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Sample records for older male veterans

  1. A Longitudinal Study of Retirement in Older Male Veterans

    ERIC Educational Resources Information Center

    Schnurr, Paula P.; Lunney, Carole A.; Sengupta, Anjana; Spiro, Avron

    2005-01-01

    In this study, the authors examined the effect of retirement on psychological and physical symptoms in 404 older male veterans who were taking part in an ongoing longitudinal study. Hierarchical linear modeling was used to analyze symptom trajectories from preretirement, peri-retirement, and postretirement periods in veterans with either lifetime…

  2. Suicide Risk and Precipitating Circumstances Among Young, Middle-Aged, and Older Male Veterans

    PubMed Central

    McFarland, Bentson H.; Huguet, Nathalie; Valenstein, Marcia

    2012-01-01

    Objectives. The purpose of this study was to evaluate the risk of suicide among veteran men relative to nonveteran men by age and to examine the prevalence of suicide circumstances among male veterans in different age groups (18–34, 35–44, 45–64, and ≥ 65 years). Methods. Data from the National Violent Death Reporting System (2003–2008) were used to calculate age-specific suicide rates for veterans (n = 8440) and nonveterans (n = 21 668) and to calculate the age-stratified mortality ratio for veterans. Multiple logistic regression was used to compare health status, stressful life events preceding suicide, and means of death among young, middle-aged, and older veterans. Results. Veterans were at higher risk for suicide compared with nonveterans in all age groups except the oldest. Mental health, substance abuse, and financial and relationship problems were more common in younger than in older veteran suicide decedents, whereas health problems were more prevalent in the older veterans. Most male veterans used firearms for suicide, and nearly all elderly veterans did so. Conclusions. Our study highlighted heightened risk of suicide in male veterans compared with nonveterans. Within the veteran population, suicide might be influenced by different precipitating factors at various stages of life. PMID:22390587

  3. Younger Veterans - Older Veterans: A Comparison of Perceptions of Hospital Treatment, Problem Areas and Needs.

    ERIC Educational Resources Information Center

    Dickman, Harold R.; Pearson, Helen J.

    The contention that younger veterans differ from their elders in their attitudes and expectations was shown to be an inaccurate generalization on the basis of this reported inquiry. Three general classes of informational data were collected from both younger and older veterans: (1) perception of hospital services; (2) patient problems and services…

  4. Care Transition Experiences of Older Veterans and Their Caregivers.

    PubMed

    Ford, Bryan Keith; Ingersoll-Dayton, Berit; Burgio, Kathryn

    2016-05-01

    This study's main objective was to examine care transition experiences of older veterans and their caregivers. Fifty patients age 65 years and older, discharged from a Veterans Affairs Medical Center hospital, completed the Care Transitions Measure-15 survey three to four weeks postdischarge. Seven patients and six caregivers participated in semistructured interviews. Overall, the quality of care transitions was rated as good; however, some items were indicated as problematic for veterans. Themes that emerged included agreeableness, frustration with complex information, caregiver education, and the timing and methods of information delivery. These findings have implications for all clinical staff working with veterans, and particularly for social workers facilitating care transitions for veterans and their caregivers. PMID:27263203

  5. Veterans Health Administration and Medicare Outpatient Health Care Utilization by Older Rural and Urban New England Veterans

    ERIC Educational Resources Information Center

    Weeks, William B.; Bott, David M.; Lamkin, Rebecca P.; Wright, Steven M.

    2005-01-01

    Older veterans often use both the Veterans Health Administration (VHA) and Medicare to obtain health care services. The authors sought to compare outpatient medical service utilization of Medicare-enrolled rural veterans with their urban counterparts in New England. The authors combined VHA and Medicare databases and identified veterans who were…

  6. Suicidal Behavior in a National Sample of Older Homeless Veterans

    PubMed Central

    Schinka, Katherine C.; Casey, Roger J.; Kasprow, Wes; Bossarte, Robert M.

    2012-01-01

    Objectives. We examined self-reported suicidal behavior of older homeless veterans to establish frequencies and predictors of recent suicidal behaviors, and their impact on transitional housing interventions. Methods. We analyzed the records of a national sample of 10 111 veterans who participated in a transition housing program over a 6-year period, ending in 2008. Results. Approximately 12% of homeless veterans reported suicidal ideation before program admission; 3% reported a suicide attempt in the 30 days before program admission. Older homeless veterans exhibiting suicidal behavior had histories of high rates of psychiatric disorders and substance abuse. Regression analyses showed that self-report of depression was the primary correlate of suicidal behavior. Suicidal behavior before program entry did not predict intervention outcomes, such as program completion, housing outcome, and employment. Conclusions. Suicidal behavior was prevalent in older homeless veterans and was associated with a history of psychiatric disorder and substance abuse. Self-reported depression was associated with these behaviors at the time of housing intervention. Despite the association with poor mental health history, suicidal behavior in older homeless veterans did not impact outcomes of transitional housing interventions. PMID:22390590

  7. Male combat veterans' narratives of PTSD, masculinity, and health.

    PubMed

    Caddick, Nick; Smith, Brett; Phoenix, Cassandra

    2015-01-01

    This article uniquely examines the ways a group of male combat veterans talk about masculinity and how, following post-traumatic stress disorder (PTSD), they performed masculinities in the context of a surfing group, and what effects this had upon their health and wellbeing. Participant observations and life history interviews were conducted with a group of combat veterans who belonged to a surfing charity for veterans experiencing PTSD. Data were rigorously explored via narrative analysis. Our findings revealed the ways in which veterans enacted masculinities in accordance with the values that were cultivated during military service. These masculine performances in the surfing group had important effects both on and for the veterans' wellbeing. Significantly, the study highlights how masculine performances can be seen alternately as a danger and as a resource for health and wellbeing in relation to PTSD. The article advances knowledge on combat veterans and mental health with critical implications for the promotion of male veterans' mental health. These include the original suggestion that health-promoting masculine performances might be recognised and supported in PTSD treatment settings. Rather than automatically viewing masculinity as problematic, this article moves the field forward by highlighting how hegemonic masculinities can be reconstructed in positive ways which might improve veterans' health and wellbeing. A video abstract of this article can be found at: https://www.youtube.com/watch?v=BaYzaOP1kAY.

  8. Functional correlates of military sexual assault in male veterans.

    PubMed

    Schry, Amie R; Hibberd, Rachel; Wagner, H Ryan; Turchik, Jessica A; Kimbrel, Nathan A; Wong, Madrianne; Elbogen, Eric E; Strauss, Jennifer L; Brancu, Mira

    2015-11-01

    Despite research findings that similar numbers of male and female veterans are affected by military sexual trauma (MST), there has been considerably less research on the effects of MST specific to male veterans. The aim of the present study was to provide preliminary data describing functional correlates of military sexual assault (MSA) among male Iraq/Afghanistan-era veterans to identify potential health care needs for this population. We evaluated the following functional correlates: posttraumatic stress disorder (PTSD) symptoms, depression symptoms, alcohol use, drug use, suicidality, social support, violent behavior in the past 30 days, incarceration, disability eligibility status, and use of outpatient mental health treatment. We compared 3 groups: (a) male veterans who endorsed a history of MSA (n = 39), (b) a general non-MSA sample (n = 2,003), and (c) a matched non-MSA sample (n = 39) identified by matching algorithms on the basis of factors (e.g., age, education, adult premilitary sexual trauma history, childhood sexual and physical trauma history, and race) that could increase veterans' vulnerability to the functional correlates examined. MSA in men was associated with greater PTSD symptom severity, greater depression symptom severity, higher suicidality, and higher outpatient mental health treatment, above and beyond the effects of vulnerability factors. These findings suggest that, for male veterans, MSA may result in a severe and enduring overall symptom profile requiring ongoing clinical management. PMID:26524280

  9. Problems in Families of Male Vietnam Veterans with Posttraumatic Stress Disorder.

    ERIC Educational Resources Information Center

    Jordan, B. Kathleen; And Others

    1992-01-01

    Interviewed 1,200 male Vietnam veterans and spouses or coresident partners of 376 of these veterans. Compared with families of male veterans without current posttraumatic stress disorder (PTSD), families of male veterans with current PTSD showed markedly elevated levels of severe and diffuse problems in marital and family adjustment, in parenting…

  10. Declining stroke burden among white and black male veteran subjects.

    PubMed

    Kamalesh, Masoor; Shen, Jianzhao; Tierney, William

    2007-01-01

    The prevalence of hypertension and diabetes is increasing. We hypothesized that this could contribute to increasing burden of stroke-the third leading cause of mortality-and investigated national trends in stroke burden among blacks and whites. From October 1990 to October 1997, 55,094 veterans were admitted with diagnosis of ischemic stroke (International Classification of Diseases [ICD] code 434 or 436) at any veterans hospital in the country were included in the study. We extracted demographic data from Veterans' Administration administrative databases. Discharge ICD-9 codes were used to assess stroke risk factors. Patients were classified as white or black, and prevalence of stroke was calculated and stratified according to age. Overall annual incidence rate fell from 2.7 per 1,000 in 1991 to 1.67 per 1,000 in 1997. Annual incidence number of stroke declined steadily in both the white and black groups from 1991 to 1997. Incidence numbers fell for all ages with greater decrease in younger age groups. Our data indicate that the burden of stroke among male veterans is decreasing. This appears to be true for both blacks and whites and across all age groups.

  11. Mortality rates between treated post-traumatic stress disorder Israeli male veterans compared to non-diagnosed veterans.

    PubMed

    Zohar, Joseph; Fostick, Leah

    2014-01-01

    The literature suggests that post-traumatic stress disorder (PTSD) is associated with increased mortality. However, to date, mortality rates amongst veterans diagnosed with post-traumatic stress disorder have not been reported for Israeli veterans, who bear a different profile than veterans from other countries. This study aims to evaluate age-adjusted mortality rates amongst Israeli Defense Forces veterans with and without PTSD diagnosis. The study was carried out in a paired sample design with 2457 male veterans with treated PTSD and 2457 matched male veterans without a PTSD diagnosis. Data on PTSD and non-PTSD veterans was collected from the Rehabilitation Division of the Israeli Ministry of Defense (MOD) and the Israeli Defense Forces' (IDF) special unit for treatment of combat stress reaction. Mortality data were collected from the Ministry of the Interior (MOI) computerized database. Comparison of mortality rates between PTSD and non-PTSD veterans was done using paired observations survival analysis by applying a proportional hazards regression model. Overall no statistically significant difference in mortality rates was found between veterans with treated PTSD and veterans without PTSD. These findings hold even when excluding veterans who died in battle and including non-PTSD veterans who died before their matched PTSD veteran was diagnosed. However, among pairs with similar military jobs PTSD group had significantly less mortality. The results of this large national cohort suggest that treated PTSD is not associated with increased mortality. We submit that the lack of this association represents the "net" pathophysiology of PTSD due to the unique characteristics of the sample.

  12. Implementing Yoga Therapy Adapted for Older Veterans Who Are Cancer Survivors

    PubMed Central

    King, Katherine; Gosian, Jeffrey; Doherty, Kelly; Chapman, Jnani; Walsh, Christina; Azar, Jill Pokaski; Danhauer, Suzanne C.; Moye, Jennifer

    2015-01-01

    Objectives This goal of this paper is to describe the reach, application, and effectiveness of an 8-week yoga therapy protocol with older cancer survivors within a Veterans Health Administration setting. Methods To document the reach of this intervention, recruitment efforts, attendance, and practice rates were tracked. To explore the application of the protocol to this population, physical therapy pre-assessment and observations by the yoga therapist were recorded to ascertain necessary pose modifications. Effectiveness was measured through pre- and post-course structured interviews, tracking self-reported symptoms of combat-related posttraumatic stress disorder, depression, anxiety, fatigue, insomnia, and pain. Results Regarding reach, 15% of eligible veterans (n = 14) enrolled, participated in 3–16 classes (M±SD = 11.64±3.39), and practiced at home for 0–56 days (M±SD = 26.36±17.87). Participants were primarily Caucasian (n = 13), male (n = 13), ranged in age from 55 to 78 years (M±SD = 65.64±5.15), and had multiple medical problems. During application, substantial individualized modifications to the yoga therapy protocol were necessary. Effectiveness of the intervention was mixed. During post-course interviews, participants reported a variety of qualitative benefits. Notably, the majority of participants reported that breathing and relaxation techniques were the most useful to learn. Group comparisons of mean pre- and post-course scores on standardized measures showed no significant differences. Conclusions A minority of older veterans express an interest in yoga, but those who do have high rates of class attendance and home practice. Careful physical pre-assessment and attentive therapists are required to undertake the adaptations required by participants with multiple comorbidities. The effectiveness of yoga in this setting requires additional study. PMID:25810693

  13. PTSD is negatively associated with physical performance and physical function in older overweight military veterans

    PubMed Central

    Hall, Katherine S.; Beckham, Jean C.; Bosworth, Hayden B.; Sloane, Richard; Pieper, Carl F.; Morey, Miriam C.

    2014-01-01

    This study examines the effect of posttraumatic stress disorder (PTSD) on function and physical performance in older overweight military Veterans with comorbid conditions. This is a secondary data analysis of older Veterans (mean age = 62.9 yr) participating in a physical activity counseling trial. Study participants with PTSD (n = 67) and without PTSD (n = 235) were identified. Self-reported physical function (36-item Short Form Health Survey) and directly measured physical performance (mobility, aerobic endurance, strength) were assessed. Multivariate analyses of variance controlling for demographic factors and psychiatric disorders demonstrated significant physical impairment among those with PTSD. PTSD was negatively associated with self-reported physical function, functioning in daily activities, and general health (p < 0.01). Those with PTSD also performed significantly worse on tests of lower-limb function (p < 0.05). Despite being significantly younger, Veterans with PTSD had comparable scores on gait speed, aerobic endurance, grip strength, and bodily pain compared with Veterans without PTSD. This study provides preliminary data for the negative association between PTSD and physical function in older military Veterans. These data highlight the importance of ongoing monitoring of physical performance among returning Veterans with PTSD and intervening in older overweight Veterans with PTSD, whose physical performance scores are indicative of accelerated risk of premature functional aging. PMID:24933726

  14. PTSD is negatively associated with physical performance and physical function in older overweight military Veterans.

    PubMed

    Hall, Katherine S; Beckham, Jean C; Bosworth, Hayden B; Sloane, Richard; Pieper, Carl F; Morey, Miriam C

    2014-01-01

    This study examines the effect of posttraumatic stress disorder (PTSD) on function and physical performance in older overweight military Veterans with comorbid conditions. This is a secondary data analysis of older Veterans (mean age = 62.9 yr) participating in a physical activity counseling trial. Study participants with PTSD (n = 67) and without PTSD (n = 235) were identified. Self-reported physical function (36-item Short Form Health Survey) and directly measured physical performance (mobility, aerobic endurance, strength) were assessed. Multivariate analyses of variance controlling for demographic factors and psychiatric disorders demonstrated significant physical impairment among those with PTSD. PTSD was negatively associated with self-reported physical function, functioning in daily activities, and general health (p < 0.01). Those with PTSD also performed significantly worse on tests of lower-limb function (p < 0.05). Despite being significantly younger, Veterans with PTSD had comparable scores on gait speed, aerobic endurance, grip strength, and bodily pain compared with Veterans without PTSD. This study provides preliminary data for the negative association between PTSD and physical function in older military Veterans. These data highlight the importance of ongoing monitoring of physical performance among returning Veterans with PTSD and intervening in older overweight Veterans with PTSD, whose physical performance scores are indicative of accelerated risk of premature functional aging.

  15. Physical activity barriers and enablers in older Veterans with lower-limb amputation.

    PubMed

    Littman, Alyson J; Boyko, Edward J; Thompson, Mary Lou; Haselkorn, Jodie K; Sangeorzan, Bruce J; Arterburn, David E

    2014-01-01

    Little is known about the types of physical activities that older individuals with lower-limb loss perform, correlates of regular physical activity (PA), and barriers and facilitators to PA. We conducted an exploratory study in 158 older Veterans from the Pacific Northwest with a partial foot (35%), below-knee (39%) and above-knee (26%) amputation. Ninety-eight percent of survey respondents were male, on average 65 yr of age and 15 yr postamputation; 36% of amputations were trauma-related. The most commonly reported physical activities were muscle strengthening (42%), yard work and/or gardening (30%), and bicycling (11%). Forty-three percent were classified as physically active based on weekly moderate- and vigorous-intensity PA. History of vigorous preamputation PA was positively associated with being active, while low wealth and watching ≥5 h/d of television/videos were inversely associated. While pain- and resource-related barriers to PA were most frequently reported, only knowledge-related and interest/motivation-related barriers were inversely associated with being active. Family support and financial assistance to join a gym were the most commonly reported factors that would facilitate PA. To increase PA in the older amputee population, interventions should address motivational issues, knowledge gaps, and television watching; reduce financial barriers to exercising; and consider involving family members.

  16. Performance-based assessment of falls risk in older veterans with executive dysfunction.

    PubMed

    Fischer, Barbara L; Hoyt, William T; Maucieri, Lawrence; Kind, Amy J; Gunter-Hunt, Gail; Swader, Teresa Chervenka; Gangnon, Ronald E; Gleason, Carey E

    2014-01-01

    Falling is a serious hazard for older veterans that may lead to severe injury, loss of independence, and death. While the American Geriatrics Society (AGS) provides guidelines to screen individuals at risk for falls, the guidelines may be less successful with specific subgroups of patients. In a veteran sample, we examined whether the Timed Up and Go (TUG) test, including a modified version, the TUG-Cognition, effectively detected potential fallers whose risk was associated with cognitive deficits. Specifically, we sought to determine whether TUG tasks and AGS criteria were differentially associated with executive dysfunction, whether the TUG tasks identified potential fallers outside of those recognized by AGS criteria, and whether these tasks distinguished groups of fallers. Participants included 120 mostly male patients referred to the Memory Assessment Clinic because of cognitive impairment. TUG-Cognition scores were strongly associated with executive dysfunction and differed systematically between fallers grouped by number of falls. These findings suggest that the TUG-Cognition shows promise in identifying fallers whose risk is related to or compounded by cognitive impairment. Future research should study the predictive validity of these measures by following patients prospectively. PMID:24933724

  17. Oxytocin improves emotion recognition for older males.

    PubMed

    Campbell, Anna; Ruffman, Ted; Murray, Janice E; Glue, Paul

    2014-10-01

    Older adults (≥60 years) perform worse than young adults (18-30 years) when recognizing facial expressions of emotion. The hypothesized cause of these changes might be declines in neurotransmitters that could affect information processing within the brain. In the present study, we examined the neuropeptide oxytocin that functions to increase neurotransmission. Research suggests that oxytocin benefits the emotion recognition of less socially able individuals. Men tend to have lower levels of oxytocin and older men tend to have worse emotion recognition than older women; therefore, there is reason to think that older men will be particularly likely to benefit from oxytocin. We examined this idea using a double-blind design, testing 68 older and 68 young adults randomly allocated to receive oxytocin nasal spray (20 international units) or placebo. Forty-five minutes afterward they completed an emotion recognition task assessing labeling accuracy for angry, disgusted, fearful, happy, neutral, and sad faces. Older males receiving oxytocin showed improved emotion recognition relative to those taking placebo. No differences were found for older females or young adults. We hypothesize that oxytocin facilitates emotion recognition by improving neurotransmission in the group with the worst emotion recognition.

  18. Erectile Dysfunction in the Older Adult Male.

    PubMed

    Mola, Joanna R

    2015-01-01

    Erectile dysfunction (ED) in the older adult male is a significant problem affecting more than 75% of men over 70 years of age in the United States. Older men have an increased likelihood of developing ED due to chronic disease, comorbid conditions, and age-related changes. Research has demonstrated that while the prevalence and severity of ED increases with age, sexual desire often remains unchanged. This article discusses the clinical picture of ED, including relevant pathophysiology, clinical presentation, and evaluation and treatment options. PMID:26197627

  19. Suicide Experiences among Institutionalized Older Veterans in Taiwan

    ERIC Educational Resources Information Center

    Ku, Yan-Chiou; Tsai, Yun-Fang; Lin, Yan-Chiou; Lin, Yea-Pyng

    2009-01-01

    Purpose: Institutionalized veterans in Taiwan are a high-risk group for completing suicide due to their institutionalization and social minority status. The purpose of this study was to understand the suicide experiences, especially the triggers of suicide in this group. Design and Methods Data: about suicide experiences were collected from 19…

  20. War stress and late-life mortality in World War II male civilian resistance veterans.

    PubMed

    Op Den Velde, Wybrand; Deeg, Dorly J H; Hovens, Johannes E; Van Duijn, Marijtje A J; Aarts, Petra G H

    2011-04-01

    The mental and physical health of 146 Dutch males exposed to severe war stress during their young adulthood were examined in 1986-1987 when they were at ages 61 to 66 years. The veterans' data were compared with a randomly selected population-based sample of same-aged males. In 2005, 70% of the war stress veterans had died, and only 35% of the comparison group. The baseline quality of life was significantly poorer in the war stress veterans than in the comparison group. Baseline variables explained 42% of the increased risk of mortality among war stress veterans. Smoking was the largest single contributor to mortality.

  1. A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska: A Methodological Caveat.

    PubMed

    Tsai, Jack; Ramaswamy, Sriram; Bhatia, Subhash C; Rosenheck, Robert A

    2015-12-01

    This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed.

  2. A Qualitative Study of Male Veterans' Violence Perpetration and Treatment Preferences.

    PubMed

    Tharp, Andra Teten; Sherman, Michelle; Holland, Kristin; Townsend, Bradford; Bowling, Ursula

    2016-08-01

    Prevention and treatment of intimate partner violence (IPV) has increasingly focused on engaging men; however, very little work has examined how men manage the negative emotions associated with relationship conflict, as well as their preferences for and perceived barriers to treatment. Given the overrepresentation of IPV among men with post-traumatic stress disorder, the perspectives of male veterans with and without post-traumatic stress disorder are critical to informing IPV prevention and treatment within the Veterans Administration (VA) healthcare system. This qualitative study involved interviews with 25 male veterans who reported recent IPV perpetration. Interview themes included coping with emotions associated with violence and preferences and barriers to seeking treatment related to IPV. Results found the participants were interested in receiving IPV treatment at the Veterans Administration, and interviews offered several suggestions for developing or adapting prevention and treatment options for male veterans and their families to take into account violence in their relationships. PMID:27483507

  3. The Association Between Benzodiazepine Use and Depression Outcomes in Older Veterans.

    PubMed

    Leggett, Amanda; Kavanagh, Janet; Zivin, Kara; Chiang, Claire; Kim, Hyungjin M; Kales, Helen C

    2015-12-01

    Benzodiazepines (BZDs) are commonly prescribed to older adults with depression, but it is unknown whether they improve antidepressant (AD) adherence or depressive symptoms. We followed 297 older veterans diagnosed with depression and provided a new AD medication prospectively for 4 months. Data include validated self-report measures and VA pharmacy records. At initial assessment, 20.5% of participants were prescribed a BZD. Those with a BZD prescription at baseline were significantly more likely than those without to have a personality disorder, schizophrenia spectrum disorder, or other anxiety disorder, and higher depressive symptom and anxiety symptom scale scores on average. In adjusted regressions, BZD use was not significantly associated with AD adherence, any improvement in depressive symptoms, or a 50% reduction in depressive symptoms. Our results suggest BZD use concurrent with AD treatment does not significantly improve depressive outcomes in older veterans.

  4. Exposure to High Risk Medications is Associated with Worse Outcomes in Older Veterans with Chronic Pain

    PubMed Central

    Makris, Una E; Pugh, Mary Jo; Alvarez, Carlos A; Berlowitz, Dan R; Turner, Barbara J; Aung, KoKo; Mortensen, Eric M

    2016-01-01

    Background Chronic pain is common, costly, and leads to significant morbidity in older adults, yet we have limited data on medication safety. We sought to evaluate the association of incident High Risk Medication in the Elderly (HRME) with mortality, emergency department (ED) or hospital care among older adults with chronic pain. Methods A retrospective Veterans Health Administration cohort study was conducted examining older Veterans with chronic pain diagnoses and use of incident HRME (opioids, skeletal muscle relaxants, antihistamines, and psychotropics). Outcomes evaluated included all-cause mortality, ED visits, or inpatient hospital care. Descriptive statistics summarized variables for the overall cohort, the chronic pain cohort, and those with and without HRME. Separate generalized linear mixed-effect regression models were used to examine the association of incident HRME on each outcome, controlling for potential confounders. Results Among 1,807,404 Veterans who received VA care in 2005–2006, 584,066 (32.3%) had chronic pain; 45,945 Veterans with chronic pain (7.9%) had incident HRME exposure. The strongest significant associations of incident HRME were for: high-risk opioids with all-cause hospitalizations (OR 2.08, 95%CI 1.95–2.23); skeletal muscle relaxants with all-cause ED visits (OR 2.62, 95%CI 2.52–2.73) and mortality (OR 0.80, 95%CI 0.74–0.86); antihistamines with all-cause ED visits (OR 2.82 95%CI 2.72–2.95); and psychotropics with all-cause hospitalizations (OR 2.15, 95%CI 1.96–2.35). Conclusions Our data indicate that incident HRME is associated with clinically important adverse outcomes in older Veterans with chronic pain and highlight the importance of being judicious with prescribing certain classes of drugs in this vulnerable population. PMID:26418380

  5. Effectiveness and safety of nitrofurantoin in outpatient male veterans

    PubMed Central

    Ingalsbe, Michelle L.; Wojciechowski, Amy L.; Smith, Kelly A.

