care; and durable medical equipment, and

  9. MINDFULNESS BEHANDLING AF DANSKE VETERANER - ET PILOTSTUDIE

    DEFF Research Database (Denmark)

    Fjorback, Lone

    2015-01-01

    I foråret 2014 mødtes en gruppe på 12 danske veteraner en gang om ugen i 9 uger for at deltage i programmet Mindfulness Baseret Stress Reduktion (MBSR). Deltagerne havde meldt sig frivilligt, og gruppen var blandet mht. alder, køn, antal udsendelser og diagnoser. Det, de havde til fælles, var...

  10. 77 FR 4471 - Tribal Veterans Cemetery Grants

    Science.gov (United States)

    2012-01-30

    ... Code, and the 2002 edition of the National Electrical Code, NFPA 70, may be obtained from the National... Frank Salvas, Director of Veterans Cemetery Grants Service, National Cemetery Administration (41E... cemetery grants under the authority of title 38 Code of Federal Regulations (CFR) Part 39.'' Further, on...

  11. Predictors of Mortality in Older Homeless Veterans.

    Science.gov (United States)

    Schinka, John A; Curtiss, Glenn; Leventhal, Katherine; Bossarte, Robert M; Lapcevic, William; Casey, Roger

    2017-10-01

    In this analysis of a cohort of older homeless veterans, we examined psychosocial, health, housing, and employment characteristics to identify predictors of mortality. Our sample of 3,620 older veterans entered Veteran Affairs homeless programs in years 2000-2003. Fifteen variables from a structured interview described this sample and served as predictors. National Death Index data for years 2000-2011 were used to ascertain death. Survival table analyses were conducted to estimate and plot cumulative survival functions. To determine predictors and estimate hazard functions, Cox proportional hazards regression analysis was conducted. Five variables (presence of a serious health issue, hospitalization for alcohol abuse, alcohol dependency, unemployment for 3 years, and age 60+) were associated with increased risk of death; three (non-White, drug dependency, and dental problems) were associated with reduced risk. A risk score, based on total unit-weighted risk for all eight predictors, was used to identify three groups that were found to differ significantly in mortality. These analyses underline the jeopardy faced by older homeless veterans in terms of early death. We were able to identify several variables associated with mortality; more importantly, we were able to show that a risk score based on status for these variables was significantly related to survival.

  12. Research Battles: Survival Tips From a Veteran

    Science.gov (United States)

    Isaacs, Linda L.

    2015-01-01

    Studies of nonorthodox medical treatments may go awry because of inherent flaws in designs that are better suited for trials of pharmaceutical products. Unintended consequences may follow from efforts at randomization, the lack of lead-in periods, required visits for medical assessment, inadequate screening, and a lack of trial publicity. A veteran of a mismanaged trial shares her experiences. PMID:26770164

  13. Helping Student Servicemembers and Veterans Succeed

    Science.gov (United States)

    Callahan, Ron; Jarrat, Dave

    2014-01-01

    Hundreds of thousands of current and former service members enter college each year, and their ranks are expected to swell as several major US military engagements overseas wind down. This article presents the following questions: (1) What is the overall success rate for student service members and veterans attending US colleges and universities;…

  14. 38 CFR 3.401 - Veterans.

    Science.gov (United States)

    2010-07-01

    ... domiciliary. (Authority: 38 U.S.C. 501) (3) Spouse, additional compensation for aid and attendance: Date of...) Director of a Department of Veterans Affairs medical center or domiciliary. From day following date of last... from hospitalization (regular or release to non-bed care). (i) Increased disability pension based on...

  15. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Emergencies A-Z Share this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

  16. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... for signs of heat stroke or exhaustion. Heat Stroke and Exhaustion Symptoms of early heat exhaustion symptoms ... heavy sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, ...

  17. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or ... the elderly are most at risk, but anyone can be affected. Here you will find information about ...

  18. Coping with Chronic Illness

    Science.gov (United States)

    ... be able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not understand why this is happening to them. These changes can cause stress, anxiety, and anger. If they do, it is important ...

  19. Parasites and Foodborne Illness

    Science.gov (United States)

    ... in the intestines of many herd animals including cows, sheep, goats, deer, and elk. The illness could ... Severe toxoplasmosis may result in damage to the eyes or brain. Infants becoming infected before birth can ...

  20. Heat Related Illnesses

    National Research Council Canada - National Science Library

    Carter, R; Cheuvront, S. N; Sawka, M. N

    2006-01-01

    .... The risk of serious heat illness can be markedly reduced by implementing a variety of countermeasures, including becoming acclimated to the heat, managing heat stress exposure, and maintaining hydration...

  1. Burden of Mental Illness

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Burden of Mental Illness Recommend on Facebook Tweet Share Compartir Depression: According ... anxiety disorder, are the most common class of mental disorders present in the general population. 5 The estimated ...

  2. Cholera Illness and Symptoms

    Science.gov (United States)

    ... Search The CDC Cancel Submit Search The CDC Cholera - Vibrio cholerae infection Note: Javascript is disabled or ... message, please visit this page: About CDC.gov . Cholera General Information Illness & Symptoms Sources of Infection & Risk ...

  3. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, dry ... consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, cool the person further ...

  4. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... ICE” in Your Cell Phone Prepare for Disasters Communication With Your Family And Your Doctor About Your ... Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be ...

  5. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of more than 104 degrees. People with these ...

  6. Mental and Physical Health Conditions in US Combat Veterans: Results From the National Health and Resilience in Veterans Study.

    Science.gov (United States)

    Thomas, Melissa M; Harpaz-Rotem, Ilan; Tsai, Jack; Southwick, Steven M; Pietrzak, Robert H

    2017-06-22

    To identify sociodemographic and military characteristics of combat-exposed and non-combat-exposed veterans in the United States and to compare rates of mental and physical health conditions in these populations. Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative survey of 1,480 US veterans conducted September-October 2013. Poststratification weights were applied to analyses to permit generalizability of results to the US veteran population. Outcomes measured included lifetime and current psychiatric disorders and physical health conditions. A total 38% of US veterans reported being exposed to combat. Compared to noncombat veterans, combat veterans were younger, had greater household income, and served a greater number of years in the military; were more likely to be male, to have served in the Marine Corps, and to use the Veterans Affairs Healthcare System as their main source of health care; and reported a greater number of lifetime potentially traumatic events. After adjustment for these sociodemographic and military differences, combat veterans were more than 3 times as likely as noncombat veterans to screen positive for lifetime posttraumatic stress disorder (PTSD) and more than twice as likely for current PTSD and had 82% greater odds of screening positive for current generalized anxiety disorder. After additionally controlling for lifetime diagnoses of PTSD and depression, alcohol or drug use disorder, and nicotine dependence, combat veterans had 68% greater odds of having attempted suicide and 85% and 38% greater odds of being diagnosed with a stroke and chronic pain, respectively. Younger combat veterans were more likely than older combat veterans to screen positive for lifetime (30.6% vs 10.1%) and current PTSD (19.2% vs 4.9%) and suicidal ideation (18.6% vs 6.9%) and to have been diagnosed with migraine headaches (12.8% vs 2.1%), while older combat veterans were more likely than

  7. Double trauma: a group therapy approach for Vietnam Veterans suffering from war and childhood trauma.

    Science.gov (United States)

    Goodman, M; Weiss, D

    1998-01-01

    A model of a 9-month exploratory psychotherapy group for male Vietnam War veterans diagnosed with posttraumatic stress disorder (PTSD) who also experienced childhood physical and sexual abuse is presented. Recent literature delineating an association between combat PTSD and earlier childhood abuse is briefly reviewed and forms the basis for a new treatment strategy. A trauma group psychotherapy approach that investigates the connections between war and childhood traumas and their effects on later adult coping and interpersonal relationships is fundamentally different than existing trauma group treatment paradigms that focus primarily on war-related events. A description of the group formation, philosophy, course, and outcome is provided and enriched by clinical material.

  8. Depression in Physical Illness

    Directory of Open Access Journals (Sweden)

    Elif Tatlidil Yaylaci

    2014-04-01

    Full Text Available People with physical illness are at an increased risk of depression, which is linked with a worse prognosis and reduced adherence to treatment. Medically ill patients with depression have reductions in quality of life, increased medical morbidity and mortality, increased functional disability, reduced occupational performance, and reductions in role functioning. Other implications of depressive comorbidity include prolonged hospital admission, amplification of physical symptoms, reduction in adherence to medical treatment, and increased medical costs and health care use.

  9. Experiencing Variation: Learning Opportunities in Doctoral Supervision

    Science.gov (United States)

    Kobayashi, Sofie; Berge, Maria; Grout, Brian W. W.; Rump, Camilla Østerberg

    2017-01-01

    This study contributes towards a better understanding of learning dynamics in doctoral supervision by analysing how learning opportunities are created in the interaction between supervisors and PhD students, using the notion of experiencing variation as a key to learning. Empirically, we have based the study on four video-recorded sessions, with…

  10. Types of Stresses Experienced by Professionals.

    Science.gov (United States)

    Gadzella, Bernadette M.; And Others

    This study was conducted to examine the types of stresses experienced by professionals. Subjects were 56 persons enrolled in graduate classes who completed the Tennessee Stress Scale-L, Work Related Stress Inventory for Professionals. Besides the Total stress score, the instrument produced three subscale scores: Stress Producers, Coping…

  11. Psychological demands experienced by recreational endurance athletes

    OpenAIRE

    McCormick, Alister; Meijen, Carla; Marcora, Samuele

    2016-01-01

    This study aimed to identify psychological demands that are commonly experienced by endurance athletes so that these demands could inform the design of performance-enhancement psychological interventions for endurance athletes. Focus group interviews were conducted with 30 recreational endurance athletes of various sports (running, cycling, and triathlon), distances, and competitive levels to explore the psychological demands of training, competition preparation, and competition participation...

  12. Activity limitations and participation restrictions experienced by ...

    African Journals Online (AJOL)

    Cite as: Urimubenshi G. Activity limitations and participation restrictions experienced by people with stroke in Musanze district in Rwanda. Afri Health ..... analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education To- day 2004, 24(2), 105–112. 20. Lincoln YS, Guba EA.

  13. Perceived and experienced restrictions in participation and ...

    African Journals Online (AJOL)

    Perceived and experienced restrictions in participation and autonomy among adult survivors of stroke in Ghana. ... There were significant differences in two domains between survivors who received physiotherapy and those who received traditional rehabilitation. Over half of the survivors also perceived they would ...

  14. Children's Actions when Experiencing Domestic Violence

    Science.gov (United States)

    Overlien, Carolina; Hyden, Margareta

    2009-01-01

    The aim of this article is, by analysing children's discourses, to investigate their actions or absence of actions during a domestic violence episode. The empirical data are recorded group therapy sessions and individual interviews with children who have grown up experiencing their fathers' violence against their mothers. The analysis shows that…

  15. Experienced and physiological fatigue in neuromuscular disorders.

    NARCIS (Netherlands)

    Schillings, M.L.; Kalkman, J.S.; Janssen, H.M.; Engelen, B.G.M. van; Bleijenberg, G.; Zwarts, M.J.

    2007-01-01

    OBJECTIVE: Fatigue has been described as a typical symptom of neurological diseases. It might be caused both by changes at the peripheral and at the central level. This study measured the level of experienced fatigue and physiological correlates of fatigue in three genetically defined neuromuscular

  16. Novice and experienced teachers’ views on professionalism

    NARCIS (Netherlands)

    Okas, Anne; van der Schaaf, Marieke; Krull, Edgar

    2014-01-01

    This article discusses teachers’ practical knowledge and beliefs of their profession based on reflective writings of twenty Estonian teachers.Ten novice and ten experienced teachers participated in the study. They put together their professional portfolios, which among other documents included

  17. Depression, anxiety, and stress in partners of Australian combat veterans and military personnel: a comparison with Australian population norms

    Directory of Open Access Journals (Sweden)

    Gail V. MacDonell

    2016-08-01

    Full Text Available Partners of Australian combat veterans are at an increased risk of experiencing mental health problems. The present study provides a comparative analysis of the mental health of partners of veterans with that of the Australian normative data. To compare different types of groups of partners, the study samples comprised: (a partners of Australian combat veterans (Sample 1: n = 282, age M = 60.79, SD = 5.05, (b a sub-sample of partners of Australian combat veterans from the previous sample (Sample 2: n = 50; M = 60.06, SD = 4.80, (c partners of Special Air Services Regiment (SASR personnel (Sample 3: n = 40, age M = 34.39SD = 7.01, and (d partners of current serving military (non-SASR personnel (Sample 4: n = 38, age M = 32.37, SD = 6.20. Respondents completed measures assessing their reported levels of depression, anxiety, and stress. Samples 1 and 2 comprised partners of Australian military veterans who reported significantly greater symptoms of depression, anxiety, and stress than the comparative population norms. The sample of SASR personnel partners (Sample 3 reported significantly lower levels of depression and anxiety, whereas the sample with non-SASR personnel partners (Sample 4 reported a significantly greater stress symptomatology than the comparative norms. Number of deployments was found to be associated with depression, anxiety, and stress in partners of non-SASR veterans (Sample 4. Lessons and protective factors can be learnt from groups within the current military as to what may assist partners and families to maintain a better level of psychosocial health.