    2015-01-01

    Objectives: The aim of the study was to assess both the safety and the effectiveness of nitrofurantoin in male veterans treated for urinary tract infections (UTIs) with varying degrees of renal impairment in the outpatient setting. Nitrofurantoin is an important oral option for treating UTIs given increasing resistance to commonly used agents. Nitrofurantoin is currently contraindicated in patients with a creatinine clearance (CrCl) of < 60 ml/min, but the reason for this threshold has not been well documented. Methods: Data were collected through a retrospective chart review from January 2004 to July 2013 of men who had received nitrofurantoin. Bivariate analyses followed by multivariate analyses were performed between patients experiencing clinical cure and those who did not, to determine factors significantly impacting effectiveness. Results: The Gram stain of the organism causing the UTI and CrCl were significant factors impacting effectiveness. For every 1 ml/min increase in CrCl, the odds of clinical cure increased by 1.3%. Patients with Gram-negative UTIs predictably had 80% cure rates with CrCl around 60 ml/min. Patients with Gram-positive UTIs required higher CrCl, nearing 100 ml/min, to establish an 80% cure rate. Adverse effects did not vary with CrCl. Conclusions: The odds of clinical cure varied with CrCl and with the type of organism causing the UTI, while adverse events did not differ based on renal function. A minimum CrCl of 60 ml/min is suggested for men to achieve an 80% cure rate for UTIs with the most common urinary pathogens. PMID:26445598

  6. Evidence of greater health care needs among older veterans of the Vietnam War.

    PubMed

    Brooks, Matthew S; Laditka, Sarah B; Laditka, James N

    2008-08-01

    This study examined self-rated health, impairments in activities of daily living, and treatment for eight health conditions among Vietnam War-era veterans, comparing those who served in Vietnam with those who served elsewhere. Data were from the nationally representative 2001 National Survey of Veterans (N = 7,907; 3,923 veterans served in Vietnam). Age-stratified (<60 years versus > or =60 years) analyses included multivariate logistic regression. In adjusted analyses, among those <60 years of age, those who served in Vietnam had notably poorer self-rated health and higher stroke risk (odds ratio, 1.51; 95% confidence interval, 1.48-1.53); odds of most other conditions were lower. Among those > or =60 years of age, those who served in Vietnam had poorer self-rated health, higher cancer risk (odds ratio, 1.33; 95% confidence interval, 1.32-1.35), and more treatment for hypertension, lung conditions, stroke, and hearing loss. Results suggest greater resource use among older veterans who served in Vietnam. Clinicians and the Department of Veterans Affairs should especially note their substantially higher cancer risk.

  7. Homeless female U.S. veterans in a national supported housing program: comparison of individual characteristics and outcomes with male veterans.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; Kane, Vincent

    2014-08-01

    As more women serve in the U.S. military, the proportion of females among homeless veterans is increasing. The current study compares the individual characteristics and 1-year outcomes of homeless female and male veterans in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program nationally. Administrative data on 43,853 veterans (10.69% females; 89.31% males) referred to HUD-VASH were analyzed for gender differences at baseline and over a 1-year period. Homeless female veterans were younger, had shorter homeless and incarceration histories, and were less likely to have substance use disorders than men. However, despite being less likely to report combat exposure, female veterans were more likely to have posttraumatic stress disorder. Homeless female veterans were also much more likely to have dependent children with them and to plan to live with family members in supported housing. Once admitted to HUD-VASH, there were no gender differences in attrition or main housing outcomes. Case managers were faster to admit female veterans to the program, reported better working alliances, and provided more services related to employment and income than male veterans. These findings suggest homeless female veterans may have certain strengths, including being younger, less involved in the criminal justice system, and more adept at relating to professional and natural supports; but special attention to noncombat trauma and family-oriented services may be needed. PMID:24730678

  8. Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans

    PubMed Central

    Karuza, Jurgis; Dunn, Andrew S.; Savino, Dorian; Katz, Paul

    2014-01-01

    Introduction: Chronic lower back pain (CLBP) is problematic in older veterans. Spinal manipulative therapy (SMT) is commonly utilized for CLBP in older adults, yet there are few randomized placebo-controlled trials evaluating SMT. Methods: The purpose of the study was to compare the effectiveness of SMT to a sham intervention on pain (Visual Analogue Scale, SF-36 pain subscale), disability (Oswestry Disability Index), and physical function (SF-36 subscale, Timed Up and Go) by performing a randomized placebo-controlled trial at 2 Veteran Affairs Clinics. Results: Older veterans (≥ 65 years of age) who were naive to chiropractic were recruited. A total of 136 were included in the study with 69 being randomly assigned to SMT and 67 to sham intervention. Patients were treated 2 times per week for 4 weeks assessing outcomes at baseline, 5, and 12 weeks postbaseline. Both groups demonstrated significant decrease in pain and disability at 5 and 12 weeks. At 12 weeks, there was no significant difference in pain and a statistically significant decline in disability scores in the SMT group when compared to the sham intervention group. There were no significant differences in adverse events between the groups. Conclusions: The SMT did not result in greater improvement in pain when compared to our sham intervention; however, SMT did demonstrate a slightly greater improvement in disability at 12 weeks. The fact that patients in both groups showed improvements suggests the presence of a nonspecific therapeutic effect. PMID:26246937

  9. The Veterans LIFE Study: A Randomized Trial of Primary Care Based Physical Activity Counseling For Older Men

    PubMed Central

    Morey, Miriam C.; Peterson, Matthew J; Pieper, Carl F.; Sloane, Richard; Crowley, Gail M.; Cowper, Patricia A.; McConnell, Eleanor S.; Bosworth, Hayden B.; Ekelund, Carola C.; Pearson, Megan P.

    2009-01-01

    BACKGROUND Slow gait is predictive of adverse health outcomes and increased health service utilization. Physical activity counseling (PAC) may enhance mobility among elders. Primary care settings are appropriate for PAC because most older adults see their primary care physician annually. Innovative use of automated telephone messaging facilitates physician counseling. OBJECTIVE To determine the effects of multi-component PAC promoting physical activity (PA) guidelines on gait speed and related measures of PA and function in older veterans. DESIGN, SETTING, AND PARTICIPANTS Randomized controlled trial of 398 male veterans, ages 70 and over receiving primary care at the Veterans’ Affairs Medical Center of Durham, N.C. INTERVENTION Twelve months of usual care (UC) or multi-component PAC consisting of baseline in-person and biweekly then monthly telephone counseling by a lifestyle counselor, one-time clinical endorsement of PA and monthly automated telephone messaging by primary care provider, and quarterly tailored mailings of progress in PA. MEASUREMENTS Gait speed (usual and rapid), self-reported PA, function and disability at baseline, 3, 6 and 12 months. RESULTS Although no between-group differences were noted for usual gait speed, rapid gait speed improved significantly more for the PAC group (1.56 (0.41) m/s to 1.68 (0.44) m/s) compared to UC (1.57 (0.40) m/sec to 1.59 (0.42) m/sec, p = 0.04). Minutes of moderate/vigorous PA increased significantly in the PAC group (from a mean (SD) 57.1 (99.3) min/wk to 126.6 (142.9) min/week) compared to the UC group (from 60.2 (116.1) to 69.6 (116.1) min/wk, p < 0.001). Changes in other functional/disability outcomes were small. CONCLUSIONS In this group of older male veterans, multi-component PA significantly improved rapid gait and PA. Translation from increased PA to overall functioning was not observed. Integration with primary care was successful. PMID:19467149

  10. Self-Mutilative Behaviors in Male Veterans with Posttraumatic Stress Disorder

    PubMed Central

    Sacks, Matthew B.; Flood, Amanda M.; Dennis, Michelle F.; Hertzberg, Michael A.; Beckham, Jean C.

    2008-01-01

    Self-mutilative behaviors (SMB) were examined in a sample of male veterans with posttraumatic stress disorder (PTSD). The primary objective was to determine the prevalence of SMB and any physical, cognitive, or affective antecedents and correlates for these behaviors. Participants included 509 male veterans with PTSD and levels of PTSD, depression, alcohol use, hostility, and impulsivity were evaluated to determine if these variables were related to SMB. Antecedents and sequelae of SMB were also examined to generate hypotheses regarding the functions of these behaviors. A second type of habit behavior, body-focused repetitive behaviors (BFRB), was also examined as part of the study. Findings indicated that veterans who engaged in either type of habit behavior were younger than those who did not engage in SMB or BFRB. Veterans reporting SMB also reported higher levels of PTSD, depression, hostility, and impulsivity compared to the BFRB and no-habit groups. Examination of habit antecedents and sequelae showed support for the automatic-positive reinforcement function of SMB. These findings are discussed in the context of research and treatment involving male veterans with PTSD who engage in SMB. PMID:17606271

  11. Sex differences in orbitofrontal connectivity in male and female veterans with TBI.

    PubMed

    McGlade, Erin; Rogowska, Jadwiga; Yurgelun-Todd, Deborah

    2015-09-01

    More female soldiers are now serving in combat theaters than at any other time. However, little is known about possible sex differences underlying the neuropathology and manifestation of one of modern war's signature injuries, traumatic brain injury (TBI). The paucity of information regarding sex differences in TBI is particularly evident when examining changes in executive function and emotion regulation associated with post concussive events. The current study objective was to observe whether patterns of orbitofrontal (OFC) functional connectivity would differ between female veterans with TBI and their male counterparts. The study further sought to determine whether OFC connectivity might be differentially associated with clinical measures of aggression and hostility. Seventeen female veterans and 24 male veterans, age 18 to 25, who met criteria for TBI completed resting state magnetic resonance imaging (MRI) and clinical assessment measures. Imaging data were analyzed using left and right seed regions of the OFC, and regression analyses were conducted to observe the relationship between resting state connectivity and self-reported aggression. Females and males in this study differed in OFC connectivity, with females demonstrating greater connectivity between left and right OFC and parietal and occipital regions and males demonstrating greater connectivity between left and right OFC and frontal and temporal regions. Significant associations between resting state connectivity and clinical measures were found only in male veterans. These findings suggest that TBI may interact with sex-specific patterns of brain connectivity in male and female veterans and exert divergent effects on clinical profiles of aggression post-injury. PMID:25864195

  12. Religiousness/Spirituality and Mental Health among Older Male Inmates

    ERIC Educational Resources Information Center

    Allen, Rebecca S.; Phillips, Laura Lee; Roff, Lucinda Lee; Cavanaugh, Ronald; Day, Laura

    2008-01-01

    Purpose: With the rapid growth in the older inmate population, emerging issues regarding physical and mental health require greater research and clinical attention. We examined the relation of religiousness/spirituality; demographic characteristics such as age, race, and type of crime; and physical and mental health among 73 older male inmates in…

  13. Employing a Group Medical Intervention for Hypertensive Male Veterans: An Exploratory Analysis

    ERIC Educational Resources Information Center

    Westheimer, Joshua M.; Capello, Jeremy; McCarthy, Christopher; Denny, Nathan

    2009-01-01

    Doctor Interactive Group Medical Appointments (DIGMAs) were conducted over a period of 7 months; 73 hypertensive male veterans were enrolled in the study and 58 completed it. Findings indicated that both systolic and diastolic blood pressure readings were significantly reduced from pretest to posttest. Participant self-report of health promoting…

  14. Social Camouflage: Interpreting Male Student Veterans' Behavior for Residence Life Professionals

    ERIC Educational Resources Information Center

    Livingston, Wade G.; Scott, David A.; Havice, Pamela A.; Cawthon, Tony W.

    2012-01-01

    The term "camouflage" implies obscurity and concealment. Male student veterans who return from the military often employ a social camouflage; though some may reveal and discuss their military experience, their overriding objective is to blend in, have a "normal" college experience, and graduate. This creates challenges for housing professionals…

  15. Compulsive sexual behavior among male military veterans: Prevalence and associated clinical factors

    PubMed Central

    SMITH, PHILIP H.; POTENZA, MARC N.; MAZURE, CAROLYN M.; MCKEE, SHERRY A.; PARK, CRYSTAL L.; HOFF, RANI A.

    2014-01-01

    Background and aims: Compulsive sexual behavior (CSB) is highly prevalent among men, often co-occurring with psychiatric disorders and traumatic experiences. Psychiatric disorders and trauma are highly prevalent among military veterans, yet there is a paucity of research on CSB among military samples. The aim of this study was to examine the prevalence of and factors associated with CSB among male military veterans. Methods: Surveys were administered to veterans of Operations Iraqi Freedom, Enduring Freedom, or New Dawn at baseline (n = 258), 3 months (n = 194), and 6 months (n = 136). Bivariate analyses and Generalized Estimating Equations were utilized to estimate associations between CSB and the following variables: psychiatric co-morbidity, childhood physical or sexual trauma, pre- and post-deployment experiences, TV/ Internet usage, and sociodemographics. Associations between CSB and specific PTSD symptom clusters were also examined. Results: CSB was reported by 16.7% of the sample at baseline. Several variables were associated with CSB in bivariate analyses; however, only PTSD severity, childhood sexual trauma, and age remained significant in multivariable GEE models. The PTSD symptom cluster re-experiencing was most strongly associated with CSB. Discussion: This exploratory study suggests that CSB is prevalent amongst veterans returning from combat and is associated with childhood trauma and PTSD, particularly re-experiencing. Conclusions: Further study is needed to identify the mechanisms linking PTSD and CSB, define the context and severity of CSB in veterans, and examine the best ways to assess and treat CSB in VA clinical settings. PMID:25592306

  16. Prevalence of Childhood Physical Abuse in Adult Male Veteran Alcoholics.

    ERIC Educational Resources Information Center

    Schaefer, Melodie R.; And Others

    1988-01-01

    The study of 100 adult male alcoholics found that about one-third reported they had been physically abused as children. Abused alcoholics reported having more severe psychological symptoms and distress than nonabused counterparts, though they did not differ in the onset, severity, or treatment history for alcohol dependency. (Author/DB)

  17. Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative.

    PubMed

    Stevens, Melissa B; Hastings, Susan Nicole; Powers, James; Vandenberg, Ann E; Echt, Katharina V; Bryan, William E; Peggs, Kiffany; Markland, Alayne D; Hwang, Ula; Hung, William W; Schmidt, Anita J; McGwin, Gerald; Ikpe-Ekpo, Edidiong; Clevenger, Carolyn; Johnson, Theodore M; Vaughan, Camille P

    2015-05-01

    Suboptimal medication prescribing for older adults has been described in a number of emergency department (ED) studies. Despite this, few studies have examined ED-targeted interventions aimed at reducing the use of potentially inappropriate medications (PIMs). Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the ED (EQUiPPED) is an ongoing multicomponent, interdisciplinary quality improvement initiative in eight Department of Veterans Affairs EDs. The project aims to decrease the use of PIMs, as identified by the Beers criteria, prescribed to veterans aged 65 and older at the time of ED discharge. Interventions include provider education; informatics-based clinical decision support with electronic medical record-embedded geriatric pharmacy order sets and links to online geriatric content; and individual provider education including academic detailing, audit and feedback, and peer benchmarking. Poisson regression was used to compare the number of PIMs that staff providers prescribed to veterans aged 65 and older discharged from the ED before and after the initiation of the EQUiPPED intervention. Initial data from the first implementation site show that the average monthly proportion of PIMs that staff providers prescribed was 9.4±1.5% before the intervention and 4.6±1.0% after the initiation of EQUiPPED (relative risk=0.48, 95% confidence interval=0.40-0.59, P<.001). Preliminary evaluation demonstrated a significant and sustained reduction of ED-prescribed PIMs in older veterans after implementation of EQUiPPED. Longer follow-up and replication at collaborating sites would allow for an assessment of the effect on health outcomes and costs. PMID:25945692

  18. PTSD and obesity in younger and older veterans: Results from the mind your heart study.

    PubMed

    Smith, Brian N; Tyzik, Anna L; Neylan, Thomas C; Cohen, Beth E

    2015-10-30

    Posttraumatic stress disorder (PTSD) is increasingly recognized as a relatively common condition that is associated with poor health, including obesity. With a sizable proportion of the population approaching older adulthood, it is important to understand PTSD-health associations in the context of age. Participants were recruited from two Veterans Administration medical centers and included 380 patients age 60 and over and 365 under age 60. PTSD diagnosis was determined by the Clinician Administered PTSD Scale. BMI was trichotomized into normal/under (≤24.9), overweight (25.0-29.9), and obese (≥30.0). Models were run in the total sample, as well as stratified by age group, and adjusted for demographics, depression, antipsychotic medication use, and physical activity. Current PTSD was associated with greater likelihood of overweight and obesity in the total sample, and lifetime PTSD was associated with significantly increased odds of obesity. In the stratified models, current and lifetime PTSD were associated with increased likelihood of overweight and obesity in the older group only. Results suggest that PTSD is associated with risk for overweight and obesity, an effect that may be particularly strong in older adults. These findings support the importance of examining PTSD and potential health correlates across the life course.

  19. Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

    ERIC Educational Resources Information Center

    Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

    2009-01-01

    Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

  20. Impact of comorbid depression on quality of life in male combat Veterans with posttraumatic stress disorder.

    PubMed

    Raab, Phillip A; Mackintosh, Margaret-Anne; Gros, Daniel F; Morland, Leslie A

    2015-01-01

    For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.

  1. Needs and concerns of male combat Veterans with mild traumatic brain injury.

    PubMed

    Daggett, Virginia S; Bakas, Tamilyn; Buelow, Janice; Habermann, Barbara; Murray, Laura L

    2013-01-01

    Traumatic brain injury (TBI) has emerged as a major cause of morbidity among U.S. servicemembers who have served in Iraq and Afghanistan. Even mild TBI (mTBI) can result in cognitive impairments that can affect the community reintegration of Veterans postdeployment. The purpose of this study was to explore the needs and concerns of combat Veterans with mTBI to provide support for an mTBI-specific conceptual model (Conceptual Model in the Context of mTBI) derived from Ferrans et al.'s health-related quality of life model and the TBI literature. Content analysis of qualitative interview data was conducted using a thematic matrix with a predetermined code list. Data saturation was achieved after interviews with eight male Veterans. Six key categories and predominant themes emerged: cognitive impairments, physical symptoms, emotions and behaviors, instrumental activities of daily living, interpersonal interactions, and community reintegration. Findings provide preliminary support for a new, context-specific conceptual model that has the potential to identify areas for future interventions to enhance community reintegration of combat Veterans with mTBI.

  2. Relationships between health status, depression and cognitive functions of institutionalized male veterans.

    PubMed

    Chung, Pei-Jung; Chiou, Chii-Jun; Chou, Fan-Hao

    2009-01-01

    The purpose of this study was to explore the relationships among health state, depression, and cognitive functions of institutionalized male veterans. A cross-sectional and correlation research design with a cluster sampling was conducted. A total of 223 veterans who were above 65 years old, with no psychiatric disorders and no organic brain lesions were recruited from two veterans' institutions in Southern Taiwan. The researcher interviewed them one-on-one using structural questionnaires, including demographic data, health status, Taiwan Geriatric Depression Scale (TGDS) and Mini-Mental State Examination (MMSE). The results of this study were as follows: (1) Veterans who were able to read, were married, had good dietary habits, avoided over-oiled and high-fat food to keep healthy, took exercise at least 30 min each time, and had static leisure activities had significant differences in cognitive functions. (2) Cognitive functions were significantly negatively correlated with age and depression, whereas positively correlated with education level, the number of children and perceived health status. (3) Depression, literacy, education level and age were the four predictors of cognitive functions, accounting for 29% of the variance. The findings of this study provide a reference to caregivers and health care professionals for home care, clinical practice and cohort study in the future.

  3. Group Treatment of Post-Traumatic Stress Disorder in Older Veterans.

    ERIC Educational Resources Information Center

    Nichols, Beverly L.; And Others

    Delayed and chronic symptoms of Posttraumatic Stress Disorder (PTSD) have been documented in Vietnam veterans for up to 10-15 years following the stressor and in veterans of World War II and Korea for as long as 40 years. Group therapy for Vietnam veterans with PTSD has been found to be an effective treatment, but prior research has not tested…

  4. The Association Between Sleep and Physical Function Among Older Veterans in an Adult Day Health Care Program

    PubMed Central

    Song, Yeonsu; Dzierzewski, Joseph; Fung, Constance H.; Rodriguez, Juan C.; Jouldjian, Stella; Mitchell, Michael; Josephson, Karen R.; Alessi, Cathy A.; Martin, Jennifer L.

    2015-01-01

    OBJECTIVES To examine whether sleep disturbance is associated with poor physical function in older veterans in an adult day health care (ADHC) program. DESIGN Cross-sectional study. SETTING One ADHC program in a Veterans Affairs Ambulatory Care Center. PARTICIPANTS Older veterans (N = 50) who were enrolled in a randomized controlled trial of a sleep intervention program and provided complete baseline data. MEASUREMENTS Participant characteristics (e.g., age, depression, relationship to caregiver, pain, comorbidity) were collected using appropriate questionnaires. Physical function was measured using the total score of activities of daily living (ADLs) and instrumental ADLs (IADLs) from the Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire. Sleep was assessed subjectively (by the Pittsburgh Sleep Quality Index and the Insomnia Severity Index) and objectively (by wrist actigraphy). RESULTS As expected, participants required substantial assistance with ADLs and IADLs. A regression model showed that participant characteristics (i.e., marital status, use of sleep medication, comorbidity, and posttraumatic stress disorder) and living arrangement (i.e., living with a spouse and/or others) were significantly associated with poor physical function. Poorer objective sleep (i.e., total sleep time, total numbers of awakenings, and total wake time) was significantly associated with poor physical function, accounting for a significant proportion of the variance above and beyond participant characteristics. CONCLUSION Objective measures of nighttime sleep disturbance were associated with poor physical function among older veterans in an ADHC program. Further research is needed to determine whether interventions to improve sleep will delay functional decline in this vulnerable population. PMID:26200520

  5. The prevalence and psychosocial correlates of suicide attempts among inpatient adolescent offspring of Croatian PTSD male war veterans.

    PubMed

    Boričević Maršanić, Vlatka; Margetić, Branka Aukst; Zečević, Iva; Herceg, Miroslav

    2014-10-01

    Despite evidence that children of male war veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk for behavior problems, very little is currently known about suicidal behaviors in this population of youth. This study aimed to examine the prevalence and psychosocial correlates of suicide attempts among psychiatrically hospitalized adolescent offspring of Croatian male PTSD veterans. Participants were psychiatric inpatients, ages 12-18 years. Self-report questionnaires assessed demographics, suicide attempts, psychopathology, parenting style, and family functioning. The prevalence of suicide attempts was 61.5% (65.2% for girls and 58.0% for boys). Internalizing symptoms, family dysfunction, lower levels of maternal and paternal care, and paternal overcontrol were significantly associated with suicide attempts. Our findings suggest that suicide attempts are common among inpatient adolescent offspring of male PTSD veterans and that interventions targeting both adolescent psychopathology and family relationships are needed for adolescents who have attempted suicide.

  6. Epidemiology of Drug-Disease Interactions in Older Veteran Nursing Home Residents

    PubMed Central

    Aspinall, Sherrie L.; Zhao, Xinhua; Semla, Todd P.; Cunningham, Francesca E.; Paquin, Allison M.; Pugh, Mary Jo; Schmader, Kenneth E.; Stone, Roslyn A.; Hanlon, Joseph T.

    2014-01-01

    Objectives Few studies have examined drug-disease interactions (DDIs) in older nursing home residents. Therefore, the objective is to describe the prevalence of, and factors associated with, DDIs according to The American Geriatrics Society 2012 Beers Criteria. Design Cross-sectional study. Setting Fifteen Veterans Affairs Community Living Centers. Participants Patients≥65 years old with a diagnosis of dementia/cognitive impairment, history of falls/hip fractures, heart failure (HF), history of peptic ulcer disease (PUD) and/or stage IV or V chronic kidney disease (CKD). Measurements Prevalence of medications that could exacerbate the above conditions (i.e., DDIs). Results Overall, 361 of 696 (51.9%) eligible residents had ≥1 DDI. None involved those with a history of PUD; one involved a resident with CKD, and four occurred in those with HF. In residents with dementia/cognitive impairment (N=540), 50.7% took a drug that could exacerbate these conditions; the most commonly involved medications were antipsychotics (35.4%) and benzodiazepines (14.4%). In those with a history of falls/hip fractures (N=267), 67.8% received an interacting medication, with SSRIs (33.1%), antipsychotics (30.7%) and anticonvulsants (25.1%) being most commonly involved. Using separate multivariable logistic regression models, factors associated with DDIs in both dementia/cognitive impairment and falls/fractures included: age 85+ (Adjusted Odds Ratio [aOR] and 95% confidence interval [CI] of 0.38; 0.24–0.60 and aOR 0.48; 95%CI 0.24–0.96, respectively); taking 5–8 medications (aOR 2.06; 95%CI 1.02–4.16 and aOR 4.76; 95%CI 1.68–13.5, respectively) and ≥9 medications (aOR 1.99; 95%CI 1.03–3.85 and aOR 3.68; 95%CI 1.41–9.61, respectively), and being a long stay patient (aOR 1.80; 95%CI 1.04–3.12 and aOR 2.35; 95%CI 1.12–4.91, respectively). Conclusion Drug-disease interactions were common in older nursing home residents with dementia/cognitive impairment and/or a history

  7. Using military friendships to optimize postdeployment reintegration for male Operation Iraqi Freedom/Operation Enduring Freedom veterans.

    PubMed

    Hinojosa, Ramon; Hinojosa, Melanie Sberna

    2011-01-01

    Social relationships are important to health out comes. The postdeployment family reintegration literature focuses on the role of the civilian family in facilitating the transition from Active Duty military deployment to civilian society. The focus on the civilian family relationship may miss other important personal connections in veterans' lives. One such connection is the relationship many veterans have with former military unit members who served with them when deployed. Drawing on interviews with male Operation Iraqi Freedom/Operation Enduring Freedom veterans conducted from 2008 to 2009, we argue that the members of a military unit, especially during armed conflict, should be considered a resource to help the "family" reintegration process rather than impede it. This research has implications for current reintegration policy and how best to assist veterans transitioning into civilian society.