  18. Suicide in Neurologic Illness.

    Science.gov (United States)

    Arciniegas, David B.; Anderson, C. Alan

    2002-11-01

    The risk of attempted or completed suicide is increased in patients with migraine with aura, epilepsy, stroke, multiple sclerosis, traumatic brain injury, and Huntington's disease. Contrary to the general perception that the risk of suicide among patients with Alzheimer's disease and other dementing conditions is low, several reports suggest that the risk of suicide in these patients increases relative to the general population. Some patients at risk for neurologic disorders are also at increased risk for suicide; in particular, the risk of suicide is increased among persons at risk for Huntington's disease, independent of the presence or absence of the Huntington's gene mutation. The risk of attempted or completed suicide in neurologic illness is strongly associated with depression, feelings of hopelessness or helplessness, and social isolation. Additional suicide risk factors in persons with neurologic illness include cognitive impairment, relatively younger age (under 60 years), moderate physical disability, recent onset or change in illness, a lack of future plans or perceived meaning in life, recent losses (personal, occupational, or financial), and prior history of psychiatric illness or suicidal behavior. Substance dependence, psychotic disorders, anxiety disorders, and some personality disorders (eg, borderline personality disorder) may also contribute to increased risk of suicide among persons with neurologic illnesses. Identification and aggressive treatment of psychiatric problems, especially depression, as well as reduction of modifiable suicide risk factors among patients with neurologic illness is needed to reduce the risk of attempted and completed suicide in this population.

  19. Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes.

    Science.gov (United States)

    Leddy, Meaghan; Stefanovics, Elina; Rosenheck, Robert

    2014-01-01

    Supported employment, specifically individual placement and support (IPS), improves competitive employment (CE) rates for individuals with serious mental illness, but has not shown greater improvement in non-vocational outcomes than other rehabilitation approaches. The Department of Veterans Affairs offers two types of vocational services, IPS and transitional work experience (TWE), but no study has compared the effectiveness of these approaches. This secondary analysis of data from a study of homeless veterans compared 6 mo improvement in diverse outcomes for five employment patterns: never worked, worked only in TWE, worked in TWE followed by CE, worked in CE without IPS, and worked in CE with IPS referral. Veterans referred to IPS were more likely to be competitively employed. Those who worked in CE (whether following TWE or with or without IPS referral) showed the greatest increase in days worked, employment income, and total income and the greatest decrease in public support income when compared with those who worked only in TWE or not at all. Veterans in TWE showed the greatest increase in residential treatment days, but there were no other differences in non-vocational outcomes between groups. There are multiple paths to CE, but few differences in non-vocational outcomes across employment experiences.

  20. 76 FR 61151 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Science.gov (United States)

    2011-10-03

    ... INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044), Department of Veterans... homeless Veterans and Veterans at risk of homelessness and their families; and provide a supportive...

  1. Prevalence of various comorbidities among veterans with chronic kidney disease and its comparison with other datasets.

    Science.gov (United States)

    Patel, Nilang; Golzy, Mojgan; Nainani, Neha; Nader, Nader D; Carter, Randolph L; Lohr, James W; Arora, Pradeep

    2016-01-01

    Chronic kidney disease (CKD) has a complicated interrelationship with various comorbidities. The purpose of this study was to describe the prevalence of various comorbidities among veterans with CKD and compare it with other datasets like Kidney Early Evaluation Program (KEEP), National Health and Nutrition Examination Survey (NHANES) and Medicare. Patients who had at least one outpatient visit in year 2007 (1 January 2007 to 31 December 2007) were included in the study (n =  75,787). Glomerular filtration rate (eGFR) was estimated by the Modification of Diet in Renal Disease (MDRD) study equation. CKD prevalence was calculated based on one or two serum creatinine values at least 3 months apart. Demographic data were obtained including age, gender, race, weight, height and body mass index (BMI). The prevalence of various comorbidities was also collected based on ICD 9 codes from the problem list. The prevalence of CKD among veterans was 47.3%, much higher than estimated in the US population. Patients with CKD were more likely to have any vascular disease (36.89% vs. 14.87%), diabetes (34.18% vs. 17.83%), hypertension (86.65% vs. 57.56%), and cancer (18.69% vs. 9.23%). Irrespective of age, the prevalence of vascular disease was much higher among veterans with CKD. The prevalence of coronary artery disease, peripheral vascular disease, and cancer was much higher among elderly veterans with CKD as compared to other datasets. CKD is a growing endemic associated with a high frequency of concomitant chronic illnesses. Public health resources should be applied for early recognition and risk modification of CKD.

  2. Microtubule Abnormalities Underlying Gulf War Illness in Neurons from Human Induced Pluripotent Cells

    Science.gov (United States)

    2017-11-01

    lines from the GW veterans themselves, given that genetic and possibly epigenetic factors potentially relevant to disease susceptibility would be pre...organophosphate DFP exposure leads to the development of depression and cognitive impairment in a rat model of Gulf War Illness. Neurotoxicology...of genetic or epigenetic background to the disease, and because disease-vulnerable proteins and pathways may be different in humans relative to

  3. Visual event-related potentials as markers of hyperarousal in Gulf War Illness: evidence against a stress-related etiology

    Science.gov (United States)

    Tillman, Gail D.; Calley, Clifford S.; Green, Timothy A.; Buhl, Virginia I.; Biggs, Melanie M.; Spence, Jeffrey S.; Briggs, Richard W.; Haley, Robert W.; Kraut, Michael A.; Hart, John

    2012-01-01

    An exaggerated response to emotional stimuli is among the many symptoms widely reported by veterans of the 1991 Persian Gulf War. These symptomologies have been attributed to damage and dysfunction associated with deployment-related exposures. We collected event-related potential data from 22 veterans meeting Haley criteria for Gulf War (GW) Syndromes 1-3 and from 8 matched GW veteran controls, who were deployed but not symptomatic, while they performed a visual three-condition oddball task where images authenticated to be associated with the 1991 Persian Gulf War were the distractor stimuli. Hyperarousal reported by ill veterans was significantly greater than that by control veterans, but this was not paralleled by higher amplitude P3a in their ERP responses to GW-related distractor stimuli. Whereas previous studies of PTSD patients have shown higher amplitude P3b responses to target stimuli that are placed amid trauma-related nontarget stimuli, ill veterans in this study showed P3b amplitudes to target stimuli—placed amid GW-related nontarget stimuli—that were significantly lower than those of the control group. Hyperarousal scores reliably predicted P3b, but not P3a, amplitudes. Although many factors may contribute to P3b amplitude differences—most notably depression and poor sleep quality, symptoms that are prevalent in the GW syndrome groups—our findings in context of previous studies on this population are consistent with the contention that dysfunction in cholinergic and dopaminergic neurotransmitter systems, and in white matter and basal ganglia may be contributing to impairments in GW veterans. PMID:23149040

  4. Alcohol and drug abuse among U.S. veterans: comparing associations with intimate partner substance abuse and veteran psychopathology.