  8. Examining the correlates of aggression among male and female Vietnam veterans.

    PubMed

    Taft, Casey T; Monson, Candice M; Hebenstreit, Claire L; King, Daniel W; King, Lynda A

    2009-01-01

    This study examined the correlates of general aggression among a nationally representative sample of male and female Vietnam veterans (N = 1,632). Findings indicated that the rates of aggression for men and women were 41% and 32%, respectively, and men appeared to perpetrate relatively more acts of severe aggression. Correlates of aggression for men included lower socioeconomic status and age, minority status, unemployment, degree of exposure to the malevolent war-zone environment and perceived threat in the war zone, posttraumatic stress disorder, antisocial personality disorder, major depressive episode, alcohol abuse/dependence, and drug abuse/dependence. For women, only lower age and unemployment were associated with aggression. Findings highlight the importance of developing models for aggression among those experiencing military deployments.

  9. Physiologic Frailty and Fragility Fracture in HIV-Infected Male Veterans

    PubMed Central

    Womack, Julie A.; Goulet, Joseph L.; Gibert, Cynthia; Brandt, Cynthia A.; Skanderson, Melissa; Gulanski, Barbara; Rimland, David; Rodriguez-Barradas, Maria C.; Tate, Janet; Yin, Michael T.; Justice, Amy C.

    2013-01-01

    Background. The Veterans Aging Cohort Study (VACS) Index is associated with all-cause mortality in individuals infected with human immunodeficiency virus (HIV). It is also associated with markers of inflammation and may thus reflect physiologic frailty. This analysis explores the association between physiologic frailty, as assessed by the VACS Index, and fragility fracture. Methods. HIV-infected men from VACS were included. We identified hip, vertebral, and upper arm fractures using ICD-9-CM codes. We used Cox regression models to assess fragility fracture risk factors including the VACS Index, its components (age, hepatitis C status, FIB-4 score, estimated glomerular filtration rate, hemoglobin, HIV RNA, CD4 count), and previously identified risk factors for fragility fractures. Results. We included 40 115 HIV-infected male Veterans. They experienced 588 first fragility fractures over 6.0 ± 3.9 years. The VACS Index score (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.11–1.19), white race (HR, 1.92; 95% CI, 1.63–2.28), body mass index (HR, 0.94; 95% CI, .92–.96), alcohol-related diagnoses (HR, 1.65; 95% CI, 1.26–2.17), cerebrovascular disease (HR, 1.95; 95% CI, 1.14–3.33), proton pump inhibitor use (HR, 1.87; 95% CI, 1.54–2.27), and protease inhibitor use (HR, 1.25; 95% CI, 1.04–1.50) were associated with fracture risk. Components of the VACS Index score most strongly associated with fracture risk were age (HR, 1.40; 95% CI, 1.27–1.54), log HIV RNA (HR, 0.91; 95% CI, .88–.94), and hemoglobin level (HR, 0.82; 95% CI, .78–.86). Conclusions. Frailty, as measured by the VACS Index, is an important predictor of fragility fractures among HIV-infected male Veterans. PMID:23378285

  10. The Comparative Effectiveness of Cognitive Processing Therapy for Male Veterans Treated in a VHA Posttraumatic Stress Disorder Residential Rehabilitation Program

    ERIC Educational Resources Information Center

    Alvarez, Jennifer; McLean, Caitlin; Harris, Alex H. S.; Rosen, Craig S.; Ruzek, Josef I.; Kimerling, Rachel

    2011-01-01

    Objective: To examine the effectiveness of group cognitive processing therapy (CPT) relative to trauma-focused group treatment as usual (TAU) in the context of a Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) residential rehabilitation program. Method: Participants were 2 cohorts of male patients in the same program…

  11. Short-term Variability in Outpatient Pain Intensity Scores in a National Sample of Older Veterans with Chronic Pain

    PubMed Central

    Dobscha, Steven K.; Morasco, Benjamin J.; Kovas, Anne E.; Peters, Dawn M.; Hart, Kyle; McFarland, Bentson H.

    2015-01-01

    Objective The Department of Veterans Affairs (VA) uses the 11-point pain numeric rating scale (NRS) to gather pain intensity information from veterans at outpatient appointments. Yet, little is known about how NRS scores may vary over time within individuals; NRS variability may have important ramifications for treatment planning. Our main objective was to describe variability in NRS scores within a one-month timeframe, as obtained during routine outpatient care in older patients with chronic pain treated in VA hospitals. A secondary objective was to explore for patient characteristics associated with within-month NRS score variability. Design Retrospective cohort study. Subjects National sample of veterans 65 years or older seen in VA in 2010 who had multiple elevated NRS scores indicating chronic pain. Methods VA datasets were used to identify the sample and demographic and clinical variables including NRS scores. For the main analysis, we identified subjects with 2 or more NRS scores obtained in each of 2 or more months in a 12 month period; we examined ranges in NRS scores across the first 2 qualifying months. Results Among 4,336 individuals in the main analysis cohort, the mean and median of the average NRS score range across the two months were 2.7 and 2.5, respectively. In multivariable models, main significant predictors of within-month NRS score variability were baseline pain intensity, overall medical comorbidity, and being divorced/separated. Conclusions The majority of patients in the sample had clinically meaningful variation in pain scores within a given month. This finding highlights the need for clinicians and their patients to consider multiple NRS scores when making chronic pain treatment decisions. PMID:25545398

  12. Self-efficacy, male rape myth acceptance, and devaluation of emotions in sexual trauma sequelae: Findings from a sample of male veterans.

    PubMed

    Voller, Emily; Polusny, Melissa A; Noorbaloochi, Siamak; Street, Amy; Grill, Joseph; Murdoch, Maureen

    2015-11-01

    Sexual trauma is an understudied but regrettably significant problem among male Veterans. As in women, sexual trauma often results in serious mental health consequences for men. Therefore, to guide potential future interventions in this important group, we investigated associations among self-efficacy, male rape myth acceptance, devaluation of emotions, and psychiatric symptom severity after male sexual victimization. We collected data from 1,872 Gulf War era Veterans who applied for posttraumatic stress disorder (PTSD) disability benefits using standard mailed survey methods. The survey asked about history of childhood sexual abuse, sexual assault during the time of Gulf War I, and past-year sexual assault as well as Veterans' perceived self-efficacy, male rape myth acceptance, devaluation of emotions, PTSD, and depression symptoms. Structural equation modeling revealed that self-efficacy partially mediated the association between participants' sexual trauma history and psychiatric symptoms. Greater male rape myth acceptance and greater devaluation of emotions were directly associated with lower self-efficacy, but these beliefs did not moderate associations between sexual trauma and self-efficacy. In this population, sexual trauma, male rape myth acceptance, and devaluation of emotions were associated with lowered self-efficacy, which in turn was associated with more severe psychiatric symptoms. Implications for specific, trauma-focused treatment are discussed.

  13. Reaching Out to Older Veterans in Need: The Elko Clinic Demonstration Project

    ERIC Educational Resources Information Center

    Juretic, Meghan; Hill, Robert; Luptak, Marilyn; Rupper, Randall; Bair, Byron; Floyd, James; Westfield, Brian; Dailey, Nancy K.

    2010-01-01

    Context: The challenge of providing meaningful health care services to veterans living in rural communities is a major public health concern that involves redefining the traditional facility-based model of care delivery employed in urban areas. Purpose: This paper describes the steps of a demonstration project, the Elko Telehealth Outreach Clinic.…

  14. Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

    PubMed

    Heath, Barbara; Bernhardt, Jaime; Michalski, Thomas J; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E; Olds, Danielle; Higgins, Patricia A; Jump, Robin L P

    2016-03-01

    We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Our outcomes suggest opportunities to engage nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting.

  15. Self-Reported Emotional and Behavioral Problems, Family Functioning and Parental Bonding among Psychiatric Outpatient Adolescent Offspring of Croatian Male Veterans with Partial PTSD

    ERIC Educational Resources Information Center

    Sarajlic Vukovic, Iris; Boricevic Maršanic, Vlatka; Aukst Margetic, Branka; Paradžik, Ljubica; Vidovic, Domagoj; Buljan Flander, Gordana

    2015-01-01

    Background: Posttraumatic stress disorder (PTSD) in male veterans has been linked with impaired family relationships and psychopathology in their children. Less is known about symptoms in children of veterans with partial PTSD. Objective: To compare mental health problems, family functioning and parent-child bonding among adolescent offspring of…

  16. Impact of Rural Residence on Survival of Male Veterans Affairs Patients after Age 65

    ERIC Educational Resources Information Center

    MacKenzie, Todd A.; Wallace, Amy E.; Weeks, William B.

    2010-01-01

    Objectives: More than 1 in 5 Veterans Affairs (VA) users lives in a rural setting. Rural veterans face different barriers to health care than their urban counterparts, but their risk of death relative to their urban counterparts is unknown. The objective of our study was to compare survival between rural and urban VA users. Methods: We linked the…

  17. Experiences and Expectations of an African American Male Veteran Student in Higher Education

    ERIC Educational Resources Information Center

    Cole-Morton, Gladys S.

    2013-01-01

    Since the Post-9/11 GI Bill an increasing number of veterans and military students are seeking to complete degrees online and through enrollment at campuses across the nation (Brown 2011). The increased number of military students in postsecondary education settings presents challenges and opportunities for both the veteran student and institution…

  18. Descriptive characteristics and cluster analysis of male veteran hazardous drinkers in an alcohol moderation intervention.

    PubMed

    Walker, Robrina; Hunt, Yvonne M; Olivier, Jake; Grothe, Karen B; Dubbert, Patricia M; Burke, Randy S; Cushman, William C

    2012-01-01

    Current efforts underway to develop the fifth edition of the Diagnostic and Statistical Manual (DSM-5) have reignited discussions for classifying the substance use disorders. This study's aim was to contribute to the understanding of abusive alcohol use and its validity as a diagnosis. Cluster analysis was used to identify relatively homogeneous groups of hazardous, nondependent drinkers by using data collected from the Prevention and Treatment of Hypertension Study (PATHS), a multisite trial that examined the ability of a cognitive-behavioral-based alcohol reduction intervention, compared to a control condition, to reduce alcohol use. Participants for this study (N = 511) were male military veterans. Variables theoretically associated with alcohol use (eg, demographic, tobacco use, and mental health) were used to create the clusters and a priori, empirically based external criteria were used to assess discriminant validity. Bivariate correlations among cluster variables were generally consistent with previous findings in the literature. Analyses of internal and discriminant validity of the identified clusters were largely nonsignificant, suggesting meaningful differences between clusters could not be identified. Although the typology literature has contributed supportive validity for the alcohol dependence diagnosis, this study's results do not lend supportive validity for the construct of alcohol abuse. PMID:22691012

  19. Anhedonia, Emotional Numbing, and Symptom Overreporting in Male Veterans with PTSD

    PubMed Central

    Kashdan, Todd B.; Elhai, Jon D.; Frueh, B. Christopher

    2007-01-01

    We used measures of positive affect and emotional expression to distinguish and better understand veterans with PTSD with symptom overreporting presentation styles. Based on prior research, symptom overreporting was defined as scores greater than eight on the Fp (Infrequency-Psychopathology) scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Data were drawn from an archival dataset of 227 combat veteran outpatients. Results were consistent with theory and research on the distinction between negative and positive affect. Major findings indicated that (a) veterans endorsing greater anhedonia had a greater likelihood of being classified as a symptom overreporter (controlling for PTSD symptoms), and (b) compared to non-symptom overreporting veterans, overreporters showed greater congruency in their presentation of diminished positive affect and their expression across self- and clinician-ratings. Our data suggest that diminished positive emotions and their behavioral expression are uniquely associated with veterans’ psychological experiences, providing insight into the nature of symptom overreporters. PMID:18769508

  20. Insomnia treatment acceptability and preferences of male Iraq and Afghanistan combat veterans and their healthcare providers.

    PubMed

    Epstein, Dana R; Babcock-Parziale, Judith L; Haynes, Patricia L; Herb, Christine A

    2012-01-01

    Sleep difficulty is a prevalent problem among returning Veterans. Although there is strong evidence for the efficacy and durability of cognitive-behavioral treatment for insomnia (CBT-I) in the general population, the interventions require motivation, attention, and adherence from patients to achieve successful outcomes. Given the unique characteristics of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans who have experienced blast-related injuries and other trauma, CBT-I for these patients may require modification, including alternative delivery methods, to ensure effective implementation and positive outcomes. We interviewed 18 OIF/OEF Veterans who screened positive for mild traumatic brain injury and 19 healthcare providers to determine the acceptability of insomnia treatments and preferences for the interventions and treatment delivery. Veterans and providers had distinct preferences for insomnia treatment and its delivery. The treatments the Veterans found most acceptable were also the ones they preferred: relaxation treatment and pharmacotherapy. The providers identified relaxation therapy as the most acceptable treatment. Veterans preferred the individual treatment format as well as electronic methods of treatment delivery. Despite some differences between patients and providers, a compromise through modification of empirically supported behavioral treatments is feasible, and implications for preference-based insomnia intervention development and testing are discussed.

  1. Mild Traumatic Brain Injury, PTSD, and Psychosocial Functioning Among Male and Female U.S. OEF/OIF Veterans.

    PubMed

    Jackson, Colleen E; Green, Jonathan D; Bovin, Michelle J; Vasterling, Jennifer J; Holowka, Darren W; Ranganathan, Gayatri; Rosen, Raymond C; Keane, Terence M; Marx, Brian P

    2016-08-01

    This study examined the unique and combined relationship between mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) with psychosocial functioning in a cohort of 1,312 U.S. male and female veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) enrolled in the Veterans After-Discharge Longitudinal Registry (Project VALOR). We assessed mTBI with structured screening questions reflective of current TBI classification standards and PTSD via the SCID-IV PTSD module; all other variables were assessed by self-report questionnaires. We identified significant diagnostic group differences in psychosocial functioning for both sexes. Individuals with PTSD, with or without a history of mTBI, reported significantly worse psychosocial functioning than individuals with mTBI alone or neither mTBI nor PTSD (males, η(2) p = .11, p < .001; females, η(2) p = .14, p < .001), even after adjusting for demographics and severity of chronic pain. The results suggested that veterans experiencing PTSD, regardless of whether they had a history of mTBI, were at increased risk for long-term psychosocial impairment. Further research examining possible benefits from improved access to resources and treatment to address these needs would be valuable. PMID:27405050

  2. Examining aggression in male Vietnam veterans who receive VA services: the role of traumatic events and combat exposure.

    PubMed

    Lenhardt, Jenna M; Howard, Jamie M; Taft, Casey T; Kaloupek, Danny G; Keane, Terence M

    2012-08-01

    We examined the relationship between trauma exposure and the perpetration of aggression by male Vietnam veterans (N = 1,328) using archival data from a multisite study conducted by the Cooperative Studies Program of the Department of Veteran Affairs (CSP-334) in the early 1990s. Both traumatic events in civilian life and combat exposure were examined as correlates of aggression. Results indicated that pre- and postmilitary traumatic events and combat exposure were all related to perpetration of aggression at the bivariate level; r = .07, r = .20, and r = .13, respectively. When these variables were examined simultaneously, only combat exposure (β = .14, p < .001) and postmilitary traumatic events (β = .20, p < .001) were associated with aggression. No interaction effects were found for civilian traumatic events and combat in relation to aggression. Results highlight the importance of attending to the psychological aftermath of exposure to traumatic events experienced during and following deployment before aggressive patterns develop. PMID:22786658

  3. Examining aggression in male Vietnam veterans who receive VA services: the role of traumatic events and combat exposure.

    PubMed

    Lenhardt, Jenna M; Howard, Jamie M; Taft, Casey T; Kaloupek, Danny G; Keane, Terence M

    2012-08-01

    We examined the relationship between trauma exposure and the perpetration of aggression by male Vietnam veterans (N = 1,328) using archival data from a multisite study conducted by the Cooperative Studies Program of the Department of Veteran Affairs (CSP-334) in the early 1990s. Both traumatic events in civilian life and combat exposure were examined as correlates of aggression. Results indicated that pre- and postmilitary traumatic events and combat exposure were all related to perpetration of aggression at the bivariate level; r = .07, r = .20, and r = .13, respectively. When these variables were examined simultaneously, only combat exposure (β = .14, p < .001) and postmilitary traumatic events (β = .20, p < .001) were associated with aggression. No interaction effects were found for civilian traumatic events and combat in relation to aggression. Results highlight the importance of attending to the psychological aftermath of exposure to traumatic events experienced during and following deployment before aggressive patterns develop.

  4. Why Do Older Men Report Low Stress Ratings? Findings from the Veterans Affairs Normative Aging Study

    ERIC Educational Resources Information Center

    Boeninger, Daria K.; Shiraishi, Ray W.; Aldwin, Carolyn M.; Spiro, Avron, III

    2009-01-01

    We examined the interplay between three explanatory hypotheses for why older adults appear to rate their problems as less stressful than do younger adults: age-related differences in personality, in types of problems, and in the appraisal process--specifically, the number of primary stress appraisals. A sample of 1,054 men from the Normative Aging…

  5. Perceptions of Older Veterans with Visual Impairments Regarding Computer Access Training and Quality of Life

    ERIC Educational Resources Information Center

    DuBosque, Richard Stanborough

    2013-01-01

    The widespread integration of the computer into the mainstream of daily life presents a challenge to various sectors of society, and the incorporation of this technology into the realm of the older individual with visual impairments is a relatively uncharted field of study. This study was undertaken to acquire the perceptions of the impact of the…

  6. Injury prevention in male veteran football players - a randomised controlled trial using "FIFA 11+".

    PubMed

    Hammes, Daniel; Aus der Fünten, Karen; Kaiser, Stephanie; Frisen, Eugen; Bizzini, Mario; Meyer, Tim

    2015-01-01

    The warm-up programme "FIFA 11+" has been shown to reduce football injuries in different populations, but so far veteran players have not been investigated. Due to differences in age, skill level and gender, a simple transfer of these results to veteran football is not recommended. The purpose of this study was to investigate the preventive effects of the "FIFA 11+" in veteran football players. Twenty veteran football teams were recruited for a prospective 9-month (1 season) cluster-randomised trial. The intervention group (INT, n = 146; 45 ± 8 years) performed the "FIFA 11+" at the beginning of each training session, while the control group (CON, n = 119; 43 ± 6 years) followed its regular training routine. Player exposure hours and injuries were recorded according to an international consensus statement. No significant difference was found between INT and CON in overall injury incidence (incidence rate ratio [IRR]: 0.91 [0.64-1.48]; P = 0.89). Only severe injuries reached statistical significance with higher incidence in CON (IRR: 0.46 [0.21-0.97], P = 0.04). Regular conduction (i.e. once a week) of the "FIFA 11+" did not prevent injuries in veteran footballers under real training and competition circumstances. The lack of preventive effects is likely due to the too low overall frequency of training sessions.

  7. Injury prevention in male veteran football players - a randomised controlled trial using "FIFA 11+".

    PubMed

    Hammes, Daniel; Aus der Fünten, Karen; Kaiser, Stephanie; Frisen, Eugen; Bizzini, Mario; Meyer, Tim

    2015-01-01

    The warm-up programme "FIFA 11+" has been shown to reduce football injuries in different populations, but so far veteran players have not been investigated. Due to differences in age, skill level and gender, a simple transfer of these results to veteran football is not recommended. The purpose of this study was to investigate the preventive effects of the "FIFA 11+" in veteran football players. Twenty veteran football teams were recruited for a prospective 9-month (1 season) cluster-randomised trial. The intervention group (INT, n = 146; 45 ± 8 years) performed the "FIFA 11+" at the beginning of each training session, while the control group (CON, n = 119; 43 ± 6 years) followed its regular training routine. Player exposure hours and injuries were recorded according to an international consensus statement. No significant difference was found between INT and CON in overall injury incidence (incidence rate ratio [IRR]: 0.91 [0.64-1.48]; P = 0.89). Only severe injuries reached statistical significance with higher incidence in CON (IRR: 0.46 [0.21-0.97], P = 0.04). Regular conduction (i.e. once a week) of the "FIFA 11+" did not prevent injuries in veteran footballers under real training and competition circumstances. The lack of preventive effects is likely due to the too low overall frequency of training sessions. PMID:25370591

  8. Potentially Inappropriate Prescribing of Primarily Renally Cleared Medications for Older Veterans Affairs Nursing Home Patients

    PubMed Central

    Hanlon, Joseph T.; Wang, Xiaoqiang; Handler, Steven M.; Weisbord, Steven; Pugh, Mary Jo; Semla, Todd; Stone, Roslyn A.; Aspinall, Sherrie L.

    2010-01-01

    Background Inappropriate prescribing of primarily renally cleared medications in older patients with kidney disease can lead to adverse outcomes. Objectives To estimate the prevalence of potentially inappropriate prescribing of 21 primarily renally cleared medications based on 2 separate estimates of renal function and to identify factors associated with this form of suboptimal prescribing in older VA nursing home (NH) patients. Design Longitudinal study Participants Participants were 1304 patients, aged 65 years or older, admitted between January 1, 2004, and June 30, 2005, for 90 days or more to 1 of 133 VA NHs. Main Measures Potentially inappropriate prescribing of primarily renally cleared medications determined by estimating creatinine clearance using the Cock-croft Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations and applying explicit guidelines for contraindicated medications and dosing. Key Results The median estimated creatinine clearance via CG was 67 mL/min, whereas it was 80 mL/min/1.73m2 with the MDRD. Overall, 11.89% patients via CG and only 5.98% via MDRD had evidence of potentially inappropriate prescribing of at least 1 renally cleared medication. The most commonly involved medications were ranitidine, glyburide, gabapentin, and nitrofurantoin. Factors associated with potentially inappropriate prescribing as per the CG were age older than 85 (adjusted odds ratio [AOR] 4.24, 95% confidence interval [CI] 2.42–7.43), obesity (AOR 0.26, 95% CI 0.14–0.50) and having multiple comorbidities (AOR 1.09 for each unit increase in the Charlson comorbidity index, 95% CI 1.01–1.19). Conclusions Potentially inappropriate prescribing of renally cleared medications is common in older VA NH patients. Intervention studies to improve the prescribing of primarily renally cleared medications in nursing homes are needed. PMID:21450179

  9. Assisted early mobility for hospitalized older veterans: preliminary data from the STRIDE program.

    PubMed

    Hastings, S Nicole; Sloane, Richard; Morey, Miriam C; Pavon, Juliessa M; Hoenig, Helen

    2014-11-01

    An important contributor to hospital-associated disability is immobility during hospitalization. Preliminary results from STRIDE, a clinical demonstration program of supervised walking for older adults admitted to the hospital with medical illness, are reported. The STRIDE program consisted of a targeted gait and balance assessment by a physical therapist, followed by daily walks supervised by a recreation therapy assistant for the duration of the hospital stay. To examine program effectiveness, STRIDE participants (n = 92) were compared with individuals referred but not enrolled (because of refusal or because program was at capacity, n = 35). Median length of stay was 4.7 days for STRIDE participants and 5.7 days for individuals receiving usual care (P = .31). There was one inpatient fall in each group (not associated with a STRIDE walk). Overall, 92% of STRIDE participants were discharged to home (rather than a skilled nursing facility (SNF)) compared to 74% of individuals receiving usual care (P = .007). Thirty-day emergency department visit rates and readmission rates were not significantly different between the two groups. STRIDE, a supervised walking program for hospitalized older adults, was feasible and safe, and program participants were less likely to be discharged to a SNF than a demographically similar comparison group. STRIDE is a promising interdisciplinary approach to promoting mobility and improving outcomes in hospitalized older adults.

  10. Effects of interactions with older males on behavior and reproductive development in first-year male red-winged blackbirds Agelaius phoeniceus.

    PubMed

    Wiley, R H; Hartnett, S A

    1976-05-01

    Male red-winged blackbirds Agelaius phoeniceus in their first year normally do not establish territories or breed. To investigate the possibility that interactions with older males might inhibit reproductive development of young males, we compared the behavior of first-year males in the presence and absence of older males. For three months during the first half of the breeding season, we studied mixed- and single-age groups of three males in standardized outdoor aviaries: two groups of three first-year males (FFF groups), two groups of one older and two first-year males (AFF groups), and one group of three older males (AAA group). In all groups one male established clear dominance, invariably the older male in AFF groups. The dominant male in FFF groups displaced subordinates less frequently than did the dominant older male in AFF groups early in the season, but equally frequently later. In May the largest testies weights of males in FFF groups were significantly lower than those of dominant older males in AFF groups. First-year males in the absence of direct interactions with older males can achieve levels of aggressive behavior comparable to those of a dominant older male in similar social environments but the seasonal development of their aggressive behavior occurs later and their testes in May are smaller than dominant adults'. This delay in the seasonal development of aggressive behavior in first-year males, independent of the immediate social environment, suggests that the age-dependent territoriality of males in this species is not strongly regulated by effects of older males on the development of younger males.

  11. Male veterans with PTSD exhibit aberrant neural dynamics during working memory processing: an MEG study

    PubMed Central

    McDermott, Timothy J.; Badura-Brack, Amy S.; Becker, Katherine M.; Ryan, Tara J.; Khanna, Maya M.; Heinrichs-Graham, Elizabeth; Wilson, Tony W.