    Science.gov (United States)

    Miller, Mark W; Reardon, Annemarie F; Wolf, Erika J; Prince, Lauren B; Hein, Christina L

    2013-02-01

    This study examined the relative influences of posttraumatic stress disorder (PTSD), other psychopathology, and intimate partner alcohol and drug use on substance-related problems in U.S. veterans (242 couples, N = 484). Hierarchical regression analyses revealed that partner alcohol and drug use severity explained more variance in veteran alcohol use and drug use (20% and 13%, respectively) than did veteran PTSD, adult antisocial behavior, or depression symptoms combined (6% for veteran alcohol use; 7% for veteran drug use). Findings shed new light on the influence of relationship factors on veteran alcohol and drug use and underscore the importance of couples-oriented approaches to treating veterans with comorbid PTSD and substance abuse. Published 2013. This article is a US Government work and is in the public domain in the USA.

  5. Family-centered care for military and veteran families affected by combat injury.

    Science.gov (United States)

    Cozza, Stephen J; Holmes, Allison K; Van Ost, Susan L

    2013-09-01

    The US military community includes a population of mostly young families that reside in every state and the District of Columbia. Many reside on or near military installations, while other National Guard, Reserve, and Veteran families live in civilian communities and receive care from clinicians with limited experience in the treatment of military families. Though all military families may have vulnerabilities based upon their exposure to deployment-related experiences, those affected by combat injury have unique additional risks that must be understood and effectively managed by military, Veterans Affairs, and civilian practitioners. Combat injury can weaken interpersonal relationships, disrupt day-to-day schedules and activities, undermine the parental and interpersonal functions that support children's health and well-being, and disconnect families from military resources. Treatment of combat-injured service members must therefore include a family-centered strategy that lessens risk by promoting positive family adaptation to ongoing stressors. This article reviews the nature and epidemiology of combat injury, the known impact of injury and illness on military and civilian families, and effective strategies for maintaining family health while dealing with illness and injury.

  6. Assessment of PTSD in Older Veterans: The Posttraumatic Stress Disorder Checklist: Military Version (PCL-M

    Directory of Open Access Journals (Sweden)

    Jeffrey S. Yarvis

    2012-04-01

    Full Text Available The Posttraumatic Stress Disorder (PTSD Checklist: Military Version (PCL-M is a 17-item, self-report measure of PTSD symptomatology in military veterans and provides one total score and four subscale scores for older veterans’ PTSD (re-experiencing, avoiding, numbing, and hyperarousal symptoms. Study subjects are 456 male veterans over 55-years old with deployed experiences selected from a larger survey data by Veterans’ Affairs Canada (VAC. This study found that overall scale reliability was excellent with alpha of .93 and subscale alphas ranging from .81 to .90. Confirmatory Factor Analysis (CFA confirmed the best fit of four first-order factor models. Criterion validity was confirmed through significant associations of the PCL-M scores with well-established measures of depression, substance abuse, and general health indices. The PCL-M is recommended as a reliable and valid tool for the clinical and empirical assessment of screening PTSD symptomatology, specifically related to older veterans military experiences.

  7. Ethnic-related stressors in the war zone: case studies of Asian American Vietnam veterans.

    Science.gov (United States)

    Loo, Chalsa M; Lim, Brian R; Koff, Gabriel; Morton, Robert K; Kiang, Peter N C

    2007-09-01

    Empirical research has shown that exposure to race-related stressors in the military by Asian American Pacific Islander Vietnam veterans, now reliably measurable, contributes uniquely and significantly to post-traumatic stress disorder (PTSD) symptoms and generalized psychiatric distress; moreover, studies reveal that adverse race-related events can meet Diagnostic and Statistical Manual of Mental Disorders-IV criteria for a PTSD diagnosis. Competence in treating PTSD or general psychiatric distress requires understanding the types of, and effects of, adverse race-related events experienced by ethnic minority veterans. Case studies highlight two types of race-related stressors-"bicultural identification and conflict" and "racial stigmatization"-which placed the veteran at greater risk of death and reduced cohesion with fellow service members. The studies demonstrate the presence of race-related stressors in one or more of the four major types of war zone stressors: traditional combat, atrocities-abusive violence, perceived threat, and malevolent environment. These case studies supplement the empirical findings on race-related stressors and PTSD, enlarging the clinician's understanding of this unique type of mental health risk factor.

  8. Retaining homeless veterans in outpatient care: a pilot study of mobile phone text message appointment reminders.

    Science.gov (United States)

    McInnes, D Keith; Petrakis, Beth Ann; Gifford, Allen L; Rao, Sowmya R; Houston, Thomas K; Asch, Steven M; O'Toole, Thomas P

    2014-09-01

    We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows. We sent 2 text message reminders to participants (n = 20) before each of their outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- and postsurvey questionnaires, open-ended questions, and review of medical records. We estimated costs and savings of large-scale implementation. Participants were satisfied with the text-messaging intervention, had very few technical difficulties, and were interested in continuing. Patient-cancelled visits and no-shows trended downward from 53 to 37 and from 31 to 25, respectively. Participants also experienced a statistically significant reduction in emergency department visits, from 15 to 5 (difference of 10; 95% confidence interval [CI]  = 2.2, 17.8; P = .01), and a borderline significant reduction in hospitalizations, from 3 to 0 (difference of 3; 95% CI = -0.4, 6.4; P = .08). Text message reminders are a feasible means of reaching homeless veterans, and users consider it acceptable and useful. Implementation may reduce missed visits and emergency department use, and thus produce substantial cost savings.