    2016-01-01

    Background Posttraumatic stress disorder (PTSD) is associated with executive functioning deficits, including disruptions in working memory. In this study, we examined the neural dynamics of working memory processing in veterans with PTSD and a matched healthy control sample using magnetoencephalography (MEG). Methods Our sample of recent combat veterans with PTSD and demographically matched participants without PTSD completed a working memory task during a 306-sensor MEG recording. The MEG data were preprocessed and transformed into the time-frequency domain. Significant oscillatory brain responses were imaged using a beamforming approach to identify spatiotemporal dynamics. Results Fifty-one men were included in our analyses: 27 combat veterans with PTSD and 24 controls. Across all participants, a dynamic wave of neural activity spread from posterior visual cortices to left frontotemporal regions during encoding, consistent with a verbal working memory task, and was sustained throughout maintenance. Differences related to PTSD emerged during early encoding, with patients exhibiting stronger α oscillatory responses than controls in the right inferior frontal gyrus (IFG). Differences spread to the right supramarginal and temporal cortices during later encoding where, along with the right IFG, they persisted throughout the maintenance period. Limitations This study focused on men with combat-related PTSD using a verbal working memory task. Future studies should evaluate women and the impact of various traumatic experiences using diverse tasks. Conclusion Posttraumatic stress disorder is associated with neurophysiological abnormalities during working memory encoding and maintenance. Veterans with PTSD engaged a bilateral network, including the inferior prefrontal cortices and supramarginal gyri. Right hemispheric neural activity likely reflects compensatory processing, as veterans with PTSD work to maintain accurate performance despite known cognitive deficits

  12. Perspectives on Sexual Health and Function of Recent Male Combat Veterans of Iraq and Afghanistan

    PubMed Central

    Helmer, Drew A; Beaulieu, Gregory; Powers, Catherine; Houlette, Cheryl; Latini, David; Kauth, Michael

    2015-01-01

    Background U.S. veterans of recent wars in Iraq and Afghanistan may be at greater risk for sexual dysfunction due to injuries, mental health conditions, medications used to treat those conditions, and psychosocial factors. Objective To explore the perceptions of recent Veterans about sexual health and dysfunction, contributing factors, its impact and solutions. Design Qualitative study. Participants Eight men who screened positive for sexual dysfunction at initial presentation to a postdeployment clinic at a Veterans Affairs medical center Approach Patients who screened positive for sexual dysfunction and indicated an interest in participating were contacted and scheduled for an in-person private interview with a researcher. Interviews were semistructured, utilizing open-ended and follow-up probe questions to elicit the individual's perspective about sexual dysfunction and its cause, impact and solutions. Interviews were recorded, transcribed and analyzed for themes. Key Results These heterosexual men discussed a range of sexual dysfunction in their activities including lack of desire, erectile dysfunction, delayed orgasm, premature ejaculation, and distraction. They also discussed the importance of setting or context and changes over time to their sexual health and function. The men shared their ideas about contributory factors, including normal aging, medication side effects, injury and a possible role for combat deployment more generally. Reported solutions for sexual dysfunction included medications, herbal remedies, and new positions and approaches to sexual activity. Participants reported discussing sexual dysfunction with their health-care providers and what was helpful. Finally, the men expressed in their own words the significant impact of sexual dysfunction on their self-perception, their partners, and their relationships. Conclusions Sexual dysfunction in recent combat veterans can have important negative effects on their health and relationships. Our

  13. Factors relating to organizational commitment of older male employees in Japan.

    PubMed

    Yamada, Yoshiko; Sugisawa, Hidehiro; Sugihara, Yoko; Shibata, Hiroshi

    2005-09-01

    Recently, an increasing number of employers have provided employment opportunities for older adults. Yet, few studies pay attention to older employees' perceptions of their employment. Using a Japanese national sample of 995 male employees aged 55 to 64, this study examined whether the existing research on organizational commitment applies to older employees, whether measures that are unique to older employees have significant relationships to their organizational commitment, and whether the effects of these factors differ by retirement status. The results of hierarchical multiple regression analyses showed significant relationships between employee organizational commitment and employment security, personal relationships in workplaces and job characteristics. Negative ageism and employer-sponsored programs for older employees also had significant relationships to organizational commitment. The effects of salary, job autonomy, job demands, and employer-sponsored programs differed by retirement status. While the study was consistent with the existing research, it also suggested the importance of measures that are unique to older employees. PMID:17021956

  14. Mineral uptake by the femora of older female X-linked hypophosphatemic (HYP) mice but not older male HYP mice.

    PubMed

    Brault, B A; Meyer, M H; Meyer, R A; Iorio, R J

    1987-09-01

    X-linked hypophosphatemic (Hyp) mice are a model of human sex-linked vitamin D-resistant rickets. Young adult Hyp mice are characterized by osteomalacia and decreased bone mineral content. However, older heterozygous Hyp female mice increase in bone mineral content with age so that by one year of age the bone mass/mm femoral length equals or exceeds normal females. To test for the occurrence of this mineral accretion in Hyp male mice and in homozygous Hyp female mice, femora from all 3 Hyp genotypes as well as normal male and female mice were analyzed at various ages from one to 52 weeks of age. Compared to normal mice, all three Hyp genotypes were depressed in bone ash, femoral length, and ash/length ratio at 13 weeks of age. After that age the femora of both heterozygous and homozygous Hyp females showed a slow mineral accretion and, by 52 weeks of age, a normal ash/length ratio. However, the femora of Hyp males, as well as those of normal males, failed to increase in bone mineral content or ash/length ratio after 13 weeks of age. The differences between male and female Hyp mice could not be explained by differences in the plasma levels of calcium, phosphate, or alkaline phosphatase. Increased bone mineral content in older Hyp mice was seen in both heterozygous and homozygous females but not in hemizygous males. Thus, the basis for this increase is not incomplete dominance of the Hyp gene in females nor the Lyon hypothesis. The accretion of mineral in older female Hyp mice despite lifelong reduced plasma phosphate levels suggests that there are factors other than phosphate that also regulate mineral accretion in this bone disease.

  15. Health Insurance and the Labor Supply Decisions of Older Workers: Evidence from a U.S. Department of Veterans Affairs Expansion

    PubMed Central

    Boyle, Melissa A.; Lahey, Joanna N.

    2010-01-01

    This paper exploits a major mid-1990s expansion in the U.S. Department of Veterans Affairs health care system to provide evidence on the labor market effects of expanding health insurance availability. Using data from the Current Population Survey, we employ a difference-in-differences strategy to compare the labor market behavior of older veterans and non-veterans before and after the VA health benefits expansion to test the impact of public health insurance on labor supply. We find that older workers are significantly more likely to decrease work both on the extensive and intensive margins after receiving access to non-employer based insurance. Workers with some college education or a college degree are more likely to transition into self-employment, a result consistent with “job-lock” effects. However, less-educated workers are more likely to leave self-employment, a result suggesting that the positive income effect from receiving public insurance dominates the “job-lock” effect for these workers. Some relatively disadvantaged sub-populations may also increase their labor supply after gaining greater access to public insurance, consistent with complementary positive health effects of health care access or decreased work disincentives for these groups. We conclude that this reform has affected employment and retirement decisions, and suggest that future moves toward universal coverage or expansions of Medicare are likely to have significant labor market effects. PMID:20694047

  16. Risk factors for homelessness among US veterans.

    PubMed

    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

  17. Risk factors for homelessness among US veterans.

    PubMed

    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.

  18. Intimate Partner Aggression Perpetrated and Sustained by Male Afghanistan, Iraq, and Vietnam Veterans with and without Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Teten, Andra L.; Schumacher, Julie A.; Taft, Casey T.; Stanley, Melinda A.; Kent, Thomas A.; Bailey, Sara D.; Dunn, Nancy Jo; White, Donna L.

    2010-01-01

    Veterans with posttraumatic stress disorder (PTSD) consistently evidence higher rates of intimate partner aggression perpetration than veterans without PTSD, but most studies have examined rates of aggression among Vietnam veterans several years after their deployment. The primary aim of this study was to examine partner aggression among male…

  19. Positive Tertiary Appraisals and Posttraumatic Stress Disorder in U.S. Male Veterans of the War in Vietnam: The Roles of Positive Affirmation, Positive Reformulation, and Defensive Denial

    ERIC Educational Resources Information Center

    Dohrenwend, Bruce P.; Neria, Yuval; Turner, Blake; Turse, Nicholas; Marshall, Randall; Lewis-Fernandez, Roberto; Koenen, Karestan C.

    2004-01-01

    A 70.9% majority of the U.S. male veterans in a nationwide sample appraised the impact of their service in Vietnam on their present lives as mainly positive. A substantial minority, 41.7%, judged the effects to be highly salient. With controls on level of exposure to war-zone stressors measured with data from military records, the valence and…

  20. Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort

    PubMed Central

    Breyer, Benjamin N.; Fang, Shona C.; Seal, Karen H.; Ranganathan, Gayatri; Marx, Brian P.; Keane, Terence M.; Rosen, Raymond C.

    2016-01-01

    We sought to determine whether posttraumatic stress disorder (PTSD) was associated with sexual health in returned warzone-deployed veterans from the recent Iraq and Afghanistan conflicts. We studied 1,581 males and females from the Veterans After-Discharge Longitudinal Registry, a gender-balanced U.S. Department of Veterans Affairs registry of health care-seeking veterans with and without PTSD. Approximately one quarter (25.1%) of males (n = 198) and 12.7% of females (n = 101) had a sexual dysfunction diagnosis and/or prescription treatment for sexual dysfunction. Both genders were more likely to have a sexual dysfunction diagnosis and/or prescription treatment if they had PTSD compared with those without PTSD (male: 27.3% vs. 21.1%, p = .054; female: 14.9% vs. 9.4%, p = .022). Among the 1,557 subjects analyzed here, males with PTSD had similar levels of sexual activity compared to those without PTSD (71.2% vs. 75.4%, p = .22), whereas females with PTSD were less likely to be sexually active compared to females without PTSD (58.7% vs. 72.1%, p < .001). Participants with PTSD were also less likely to report sex-life satisfaction (male: 27.6% vs. 46.0%, p < .001; female: 23.0% vs. 45.7%, p < .001) compared with those without PTSD. Although PTSD was not associated with sexual dysfunction after adjusting for confounding factors, it was significantly negatively associated with sex-life satisfaction in female veterans with a prevalence ratio of .71, 95% confidence interval [.57, .90]. PMID:27128485

  1. Physical activity as a protective factor against depressive symptoms in older Chinese veterans in the community: result from a national cross-sectional study

    PubMed Central

    Du, Wen-Jin; Tan, Ji-Ping; Yi, Fang; Zou, Yong-Ming; Gao, Ya; Zhao, Yi-Ming; Wang, Lu-Ning

    2015-01-01

    Background Physical activity is generally considered to be effective in reducing the prevalence of depression and promoting remission of its symptoms. However, large-scale epidemiological research on this issue is lacking in older Chinese adults. We performed a nationwide epidemiological survey to determine the relationship between physical activity and depressive symptoms in older Chinese veterans in the community, with adjustment for potential confounders. Methods A cross-sectional study was conducted in a representative sample of 9,676 community-dwelling older Chinese veterans. Depressive symptoms were identified using the Center for Epidemiological Studies Depression Scale. Physical activity was self-reported using a one-year physical activity questionnaire. Information about covariates was obtained by questionnaire-based interview. Relationships between study variables and symptoms of depression were estimated using unadjusted and adjusted analyses. Results The median age was 82.29 (interquartile range 80.25–84.60) years. In total, 81.84% of the study participants engaged in physical activity that was predominantly light in intensity. In unadjusted analyses, physical activity was associated with a significantly decreased likelihood of depressive symptoms (5.43% versus 18.83%, P<0.0001). Multivariate logistic regression with adjustment and controlling for confounders, physical activity was still inversely associated with depressive symptoms and was the only independent protective factor (odds ratio 0.57, 95% confidence interval 0.44–0.72, P<0.0001) among the associated factors in this study. In a univariate general linear model, there was a significant difference in Center for Epidemiological Studies Depression Scale score between subjects participating in active physical activity and those who did not (F=59.07, P<0.0001). Conclusion This study found an inverse relationship between physical activity and symptoms of depression in older Chinese veterans in

  2. The impact of endorsing Spitzer's proposed criteria for PTSD in the forthcoming DSM-V on male and female Veterans.

    PubMed

    Miller, Lyndsey N; Chard, Kathleen M; Schumm, Jeremiah A; O'Brien, Carol

    2011-06-01

    This study explored differences between Spitzer's proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer's proposed criteria. Veterans who met both DSM-IV and Spitzer's proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed criteria. These findings have important implications regarding proposed changes to the diagnostic classification criteria for PTSD in the forthcoming DSM-V.

  3. Informal and Formal Help Seeking Among Older Black Male Foster Care Youth and Alumni

    PubMed Central

    McMillen, J. Curtis; Snowden, Lonnie R.

    2016-01-01

    Using the behavioral model for vulnerable populations as a framework, this study examined predisposing, enabling, and need factors related to seeking help from formal and informal sources among older Black male foster youth and alumni. Results of logistic regression analyses showed that emotional control, a predisposing variable, was related to help-seeking. Specifically, greater adherence to the norm of emotional control was related to lower likelihood of using informal or formal sources of help. These results support the literature on males, in general, and Black males, in particular, that posits that inhibitions to express emotions are a barrier to their help seeking. Implications for help seeking among vulnerable populations of adolescent and young adult Black males are discussed. PMID:27134513

  4. Sexual experience and plasma testosterone levels in male veterans after spinal cord injury.

    PubMed

    Phelps, G; Brown, M; Chen, J; Dunn, M; Lloyd, E; Stefanick, M L; Davidson, J M; Perkash, I

    1983-02-01

    Fifty men with spinal cord injuries (SCI) were asked to complete a questionnaire concerning their sexuality before and after injury. Medical examination confirmed the location and completeness of the injury and extracted information about genitourologic status. The respondents rated sexuality highly as a concern in living, and a wide variety of sexual techniques were reported. A marked decrease in sexual activity, satisfaction, and feelings of sexual adequacy was reported after injury, as compared to retrospective "before injury" responses, lack of opportunity being reported as causative by 66% of the subjects and insufficient personal satisfaction by 59%. Seventy-five percent of the subjects experienced sexual arousal from genital stimulation, and several methods of eliciting erection were cited. Orgasm was described by a variety of terms. Significant differences were found between quadriplegic and paraplegic patients in answers to several items, though there was generally no difference between cervical and thoracic groups, which were more specifically broken down with respect to motor or sensory/complete or incomplete lesions. Plasma testosterone levels were found to fall well within the normal adult male range, as were levels of free testosterone and serum sex binding protein. The resulting information demonstrated more sexual concern among men with SCI than the literature previously indicated. PMID:6681699

  5. Predictors of Calf Arterial Compliance in Male Veterans With Psychiatric Diagnoses

    PubMed Central

    Koola, Maju Mathew; Sorkin, John D.; Fargotstein, Molly; Brown, W. Virgil; Cuthbert, Bruce; Hollis, Jeffrey; Raines, Jeffrey K.; Duncan, Erica J.

    2016-01-01

    Background Peripheral arterial compliance (PAC) is a measure of the ability of the vascular tree to dilate in response to a pressure wave. Reduced PAC is seen in patients with psychiatric diagnoses and has been associated with increased risk for stroke, myocardial infarction, and mortality. The objective of this pilot study was to identify predictors of reduced PAC in subjects with psychiatric diagnoses. Methods Male psychiatric subjects (N = 77) were studied in a cross-sectional study of medication effects on PAC conducted from August 2005 to February 2010. Calf and thigh compliance were modeled in separate linear regressions. The models were adjusted for age, race, smoking status, presence or absence of the metabolic syndrome, current treatment with a statin, diagnosis of schizophrenia or schizoaffective disorder, current antipsychotic treatment, and body mass index (BMI). Results Of the 77 subjects (mean ± SD age of 53.7 ± 8.8 years), 41 were white, 36 were black, and 27 were diagnosed with schizophrenia or schizoaffective disorder (DSM-IV criteria). Fifty participants were being treated with an antipsychotic medication, while the remaining 27 were off of antipsychotics for at least 2 months. Our model explained 27% of the variance in calf compliance. Black subjects had reduced calf compliance compared to white subjects (P = .02). Having metabolic syndrome was associated with reduced PAC at a trend level (P < .08), and BMI (P = .004) and BMI2 (P = .011) were significant predictors of calf compliance. Schizophrenia versus other psychiatric diagnoses and antipsychotic treatment were not significantly associated with calf compliance. Conclusions In this pilot study, significant predictors of calf compliance were race (black vs white) and BMI. PAC is a noninvasive measure that may be a predictor of cardiovascular risk in psychiatric patients. The reduced PAC seen in patients with psychiatric diagnoses does not appear to be directly related to their diagnosis or

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

    PubMed Central

    2010-01-01

    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 < 0.001) and having a spinal lesion in the cervical region (P = 0.001) were associated with poorer PCS. Older age (P < 0.001) and higher education (P = 0.01) were associated with better mental health-related quality of life (MCS), while being a veteran and having a spinal lesion in the cervical region (P = 0.02) were associated with poorer MCS. 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

  7. Understanding how deployment experiences change over time: Comparison of female and male OEF/OIF and Gulf War veterans.

    PubMed

    Fox, Annie B; Walker, Brian E; Smith, Brian N; King, Daniel W; King, Lynda A; Vogt, Dawne

    2016-03-01

    Despite increased attention to the evolving nature of war, the unique challenges of contemporary deployment, and women's changing role in warfare, few studies have examined differences in deployment stressors across eras of service or evaluated how gender differences in deployment experiences have changed over time. Using data collected from two national survey studies, we examined war cohort and gender differences in veterans' reports of both mission-related and interpersonal stressors during deployment. Although Operation Enduring Freedom and Operation Iraqi Freedom veterans reported more combat experiences and greater preparedness for deployment compared to Gulf War veterans, Gulf War veterans reported higher levels of other mission-related stressors, including difficult living and working environment, perceived threat, and potential exposure to nuclear, biological, and chemical weapons. Gender differences also emerged, with men reporting greater exposure to mission-related stressors and women reporting higher levels of interpersonal stressors. However, the size and nature of gender differences did not differ significantly when comparing veterans of the two eras. By understanding how risk factors for PTSD differ based on war era and gender, veterans' experiences can be better contextualized. PMID:25866959

  8. Labor Market Status of Older Males in the United States, 1880–1940

    PubMed Central

    Lee, Chulhee

    2009-01-01

    This article explores the labor market status of older males in the early twentieth century, focusing on how the extent of pressure toward retirement differed across occupations and how it changed over time. A comparison of the probability of retirement across occupations shows that men who had better occupations in terms of economic status and work conditions were less likely to retire than were those with poorer jobs. The difficulty faced by older workers in the labor market, as measured by the relative incidence of long-term unemployment, was relatively severe among craftsmen, operatives, and salesmen. In contrast, aged farmers, professionals, managers, and proprietors appear to have fared well in the labor market. The pattern of shifts in the occupational structure that occurred between 1880 and 1940 suggests that industrialization had brought a growth of the sectors in which the pressure toward departure from employment at old ages was relatively strong. PMID:20234793

  9. A Prospective Study of Mortality and Trauma-Related Risk Factors Among a Nationally Representative Sample of Vietnam Veterans.

    PubMed

    Schlenger, William E; Corry, Nida H; Williams, Christianna S; Kulka, Richard A; Mulvaney-Day, Norah; DeBakey, Samar; Murphy, Catherine M; Marmar, Charles R

    2015-12-15

    Because Vietnam veterans comprise the majority of all living veterans and most are now older adults, the urgency and potential value of studying the long-term health effects of service in the Vietnam War, including effects on mortality, is increasing. The present study is the first prospective mortality assessment of a representative sample of Vietnam veterans. We used one of the longest follow-up periods to date (spanning older adulthood) and conducted one of the most comprehensive assessments of potential risk factors. Vital status and cause of death were ascertained for the 1,632 veterans who fought in the Vietnam theater (hereafter referred to as theater veterans) and for 716 Vietnam War-era veterans (hereafter referred to as era veterans) who participated in the National Vietnam Veterans Readjustment Study (1987-2011). As of April 2011, 16.0% (95% confidence interval: 13.1, 19.0) of all Vietnam veterans who were alive in the 1980s were deceased. Male theater veterans with a high probability of posttraumatic stress disorder (PTSD) were nearly 2 times more likely to have died than were those without PTSD, even after adjustment for sociodemographic and other characteristics. A high level of exposure to war zone stress was independently associated with mortality for both male and female theater veterans after adjustment for sociodemographic characteristics, PTSD, and physical comorbid conditions. Theater veterans with a high level of exposure to war zone stress and a high probability of PTSD had the greatest mortality risk (adjusted hazard ratio = 2.34, 95% confidence interval: 1.24, 4.43).

  10. A Prospective Study of Mortality and Trauma-Related Risk Factors Among a Nationally Representative Sample of Vietnam Veterans.

    PubMed

    Schlenger, William E; Corry, Nida H; Williams, Christianna S; Kulka, Richard A; Mulvaney-Day, Norah; DeBakey, Samar; Murphy, Catherine M; Marmar, Charles R

    2015-12-15

    Because Vietnam veterans comprise the majority of all living veterans and most are now older adults, the urgency and potential value of studying the long-term health effects of service in the Vietnam War, including effects on mortality, is increasing. The present study is the first prospective mortality assessment of a representative sample of Vietnam veterans. We used one of the longest follow-up periods to date (spanning older adulthood) and conducted one of the most comprehensive assessments of potential risk factors. Vital status and cause of death were ascertained for the 1,632 veterans who fought in the Vietnam theater (hereafter referred to as theater veterans) and for 716 Vietnam War-era veterans (hereafter referred to as era veterans) who participated in the National Vietnam Veterans Readjustment Study (1987-2011). As of April 2011, 16.0% (95% confidence interval: 13.1, 19.0) of all Vietnam veterans who were alive in the 1980s were deceased. Male theater veterans with a high probability of posttraumatic stress disorder (PTSD) were nearly 2 times more likely to have died than were those without PTSD, even after adjustment for sociodemographic and other characteristics. A high level of exposure to war zone stress was independently associated with mortality for both male and female theater veterans after adjustment for sociodemographic characteristics, PTSD, and physical comorbid conditions. Theater veterans with a high level of exposure to war zone stress and a high probability of PTSD had the greatest mortality risk (adjusted hazard ratio = 2.34, 95% confidence interval: 1.24, 4.43). PMID:26634285

  11. Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study

    PubMed Central

    Yi, Sang-Wook; Ohrr, Heechoul

    2015-01-01

    Objectives: Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men. Methods: From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004. Results: Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older. Conclusions: Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older. PMID:25857648

  12. Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System: Associations with Patient and Treatment Setting Characteristics

    PubMed Central

    Zivin, Kara; Kim, H. Myra; McCarthy, John F.; Austin, Karen L.; Hoggatt, Katherine J.; Walters, Heather; Valenstein, Marcia

    2007-01-01

    Objectives. We sought to report clinical and demographic factors associated with suicide among depressed veterans in an attempt to determine what characteristics identified depressed veterans at high risk for suicide. Methods. We used longitudinal, nationally representative data (1999–2004) to determine suicide rates among depressed veterans, estimating time until suicide using Cox proportional hazards regression models. Results. Of 807694 veterans meeting study criteria, 1683 (0.21%) committed suicide during follow-up. Increased suicide risks were observed among male, younger, and non-Hispanic White patients. Veterans without service-connected disabilities, with inpatient psychiatric hospitalizations in the year prior to their qualifying depression diagnosis, with comorbid substance use, and living in the southern or western United States were also at higher risk. Posttraumatic stress disorder (PTSD) with comorbid depression was associated with lower suicide rates, and younger depressed veterans with PTSD had a higher suicide rate than did older depressed veterans with PTSD. Conclusions. Unlike the general population, older and younger veterans are more prone to suicide than are middle-aged veterans. Future research should examine the relationship between depression, PTSD, health service use, and suicide risks among veterans. PMID:17971541

  13. Cervical and lumbar MRI in asymptomatic older male lifelong athletes: Frequency of degenerative findings

    SciTech Connect

    Healy, J.F.; Healy, B.B.; Wong, W.H.M.; Olson, E.M.

    1996-01-01

    The athletic activity of the adult U.S. population has increased markedly in the last 20 years. To evaluate the possible long-term effects of such activity on the cervical and lumbar spine, we studied a group of asymptomatic currently very active lifelong male athletes over age 40 (41-69 years old, av. age 53). Nineteen active, lifelong male athletes were studied with MRI and the results compared with previous imaging studies of other populations. An athletic history and a spine history were also taken. Evidence of asymptomatic degenerative spine disease was similar to that seen in published series of other populations. Degenerative changes including disk protrusion and herniation, spondylosis, and spinal stenosis were present and increased in incidence with increasing patient age. In this group, all MRI findings proved to be asymptomatic and did not limit athletic activity. The incidence of lumbar degenerative changes in our study population of older male athletes was similar to those seen in other populations. 14 refs., 8 figs., 1 tab.

  14. Increased Air Velocity Reduces Thermal and Cardiovascular Strain in Young and Older Males during Humid Exertional Heat Stress.

    PubMed

    Wright Beatty, Heather E; Hardcastle, Stephen G; Boulay, Pierre; Flouris, Andreas D; Kenny, Glen P

    2015-01-01

    Older adults have been reported to have a lower evaporative heat loss capacity than younger adults during exercise when full sweat evaporation is permitted. However, it is unclear how conditions of restricted evaporative and convective heat loss (i.e., high humidity, clothing insulation) alter heat stress. to the purpose of this study was to examine the heat stress responses of young and older males during and following exercise in a warm/humid environment under two different levels of air velocity. Ten young (YOUNG: 24±2 yr) and 10 older (OLDER: 59±3 yr) males, matched for body surface area performed 4×15-min cycling bouts (15-min rest) at a fixed rate of heat production (400 W) in warm/humid conditions (35°C, 60% relative humidity) under 0.5 (Low) and 3.0 (High) m·s(-1) air velocity while wearing work coveralls. Rectal (Tre) and mean skin (MTsk) temperatures, heart rate (HR), local sweat rate, % max skin blood flow (SkBF) (recovery only), and blood pressure (recovery only) were measured. High air velocity reduced core and skin temperatures (p < 0.05) equally in YOUNG and OLDER males (p > 0.05) but was more effective in reducing cardiovascular strain (absolute and % max HR; p < 0.05) in YOUNG males (p < 0.05). Greater increases in local dry heat loss responses (% max SkBF and cutaneous vascular conductance) were detected across time in OLDER than YOUNG males in both conditions (p < 0.05). Local dry heat loss responses and cardiovascular strain were attenuated during the High condition in YOUNG compared to OLDER (p < 0.05). High air velocity reduced the number of males surpassing the 38.0°C Tre threshold from 90% (Low) to 50% (High). Despite age-related local heat loss differences, YOUNG and OLDER males had similar levels of heat stress during intermittent exercise in warm and humid conditions while wearing work coveralls. Increased air velocity was effective in reducing heat stress equally, and cardiovascular strain to a greater extent, in YOUNG and OLDER

  15. Increased Air Velocity Reduces Thermal and Cardiovascular Strain in Young and Older Males during Humid Exertional Heat Stress.

    PubMed

    Wright Beatty, Heather E; Hardcastle, Stephen G; Boulay, Pierre; Flouris, Andreas D; Kenny, Glen P

    2015-01-01

    Older adults have been reported to have a lower evaporative heat loss capacity than younger adults during exercise when full sweat evaporation is permitted. However, it is unclear how conditions of restricted evaporative and convective heat loss (i.e., high humidity, clothing insulation) alter heat stress. to the purpose of this study was to examine the heat stress responses of young and older males during and following exercise in a warm/humid environment under two different levels of air velocity. Ten young (YOUNG: 24±2 yr) and 10 older (OLDER: 59±3 yr) males, matched for body surface area performed 4×15-min cycling bouts (15-min rest) at a fixed rate of heat production (400 W) in warm/humid conditions (35°C, 60% relative humidity) under 0.5 (Low) and 3.0 (High) m·s(-1) air velocity while wearing work coveralls. Rectal (Tre) and mean skin (MTsk) temperatures, heart rate (HR), local sweat rate, % max skin blood flow (SkBF) (recovery only), and blood pressure (recovery only) were measured. High air velocity reduced core and skin temperatures (p < 0.05) equally in YOUNG and OLDER males (p > 0.05) but was more effective in reducing cardiovascular strain (absolute and % max HR; p < 0.05) in YOUNG males (p < 0.05). Greater increases in local dry heat loss responses (% max SkBF and cutaneous vascular conductance) were detected across time in OLDER than YOUNG males in both conditions (p < 0.05). Local dry heat loss responses and cardiovascular strain were attenuated during the High condition in YOUNG compared to OLDER (p < 0.05). High air velocity reduced the number of males surpassing the 38.0°C Tre threshold from 90% (Low) to 50% (High). Despite age-related local heat loss differences, YOUNG and OLDER males had similar levels of heat stress during intermittent exercise in warm and humid conditions while wearing work coveralls. Increased air velocity was effective in reducing heat stress equally, and cardiovascular strain to a greater extent, in YOUNG and OLDER

  16. Long-Term Exposure to Ambient Fine Particulate Matter and Renal Function in Older Men: The Veterans Administration Normative Aging Study

    PubMed Central

    Mehta, Amar J.; Zanobetti, Antonella; Bind, Marie-Abele C.; Kloog, Itai; Koutrakis, Petros; Sparrow, David; Vokonas, Pantel S.; Schwartz, Joel D.

    2016-01-01

    Background: It is unknown if ambient fine particulate matter (PM2.5) is associated with lower renal function, a cardiovascular risk factor. Objective: We investigated whether long-term PM2.5 exposure was associated with estimated glomerular filtration rate (eGFR) in a cohort of older men living in the Boston Metropolitan area. Methods: This longitudinal analysis included 669 participants from the Veterans Administration Normative Aging Study with up to four visits between 2000 and 2011 (n = 1,715 visits). Serum creatinine was measured at each visit, and eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration equation. One-year exposure to PM2.5 prior to each visit was assessed using a validated spatiotemporal model that utilized satellite remote-sensing aerosol optical depth data. eGFR was modeled in a time-varying linear mixed-effects regression model as a continuous function of 1-year PM2.5, adjusting for important covariates. Results: One-year PM2.5 exposure was associated with lower eGFRs; a 2.1-μg/m3 interquartile range higher 1-year PM2.5 was associated with a 1.87 mL/min/1.73 m2 lower eGFR [95% confidence interval (CI): –2.99, –0.76]. A 2.1 μg/m3-higher 1-year PM2.5 was also associated with an additional annual decrease in eGFR of 0.60 mL/min/1.73 m2 per year (95% CI: –0.79, –0.40). Conclusions: In this longitudinal sample of older men, the findings supported the hypothesis that long-term PM2.5 exposure negatively affects renal function and increases renal function decline. Citation: Mehta AJ, Zanobetti A, Bind MC, Kloog I, Koutrakis P, Sparrow D, Vokonas PS, Schwartz JD. 2016. Long-term exposure to ambient fine particulate matter and renal function in older men: the VA Normative Aging Study. Environ Health Perspect 124:1353–1360; http://dx.doi.org/10.1289/ehp.1510269 PMID:26955062

  17. Comprehension of Fish Consumption Guidelines Among Older Male Anglers in Wisconsin.

    PubMed

    Christensen, Krista Y; Raymond, Michelle R; Thompson, Brooke A; Schrank, Candy S; Williams, Meghan C W; Anderson, Henry A

    2016-02-01

    Although awareness of Wisconsin's fish consumption guidelines is high among older male anglers, little is known about comprehension of guideline content, and many anglers have levels of contaminants high enough to be associated with adverse health outcomes. The Environmental Protection Agency Great Lakes Restoration Initiative supported evaluation and revision of Wisconsin's fish consumption guideline program, using a web based survey of male Wisconsin anglers over the age of 50. A total of 3740 men completed the online survey; the median age of respondents was 62 years, and nearly all had lived and fished in Wisconsin for over 10 years. Comprehension of guideline content was relatively high, although two knowledge gaps were identified, one relating to mercury exposures and fish preparation, and the other to polychlorinated biphenyl content of certain fish species. The fishing regulations booklet distributed with annual fishing licenses and warning signs posted at fishing locations were commonly reported sources of guideline information in Wisconsin. Residents of coastal counties and consumers of Great Lakes fish were more likely to report guideline knowledge and behavior changes reflective of guideline knowledge, when compared to inland residents and those not consuming Great Lakes fish, respectively. In general, Wisconsin's consumption guidelines do not appear to discourage men from eating the fish they catch; rather, the most common behavioral changes included modifying the species eaten or the water body source of their meals. Continued efforts to educate anglers about the risks and benefits of fish consumption are needed. PMID:26306781

  18. Comprehension of Fish Consumption Guidelines Among Older Male Anglers in Wisconsin.

    PubMed

    Christensen, Krista Y; Raymond, Michelle R; Thompson, Brooke A; Schrank, Candy S; Williams, Meghan C W; Anderson, Henry A

    2016-02-01

    Although awareness of Wisconsin's fish consumption guidelines is high among older male anglers, little is known about comprehension of guideline content, and many anglers have levels of contaminants high enough to be associated with adverse health outcomes. The Environmental Protection Agency Great Lakes Restoration Initiative supported evaluation and revision of Wisconsin's fish consumption guideline program, using a web based survey of male Wisconsin anglers over the age of 50. A total of 3740 men completed the online survey; the median age of respondents was 62 years, and nearly all had lived and fished in Wisconsin for over 10 years. Comprehension of guideline content was relatively high, although two knowledge gaps were identified, one relating to mercury exposures and fish preparation, and the other to polychlorinated biphenyl content of certain fish species. The fishing regulations booklet distributed with annual fishing licenses and warning signs posted at fishing locations were commonly reported sources of guideline information in Wisconsin. Residents of coastal counties and consumers of Great Lakes fish were more likely to report guideline knowledge and behavior changes reflective of guideline knowledge, when compared to inland residents and those not consuming Great Lakes fish, respectively. In general, Wisconsin's consumption guidelines do not appear to discourage men from eating the fish they catch; rather, the most common behavioral changes included modifying the species eaten or the water body source of their meals. Continued efforts to educate anglers about the risks and benefits of fish consumption are needed.

  19. Patterns of Multimorbidity in Elderly Veterans

    PubMed Central

    Steinman, Michael A.; Lee, Sei J.; Boscardin, W. John; Miao, Yinghui; Fung, Kathy Z.; Moore, Kelly L.; Schwartz, Janice B.

    2014-01-01

    OBJECTIVES To determine patterns of co-occurring diseases in older adults and the extent to which these patterns vary between the young-old and the old-old. DESIGN Observational study. SETTING Department of Veterans Affairs. PARTICIPANTS Veterans aged 65 years and older (1.9 million male, mean age 76 ± 7; 39,000 female, mean age 77 ± 8) with two or more visits to Department of Veterans Affairs (VA) or Medicare settings in 2007 and 2008. MEASUREMENTS The presence of 23 common conditions was assessed using hospital discharge diagnoses and outpatient encounter diagnoses from the VA and Medicare. RESULTS The mean number of chronic conditions (out of 23 possible) was 5.5 ± 2.6 for men and 5.1 ± 2.6 for women. The prevalence of most conditions increased with advancing age, although diabetes mellitus and hyperlipidemia were 11% to 13% less prevalent in men and women aged 85 and older than in those aged 65 to 74 (P < .001 for each). In men, the most common three-way combination of conditions was hypertension, hyperlipidemia, and coronary heart disease, which together were present in 37% of men. For women, the most common combination was hypertension, hyperlipidemia, and arthritis, which co-occurred in 25% of women. Reflecting their high population prevalence, hypertension and hyperlipidemia were both present in 9 of the 15 most common three-way disease combinations in men and in 11 of the 15 most common combinations in women. The prevalence of many disease combinations varied substantially between young-old and old-old adults. CONCLUSIONS Specific combinations of diseases are highly prevalent in older adults and inform the development of guidelines that account for the simultaneous presence of multiple chronic conditions. PMID:23035702

  20. Levels of nutrients in relation to fish consumption among older male anglers in Wisconsin

    PubMed Central

    Christensen, Krista Y.; Thompson, Brooke A.; Werner, Mark; Malecki, Kristen; Imm, Pamela; Anderson, Henry A.

    2016-01-01

    Fish are an important source of nutrients including omega-3 fatty acids, which may reduce risk of adverse health outcomes such as cardiovascular disease; however, fish may also contain significant amounts of environmental pollutants. The Wisconsin Departments of Health Services and Natural Resources developed a survey instrument, along with a strategy to collect human biological samples to assess the risks and benefits associated with long-term fish consumption among older male anglers in Wisconsin. The target population was men aged 50 years and older, who fish Wisconsin waters and live in the state of Wisconsin. Participants provided blood and hair samples and completed a detailed (paper) questionnaire, which included questions on basic demographics, health status, location of catch and species of fish caught/eaten, consumption of locally caught and commercially purchased fish, and awareness and source of information for local and statewide consumption guidelines. Biological samples were used to assess levels of docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), eicosapentaenoic acid (EPA); vitamin D; and selenium in blood. Quantile regression analysis was used to investigate the associations between biomarker levels and self-reported consumption of fish from the Great Lakes and other areas of concern, other locally caught fish, and commercially purchased fish (meals per year). Respondents were largely non-Hispanic white men in their 60’s with at least some college education, and about half were retired. Fish consumption was high (median of 54.5 meals per year), with most fish meals coming from locally-caught fish. Multivariate regression models showed that the effect of supplement use was much greater than that of fish consumption, on nutrient levels, although consumption of fish from the Great Lakes and areas of concern was significantly associated with higher levels of vitamin D even after controlling for supplement usage. PMID:26296180

  1. Is co-contraction responsible for the decline in maximal knee joint torque in older males?

    PubMed

    Billot, Maxime; Duclay, Julien; Simoneau-Buessinger, Emilie M; Ballay, Yves; Martin, Alain

    2014-04-01

    While it is often reported that muscular coactivation increases with age, the mechanical impact of antagonist muscles, i.e., the antagonist torque, remains to be assessed. The aim of this study was to determine if the mechanical impact of the antagonist muscles may contribute to the age-related decline in the resultant torque during maximal voluntary contraction in knee flexion (KF) and knee extension (KE). Eight young (19-28 years old) and eight older (62-81 years old) healthy males participated in neuromuscular testing. Maximal resultant torque was simultaneously recorded with the electromyographic activity of quadriceps and hamstring muscles. The torque recorded in the antagonist muscles was estimated using a biofeedback technique. Resultant torques significantly decreased with age in both KF (-41 %, p < 0.005) and KE (-35 %, p < 0.01). Agonist and antagonist torques were significantly reduced in KF (-44 %, p < 0.05; -57 %, p < 0.05) and in KE (-37 %, p < 0.01; -50 %, p < 0.05). The torque elicited by double twitch stimulation (-37 %, p < 0.01) and the activation level (-12 %, p < 0.05) of quadriceps was significantly lower in older men compared to young men. This study showed that antagonist torques were not responsible for age-related declines in KF and KE resultant torques. Therefore, decreased resultant torques with age, in particular in KE, can primarily be explained by impairments of the peripheral factors (excitation-contraction coupling) as well as by decreased neural agonist activation.

  2. Positive tertiary appraisals and posttraumatic stress disorder in U.S. male veterans of the war in Vietnam: the roles of positive affirmation, positive reformulation, and defensive denial.

    PubMed

    Dohrenwend, Bruce P; Neria, Yuval; Turner, J Blake; Turse, Nicholas; Marshall, Randall; Lewis-Fernandez, Roberto; Koenen, Karestan C

    2004-06-01

    A 70.9% majority of the U.S. male veterans in a nationwide sample appraised the impact of their service in Vietnam on their present lives as mainly positive. A substantial minority, 41.7%, judged the effects to be highly salient. With controls on level of exposure to war-zone stressors measured with data from military records, the valence and salience of these appraisals are investigated in relation to posttraumatic stress disorder (PTSD) and other indicators of wartime and postwar functioning. The results are consistent with the hypothesis that mainly positive tertiary appraisals are affirmations of successful wartime and postwar adaptation rather than defensive denials related to maladaptive outcomes. The possibility that mainly positive tertiary appraisals also contribute to successful postwar adaptation is discussed.

  3. Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: risk factors, war-zone stressors, and resilience-recovery variables.

    PubMed

    King, D W; King, L A; Foy, D W; Keane, T M; Fairbank, J A

    1999-02-01

    Relationships among pretrauma risk factors (e.g., family instability, childhood antisocial behavior), war-zone stressors (e.g., combat, perceived threat), posttrauma resilience-recovery variables (e.g., hardiness, social support), and posttraumatic stress disorder (PTSD) symptom severity were examined. Data from a national sample of 432 female and 1,200 male veterans were analyzed using structural equation modeling. For both genders, direct links to PTSD from pretrauma, war-zone, and posttrauma variable categories were found; several direct associations between pretrauma and posttrauma variables were documented. Although war-zone stressors appeared preeminent for PTSD in men, posttrauma resilience-recovery variables were more salient for women. Researchers, policymakers, and clinicians are urged to take a broad view on trauma and its sequelae, especially regarding possible multiple exposures over time and the depletion and availability of important resources.

  4. Significant differences in fecal microbiota are associated with various stages of glucose tolerance in African American male veterans.

    PubMed

    Ciubotaru, Irina; Green, Stefan J; Kukreja, Subhash; Barengolts, Elena

    2015-11-01

    The importance of gut microbiota in pathogenesis of diabetes remains unknown. This study investigated the relationship between microbiota and metabolic markers in African American men (AAM) with prediabetes and hypovitaminosis D. The study was ancillary to a randomized trial of vitamin D supplementation with weekly ergocalciferol (50,000 IU) conducted in AAM veterans over 12 months (D Intervention in Veterans Affairs). Glycemic groups (Gr) were characterized based on changes in oral glucose tolerance between baseline and exit. Subjects with stable normal glucose tolerance were assigned to Gr-1 and those with stable prediabetes (impaired glucose tolerance and impaired fasting glucose) to Gr-2. Microbiota composition was analyzed in stool collected at the exit (n = 115) and compared between Gr-1 and Gr-2, as well as between the lowest and highest quartiles of dietary intake of energy and fat, hemoglobin A1c, and serum 25-hydroxyvitamin D (25[OH]D) level. Differences between Gr-1 and Gr-2 included the Bacteroidetes/Firmicutes and Bacteroidales/Clostridia ratios and differences in genera such as Ruminococcus and Dialister. Changes in specific taxa associated with the lowest and highest quartiles of 25(OH)D (eg, Ruminococcus, Roseburia, Blautia, Dorea) were clearly distinct from those of dietary intake (eg, Bacteroides, Bacteroides/Prevotella ratio) or A1c (eg, Faecalibacterium, Catenibacterium, Streptococcus). These findings suggest a novel interaction between microbiota and vitamin D and a role for microbiota in early stages of diabetes development. Although results suggest that specific taxa are associated with glycemic stability over time, a causative relationship between microbiota makeup and dysglycemia is still to be demonstrated. PMID:26209747

  5. Subjective social support in older male Italian-born immigrants in Australia.

    PubMed

    Stanaway, Fiona F; Kendig, Hal L; Blyth, Fiona M; Cumming, Robert G; Naganathan, Vasi; Waite, Louise M

    2011-06-01

    This paper describes differences in subjective social support between older male Italian-born immigrants in Australia and their Australian-born counterparts. Data came from 335 Italian-born and 849 Australian-born men aged 70 years and over who participated in the baseline phase of the Concord Health and Ageing in Men Project (CHAMP) in inner suburban Sydney, Australia. Social support was measured using the shortened (11 item) version of the Duke Social Support Index (DSSI). This index measures both social interactions and expressive social support. Logistic regression was used to examine differences in subjective social support between the two groups of men after controlling for other related factors. Italian-born men were about twice as likely to report low subjective social support compared to Australian-born men (unadjusted odds ratio (OR) = 1.8, p = 0.0002). This difference remained after adjustment for sociodemographic, socioeconomic, social network and health factors (adjusted OR = 2.1, p = 0.0007). Italian-born men were more likely to report that they had no non-family members in the local area to rely on. However, lack of non-family supports did not remain significantly associated with perceived social support after adjustment for social interactions and depressive symptoms. Italian-born men were more likely to report low subjective support despite the presence of several protective factors such as a greater number of local family supports and a high rate of home ownership.

  6. Incarcerated Veterans Outreach Program.

    PubMed

    Schaffer, Bradley J

    2016-01-01

    The objective of this study is to identify and facilitate re-entry services for military veterans in the Criminal Justice System through the Incarcerated Veteran Outreach Program. Veterans are explored as a subgroup of the general inmate jail populations in southern Ohio based upon veteran's status, military discharges, service-related injuries, treatment needs, pre-release planning, and re-entry services. Veterans reported having psycho-social problems, diverse levels of criminality, criminogenic needs, and significant episodes of homelessness. A sample of 399 incarcerated veterans in state prison, county jails, and community corrections setting were identified and completed the psycho-social pre-release assessment. Their average age was 44.6; they were more likely to be White males, divorced, most honorably discharged, and were represented in the following eras: 34% Vietnam, 35% post-Vietnam, 26% Persian Gulf War, and 5% Operation Iraqi Freedom/Operation Enduring Freedom. The findings encourage the development of a re-entry outreach model and strategies to prevent episodes of criminal recidivism. PMID:25975930

  7. The influence of self-compassion on emotional well-being among early and older adolescent males and females

    PubMed Central

    Bluth, Karen; Blanton, Priscilla W.

    2014-01-01

    Self-compassion has been associated with well-being in adult samples, but has rarely been assessed in adolescents. In this study, 90 students ages 11–18 completed an online survey assessing self-compassion, life satisfaction, perceived stress and positive and negative affect. Findings indicated that older female adolescents had lower self-compassion than either older male adolescents or early adolescents of either gender, and self-compassion was associated significantly with all dimensions of emotional well-being with the exception of positive affect. Additionally, phase of adolescence, but not gender, was found to moderate the relationship between self-compassion and dimensions of well-being; for older adolescents, the inverse relationship between self-compassion and negative affect was stronger. Lastly, the influence of the various components of self-compassion was investigated and discussed. PMID:25750655

  8. "Still Game": An Analysis of the Life History and Career Disappointments of One Veteran Male Teacher of Physical Education in Scotland

    ERIC Educational Resources Information Center

    Thorburn, Malcolm

    2011-01-01

    Relatively little is known about veteran teachers' professional lives and especially of veteran teachers who have failed to secure promoted teaching positions. This is a weakness in our understanding of teachers' lives given the social and policy changes which have taken place in teaching over recent decades. Through a series of 10 semi-structured…

  9. Consideration of forgiveness to enhance the health status of older male prisoners confronting spiritual, social, or emotional vulnerability.

    PubMed

    Bishop, Alex J; Randall, G Kevin; Merten, Michael J

    2014-12-01

    Participants in this study included 261 men, aged 45 and older, residing within state-managed correctional facilities in Oklahoma. Path analysis was used to examine an integrated mediation model. Spiritual ambivalence, loneliness, and depressive affect had direct negative associations with forgiveness, controlling for age, race, education, and type of crime. Forgiveness also maintained a direct positive association with perceived health status, whereas depressive affect maintained a direct negative association with perceived health status. In addition, a significant indirect effect of depressive affect on perceived health through forgiveness emerged. Overall, the model explained 38% of the variance in forgiveness and 23% in perceived health. Greater spiritual ambivalence, loneliness, and depressive affect diminish forgiveness among older male prisoners, yet higher levels of forgiveness, are associated with greater perceived health. PMID:25332306

  10. Health care of homeless veterans.

    PubMed

    O'Toole, Thomas P; Conde-Martel, Alicia; Gibbon, Jeanette L; Hanusa, Barbara H; Fine, Michael J

    2003-11-01

    It is important to understand the needs of those veterans who are homeless. We describe characteristics of homeless male veterans and factors associated with needing VA benefits from a two-city, community survey of 531 homeless adults. Overall, 425 were male, of whom 127 were veterans (29.9%). Significantly more veterans had a chronic medical condition and two or more mental health conditions. Only 35.1% identified a community clinic for care compared with 66.8% of non-veterans (P <.01); 47.7% identified a shelter-based clinic and 59.1% reported needing VA benefits. Those reporting this need were less likely to report a medical comorbidity (58.7% vs 76.9%; P =.04), although 66.7% had a mental health comorbidity and 82.7% met Diagnosic Screening Manual (DSM)-IIIR criteria for substance abuse/dependence. They were also significantly more likely to access shelter clinics compared with veterans without this need. Homeless veterans continue to have substantial health issues. Active outreach is needed for those lacking access to VA services. PMID:14687279

  11. Near-Miss Discharge of an Older Adult Male With Central Cord Syndrome.

    PubMed

    Martin, Kyle L; Hicks, Rodney W

    2015-01-01

    Acute traumatic central cord syndrome (ATCCS) occurs in more than 11,000 individuals annually. A common cause in older adult is a low-velocity hypertension neck injury. This article reviews ATCCS from the perspective of an older adult who, after a fall at his primary residence, sustained a facial laceration. Just prior to discharge, neurological deficits were noted, which required further investigation with magnetic resonance imaging. Subsequently, the findings required emergent surgical intervention. Emergency nurses should be familiar with muscle assessment, deep tendon reflex assessment, and nervous system dermatomes. The value of repeating the physical examination prior to discharge is discussed.

  12. Attitudes, Perceptions and Potential Uptake of Male Circumcision among Older Men in Turkana County, Kenya Using Qualitative Methods

    PubMed Central

    Macintyre, Kate; Andrinopoulos, Katherine; Moses, Natome; Bornstein, Marta; Ochieng, Athanasius; Peacock, Erin; Bertrand, Jane

    2014-01-01

    Background In many communities, older men (i.e., over 25 years of age) have not come forward for Voluntary Medical Male Circumcision (VMMC) services. Reasons for low demand among this group of men are not well understood, and may vary across geographic and cultural contexts. This paper examines the facilitators and barriers to VMMC demand in Turkana County, Kenya, with a focus on older men. This is one of the regions targeted by the VMMC program in Kenya because the Turkana ethnic group does not traditionally circumcise, and the rates of HIV and STD transmission are high. Methods and Findings Twenty focus group discussions and 69 in-depth interviews were conducted with circumcised and uncircumcised men and their partners to elicit their attitudes and perceptions toward male circumcision. The interviews were conducted in urban, peri-urban, and rural communities across Turkana. Our results show that barriers to circumcision include stigma associated with VMMC, the perception of low risk for HIV for older men and their “protection by marriage,” cultural norms, and a lack of health infrastructure. Facilitators include stigma against not being circumcised (since circumcision is associated with modernity), protection against disease including HIV, and cleanliness. It was also noted that older men should adopt the practice to serve as role models to younger men. Conclusions Both men and women were generally supportive of VMMC, but overcoming barriers with appropriate communication messages and high quality services will be challenging. The justification of circumcision being a biomedical procedure for protection against HIV will be the most important message for any communication strategy. PMID:24802112

  13. Veterans Crisis Line

    MedlinePlus

    ... also access and download the Veterans Crisis Line Branding Guidelines for guidance on how to consistently apply ... Program ADMINISTRATION Veterans Health Administration Veterans Benefits Administration National Cemetery Administration U.S. Department of Veterans Affairs | 810 ...