  9. Screening for Food Insecurity in Six Veterans Administration Clinics for the Homeless, June-December 2015.

    Science.gov (United States)

    O'Toole, Thomas P; Roberts, Christopher B; Johnson, Erin E

    2017-01-12

    We assessed findings from a food-insecurity screening of a national sample of Veterans Administration clinics for homeless and formerly homeless veterans. We reviewed results from initial screenings administered at 6 Veterans Administration primary care clinics for the homeless and responses from clinic staff members interviewed about the screening program. A total of 270 patients were screened. The average age was 53 years, and most were male (93.1%). Screening showed a high prevalence of food insecurity. Of the 270, 48.5% reported they experienced food insecurity in the previous 3 months, 55.0% reported averaging 2 meals a day, and 27.3% averaged 1 meal a day. Eighty-seven percent prepared their own meals, relying on food they bought (54.2%), help from friends and family (19.1%), and soup kitchens and food pantries (22%); 47.3% received Supplemental Nutrition Assistance Program benefits (food stamps). Additionally, of those who screened positive for food insecurity 19.8% had diabetes or prediabetes, and 43.5% reported hypoglycemia symptoms when without food. Clinic staff members responded positively to the screening program and described it as a good rapport builder with patients. Integrating screening for food insecurity among patients in clinical settings was well received by both patients and health care providers. Addressing these positive findings of food insecurity requires a multidisciplinary health care approach.

  10. Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

    Science.gov (United States)

    Harrold, S Akeya; Libet, Julian; Pope, Charlene; Lauerer, Joy A; Johnson, Emily; Edlund, Barbara J

    2017-08-01

    Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442). Numerous factors contribute to premature mortality in persons with SMI, including suicide and accidental death (Richardson RC, Faulkner G, McDevitt J, Skrinar GS, Hutchinson D, Piette JD. Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005;56(3):324-331; Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442), but research has shown that adverse health behaviors-including smoking, low rate of physical activity, poor diet, and high alcohol consumption-also significantly contribute to premature deaths (Jones J. Life expectancy in mental illness. Psychiatry Services. 2010. Retrieved from http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness). This quality improvement (QI) project sought to improve health and wellness for veterans in the Mental Health Intensive Case Management Program (MHICM), which is a community-based intensive program for veterans with SMI at risk for decompensation and frequent hospitalizations. At the time of this QI project, the program had 69 veterans who were assessed and treated weekly in their homes. The project introduced a pedometer steps intervention adapted from the VA MOVE! Program-a physical activity and weight management program-with the addition of personalized assistance from trained mental health professionals in the veteran's home environment. Because a large percentage of the veterans in the MHICM program had high blood pressure and increased weight, these outcomes were the focus of this project. Through mental health case management involvement and

  11. Characteristics and drinking patterns of veterans with alcohol dependence with and without post-traumatic stress disorder.

    Science.gov (United States)

    Fuehrlein, Brian; Ralevski, Elizabeth; O'Brien, Erin; Jane, J Serrita; Arias, Albert J; Petrakis, Ismene L

    2014-02-01

    Alcohol use disorders and post-traumatic stress disorder (PTSD) are highly prevalent and commonly co-occur, notably in veterans. We explored differences in the pre-treatment characteristics of veterans with alcohol dependence (AD) alone compared to those with co-occurring AD and PTSD. Veterans were recruited to participate in two different treatment studies and baseline characteristics were compared. Those with co-occurring illnesses demonstrated significantly higher pre-treatment pathology across all psychopathological domains. While those with AD alone averaged more days of drinking and had more heavy drinking days, those with co-occurring illnesses reported more drinking-related symptoms. The presence of a major depressive episode had no effect on drinking. Within the PTSD group, combat exposure was associated with increased drinking independent of the severity of PTSD symptoms. This study underscores the importance of screening for comorbidity in clinical treatment settings, and for collecting detailed drinking histories and assessing psychiatric symptoms across all domains of psychopathology. © 2013.

  12. Mindfulness-based Stress Reduction (MBSR) and Its Effects on Psychoimmunological Factors of Chemically Pulmonary Injured Veterans.

    Science.gov (United States)

    Arefnasab, Zahra; Babamahmoodi, Abdolreza; Babamahmoodi, Farhang; Noorbala, Ahmad Ali; Alipour, Ahmad; Panahi, Yunes; Shams, Jamal; Riazi Rad, Farhad; Khaze, Vahid; Ghanei, Mostafa

    2016-12-01

    Mindfulness-based Stress Reduction (MBSR) is a treatment program for relieving stress and coping with chronic illnesses. In recent three decades, studies have shown that MBSR has a positive effect on physical and psychological dimensions of chronic illnesses. Chemically pulmonary injured veterans have chronic pulmonary and psychological problems due to mustard gas exposure and complications of Iran-Iraq war. These stresses have negative effects on their general health and immune system. To the best of our knowledge, this is the first study conducted on psychoneuroimmunology and MBSR in these patients. Forty male pulmonary injured veterans were randomly divided in two groups with 20 participants (MBSR and wait-list control). Then MBSR group received 8 weekly sessions of intervention. We tested mental health based on general health questionnaire (GHQ)-28 questionnaire, health-related quality of life (based on St. George respiratory questionnaire (SGRQ) ) and immunity in MBSR groups; before and after intervention "mixed factorial analyses of variance" test was used for analyzing data fpr each dependent variable and appropriate t-tests were done in The necessary condition. Results showed that mental health and health- related quality of life, in MBSR group compared to wait-list control improved [F (1,38)=26.46, pMBSR may be a new treatment approach for improving immunity and overall health in chemically pulmonary injured veterans.

  13. Disabled employees' perceptions of ill-treatment in the workplace

    NARCIS (Netherlands)

    Fevre, R.; Robinson, A.; Jones, T.; Lewis, D.

    2013-01-01

    There are few quantitative studies that show the workplace is experienced in a different way by employees with disabilities. This article fills this gap using data from the British Workplace Behaviour Survey, which found that employees with disabilities and long-term illnesses were more likely to

  14. 20 CFR 404.1310 - Who is a World War II veteran.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Who is a World War II veteran. 404.1310... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1310 Who is a World War II veteran. You are a World War II veteran if you were in the active...

  15. 77 FR 52135 - Advisory Committee on Homeless Veterans, Notice of Meeting

    Science.gov (United States)

    2012-08-28

    ... AFFAIRS Advisory Committee on Homeless Veterans, Notice of Meeting The Department of Veterans Affairs (VA... Committee on Homeless Veterans will be held on September 5-7, 2012, in the Onondaga 3 Room at the Embassy... Veterans. The Committee shall assemble and review information relating to the needs of homeless Veterans...

  16. 75 FR 29366 - ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center...

    Science.gov (United States)

    2010-05-25

    ... of the Assistant Secretary for Veterans' Employment and Training ``Homeless Veterans' Reintegration... the Homeless Veterans' Reintegration Program (HVRP) to include the Homeless Female Veterans and... to expedite the reintegration of homeless Veterans into the labor force. In order to assist the USDOL...

  17. 76 FR 21107 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-04-14

    ... AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The Department of Veterans Affairs... VA health care to enrolled Veterans residing in rural areas and discusses ways to improve and enhance... Secretary, VA Veteran Centers services, rural women Veteran health care, and the meeting agenda and planning...