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

    PubMed

    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.

  15. [Health in peril: repercussions of ageism on the psychological disengagement of male nurses aged 45 years and older].

    PubMed

    Lagacé, Martine; Tougas, Francine; Laplante, Joelle; Neveu, Jean-François

    2008-01-01

    These two studies are designed to evaluate the reactions of male nurses aged 45 years and older toward ageism. The goal of the first study is to test the prestigious work domain model of psychological disengagement resulting from a previous study conducted among female nurses. This model has been confirmed through path analyses conducted on a sample of 236 male nurse technicians; by the same token, it has been shown to apply in the case of lower-status employees working in a prestigious field. In particular, the more a male nurse aged 45 and older experiences relative personal deprivation, the more he discredits feedback from his co-workers and superiors; such discrediting, in turn, leads to devaluation of the domain of work, which in turn lowers self-esteem. The goal of the second study is three-fold, namely: (a) testing the disengagement model among 419 male nurse clinicians; (b) extending this model through the addition of ageist communication as a variable triggering personal relative deprivation; and (c) constructing a scale of ageist communication. Path analyses have again confirmed that the way a domain is appreciated influences the negative impact that devaluation can produce on self-esteem, regardless of the gender or status of the employee working in that field. In addition, these results demonstrate the central role played by communication in the workplace as a vehicle of ageism and as a precursor of ageing employees' discomfort. The discussion covers the implications of ageing employees' reactions toward ageism as well as the consequences of depreciatory language and exclusionary communication practices in the workplace. PMID:19158044

  16. Learning to Obtain Reward, but Not Avoid Punishment, Is Affected by Presence of PTSD Symptoms in Male Veterans: Empirical Data and Computational Model

    PubMed Central

    Myers, Catherine E.; Moustafa, Ahmed A.; Sheynin, Jony; VanMeenen, Kirsten M.; Gilbertson, Mark W.; Orr, Scott P.; Beck, Kevin D.; Pang, Kevin C. H.; Servatius, Richard J.

    2013-01-01

    Post-traumatic stress disorder (PTSD) symptoms include behavioral avoidance which is acquired and tends to increase with time. This avoidance may represent a general learning bias; indeed, individuals with PTSD are often faster than controls on acquiring conditioned responses based on physiologically-aversive feedback. However, it is not clear whether this learning bias extends to cognitive feedback, or to learning from both reward and punishment. Here, male veterans with self-reported current, severe PTSD symptoms (PTSS group) or with few or no PTSD symptoms (control group) completed a probabilistic classification task that included both reward-based and punishment-based trials, where feedback could take the form of reward, punishment, or an ambiguous “no-feedback” outcome that could signal either successful avoidance of punishment or failure to obtain reward. The PTSS group outperformed the control group in total points obtained; the PTSS group specifically performed better than the control group on reward-based trials, with no difference on punishment-based trials. To better understand possible mechanisms underlying observed performance, we used a reinforcement learning model of the task, and applied maximum likelihood estimation techniques to derive estimated parameters describing individual participants’ behavior. Estimations of the reinforcement value of the no-feedback outcome were significantly greater in the control group than the PTSS group, suggesting that the control group was more likely to value this outcome as positively reinforcing (i.e., signaling successful avoidance of punishment). This is consistent with the control group’s generally poorer performance on reward trials, where reward feedback was to be obtained in preference to the no-feedback outcome. Differences in the interpretation of ambiguous feedback may contribute to the facilitated reinforcement learning often observed in PTSD patients, and may in turn provide new insight into

  17. Learning to obtain reward, but not avoid punishment, is affected by presence of PTSD symptoms in male veterans: empirical data and computational model.

    PubMed

    Myers, Catherine E; Moustafa, Ahmed A; Sheynin, Jony; Vanmeenen, Kirsten M; Gilbertson, Mark W; Orr, Scott P; Beck, Kevin D; Pang, Kevin C H; Servatius, Richard J

    2013-01-01

    Post-traumatic stress disorder (PTSD) symptoms include behavioral avoidance which is acquired and tends to increase with time. This avoidance may represent a general learning bias; indeed, individuals with PTSD are often faster than controls on acquiring conditioned responses based on physiologically-aversive feedback. However, it is not clear whether this learning bias extends to cognitive feedback, or to learning from both reward and punishment. Here, male veterans with self-reported current, severe PTSD symptoms (PTSS group) or with few or no PTSD symptoms (control group) completed a probabilistic classification task that included both reward-based and punishment-based trials, where feedback could take the form of reward, punishment, or an ambiguous "no-feedback" outcome that could signal either successful avoidance of punishment or failure to obtain reward. The PTSS group outperformed the control group in total points obtained; the PTSS group specifically performed better than the control group on reward-based trials, with no difference on punishment-based trials. To better understand possible mechanisms underlying observed performance, we used a reinforcement learning model of the task, and applied maximum likelihood estimation techniques to derive estimated parameters describing individual participants' behavior. Estimations of the reinforcement value of the no-feedback outcome were significantly greater in the control group than the PTSS group, suggesting that the control group was more likely to value this outcome as positively reinforcing (i.e., signaling successful avoidance of punishment). This is consistent with the control group's generally poorer performance on reward trials, where reward feedback was to be obtained in preference to the no-feedback outcome. Differences in the interpretation of ambiguous feedback may contribute to the facilitated reinforcement learning often observed in PTSD patients, and may in turn provide new insight into how

  18. Nutritional self-care in two older Norwegian males: a case study

    PubMed Central

    Tomstad, Solveig T; Söderhamn, Ulrika; Espnes, Geir Arild; Söderhamn, Olle

    2013-01-01

    Background: Knowledge about how to support nutritional self-care in the vulnerable elderly living in their own homes is an important area for health care professionals. The aim of this case study was to evaluate the effects of nutritional intervention by comparing perceived health, sense of coherence, self-care ability, and nutritional risk in two older home-dwelling individuals before, during, and after intervention and to describe their experiences of nutritional self-care before and after intervention. Methods: A study circle was established to support nutritional self-care in two older home-dwelling individuals (≥65 years of age), who participated in three meetings arranged by health professionals over a period of six months. The effects of this study circle were evaluated using the Nutritional Form For the Elderly, the Self-care Ability Scale for the Elderly (SASE), the Appraisal of Self-care Agency scale, the Sense of Coherence (SOC) scale, and responses to a number of health-related questions. Qualitative interviews were performed before and after intervention to interpret the changes that occurred during intervention. Results: A reduced risk of undernutrition was found for both participants. A higher total score on the SASE was obtained for one participant, along with a slightly stronger preference for self-care to maintain sufficient food intake, was evident. For the other participant, total score on the SASE decreased, but the SOC score improved after intervention. Decreased mobility was reported, but this did not influence his food intake. The study circle was an opportunity to express personal views and opinions about food intake and meals. Conclusion: An organized meeting place for dialogue between older home-dwelling individuals and health care professionals can stimulate the older person’s engagement, consciousness, and learning about nutritional self-care, and thereby be of importance in reducing the risk of undernutrition. PMID:23807843

  19. 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.

    PubMed

    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.

  20. Queering the Adult Gaze: Young Male Hustlers and Their Alliances with Older Gay Men

    ERIC Educational Resources Information Center

    Raible, John

    2011-01-01

    Based on ethnographic data collected at a gay bar with sexual minority youths as dancers or strippers, this study calls attention to the gazes through which adults view and position male youths. It highlights a dancer named Austin, who at times engaged in the underground hustling economy centered in the bar. The findings suggest that the social…

  1. Racial disparities in diabetes a century ago: evidence from the pension files of US Civil War veterans.

    PubMed

    Humphreys, Margaret; Costanzo, Philip; Haynie, Kerry L; Ostbye, Truls; Boly, Idrissa; Belsky, Daniel; Sloan, Frank

    2007-04-01

    Using a comprehensive database constructed from the pension files of US Civil War veterans, we explore characteristics and occurrence of type 2 diabetes among older black and white males, living circa 1900. We find that rates of diagnosed diabetes were much lower among males in this period than a century later. In contrast to the late 20th Century, the rates of diagnosed diabetes were lower among black than among white males, suggesting that the reverse pattern is of relatively recent origin. Two-thirds of both white and black veterans had body-mass indexes (BMIs) in the currently recommended weight range, a far higher proportion than documented by recent surveys. Longevity among persons with diabetes was not reduced among Civil War veterans, and those with diabetes suffered comparatively few sequelae of the condition. Over 90% of black veterans engaged in low paying, high-physical effort jobs, as compared to about half of white veterans. High rates of work-related physical activity may provide a partial explanation of low rates of diagnosed diabetes among blacks. We found no evidence of discrimination in testing by race, as indicated by rates of examinations in which a urinalysis was performed. This dataset is valuable for providing a national benchmark against which to compare modern diabetes prevalence patterns. PMID:17240029

  2. Construct Validation of Three Nutrition Questions Using Health and Diet Ratings in Older Canadian Males Living in the Community.

    PubMed

    Akhtar, Usman; Keller, Heather H; Tate, Robert B; Lengyel, Christina O

    2015-12-01

    Brief nutrition screening tools are desired for research and practice. Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-II, 14 items) and the abbreviated version SCREEN-II-AB (8 items) are valid and reliable nutrition screening tools for older adults. This exploratory study used a retrospective cross-sectional design to determine the construct validity of a subset of 3 items (weight loss, appetite, and swallowing difficulty) currently on the SCREEN-II and SCREEN-II-AB tools. Secondary data on community-dwelling senior males (n = 522, mean ± SD age = 86.7 ± 3.0 years) in the Manitoba Follow-up Study (MFUS) study were available for analysis. Participants completed the mailed MFUS Nutrition Survey that included SCREEN-II items and questions pertaining to self-rated health, diet healthiness, and rating of the importance of nutrition towards successful aging as the constructs for comparison. Self-perceived health status (F = 14.7, P < 0.001), diet healthiness (ρ = 0.17, P = 0.002) and the rating of nutrition's importance to aging (ρ = 0.10, P = 0.03) were correlated with the 3-item score. Inferences were consistent with associations between these construct variables and the full SCREEN-II. Three items from SCREEN-II and SCREEN-II-AB demonstrate initial construct validity with self-perceived health status and diet healthiness ratings by older males; further exploration for criterion and predictive validity in more diverse samples is needed.

  3. Do nitric oxide synthase and cyclooxygenase contribute to the heat loss responses in older males exercising in the heat?

    PubMed Central

    Fujii, Naoto; Paull, Gabrielle; Meade, Robert D; McGinn, Ryan; Stapleton, Jill M; Akbari, Pegah; Kenny, Glen P

    2015-01-01

    This study evaluated the separate and combined roles of nitric oxide synthase (NOS) and cyclooxygenase (COX) in forearm sweating and cutaneous vasodilatation in older adults during intermittent exercise in the heat. Twelve healthy older (62 ± 7 years) males peformed two 30 min cycling bouts at a fixed rate of metabolic heat production (400 W) in the heat (35°C, 20% relative humidity). The exercise bouts were followed by 20 and 40 min of recovery, respectively. Forearm sweat rate (ventilated capsule) and cutaneous vascular conductance (CVC, laser Doppler perfusion units/mean arterial pressure) were evaluated at four skin sites that were continuously perfused via intradermal microdialysis with: (1) lactated Ringer solution (Control), (2) 10 mm ketorolac (non-selective COX inhibitor), (3) 10 mm NG-nitro-l-arginine methyl ester (l-NAME; non-selective NOS inhibitor) or (4) a combination of 10 mm ketorolac + 10 mm l-NAME. Sweating was not different between the four sites during either exercise bout (main effect P = 0.92) (average of last 5 min of second exercise, Control, 0.80 ± 0.06; ketorolac, 0.77 ± 0.09; l-NAME, 0.74 ± 0.07; ketorolac + l-NAME, 0.77 ± 0.09 mg min−1 cm−2). During both exercise bouts, relative to CVC evaluated at the Control site (average of last 5 min of second exercise, 69 ± 6%max), CVC was similar at the ketorolac site (P = 0.62; 66 ± 4%max) whereas it was attenuated to a similar extent at both the l-NAME (49 ± 8%max) and ketorolac + l-NAME (54 ± 8%max) sites (both P < 0.05). Thus, we demonstrate that NOS and COX are not functionally involved in forearm sweating whereas only NOS contributes to forearm cutaneous vasodilatation in older adults during intermittent exercise in the heat. Key points Studies show that nitric oxide synthase (NOS) and cyclooxygenase (COX) are involved in sweating and cutaneous vascular regulation in young adults in a potentially interactive manner. We evaluated the

  4. Risk factors for hepatitis C infection among Vietnam era veterans versus nonveterans: results from the Chronic Hepatitis Cohort Study (CHeCS).

    PubMed

    Boscarino, Joseph A; Sitarik, Alexandra; Gordon, Stuart C; Rupp, Loralee B; Nerenz, David R; Vijayadeva, Vinutha; Schmidt, Mark A; Henkle, Emily; Lu, Mei

    2014-10-01

    Research suggests that Vietnam era veterans have a higher prevalence of hepatitis C virus (HCV) than other veterans and nonveterans. However, the reasons for this are unclear, since this research has been conducted among Department of Veterans Affairs (VA) patients and most veterans do not use the VA. The current study compares HCV risk factors between the Vietnam era veterans and nonveterans seen in 4 large non-VA systems to explain this disparity. A total of 4,636 HCV patients completed surveys in 2011-2012. Vietnam era veterans were defined as those who served in the military any time between 1964 and 1975. Bivariate tests followed by logistic regressions, and multivariable modeling were conducted to study risk factors among Vietnam era veterans and nonveterans. Since few veterans were female (~2 %), they were excluded. Among male respondents (N = 2,638), 22.5 % were classified as Vietnam era veterans. Compared to nonveterans, these patients were older (p < 0.001), more educated (p < 0.001), less often foreign born (p = 0.009), more often married (p < 0.001), less often employed, and less likely to have a history of drug abuse treatment (p < 0.001). Comparison of specific risk factor differences for HCV infection by veteran status suggested that while injection drug use approached statistical significance (nonveterans = 46.1 % vs. Vietnam era veterans = 41.4 %, p = 0.06), only reported sex with men was significant (nonveterans = 2.4 % vs. Vietnam era veterans = 0.6 %, p = 0.013). In multivariate logistic regression controlling for age, education, country of birth, marital status and study site, no HCV risk factor was associated with Vietnam era veteran status. However, veterans were more likely to report "other" exposures were the source of infection than nonveterans (p < 0.001). While Vietnam era veterans seen in non-VA facilities do not report a higher prevalence of common HCV risk factors, such as injection drug use, they are more likely to report "other

  5. Secondary Traumatization in Vietnam Veterans' Families.

    PubMed

    Yager, Thomas J; Gerszberg, Nicole; Dohrenwend, Bruce P

    2016-08-01

    This research focused on secondary traumatization of wives and offspring of 115 male Vietnam veterans, a subsample from the National Vietnam Veterans Readjustment Study who had one or more children aged 6 to 16 years and had had a clinical interview. Traumatization was defined as meeting criteria for lifetime war-related posttraumatic stress disorder (PTSD). Secondary traumatization was operationalized by elevated scores on children's internalizing or externalizing behavior problems and on wives' demoralization. There was evidence of secondary traumatization in the veterans' sons (odds ratio [OR] = 20.31 for internalizing behavior problems). Current PTSD in the veterans was associated with demoralization in their wives or partners (β = 0.24), which in turn was associated with behavior problems in their daughters (ORs = 2.67 and 4.61 for internalizing and externalizing behavior problems, respectively; these were adjusted for veteran's PTSD). Demoralization of the wife or partner was also associated with current alcoholism in the veterans (β = 0.30, adjusting for veteran's PTSD). These associations were also adjusted for other veteran risk factors, including severity of combat exposure, involvement in harming civilians or prisoners, and prewar vulnerability. Even with the degree of secondary traumatization present, the veterans' children appeared at least as healthy as counterparts in the general population. PMID:27529559

  6. Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

    PubMed

    D'Souza, Maria F; Davagnino, Judith; Hastings, S Nicole; Sloane, Richard; Kamholz, Barbara; Twersky, Jack

    2015-06-01

    Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with dementia and their family caregivers, including attention to behavioral symptoms, functional impairment, and home safety, on a consultation basis. The objectives of this study were to describe the COACH program in its first 2 years of operation, assess alignment of program components with quality measures, report characteristics of program participants, and compare rates of placement outside the home with those of a nontreatment comparison group using a retrospective cohort design. Participants were community-dwelling individuals with dementia aged 65 and older who received primary care in the medical center's outpatient clinics and their family caregivers, who were enrolled as dyads (n = 133), and a control group of dyads who were referred to the program and met clinical eligibility criteria but did not enroll (n = 29). Measures included alignment with Dementia Management Quality Measures and time to placement outside the home during 12 months of follow-up after referral to COACH. Results of the evaluation demonstrated that COACH aligns with nine of 10 clinical process measures identified using quality measures and that COACH delivers several other valuable services to enhance care. Mean time to placement outside the home was 29.6 ± 14.3 weeks for both groups (P = .99). The present study demonstrates the successful implementation of a home-based care coordination intervention for persons with dementia and their family caregivers that is strongly aligned with quality measures. PMID:26032224

  7. Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

    PubMed

    D'Souza, Maria F; Davagnino, Judith; Hastings, S Nicole; Sloane, Richard; Kamholz, Barbara; Twersky, Jack

    2015-06-01

    Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with dementia and their family caregivers, including attention to behavioral symptoms, functional impairment, and home safety, on a consultation basis. The objectives of this study were to describe the COACH program in its first 2 years of operation, assess alignment of program components with quality measures, report characteristics of program participants, and compare rates of placement outside the home with those of a nontreatment comparison group using a retrospective cohort design. Participants were community-dwelling individuals with dementia aged 65 and older who received primary care in the medical center's outpatient clinics and their family caregivers, who were enrolled as dyads (n = 133), and a control group of dyads who were referred to the program and met clinical eligibility criteria but did not enroll (n = 29). Measures included alignment with Dementia Management Quality Measures and time to placement outside the home during 12 months of follow-up after referral to COACH. Results of the evaluation demonstrated that COACH aligns with nine of 10 clinical process measures identified using quality measures and that COACH delivers several other valuable services to enhance care. Mean time to placement outside the home was 29.6 ± 14.3 weeks for both groups (P = .99). The present study demonstrates the successful implementation of a home-based care coordination intervention for persons with dementia and their family caregivers that is strongly aligned with quality measures.

  8. Condom Use, Sexual Risk, and Self-Reported STI in a Sample of Older Male Clients of Heterosexual Prostitution in the United States.

    PubMed

    Milrod, Christine; Monto, Martin

    2016-07-01

    While there is evidence of increasing rates of sexually transmitted infections (STIs) among older men in the United States, there has been little research on older male clients of female sex providers. The purpose of the current study was to understand the sexual risk behaviors and psychosocial correlates among older men hiring sex providers through provider review websites and discussion boards. A convenience sample of 208 male clients ages 60 to 84 completed online surveys about their sexual behavior and psychosocial factors. Participants indicated the most common sexual activities with providers in the past 12 months were receiving condomless fellatio (33.7%) and having penile-vaginal intercourse with a condom (31.7%). Although condomless penile-vaginal sex with a provider in the past 12 months was only reported by 2.9%, about half (51%) of the respondents indicated that they had experienced this at least once during their lifetime. This was associated with a preference for providers who do not require condoms, having been previously diagnosed with an STI, and perceiving one's HIV risk to be higher, as well as advancing age and having more emotional relationships with providers. Findings demonstrate the need for general and sexual health care practitioners to openly discuss protective measures and strategies for avoiding STIs among their older-to-elderly male patients. PMID:26739295

  9. An Examination of Family Adjustment among Operation Desert Storm Veterans

    ERIC Educational Resources Information Center

    Taft, Casey T.; Schumm, Jeremiah A.; Panuzio, Jillian; Proctor, Susan P.

    2008-01-01

    This study examined interrelationships among combat exposure, symptoms of posttraumatic stress disorder (PTSD), and family adjustment in a sample of male and female Operation Desert Storm veterans (N = 1,512). In structural equation models for both male and female veterans, higher combat exposure was associated with higher PTSD symptoms, which in…

  10. Depression and dementias among military veterans.

    PubMed

    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.

  11. Applying Posttraumatic Stress Disorder MMPI Subscale to World War II POW Veterans.

    ERIC Educational Resources Information Center

    Query, William T.; And Others

    1986-01-01

    Examined the validity of the Minnesota Multiphasic Personality Inventory-Posttraumatic Stress Disorder (PTSD) subscale in diagnosing older prisoner of war (POW) veterans. Results indicated that the PTSD subscale can be generalized to older veterans. PTSD was more common among POWs from the Pacific theater than those from Europe, however, the…

  12. Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

    PubMed

    Boyle, Melissa A; Lahey, Joanna N

    2016-01-01

    Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act.

  13. Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

    PubMed

    Boyle, Melissa A; Lahey, Joanna N

    2016-01-01

    Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act. PMID:26734757

  14. Suicide assessment and action for women veterans.

    PubMed

    Conard, Patricia L; Armstrong, Myrna L; Young, Cathy; Hogan, La Micha

    2015-04-01

    Many deployed women Veterans, as described in a previous article, have experienced similar combat exposure as their male counterparts in wars since 1990. Upon reintegration, many Veterans visit civilian health facilities with behavioral health issues, sometimes voicing and/or attempting suicide. Effective nursing assessment and actions are needed to specifically care for this unique population. Any suicide variables (e.g., ideation, attempts, completed) are concerning; therefore, all women Veterans from the Vietnam, Gulf I, Iraq, and Afghanistan wars should be assessed. The first priority is always patient safety. Timely and frequent screening for a variety of risk factors, documented for both men and women Veterans, and women specifically, are important. Symptomology may not become evident for 3 to 15 months into reintegration. Applicable dialogue can recognize changing thoughts, judgment, and behavior patterns. Health promotion efforts, interventions, and resourceful referrals are provided.

  15. Reduced white matter integrity in the cingulum and anterior corona radiata in posttraumatic stress disorder in male combat veterans: A diffusion tensor imaging study

    PubMed Central

    Sanjuan, Pilar Margaret; Thoma, Robert; Claus, Eric Daniel; Mays, Nicci; Caprihan, Arvind

    2014-01-01

    Posttraumatic stress (PTSD) and alcohol use (AUD) disorders are associated with abnormal anterior cingulate cortex/ventromedial prefrontal cortex, thalamus, and amygdala function, yet microstructural white matter (WM) differences in executive-limbic tracts are likely also involved. Investigating WM in limbic-thalamo-cortical tracts, this study hypothesized (1) fractional anisotropy (FA) in dorsal cingulum, parahippocampal cingulum, and anterior corona radiata (ACR) would be lower in individuals with comorbid PTSD/AUD compared to in individuals with AUD-only and (2) that FA would be related to both AUD and PTSD severity. 22 combat veterans with comorbid PTSD/AUD or AUD-only completed DTI scans. ANCOVAs indicated lower FA in right (F(df= 1,19)=9.091, P=0.0071) and left (F(df= 1,19) = 10.375, P=0.0045) dorsal cingulum and right ACR (F(df= 1,19) = 18.914, P= 0.0003) for individuals with comorbid PTSD/AUD vs. individuals with AUD-only, even controlling for alcohol use. Multiple linear regressions revealed that FA in the right ACR was inversely related to PTSD severity (r= −0.683, P=0.004). FA was not significantly related to alcohol severity. Reduced WM integrity in limbic-thalamo-cortical tracts is implicated in PTSD, even in the presence of comorbid AUD. These findings suggest that diminished WM integrity in tracts important for top-down control may be an important anomaly in PTSD and/or comorbid PTSD/AUD. PMID:24074963

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

    PubMed

    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.

  17. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers

    PubMed Central

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-01-01

    Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous

  18. Veterans Administration Databases

    Cancer.gov

    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.

  19. Student Veterans Organizations

    ERIC Educational Resources Information Center

    Summerlot, John; Green, Sean-Michael; Parker, Daniel

    2009-01-01

    Students who have experienced conflict as members of the military come to college expecting to be supported, if not honored for their service. One way that campus administrators can facilitate transitions for student veterans is to assist in founding and maintaining campus-based student organizations for veterans. Military service is a bonding…

  20. Veterans as physician assistants.

    PubMed

    Brock, Douglas; Evans, Timothy; Garcia, Drew; Bester, Vanessa; Gianola, F J

    2015-11-01

    The physician assistant (PA) profession emerged nearly 50 years ago to leverage the healthcare experience of Vietnam-era military trained medics and corpsmen to fill workforce shortages in medical care. In 2009, the American Recovery and Reinvestment Act Primary Care Training and Enhancement program was established to improve access to primary care. Training military veterans as PAs was again identified as a strategy to meet provider access shortages. However, fewer than 4% of veterans with military healthcare training are likely to apply to PA school and little is known regarding the factors that predict acceptance to training. In 2012, we surveyed all veteran applicants and a stratified random sample of nonveterans applying to PA training. We compare the similarities and differences between veteran and nonveteran applicants, application barriers, and the factors predicting acceptance. We conclude with a discussion of the link between modern veterans and the PA profession. PMID:26501578

  1. Veterans' physical health.

    PubMed

    Tansey, Catherine M; Raina, Parminder; Wolfson, Christina

    2013-01-01

    How individuals age is affected by life experiences. What we know today about aging has been largely shaped by a generation who experienced the special circumstances of wartime in their formative years. In this review, we investigate the research question, "What is known about the physical health of Canadian veterans?" In answering this question, we summarize the literature on Canadian Veterans but also include international literature on the physical health of American and Australian Veterans, along with some information from reports from Great Britain and other parts of Europe. Areas in which veterans perhaps fare worse than civilians of similar age include general health, hearing loss, musculoskeletal disorders, infections, cirrhosis, skin conditions, stomach conditions, neurologic conditions, and cardiovascular disease. The differing effects of combat on female veterans are also summarized. The healthy warrior effect is discussed along with its impact on research findings and the importance of choosing an appropriate control group.