  18. Gendering psychosis: the illness of Zelda Fitzgerald.

    Science.gov (United States)

    Seeman, Mary V

    2016-03-01

    Psychiatric textbooks tend to describe psychosis as it is experienced by men. The well-documented illness of Zelda Fitzgerald illustrates the feminine side of psychosis. The distinctive features of Zelda's illness--its specific precipitants, the timing of its onset, the discontinuities in its course, the pronounced mood swings, the preservation of intellect and of agency, the maintenance of human ties, the association of flare-ups with immune and hormonal changes, the responsiveness to treatment, the lifelong creativity and productivity--show the female side of psychotic illness, one that is rarely described in diagnostic manuals. This paper relies on Nancy Milford's biography of Zelda, as well as on several other biographical sources and, using Zelda's own words and the words of her husband and friends, allows entry into a feminine world of psychosis, not encountered in textbooks. The expression of psychotic illness varies from person to person, its exact shape depending on many factors, most of them still undetermined, but gender is a critically important core component of variance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. The illness/non-illness model: hypnotherapy for physically ill patients.

    Science.gov (United States)

    Navon, Shaul

    2014-07-01

    This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.

  20. Experiencing the enchantment of place and mobility

    DEFF Research Database (Denmark)

    Bærenholdt, Jørgen Ole

    2016-01-01

    Experiences of place and mobility play central roles not only in what was traditionally understood as tourism, but also in the broader practices of travelling and visiting sites and sights. On the one hand, such experiences are performed to an extent where it is difficult to isolate the sites...... and movements experienced per se, since visitors and travellers take part in ‘doing’ places and mobility. On the other, experience sites and routes stand out with specific traces and characteristics affording some – and not other – experiences. This paper discusses conceptual understandings that may help...... to better analyse what it takes to perform tourist sites. Following a discussion of Walter Benjamin’s way of understanding experiences as Erlebnisse, I suggest that ideas about multiplicity and absence-presence in Actor-Network Theory can develop new insights into how place and mobility are experienced...

  1. Deprivation as un-experienced harm?

    DEFF Research Database (Denmark)

    Keerus, Külli; Gjerris, Mickey; Röcklinsberg, Helena

    2017-01-01

    Tom Regan encapsulated his principle of harm as a prima facie direct duty not to harm experiencing subjects of a life. However, his consideration of harm as deprivation, one example of which is loss of freedom, can easily be interpreted as a harm, which may not be experienced by its subject....... This creates a gap between Regan’s criterion for moral status and his account of what our duties are. However, in comparison with three basic paradigms of welfare known in nonhuman animal welfare science, Regan’s understanding coheres with a modified version of a feelings-based paradigm: not only the immediate...... feelings of satisfaction, but also future opportunities to have such feelings, must be taken into account. Such an interpretation is compatible with Regan’s understanding of harm as deprivation. The potential source of confusion, however, lies in Regan’s own possible argumentative mistakes....

  2. The Occupational Wellbeing of People Experiencing Homelessness

    OpenAIRE

    Thomas, Yvonne; Gray, M.; McGinty, S.

    2017-01-01

    This paper reports findings of a study that utilised an occupational perspective to explore how wellbeing was achieved and sustained by the occupations of people experiencing homelessness in Australia. Thirty three in-depth qualitative interviews were conducted with homeless individuals in a regional city in Australia. Data from the interviews were thematically analysed to understand the relationship between wellbeing, as defined by the individual, and the occupations engaged in by people exp...

  3. Women experiencing the intergenerationality of conjugal violence

    OpenAIRE

    Paixão,Gilvânia Patrícia do Nascimento; Gomes,Nadirlene Pereira; Diniz,Normélia Maria Freire; Lira,Margaret Ollinda de Souza Carvalho e; Carvalho,Milca Ramaiane da Silva; Silva,Rudval Souza da

    2015-01-01

    Objective: to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence. Method: qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011). Results: the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed vio...

  4. Security Selection Factors: Novice Versus Experienced Investors

    OpenAIRE

    Steven Freund; Dev Prasad; Frank Andrews

    2013-01-01

    In this study, we examine the differences in the factors perceived to be significant in the security selection process between novice and experienced investors. We apply the direct inquiry approach to two distinct groups: One group is composed of students enrolled in traditional face-to-face introductory investments classes, while the other group consists of students enrolled in the online sections of the same course. The online students tend to be generally older part-time students with grea...

  5. Mental Illness, Your Client and the Criminal Law: A Handbook for Attorneys Who Represent Persons with Mental Illness.

    Science.gov (United States)

    2002

    This handbook for attorneys represents part of an effort to improve legal representation for criminal defendants with mental illness. The handbook was developed and reviewed by both mental health professionals and attorneys experienced in criminal and mental health law. However, it is not a comprehensive guide on mental health law or on how to…

  6. The initial psychotherapy interview: a content analysis of the verbal responses of novice and experienced therapists.

    Science.gov (United States)

    Cicchetti, D V; Ornston, P S

    1976-07-01

    This study tested and confirmed the clinical impressions that (a) the novice psychotherapist may focus so much upon the exact words and nonverbal behavior patterns of his client (the process of making "concrete" statements) that he may lose sight of the larger picture that his client may be revealing at any given moment during the interview; (b) the experienced psychotherapist, on the other hand, seems to be responding to the words of the patient at a level of abstraction that attempts to integrate and understand the messages that the patient is trying to convey about himself; and (c) this latter process is reflected in the making of relatively more "abstract" comments than is true of the novice. Ss were 24 first-year psychiatric residents and 19 staff psychologists and psychiatrists at a veterans hospital and a medical school. The learning theory implications of these findings is discussed.

  7. Burnout among Low and High Experienced Teachers

    Directory of Open Access Journals (Sweden)

    Seyedehhava Mousavy

    2012-09-01

    Full Text Available Burnout is a serious psychological syndrome that can affect not only an individual’s well-being, but also the functioning of whole organisations, such as schools. It is characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment.The level of burnout among teachers in the field of education has a negative impact on student success. The present investigation examines the level of burn out among high and low experienced teachers. It focused on a group of English teachers from different nationalities: Iranian, and Malaysian at UPM to examine if there is any relation between burnout and experience level. The sample consisted of 30 English teachers. Two instruments namely, The Maslach Burnout Inventory and Demographic Questionnaire were used to collect data. Data analysis revealed that there is no significant difference in depersonalization and personal accomplishment scores between low and high experienced teachers. But the result of this study also revealed that there is a significant difference in Emotional Exhaustion scores between low and high experienced teachers. Further research is required to explore the roots and the causes of burnout.

  8. Stigma experienced by persons under psychiatric care.

    Science.gov (United States)

    Struch, Naomi; Levav, Itzhak; Shereshevsky, Yechiel; Baidani-Auerbach, Alona; Lachman, Max; Daniel, Noga; Zehavi, Tali

    2008-01-01

    Mental health-related stigma causes suffering and interferes with care and social inclusion. This study explored stigma as experienced by mental health service users. Particular attention is given to their use of coping mechanisms. Interviews were held with 167 adults undergoing outpatient psychiatric treatment; two-thirds of them had previously been hospitalized. Examples of frequency of stigma-related situations included the following: Over half of service users expect people to refuse to have a person with a mental disorder as a co-worker or neighbor, or to engage in other types of social contact. A sizeable group acknowledged that they feared or had experienced rejection. A third of respondents reported they feared or had experienced inappropriate treatment by their doctor. Service users utilize several coping mechanisms to deal with stigma, among them: education, withdrawal, secrecy, and positive distinctiveness. Although we studied a convenience sample of service users, our findings provide sufficient basis to suggest different types of intervention, i.e., to address stigma in the course of treatment in the specialist settings, to promote the establishment of mutual support groups, and to raise family physicians' awareness with regard to the stigma that may be present when caring for persons with mental disorders.

  9. Mortality in Italian veterans deployed in Bosnia-Herzegovina and Kosovo.

    Science.gov (United States)

    Capocaccia, Riccardo; Biselli, Roberto; Ruggeri, Raffaella; Tesei, Cristiano; Grande, Enrico; Martina, Lucia; Rocchetti, Anna; Salmaso, Stefania; Caldora, Massimiliano; Francisci, Silvia

    2016-08-01

    The possible increase of cancer risk in military personnel deployed in Balkans during and after the 1992-1999 wars, mainly related to the depleted uranium, was addressed by several studies on European veterans of those war theatres. This article reports on the results of the mortality study on the Italian cohort of Bosnia and Kosovo veterans (Balkan cohort). Mortality rates for the Balkan cohort (71 144 persons) were compared with those of the Italian general population as well as to those of a comparable and unselected control cohort of not deployed military personnel (114 269 persons). Ascertainment of vital status during the period 1995-2008 of all the persons in the two cohorts has been carried out through deterministic record linkage with the national death records database, from information provided by the respective Armed Force General Staff, and through the civil registry offices of the veterans' residence or birth municipalities. The Balkan cohort experienced a mortality rates lower than both the general population (SMR = 0.56; 95% CI 0.51-0.62) and the control group (SMR = 0.88; 95% CI 0.79-0.97). Cancer mortality in the deployed cohort group was half of that from the general population mortality rates (SMR = 0.50; 95% CI 0.40-0.62) and slightly lower if compared with the control group cancer mortality rates (SMR = 0.95; 95% CI 0.77-1.18). Balkan veteran cohort did not show any increase in general mortality or in cancer mortality. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    R Lee Kirby

    Full Text Available To test the hypotheses that community-dwelling veterans with spinal cord injury (SCI who receive the Wheelchair Skills Training Program (WSTP in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC group.We carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30-45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST and Craig Handicap Assessment and Reporting Technique (CHART scores.Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001 and retained their scores at one year follow-up. The success rates for individual skills were consistent with the total and subtotal WST scores. The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021.Individualized wheelchair skills training in the home environment substantially improves the advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation.

  11. Impact of Childhood Abuse on Physical and Mental Health Status and Health Care Utilization Among Female Veterans.

    Science.gov (United States)

    Mercado, Rowena C; Wiltsey-Stirman, Shannon; Iverson, Katherine M

    2015-10-01

    To determine whether childhood abuse predicts health symptoms and health care use among female veterans. Participants were 369 female patients at Veterans Affairs hospitals in New England who completed a mail survey. Multiple regression analyses were conducted to determine the differential impact of childhood physical abuse and childhood sexual abuse on health symptoms and health care use, while accounting for age, race, military branch, and military sexual trauma (MST). In our sample, 109 (29%) female veterans reported experiencing childhood abuse. After adjusting for age, race, military branch, childhood sexual abuse, and MST, childhood physical abuse was predictive of poorer physical health, and greater depressive and post-traumatic stress disorder symptoms. No significant association was found between childhood sexual abuse and poor physical or mental health status. After adjusting for other factors, childhood physical abuse was associated with more frequent use of medical health care. Childhood sexual abuse was not a predictor for health care use. Childhood physical abuse remains an important contributor to physical health and mental health, even after adjusting for the more proximate experience of MST. Screening for adverse childhood experiences may facilitate access to appropriate physical and mental health treatment among female veterans. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  12. Caregiving-Related Sleep Problems and Their Relationship to Mental Health and Daytime Function in Female Veterans.

    Science.gov (United States)

    Song, Yeonsu; Washington, Donna L; Yano, Elizabeth M; McCurry, Susan M; Fung, Constance H; Dzierzewski, Joseph M; Rodriguez, Juan Carlos; Jouldjian, Stella; Mitchell, Michael N; Alessi, Cathy A; Martin, Jennifer L

    2016-10-03

    To identify caregiving-related sleep problems and their relationship to mental health and daytime function in female Veterans. Female Veterans (N = 1,477) from cross-sectional, nationwide, postal survey data. The survey respondent characteristics included demographics, comorbidity, physical activity, health, use of sleep medications, and history of sleep apnea. They self-identified caregiving- related sleep problems (i.e., those who had trouble sleeping because of caring for a sick adult, an infant/child, or other respondents). Patient Health Questionnaire (PHQ-4) was used to assess mental health, and daytime function was measured using 11 items of International Classification of Sleep Disorders-2 (ICSD-2). Female Veterans with self-identified sleep problems due to caring for a sick adult (n = 59) experienced significantly more symptoms of depression and anxiety (p sleep problems due to caring for an infant or child (n = 95) or all other respondents (n = 1,323) after controlling for the respondent characteristics. Healthcare providers should pay attention to assessing sleep characteristics of female Veterans with caregiving responsibilities, particularly those caregiving for a sick adult.