  2. Can the Theory of Planned Behavior predict dietary intention and future dieting in an ethnically diverse sample of overweight and obese veterans attending medical clinics?

    PubMed

    Lash, Denise N; Smith, Jane Ellen; Rinehart, Jenny K

    2016-04-01

    Obesity has become a world-wide epidemic; in the United States (U.S.) approximately two-thirds of adults are classified as overweight or obese. Military veterans' numbers are even higher, with 77% of retired or discharged U.S. veterans falling in these weight categories. One of the most common methods of changing one's weight is through dieting, yet little is known regarding the factors that facilitate successful dieting behavior. The current investigation tested the Theory of Planned Behavior's (TPB) ability to predict dietary intention and future dieting in a sample of 84 overweight and obese patients attending medical clinics at a Veterans Affairs Hospital in the southwestern part of the U.S. Participants primarily were male (92%) and ethnic/racial minorities (58%). Perceived need and anticipated regret were added to the standard TPB model. While the TPB predicted dietary intention, it did not significantly account for improved dietary behaviors. Anticipated regret significantly enhanced the basic TPB's ability to predict intention to diet, while perceived need did not. These findings highlight the difficulty in predicting sustained change in a complex behavior such as dieting to lose weight. The need for more work with older, overweight/obese medical patients attending veterans' facilities is stressed, as is the need for such work with male patients and ethnic minorities in particular. PMID:26792774

  3. Diabetes reduces the cognitive function with the decrease of the visual perception and visual motor integration in male older adults.

    PubMed

    Yun, Hyo-Soon; Kim, Eunhwi; Suh, Soon-Rim; Kim, Mi-Han; Kim, Hong

    2013-01-01

    This study investigated the influence of diabetes on cognitive decline between the diabetes and non- diabetes patients and identified the associations between diabetes and cognitive function, visual perception (VP), and visual motor integration (VMI). Sixty elderly men (67.10± 1.65 yr) with and without diabetes (n= 30 in each group) who were surveyed by interview and questionnaire in South Korea were enrolled in this study. The score of Mini-Mental State Examination of Korean version (MMSE-KC), Motor-free Visual Perception Test-Vertical Format (MVPT-V), and Visual-Motor Integration 3rd Revision (VMI-3R) were assessed in all of the participants to evaluate cognitive function, VP, and VMI in each. The score of MMSE-KC in the diabetic group was significantly lower than that of the non-diabetes group (P< 0.01). Participants in the diabetes group also had lower MVPT-V and VMI-3R scores than those in the non-diabetes group (P< 0.01, respectively). Especially, the scores of figure-ground and visual memory among the subcategories of MVPT-V were significantly lower in the diabetes group than in the non-diabetes group (P< 0.01). These findings indicate that the decline in cognitive function in individuals with diabetes may be greater than that in non-diabetics. In addition, the cognitive decline in older adults with diabetes might be associated with the decrease of VP and VMI. In conclusion, we propose that VP and VMI will be helpful to monitor the change of cognitive function in older adults with diabetes as part of the routine management of diabetes-induced cognitive declines. PMID:24282807

  4. Recalled sexual experiences in childhood with older partners: a study of Brazilian men who have sex with men and male-to-female transgender persons.

    PubMed

    Carballo-Diéguez, Alex; Balan, Ivan; Dolezal, Curtis; Mello, Maeve B

    2012-04-01

    This study assessed the prevalence of recalled childhood sexual experiences with an older partner among men who have sex with men (MSM) and/or male-to-female transgender persons recruited in Campinas, Brazil. It also analyzed associations between such recalled experiences and sexual risk behavior in adulthood. Participants recruited using respondent driven sampling completed a self-administered, computer-based questionnaire, and underwent HIV testing. For data analysis, raw scores were weighted based on participants' reported network size. Of 575 participants (85% men and 15% transgender), 32% reported childhood sexual experiences with an older partner. Mean age at first experience was 9 years, partners being, on average, 19 years old, and mostly men. Most frequent behaviors were partners exposing their genitals, mutual fondling, child masturbating partner, child performing oral sex on partner, and child being anally penetrated. Only 29% of the participants who had had such childhood sexual experiences considered it abuse; 57% reported liking, 29% being indifferent and only 14% not liking the sexual experience at the time it happened. Transgender participants were significantly more likely to report such experiences and, compared with men, had less negative feelings about the experience at the time of the interview. No significant associations were found between sexual experiences in childhood and unprotected receptive or insertive anal intercourse in adulthood. Results highlight the importance of assessing participants' perception of abuse, regardless of researchers' pre-determined criteria to identify abuse. MSM and transgender people may experience childhood sexual experiences with older partners differently from other populations (e.g., heterosexuals), particularly in countries with different cultural norms concerning sexuality than those prevalent in Europe and the U.S.

  5. Recalled sexual experiences in childhood with older partners: a study of Brazilian men who have sex with men and male-to-female transgender persons.

    PubMed

    Carballo-Diéguez, Alex; Balan, Ivan; Dolezal, Curtis; Mello, Maeve B

    2012-04-01

    This study assessed the prevalence of recalled childhood sexual experiences with an older partner among men who have sex with men (MSM) and/or male-to-female transgender persons recruited in Campinas, Brazil. It also analyzed associations between such recalled experiences and sexual risk behavior in adulthood. Participants recruited using respondent driven sampling completed a self-administered, computer-based questionnaire, and underwent HIV testing. For data analysis, raw scores were weighted based on participants' reported network size. Of 575 participants (85% men and 15% transgender), 32% reported childhood sexual experiences with an older partner. Mean age at first experience was 9 years, partners being, on average, 19 years old, and mostly men. Most frequent behaviors were partners exposing their genitals, mutual fondling, child masturbating partner, child performing oral sex on partner, and child being anally penetrated. Only 29% of the participants who had had such childhood sexual experiences considered it abuse; 57% reported liking, 29% being indifferent and only 14% not liking the sexual experience at the time it happened. Transgender participants were significantly more likely to report such experiences and, compared with men, had less negative feelings about the experience at the time of the interview. No significant associations were found between sexual experiences in childhood and unprotected receptive or insertive anal intercourse in adulthood. Results highlight the importance of assessing participants' perception of abuse, regardless of researchers' pre-determined criteria to identify abuse. MSM and transgender people may experience childhood sexual experiences with older partners differently from other populations (e.g., heterosexuals), particularly in countries with different cultural norms concerning sexuality than those prevalent in Europe and the U.S. PMID:21484505

  6. Perspectives of family and veterans on family programs to support reintegration of returning veterans with posttraumatic stress disorder.

    PubMed

    Fischer, Ellen P; Sherman, Michelle D; McSweeney, Jean C; Pyne, Jeffrey M; Owen, Richard R; Dixon, Lisa B

    2015-08-01

    Combat deployment and reintegration are challenging for service members and their families. Although family involvement in mental health care is increasing in the U.S. Department of Veterans Affairs (VA) system, little is known about family members' preferences for services. This study elicited the perspectives of returning Afghanistan and Iraq war veterans with posttraumatic stress disorder and their families regarding family involvement in veterans' mental health care. Semistructured qualitative interviews were conducted with 47 veterans receiving care for posttraumatic stress disorder at the Central Arkansas Veterans Healthcare System or Oklahoma City VA Medical Center and 36 veteran-designated family members. Interviews addressed perceived needs related to veterans' readjustment to civilian life, interest in family involvement in joint veteran/family programs, and desired family program content. Interview data were analyzed using content analysis and constant comparison. Both groups strongly supported inclusion of family members in programs to facilitate veterans' postdeployment readjustment and reintegration into civilian life. Both desired program content focused on information, practical skills, support, and gaining perspective on the other's experience. Although family and veteran perspectives were similar, family members placed greater emphasis on parenting-related issues and the kinds of support they and their children needed during and after deployment. To our knowledge, this is the first published report on preferences regarding VA postdeployment reintegration support that incorporates the perspectives of returning male and female veterans and those of their families. Findings will help VA and community providers working with returning veterans tailor services to the needs and preferences of this important-to-engage population.

  7. Perspectives of family and veterans on family programs to support reintegration of returning veterans with posttraumatic stress disorder.

    PubMed

    Fischer, Ellen P; Sherman, Michelle D; McSweeney, Jean C; Pyne, Jeffrey M; Owen, Richard R; Dixon, Lisa B

    2015-08-01

    Combat deployment and reintegration are challenging for service members and their families. Although family involvement in mental health care is increasing in the U.S. Department of Veterans Affairs (VA) system, little is known about family members' preferences for services. This study elicited the perspectives of returning Afghanistan and Iraq war veterans with posttraumatic stress disorder and their families regarding family involvement in veterans' mental health care. Semistructured qualitative interviews were conducted with 47 veterans receiving care for posttraumatic stress disorder at the Central Arkansas Veterans Healthcare System or Oklahoma City VA Medical Center and 36 veteran-designated family members. Interviews addressed perceived needs related to veterans' readjustment to civilian life, interest in family involvement in joint veteran/family programs, and desired family program content. Interview data were analyzed using content analysis and constant comparison. Both groups strongly supported inclusion of family members in programs to facilitate veterans' postdeployment readjustment and reintegration into civilian life. Both desired program content focused on information, practical skills, support, and gaining perspective on the other's experience. Although family and veteran perspectives were similar, family members placed greater emphasis on parenting-related issues and the kinds of support they and their children needed during and after deployment. To our knowledge, this is the first published report on preferences regarding VA postdeployment reintegration support that incorporates the perspectives of returning male and female veterans and those of their families. Findings will help VA and community providers working with returning veterans tailor services to the needs and preferences of this important-to-engage population. PMID:26213788

  8. Veterans and chronic pain

    PubMed Central

    Wilson, Sarah

    2013-01-01

    Summary points 1. Musculoskeletal problems are the commonest reason for medical discharge in all the British armed forces. By definition, these problems are chronic and resistant to treatment. 2. Pain is also common in veterans who have experienced severe injuries (polytrauma), often accompanied by post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) orpostconcussive syndrome. 3. In veterans seeking treatment for chronic pain, PTSD is common. There is also evidence for elevated levels of alcohol misuse in veterans who have been deployed to conflict. However, most veterans do not have pain, PTSD or alcohol problems. 4. Pain clinicians would benefit from training in meeting veterans’ needs, in order to promote their engagement and successful treatment. This should include countering stereotypes, information about the military and support for the assessment and onward referral of PTSD and alcohol problems. PMID:26516504

  9. Paralyzed Veterans of America

    MedlinePlus

    ... the Heroes Circle I Want to Donate my Vehicle I Want to Make Thrift Donations I Want ... I.V.E. Clothing Donation Program Donate a Vehicle: Wheels Helping Warriors REVolution - Racing to Empower Veterans ...

  10. Veterans and Military Health

    MedlinePlus

    ... stressful. The stress can put service members and veterans at risk for mental health problems. These include anxiety, post-traumatic stress disorder, depression and substance abuse. Suicide can also be ...

  11. Center for Women Veterans

    MedlinePlus

    ... Guard/Reserve Clinician/Researcher/Trainee Menu Menu For Veterans Benefit Information Agent Orange Post Traumatic Stress Disorder (PTSD) eBenefits Benefit & Claim Status (Registration Required) Disability ...

  12. Department of Veterans Affairs

    MedlinePlus

    ... a variety of benefits and services that provide financial and other forms of assistance to Servicemembers, Veterans, their dependents and survivors. Compensation Education & Training Home Loans Life Insurance Vocational Rehabilitation Get Started Burials & Memorials VA operates ...

  13. Exposure to flaxseed and its purified lignan reduces bone strength in young but not older male rats.

    PubMed

    Ward, W E; Yuan, Y V; Cheung, A M; Thompson, L U

    2001-05-11

    Flaxseed is the richest source of the plant lignan secoisolariciresinol diglycoside (SDG), which is converted to the two major mammalian lignans, enterodiol (ED) and enterolactone (EL), by colonic bacteria. Because both ED and EL can produce biological effects similar to estrogen, exposure to lignans during early stages of development may adversely alter the normal development of bone in males since bone is a hormone-sensitive tissue. To determine whether early exposure to flaxseed or its lignan compromised the acquisition of bone mass or reduced bone strength, male offspring were exposed to one of three diets during lactation only (birth through postnatal day [PND] 21) via mother's milk or continuously from the start of lactation through to adolescence (PND 50) or young adulthood (PND 132). The diets were a basal diet (BD) that was devoid of phytoestrogens, BD containing 10% flaxseed, or BD containing the equivalent quantity of SDG present in a 10% flaxseed diet. To assess bone quantity, the bone mineral content (BMC) and bone mineral density (BMD) of femurs were assessed by dual-energy x-ray absorptiometry. Since the biomechanical properties of bone are indicators of the microarchitecture and thus bone quality, the biomechanical strength of femurs was assessed by three-point bending. At PND 50, ultimate bending stress and Young's modulus, measures of bone strength, were reduced among rats that received the 10% flaxseed diet from PND 0 through PND 50, while there were no marked differences in bone size, BMC, or BMD among groups. Interestingly, this effect does not appear to be due to the lignan in flaxseed, as continuous exposure to the diet containing the equivalent quantity of lignan (10 S diet) did not alter any measures of bone strength. In contrast to PND 50, bone strength did not differ among groups at PND 132, indicating that the compromise in bone strength was not sustained into early adulthood. Bone size, BMC, and BMD continued to be similar among

  14. Health benefits for veteran (senior) tennis players

    PubMed Central

    Marks, B L

    2006-01-01

    To explore the health benefits of tennis participation in veteran players and to identify future research needs, an electronic literature search using the Ovid (Cinhal, Medline, Sport Discus) library databases from 1966–2005 was undertaken. Specific search words were employed related to tennis, aging, exercise, health, and the psychophysiological systems. Public access internet search engines were also used (Google, PubMed), along with non‐electronic searches of library holdings. There is ample research documenting the health benefits of regular participation in moderately intense aerobic activity. There have been research studies targeting veteran tennis players but most were cross sectional. No tennis related study successfully eliminated all confounding cross training effects. The health of veteran tennis players is improved by enhanced aerobic capacity, greater bone densities in specific regions, lower body fat, greater strength, and maintained reaction time performance in comparison with age matched but less active controls. However, it is not certain whether tennis alone can be a sole contributor to these physiological variables. Well controlled longitudinal research among elite veteran and novice older adult players is needed. PMID:16632583

  15. Association between low dietary zinc and hyperuricaemia in middle-aged and older males in China: a cross-sectional study

    PubMed Central

    Xie, Dong-xing; Xiong, Yi-lin; Zeng, Chao; Wei, Jie; Yang, Tuo; Li, Hui; Wang, Yi-lun; Gao, Shu-guang; Li, Yu-sheng; Lei, Guang-hua

    2015-01-01

    Objective To examine the associations between dietary zinc intake and hyperuricaemia. Design Cross-sectional study. Setting This study was conducted in a health examination centre of China. Participants A total of 5168 middle-aged and older participants (aged 40 years or above) (2697 men and 2471 women) were included. Outcome measures Dietary zinc intake was assessed using a validated semiquantitative food frequency questionnaire. Hyperuricaemia was defined as uric acid ≥416 µmol/L for males and ≥360 µmol/L for females. Results For males, the prevalence of hyperuricaemia was 22.9%. After adjusting for age, body mass index (BMI) and energy intake, the ORs were 0.68 (95% CI 0.45 to 0.92) in the second quintile, 0.63 (95% CI 0.45 to 0.89) in the third quintile, 0.68 (95% CI 0.46 to 1.00) in the fourth quintile and 0.55 (95% CI 0.35 to 0.87) in the fifth quintile comparing the lowest quintile of Zn intake, respectively (p for trend=0.03). In the multivariable adjusted model, the relative odds of hyperuricaemia were significantly decreased by 0.71 times in the second quintile of zinc intake (OR 0.71, 95% CI 0.52 to 0.98), 0.64 times in the third quintile (OR 0.65, 95% CI 0.44 to 0.94) and 0.55 times in the fifth quintile (OR 0.56, 95% CI 0.32 to 0.97) compared with those in the lowest quintile, and p for trend was 0.064. For females, the prevalence of hyperuricaemia was 10.0%, and unadjusted, minimally adjusted as well as multivariable adjusted ORs all suggested no significant association between dietary zinc intake and hyperuricaemia. Conclusions The findings of this cross-sectional study indicated that dietary zinc intake was inversely associated with hyperuricaemia in middle-aged and older males, but not in females. The association was significant after considering the influence of age, BMI and energy intake, and after that, minimum adjustment remained independent of further confounding factors such as vitamin C intake, alcohol drinking status and

  16. Short-term testosterone manipulations do not affect cognition or motor function but differentially modulate emotions in young and older male rhesus monkeys

    PubMed Central

    Kelly, Brian; Maguire-Herring, Vanessa; Rose, Christian M.; Gore, Heather E.; Ferrigno, Stephen; Novak, Melinda A.; Lacreuse, Agnès

    2014-01-01

    Human aging is characterized by declines in cognition and fine motor function as well as improved emotional regulation. In men, declining levels of testosterone (T) with age have been implicated in the development of these age-related changes. However, studies examining the effects of T replacement on cognition, emotion and fine motor function in older men have not provided consistent results. Rhesus monkeys (Macaca mulatta) are excellent models for human cognitive aging and may provide novel insights on this issue. We tested 10 aged intact male rhesus monkeys (mean age = 19, range 15–25) on a battery of cognitive, motor and emotional tasks at baseline and under low or high T experimental conditions. Their performance was compared to that of 6 young males previously tested in the same paradigm (Lacreuse et al., 2009; Lacreuse et al., 2010). Following a 4-week baseline testing period, monkeys were treated with a gonadotropin releasing hormone agonist (Depot Lupron, 200 µg/kg) to suppress endogenous T and were tested on the task battery under a 4-week high T condition (injection of Lupron + T enanthate, 20 mg/kg, n = 8) or 4-week low T condition (injection of Lupron + oil vehicle, n = 8) before crossing over to the opposite treatment. The cognitive tasks consisted of the Delayed Non-Matching-to-Sample (DNMS), the Delayed Response (DR), and the Delayed Recognition Span Test (spatial-DRST). The emotional tasks included an object Approach-Avoidance task and a task in which monkeys were played videos of unfamiliar conspecifics in different emotional context (Social Playbacks). The fine motor task was the Lifesaver task that required monkeys to remove a Lifesaver candy from rods of different complexity. T manipulations did not significantly affect visual recognition memory, working memory, reference memory or fine motor function at any age. In the Approach-Avoidance task, older monkeys, but not younger monkeys, spent more time in proximity of novel objects in the high

  17. Short-term testosterone manipulations do not affect cognition or motor function but differentially modulate emotions in young and older male rhesus monkeys.

    PubMed

    Kelly, Brian; Maguire-Herring, Vanessa; Rose, Christian M; Gore, Heather E; Ferrigno, Stephen; Novak, Melinda A; Lacreuse, Agnès

    2014-11-01

    Human aging is characterized by declines in cognition and fine motor function as well as improved emotional regulation. In men, declining levels of testosterone (T) with age have been implicated in the development of these age-related changes. However, studies examining the effects of T replacement on cognition, emotion and fine motor function in older men have not provided consistent results. Rhesus monkeys (Macaca mulatta) are excellent models for human cognitive aging and may provide novel insights on this issue. We tested 10 aged intact male rhesus monkeys (mean age=19, range 15-25) on a battery of cognitive, motor and emotional tasks at baseline and under low or high T experimental conditions. Their performance was compared to that of 6 young males previously tested in the same paradigm (Lacreuse et al., 2009; Lacreuse et al., 2010). Following a 4-week baseline testing period, monkeys were treated with a gonadotropin releasing hormone agonist (Depot Lupron, 200 μg/kg) to suppress endogenous T and were tested on the task battery under a 4-week high T condition (injection of Lupron+T enanthate, 20 mg/kg, n=8) or 4-week low T condition (injection of Lupron+oil vehicle, n=8) before crossing over to the opposite treatment. The cognitive tasks consisted of the Delayed Non-Matching-to-Sample (DNMS), the Delayed Response (DR), and the Delayed Recognition Span Test (spatial-DRST). The emotional tasks included an object Approach-Avoidance task and a task in which monkeys were played videos of unfamiliar conspecifics in different emotional context (Social Playbacks). The fine motor task was the Lifesaver task that required monkeys to remove a Lifesaver candy from rods of different complexity. T manipulations did not significantly affect visual recognition memory, working memory, reference memory or fine motor function at any age. In the Approach-Avoidance task, older monkeys, but not younger monkeys, spent more time in proximity of novel objects in the high T condition

  18. Short-term testosterone manipulations do not affect cognition or motor function but differentially modulate emotions in young and older male rhesus monkeys.

    PubMed

    Kelly, Brian; Maguire-Herring, Vanessa; Rose, Christian M; Gore, Heather E; Ferrigno, Stephen; Novak, Melinda A; Lacreuse, Agnès

    2014-11-01

    Human aging is characterized by declines in cognition and fine motor function as well as improved emotional regulation. In men, declining levels of testosterone (T) with age have been implicated in the development of these age-related changes. However, studies examining the effects of T replacement on cognition, emotion and fine motor function in older men have not provided consistent results. Rhesus monkeys (Macaca mulatta) are excellent models for human cognitive aging and may provide novel insights on this issue. We tested 10 aged intact male rhesus monkeys (mean age=19, range 15-25) on a battery of cognitive, motor and emotional tasks at baseline and under low or high T experimental conditions. Their performance was compared to that of 6 young males previously tested in the same paradigm (Lacreuse et al., 2009; Lacreuse et al., 2010). Following a 4-week baseline testing period, monkeys were treated with a gonadotropin releasing hormone agonist (Depot Lupron, 200 μg/kg) to suppress endogenous T and were tested on the task battery under a 4-week high T condition (injection of Lupron+T enanthate, 20 mg/kg, n=8) or 4-week low T condition (injection of Lupron+oil vehicle, n=8) before crossing over to the opposite treatment. The cognitive tasks consisted of the Delayed Non-Matching-to-Sample (DNMS), the Delayed Response (DR), and the Delayed Recognition Span Test (spatial-DRST). The emotional tasks included an object Approach-Avoidance task and a task in which monkeys were played videos of unfamiliar conspecifics in different emotional context (Social Playbacks). The fine motor task was the Lifesaver task that required monkeys to remove a Lifesaver candy from rods of different complexity. T manipulations did not significantly affect visual recognition memory, working memory, reference memory or fine motor function at any age. In the Approach-Avoidance task, older monkeys, but not younger monkeys, spent more time in proximity of novel objects in the high T condition

  19. The Effects of Misclassification Biases on Veteran Suicide Rate Estimates

    PubMed Central

    Kaplan, Mark S.; McFarland, Bentson H.

    2014-01-01

    Objectives. We assessed the impact that possible veteran suicide misclassification biases (i.e., inaccuracy in ascertainment of veteran status on the death certificate and misclassification of suicide as other manner of death) have on veteran suicide rate estimates. Methods. We obtained suicide mortality data from the 2003–2010 National Violent Death Reporting System and the 2003–2010 Department of Defense Casualty Analysis System. We derived population estimates from the 2003–2010 American Community Survey and 2003–2010 Department of Veterans Affairs data. We computed veteran and nonveteran suicide rates. Results. The results showed that suicide rates were minimally affected by the adjustment for the misclassification of current military personnel suicides as veterans. Moreover, combining suicides and deaths by injury of undetermined intent did not alter the conclusions. Conclusions. The National Violent Death Reporting System is a valid surveillance system for veteran suicide. However, more than half of younger (< 25 years) male and female suicides, labeled as veterans, were likely to have been current military personnel at the time of their death and misclassified on the death certificate. PMID:24228669

  20. US Veterans' Use Of VA Mental Health Services And Disability Compensation Increased From 2001 To 2010.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2016-06-01

    There has been concern about the capacity of the Department of Veterans Affairs (VA) health care system to provide care for veterans returning from war zones in the Middle East and Afghanistan. We used two nationally representative surveys of US veterans in 2001 and 2010 to examine changes in the veteran population and veterans' use of health care services after a decade of war. The population was older and more diverse in 2010 than in 2001. In both years, veterans who served in the World War II era or earlier were more likely to have been exposed to combat-related trauma than veterans of more recent service eras. In 2010 veterans who served in the Persian Gulf War era (1990 through the wars in Iraq and Afghanistan) were more likely to have used VA mental health services and to have received VA disability compensation than veterans of previous service eras. Compared to veterans in 2001, those in 2010 were two times more likely to have used any VA health services and were more likely to have received VA disability compensation. These findings highlight changes in the veteran population over time that are important to consider in planning for future VA services. PMID:27269011

  1. Functional neuroimaging with default mode network regions distinguishes PTSD from TBI in a military veteran population.