  13. Rehospitalization in the First Year Following Veteran and Service Member TBI: A VA TBI Model Systems Study.

    Science.gov (United States)

    Tran, Johanna; Hammond, Flora; Dams-OʼConnor, Kristen; Tang, Xinyu; Eapen, Blessen; McCarthy, Marissa; Nakase-Richardson, Risa

    To determine the incidence and causes of rehospitalization following military or Veteran traumatic brain injury (TBI). Department of Veterans Affairs (VA) Veterans Health Administration Polytrauma Rehabilitation Centers (VHA PRCs). Consecutive sample of VHA TBI Model System participants (N = 401). Prospective observational cohort study. Number and type of rehospitalizations in first year post-TBI. Forty-one percent of 401 participants were rehospitalized. Rehospitalization status was associated with greater injury severity and receipt of TBI while active duty. Of those rehospitalized, 30% had 2 or more readmissions. Participants experiencing multiple rehospitalizations (2+) were more likely to have sustained their TBI during deployment than those with none or single rehospitalization. This group also sustained more severe injuries and spent more time in VA PRC inpatient rehabilitation. Common reasons for rehospitalization included inpatient rehabilitation (33%), unspecified (26%), orthopedic (10%), seizures (8%), infection (8%), and psychiatric (7%). This is the first study examining military and Veteran rehospitalization following TBI requiring inpatient rehabilitation at a VA PRC. Findings indicate frequent rehospitalizations in the first year postinjury, suggesting the need for preventive models of health maintenance following inpatient rehabilitation discharge. Greater surveillance of those with deployment-related TBI or active duty at the time of injury and greater TBI severity may be warranted.

  14. Chronic Fatigue Syndrome in Gulf War Veterans

    Science.gov (United States)

    ... Illnesses Influenza (Flu) Influenza (Flu) Home About Flu Vaccination Prevent Flu Treatment Tools & Materials For Health Professionals Pandemic Flu Health & Wellness Health & Wellness Index Tobacco ...

  15. [Mental illness and media].

    Science.gov (United States)

    Magli, Erica; Buizza, Chiara; Pioli, Rosaria

    2004-06-01

    Many knowledges on the mental disease that the community possesses are turning out of information disclosed from the media. It's common in the press to connect actions of violence and murders to the mental diseases. For this reason, the reader is induced to infer that murders and other violent actions are more frequent in people who have suffered from mentally ill, than in the general population. The mystifying impression provided by media accrues from the fact that these reports are rarely compensated from positive reports. Objective of the present study is to characterize the type of information concerning mental illness diffused from the local daily paper "Giornale di Brescia" in the year 2001. The results show that many articles connote negatively the mental disease. The journalistic sensationalism, denounced facing the speech of the prejudgment in the comparisons of the mentally ill people, seems to still remain, in the considered year of publication, one unchanging tendency.

  16. Predictors of Incarceration of Veterans Participating in U.S. Veterans' Courts.

    Science.gov (United States)

    Johnson, R Scott; Stolar, Andrea G; McGuire, James F; Mittakanti, Krithika; Clark, Sean; Coonan, Loretta A; Graham, David P

    2017-02-01

    Significant variability exists regarding the criteria and procedures used by different veterans' courts (VCs) across the country. Limited guidance is available regarding which VC model has the most successful outcomes. The purpose of this study was to examine factors associated with incarceration during VC participation. This study used data for 1,224 veterans collected from the HOMES (Homeless Operations Management and Evaluation System) database of the Department of Veterans Affairs, as well as data from a national phone survey inventory of all U.S. VCs. To identify variables associated with incarceration during VC participation, four backward conditional logistic regressions were performed. The following variables were associated with higher rates of incarceration because of a veteran's noncompletion of the VC program: charges of probation or parole violations, longer stays in the VC program, end of VC participation because of incarceration for a new arrest or case transfer by the legal system, and requiring mental health follow-up but not undergoing treatment. The following variables were associated with lower rates of incarceration: stable housing and participating in a VC program that referred veterans for substance abuse treatment. This study offers VCs a thorough review of an extensive set of recidivism data. Further investigation is necessary to understand the impact of VCs.

  17. [Prophecy and mental illness].

    Science.gov (United States)

    Vishne, Tali; Harary, Eran

    2005-09-01

    It is a well known platitude that a mentally ill person may "think that he is God" or "believes that he is the Messiah". Despite the generalization and shallowness of this attitude, sometimes psychotic patients indeed have delusions with contents of divine revelation, messianic assignments or prophetic power. In this current article we examine the different connections between prophecy and mental condition, especially psychotic. We present sources that combine prophecy and insanity, and also possible psychiatric interpretation of these situations. Finally, we present the attitude of the Rambam to prophecy and the personality characteristics of the prophet, limiting the possibility of the mentally ill patient who pretends to be a prophet.

  18. On being Credibly Ill

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna

    2011-01-01

    of individuals that are defined by their lack of a bio-medical diagnosis. Their ‘lack’ of identity accentuates how gender and class become central in the categorisation practices, constructing the ill person as either bio-medically sick or as a person who may be suffering but only from diffuse psychological...... problems. The paper shows that it is predominantly poorly educated women without a bio-medical diagnosis that welfare officers describe as suffering from psychological problems despite the fact that the women themselves focus on physical ailments in their illness stories. Men and better-educated women...

  19. ‘Everything just seems much more right in nature’: How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden

    Science.gov (United States)

    Poulsen, Dorthe Varning; Stigsdotter, Ulrika K; Djernis, Dorthe; Sidenius, Ulrik

    2016-01-01

    Available evidence shows that an increasing number of soldiers are seeking help for post-traumatic stress disorder. The post-traumatic stress disorder condition has big emotional and psychological consequences for the individual, his/her family and the society. Little research has been done to explore the impact of nature-based therapy for veterans with post-traumatic stress disorder although there is a growing amount of evidence pointing towards positive outcome. This qualitative study aims to achieve a deeper understanding of this relationship from the veteran’s perspective. Eight Danish veterans participated in a 10-week nature-based therapy. Qualitative interviews were conducted and analysed using the interpretative phenomenological method. The results indicated that the veterans have achieved tools to use in stressful situations and experienced an improvement in their post-traumatic stress disorder symptoms. PMID:28070397

  20. ‘Everything just seems much more right in nature’: How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden

    Directory of Open Access Journals (Sweden)

    Dorthe Varning Poulsen

    2016-03-01

    Full Text Available Available evidence shows that an increasing number of soldiers are seeking help for post-traumatic stress disorder. The post-traumatic stress disorder condition has big emotional and psychological consequences for the individual, his/her family and the society. Little research has been done to explore the impact of nature-based therapy for veterans with post-traumatic stress disorder although there is a growing amount of evidence pointing towards positive outcome. This qualitative study aims to achieve a deeper understanding of this relationship from the veteran’s perspective. Eight Danish veterans participated in a 10-week nature-based therapy. Qualitative interviews were conducted and analysed using the interpretative phenomenological method. The results indicated that the veterans have achieved tools to use in stressful situations and experienced an improvement in their post-traumatic stress disorder symptoms.