    PubMed

    Raji, Cyrus A; Willeumier, Kristen; Taylor, Derek; Tarzwell, Robert; Newberg, Andrew; Henderson, Theodore A; Amen, Daniel G

    2015-09-01

    PTSD and TBI are two common conditions in veteran populations that can be difficult to distinguish clinically. The default mode network (DMN) is abnormal in a multitude of neurological and psychiatric disorders. We hypothesize that brain perfusion SPECT can be applied to diagnostically separate PTSD from TBI reliably in a veteran cohort using DMN regions. A group of 196 veterans (36 with PTSD, 115 with TBI, 45 with PTSD/TBI) were selected from a large multi-site population cohort of individuals with psychiatric disease. Inclusion criteria were peacetime or wartime veterans regardless of branch of service and included those for whom the traumatic brain injury was not service related. SPECT imaging was performed on this group both at rest and during a concentration task. These measures, as well as the baseline-concentration difference, were then inputted from DMN regions into separate binary logistic regression models controlling for age, gender, race, clinic site, co-morbid psychiatric diseases, TBI severity, whether or not the TBI was service related, and branch of armed service. Predicted probabilities were then inputted into a receiver operating characteristic analysis to compute sensitivity, specificity, and accuracy. Compared to PSTD, persons with TBI were older, male, and had higher rates of bipolar and major depressive disorder (p < 0.05). Baseline quantitative regions with SPECT separated PTSD from TBI in the veterans with 92 % sensitivity, 85 % specificity, and 94 % accuracy. With concentration scans, there was 85 % sensitivity, 83 % specificity and 89 % accuracy. Baseline-concentration (the difference metric between the two scans) scans were 85 % sensitivity, 80 % specificity, and 87 % accuracy. In separating TBI from PTSD/TBI visual readings of baseline scans had 85 % sensitivity, 81 % specificity, and 83 % accuracy. Concentration scans had 80 % sensitivity, 65 % specificity, and 79 % accuracy. Baseline-concentration scans had 82

  2. Functional neuroimaging with default mode network regions distinguishes PTSD from TBI in a military veteran population.

    PubMed

    Raji, Cyrus A; Willeumier, Kristen; Taylor, Derek; Tarzwell, Robert; Newberg, Andrew; Henderson, Theodore A; Amen, Daniel G

    2015-09-01

    PTSD and TBI are two common conditions in veteran populations that can be difficult to distinguish clinically. The default mode network (DMN) is abnormal in a multitude of neurological and psychiatric disorders. We hypothesize that brain perfusion SPECT can be applied to diagnostically separate PTSD from TBI reliably in a veteran cohort using DMN regions. A group of 196 veterans (36 with PTSD, 115 with TBI, 45 with PTSD/TBI) were selected from a large multi-site population cohort of individuals with psychiatric disease. Inclusion criteria were peacetime or wartime veterans regardless of branch of service and included those for whom the traumatic brain injury was not service related. SPECT imaging was performed on this group both at rest and during a concentration task. These measures, as well as the baseline-concentration difference, were then inputted from DMN regions into separate binary logistic regression models controlling for age, gender, race, clinic site, co-morbid psychiatric diseases, TBI severity, whether or not the TBI was service related, and branch of armed service. Predicted probabilities were then inputted into a receiver operating characteristic analysis to compute sensitivity, specificity, and accuracy. Compared to PSTD, persons with TBI were older, male, and had higher rates of bipolar and major depressive disorder (p < 0.05). Baseline quantitative regions with SPECT separated PTSD from TBI in the veterans with 92 % sensitivity, 85 % specificity, and 94 % accuracy. With concentration scans, there was 85 % sensitivity, 83 % specificity and 89 % accuracy. Baseline-concentration (the difference metric between the two scans) scans were 85 % sensitivity, 80 % specificity, and 87 % accuracy. In separating TBI from PTSD/TBI visual readings of baseline scans had 85 % sensitivity, 81 % specificity, and 83 % accuracy. Concentration scans had 80 % sensitivity, 65 % specificity, and 79 % accuracy. Baseline-concentration scans had 82

  3. Colleges Cite Inequities in New Benefits for Veterans

    ERIC Educational Resources Information Center

    Eckstein, Megan

    2009-01-01

    When the new GI Bill was signed into law last summer, advocates said its education benefits would significantly expand veterans' higher-education options. Beneficiaries would receive substantially more money than they did under older programs, enough to pay for the most expensive public institution in their state instead of only covering…

  4. An Open-Label Randomized Crossover Trial of Lyophilized Black Raspberries on Postprandial Inflammation in Older Overweight Males: A Pilot Study.

    PubMed

    Sardo, Christine L; Kitzmiller, Joseph P; Apseloff, Glen; Harris, Robin B; Roe, Denise J; Stoner, Gary D; Jacobs, Elizabeth T

    2016-01-01

    This study was a 14-day, outpatient, open-label randomized crossover trial of lyophilized black raspberries (BRBs) in older overweight or obese males to determine whether BRB consumption affects postprandial inflammation associated with consumption of a high-fat high-calorie (HFHC) meal. Ten study participants consumed 45 g/d of lyophilized BRBs for 4 days, followed by a HFHC breakfast plus BRBs on day 6 or consumed the HFHC breakfast on day 6 without previous consumption of BRBs and then crossed over to the other treatment after a 2-day washout period. Blood samples were obtained before and 1, 2, 4, 8, and 12 hours after consumption of the HFHC breakfast. The primary study outcomes were changes in area under the concentration-time curve (AUC) for interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α). The secondary outcomes were safety and tolerability of lyophilized BRB powder. The chronology and values of measured serum concentrations for IL-6, TNF-α, and CRP were consistent with those described previously by other investigators. The AUC of serum IL-6 was lowered significantly (P = 0.03, n = 10) with BRB consumption (34.3 ± 7.6 pg·mL⁻¹·h⁻¹ compared with 42.4 ± 17.9 pg·mL⁻¹·h⁻¹ for consumption of the HFHC meal alone). However, no significant differences (change in AUC) were calculated for serum CRP and TNF-α. The findings of this pilot study suggest that consumption of lyophilized BRBs may attenuate postprandial inflammation in overweight or obese males consuming a HFHC meal. Further investigation of BRBs is warranted to better elucidate their inflammomodulatory potential.

  5. Veterans' Employment and Training Service

    MedlinePlus

    ... Twitter Instagram RSS Email Share Veterans' Employment and Training Service (VETS) Menu About VETS Who We Are & ... of the U.S. Armed Forces. About USERRA Online Training USERRA 101 USERRA 102 USERRA Advisor Veterans' Preference ...

  6. Rehabilitation and the Veterans' Administration

    NASA Technical Reports Server (NTRS)

    Meister, F.

    1974-01-01

    The Veteran's Administration health care system provides prosthetic and sensory aids for the rehabilitation of neurologically handicapped veterans. Research and development centers include prosthetic clinic teams, orthopedic shops, restoration clinics, bioengineering services, orthotics, etc.

  7. National Coalition for Homeless Veterans

    MedlinePlus

    ... Donate 1 2 3 4 NCHV will end homelessness among veterans by shaping public policy, promoting collaboration, ... providers. CFC #50917 You have helped reduce veteran homelessness by 70% since 2005. SITE SEARCH Search HEADLINES ...

  8. Barriers to Veterans Health Administration Care in a Nationally Representative Sample of Women Veterans

    PubMed Central

    Vogt, Dawne; Bergeron, Amy; Salgado, Dawn; Daley, Jennifer; Ouimette, Paige; Wolfe, Jessica

    2006-01-01

    BACKGROUND Women veterans are generally less healthy than their nonveteran female counterparts or male veterans. Accumulating evidence suggests there may be barriers to women veterans' access to and use of Veterans Health Administration (VHA) care. OBJECTIVE To document perceived and/or actual barriers to care in a nationally representative sample of women veterans and examine associations with VHA use. DESIGN Cross-sectional telephone survey. PARTICIPANTS Women who are current and former users of VHA from VA's National Registry of Women Veterans. MEASUREMENTS Assessments of perceptions of VHA care, background characteristics, and health service use. RESULTS Perceptions of VHA care were most positive regarding facility/physical environment characteristics and physician skill and sensitivity and least positive regarding the availability of needed services and logistics of receiving VHA care (M=0.05 and M=−0.10; M=−0.23 and M=−0.25, respectively). The most salient barrier to the use of VHA care was problems related to ease of use. Moreover, each of the barriers constructs contributed unique variance in VHA health care use above and beyond background characteristics known to differentiate current users from former VHA users (Odds ratio [OR]=4.03 for availability of services; OR=2.63 for physician sensitivity and skill: OR=2.70 for logistics of care; OR=2.30 for facility/physical environment). Few differences in barriers to care and their association with VHA health care use emerged for women with and without service-connected disabilities. CONCLUSIONS Findings highlight several domains in which VHA decisionmakers can intervene to enhance the care available to women veterans and point to a number of areas for further investigation. PMID:16637940

  9. Breast Cancer in Transgender Veterans: A Ten-Case Series.

    PubMed

    Brown, George R

    2015-03-01

    All known cases of breast cancer in patients with a diagnosis consistent with transgender identification were identified in the Veterans Health Administration (1996-2013). Ten cases were confirmed: seven birth sex females and three birth sex males. Of the three birth sex males, two identified as gender dysphoric male-to-female and one identified as transgender with transvestic fetishism. The birth sex males all presented with late-stage disease that proved fatal, whereas most of the birth sex female transgender veterans presented with earlier stage disease that could be treated. These cases support the importance of screening for breast cancer using standard guidelines in birth sex males and females. Family history of breast cancer should be obtained from transgender people as part of routine care. This report expands the known cases of breast cancer in transgender persons from 5 to 12 (female-to-male) and from 10 to 13 (male-to-female).

  10. Psychosocial Equine Program for Veterans.

    PubMed

    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.

  11. Psychosocial Equine Program for Veterans.

    PubMed

    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. PMID:26897999

  12. Data on Vietnam Era Veterans.

    ERIC Educational Resources Information Center

    Veterans Administration, Washington, DC. Office of the Controller.

    Statistical data are presented on Vietnam era veterans for the following topics: employment status, medical status, compensation and pension, education, housing assistance, expenditures, and demographic information. The estimated number and age of veterans in civil life, categorized by sex and state, and the educational attainment of veterans at…

  13. Employment Services Needs of Veterans.

    ERIC Educational Resources Information Center

    Perspective: Essays and Reviews of Issues in Employment Security and Employment and Training Programs, 1989

    1989-01-01

    This issue of an annual journal contains 20 papers reflecting on the efforts of U.S. employment security and training programs to meet the needs of veterans. Part I, "National Perspective," contains five essays: "Policy Issues for Veteran Job Training Programs" (Martin F. Smith); "Cognizant Ramblings: Superfluous Lags the Veteran on the Stage…

  14. Veterans in Small Business.

    ERIC Educational Resources Information Center

    American Association of Community and Junior Colleges, Washington, DC. National Small Business Training Network.

    These materials provide information on conducting small business training seminars for veterans. First, a discussion is presented of the development of the guide based on 1983 field testing of the seminar and evaluations conducted by Small Business Administration (SBA) officials, the seminar contracts, and trainers. The next sections deal with the…

  15. Rural Women Veterans' Use and Perception of Mental Health Services.

    PubMed

    Ingelse, Kathy; Messecar, Deborah

    2016-04-01

    While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest

  16. Rural Women Veterans' Use and Perception of Mental Health Services.

    PubMed

    Ingelse, Kathy; Messecar, Deborah

    2016-04-01

    While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest

  17. Traumatic brain injury, PTSD, and current suicidal ideation among Iraq and Afghanistan U.S. veterans.

    PubMed

    Wisco, Blair E; Marx, Brian P; Holowka, Darren W; Vasterling, Jennifer J; Han, Sohyun C; Chen, May S; Gradus, Jaimie L; Nock, Matthew K; Rosen, Raymond C; Keane, Terence M

    2014-04-01

    Suicide is a prevalent problem among veterans deployed to Iraq and Afghanistan. Traumatic brain injury (TBI) and psychiatric conditions, such as posttraumatic stress disorder (PTSD), are potentially important risk factors for suicide in this population, but the literature is limited by a dearth of research on female veterans and imprecise assessment of TBI and suicidal behavior. This study examined 824 male and 825 female U.S. veterans who were enrolled in the baseline assessment of the Veterans After-Discharge Longitudinal Registry (Project VALOR), an observational registry of veterans with and without PTSD who deployed in support of the wars in Iraq and Afghanistan and were enrolled in the Veterans Affairs healthcare system. Results indicated that current depressive symptoms, PTSD, and history of prior TBI were all significantly associated with current suicidal ideation (Cohen's d = 0.91, Cramers' Vs = .19 and .08, respectively). After adding a number of variables to the model, including psychiatric comorbidity, TBI history was associated with increased risk of current suicidal ideation among male veterans only (RR = 1.55). TBI is an important variable to consider in future research on suicide among veterans of the wars in Iraq and Afghanistan, particularly among male veterans. PMID:24639101

  18. Ethnic differences in symptoms among female veterans diagnosed with PTSD.

    PubMed

    C'de Baca, Janet; Castillo, Diane; Qualls, Clifford

    2012-06-01

    Among U.S. male Vietnam veterans, Hispanics have been shown to have higher rates of posttraumatic stress disorder (PTSD) than African Americans and non-Hispanic Whites (Kulka et al., 1990). In terms of gender, Tolin and Foa's (2006) meta-analysis suggested women experience higher rates of PTSD than men. This study examined ethnic differences in PTSD and other symptomatology among 398 female veterans (63% non-Hispanic White, 28% Hispanic, 9% African American) seeking treatment for PTSD from 1995 to 2009 at a Veterans Administration (VA) behavioral health clinic. The following symptom clusters were examined: anxiety/PTSD, depression, anger/hostility, and psychotic/dissociative symptoms. Few differences were found among the groups, suggesting the 3 ethnic groups studied were more similar than different. African American female veterans, however, scored higher on measuring ideas of persecution/paranoia, although this may reflect an adaptive response to racism. These findings warrant further investigation to elucidate this relationship.

  19. Is Veteran Status and Suicide Risk Assessed in Community Long-Term Care? A Review of the States' Assessment Instruments

    ERIC Educational Resources Information Center

    Matthieu, Monica M.; Welch, Benjamin; Morrow-Howell, Nancy; Proctor, Enola; Nickel, Michael; Navarro, Jessica; Moon, Alyson

    2010-01-01

    Given recent policy initiatives to address suicide risk among older persons and veterans, community-based elder serving agencies may serve an important role in identifying and referring individuals at risk for suicide. A review of state-level long-term assessment instruments was conducted to determine whether veteran status and suicide are…

  20. Health behaviors and demographic factors of chronic health conditions among elderly veteran men.

    PubMed

    Tran, Thanh V; Canfield, Julie; Wang, Kaipeng

    2016-04-01

    As male veterans age, there are unique opportunities for health-related prevention efforts to be introduced throughout the life cycle to ameliorate the effects of chronic health conditions such as cardiovascular disease, asthma, arthritis, and diabetes. This study analyzed data from the Behavioral Risk Factor Surveillance System (2012) with a sample of 27,187 male veterans aged 65-84 years and 4,079 male veterans over 85 years of age. The study examined associations between behaviors, demographics, and five chronic health conditions with variables that included marital status, health insurance coverage, alcohol consumption, smoking history, and income levels. These associations varied between the two age groups, suggesting the need for intervention with veterans across their lifespans. Public health social workers could help veterans modify their health behaviors to prevent the occurrence or worsening of chronic health conditions over time and across the aging process. PMID:27123687

  1. 75 FR 22164 - Urban Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... Veterans and Homeless Veterans With Families' Reintegration Into Employment AGENCY: Veterans' Employment... training, and skills training) to expedite the reintegration of homeless Veterans into the labor...

  2. Future Veteran Enrollment: How Long? How Deep?

    ERIC Educational Resources Information Center

    Daly, Robert; Bateman, Harold

    In order to assess the probable impact of the June, 1976 loss of veteran's benefits for Korean-era veterans, Santa Ana College administered a questionnaire to 4,350 veterans enrolled in the spring of 1975. The questionnaire was returned by 1,299 veterans, a 29.9 percent rate of return. Of those responding, 469 veterans (36.1 percent) were…

  3. Clinical presentation of PTSD in World War II combat veterans.

    PubMed

    Hierholzer, R; Munson, J; Peabody, C; Rosenberg, J

    1992-08-01

    Clinicians have increasingly recognized posttraumatic stress disorder (PTSD) among Vietnam veterans, but the disorder may be easily overlooked among World War II combat veterans. The authors review recent studies of PTSD in older veterans and describe five cases that illustrate the diverse clinical presentations of PTSD in this population. Symptoms included anxiety, cognitive and somatic complaints, depression, alcohol dependence, and amnestic periods. Despite the varied presentations, a fairly consistent patient profile emerged. Patients avoided reminders of war, showed an exaggerated startle response, and experienced restless sleep and chronic anxiety. Factors associated with exacerbations of symptoms were retirement and reminders of war experiences. Although past studies have emphasized resuppression of the trauma, the authors encourage a flexible approach to treatment, including exploratory techniques. PMID:1427683

  4. Acute myocardial infarction in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched nonveterans.

    PubMed

    Bergman, Beverly P; Mackay, Daniel F; Pell, Jill P

    2014-06-15

    Few studies of veterans have examined cardiovascular disease as the primary outcome, other than in relation to specific conflicts or hazards. To assess the long-term risk and prognosis of acute myocardial infarction (AMI) in United Kingdom veterans from a broad range of military backgrounds and experience, we conducted a retrospective cohort study of 57,000 veterans resident in Scotland and 173,000 civilians matched on age, sex, and area of residence. Cox proportional hazards models were used to compare the risks of fatal/nonfatal AMI overall, by sex, and by year of birth, adjusting for the potentially confounding effect of socioeconomic status, and to compare rates of case-fatality following AMI at 30-day, 1-year, and 5-year follow-up. Over a mean follow-up period of 29 years between 1981 and 2012, a total of 2,106 (3.8%) veterans experienced an AMI as compared with 5,261 (3.1%) nonveterans (hazard ratio = 1.22, 95% confidence interval: 1.16, 1.29; P < 0.001). There was an increased risk of AMI among veterans born in 1945-1959 but not among those born from 1960 onward. Case-fatality was lower among veterans at 30-day, 1-year, and 5-year follow-up. We conclude that health behaviors such as smoking may have increased the risk of AMI in older veterans but that younger veterans have benefited from in-service health promotion initiatives.

  5. Long-term effects of military service on mental health among veterans of the Vietnam War era.

    PubMed

    Brooks, Matthew S; Laditka, Sarah B; Laditka, James N

    2008-06-01

    Comparing outcomes of veterans who served in Vietnam and those who served elsewhere, we examined treatment of post-traumatic stress disorder, treatment of other mental health conditions, psychiatric treatment location, and six mental health well-being measures. The analytic sample consisted of nationally representative data from the 2001 National Survey of Veterans. Analyses included multivariate logistic regression that controlled for sociodemographic characteristics. Of Vietnam War-era veterans in the National Survey of Veterans (N = 7,914), 3,937 served in Vietnam and 3,977 served elsewhere. These veterans were stratified into < 60 years of age (N = 6,141) and > or = 60 years of age (N = 1,766). Veterans who served in Vietnam had notably poorer mental health than did those who served elsewhere. There were striking mental health differences between younger and older veterans; younger veterans had substantially worse measures of mental health. These results suggest greater resource needs among younger Vietnam War veterans. Clinicians and the Department of Veterans Affairs should focus on mental health services for younger veterans.

  6. Women Veterans Health Care: Frequently Asked Questions

    MedlinePlus

    ... Program Overview » Outreach Materials » FAQs Women Veterans Health Care Menu Menu Womens Health Women Veterans Health Care ... can I call for more help? What health care services are available to women Veterans? A full ...

  7. Cancer incidence in Dutch Balkan veterans.

    PubMed

    Bogers, Rik P; van Leeuwen, Flora E; Grievink, Linda; Schouten, Leo J; Kiemeney, Lambertus A L M; Schram-Bijkerk, Dieneke

    2013-10-01

    Suspicion has been raised about an increased cancer risk among Balkan veterans because of alleged exposure to depleted uranium. The authors conducted a historical cohort study to examine cancer incidence among Dutch Balkan veterans. Male military personnel (n=18,175, median follow-up 11 years) of the Army and Military Police who had been deployed to the Balkan region (1993-2001) was compared with their peers not deployed to the Balkans (n=135,355, median follow-up 15 years) and with the general Dutch population of comparable age and sex. The incidence of all cancers and 4 main cancer subgroups was studied in the period 1993-2008. The cancer incidence rate among Balkan deployed military men was 17% lower than among non-Balkan deployed military men (hazard ratio 0.83 (95% confidence interval 0.69, 1.00)). For the 4 main cancer subgroups, hazard ratios were statistically non-significantly below 1. Also compared to the general population cancer rates were lower in Balkan deployed personnel (standardised incidence rate ratio (SIR) 0.85 (0.73, 0.99). The SIR for leukaemia was 0.63 (0.20, 1.46). The authors conclude that earlier suggestions of increased cancer risks among veterans are not supported by empirical data. The lower risk of cancer might be explained by the 'healthy warrior effect'. PMID:23707157

  8. Empty Promise: Black American Veterans and the New GI Bill

    ERIC Educational Resources Information Center

    Ottley, Alford H.

    2014-01-01

    The 2008 GI Bill offers college funds for veterans. Yet Black male vets are not taking advantage of these benefits. This chapter examines personal and societal problems that hinder access to higher education for Black vets, and suggests some ways adult educators can advocate for these young men.

  9. College Is for Veterans, Too

    ERIC Educational Resources Information Center

    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…

  10. Perceived Insufficient Rest or Sleep among Veterans: Behavioral Risk Factor Surveillance System 2009

    PubMed Central

    Faestel, Paul M.; Littell, Christopher T.; Vitiello, Michael V.; Forsberg, Christopher W.; Littman, Alyson J.

    2013-01-01

    Study Objectives: Sleep problems are of particular concern among the active duty military population as factors such as inconsistent work hours and deployment may compromise adequate sleep and adversely impact performance. However, few prior studies have investigated whether the prevalence of sleep problems differ between Veterans and demographically similar non-Veterans. The purpose of this study is to investigate whether self-reported insufficient rest or sleep varies in relation to Veteran status and to identify high-risk groups of Veterans. Methods: This study used data from the 2009 Behavioral Risk Factor Surveillance System (analyzed in 2011), a state based national telephone survey of non-institutionalized US adults. Insufficient rest was assessed in 411,313 adults aged 21 and older, of whom 55,361 were Veterans. Sleep duration was assessed in 6 states (n = 4,936 Veterans and 30,983 non-Veterans). Model-based direct rate adjustment was used to estimate the prevalence of insufficient rest or sleep while controlling for confounding. Multivariable logistic regression was used to estimate odds ratios of insufficient sleep or rest in subgroups of Veterans. Results: After multivariable adjustment, insufficient rest or sleep (22.7% vs. 21.1%, p < 0.001) and short sleep duration (< 7 h/night, 34.9% vs. 31.3%, p = 0.026) were more common among Veterans than non-Veterans. When the Veteran group was further divided among newly transitioned (≤ 12 months) and longer-term Veterans (> 12 months), the overall test for a difference was not statistically significant between groups, mainly because there was little difference in sleep between the two groups of Veterans. High-risk Veteran subgroups included those who were 21-44 years of age (vs. 65-74), women, non-whites, current smokers, obese, unable to work, and those in poor health. Conclusions: This study suggests that Veterans have a high burden of sleep problems and identifies subgroups that should be targeted to

  11. Suicide among War Veterans

    PubMed Central

    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

  12. 78 FR 59426 - Board of Veterans Appeals, Veterans Information Office, Voice of the Veteran Call Center Survey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... Register on September 6, 2013 (78 FR 54957), that contained errors. VA announced that the Board of Veterans... (202) 632-7492. Correction In FR Doc. 2013-21692, published on September 6, 2013, at 78 FR 54957, make... AFFAIRS Board of Veterans Appeals, Veterans Information Office, Voice of the Veteran Call Center...

  13. Factors associated with survival in the National Registry of Veterans with ALS.

    PubMed

    Pastula, Daniel M; Coffman, Cynthia J; Allen, Kelli D; Oddone, Eugene Z; Kasarskis, Edward J; Lindquist, Jennifer H; Morgenlander, Joel C; Norman, Barbara B; Rozear, Marvin P; Sams, Laura A; Sabet, Arman; Bedlack, Richard S

    2009-01-01

    The clinical course of patients with ALS is highly variable. While the median survival time from symptom onset is 2-4 years, there are reports of survival ranging from less than a year to more than 40 years. Such variability makes planning difficult for patients and physicians, and complicates clinical trial design. We sought to validate previous predictors of survival and search for new ones using a large group of ALS patients in the National Registry of Veterans with ALS. We were especially interested in how various aspects of military service might affect survival. Subjects were those in the National Registry of Veterans with ALS who had probable or definite ALS (according to El Escorial criteria). A multivariable Cox proportional hazard regression model was used to examine variables for statistical association with ventilator-free survival time (determined from date of first diagnosis). Subjects who had not died or started ventilation by 31 October 2006 were censored. Our group of 1085 US military veterans with ALS was primarily male (98%) and white (94%), with mostly sporadic (95%) and extremity-onset (76%) ALS. Symptom onset occurred at a mean age of 59.3 years (60.6 years for diagnosis). Median survival time from symptom onset was 4.7 years (3.3 years from diagnosis). In our multivariable model, older age at diagnosis (HR 1.41 (95% CI 1.27-1.55) per 10-year increase), non-extremity site of onset (HR 1.55 (1.24-1.94)), and past deployment to Vietnam (HR 1.73 (1.36-2.19)) were all associated with shortened survival. A longer time to diagnosis was associated with better survival (HR 0.77 (0.70-0.84) per one year increase in diagnosis time). In this unique cohort of veterans with ALS, traditional factors of reduced survival remained important. In addition, past deployment to Vietnam was found to be associated with shortened survival as well. This finding could be due to a common exposure, a shared characteristic, an unmeasured confounder, or an enrollment bias

  14. Comparison of the Use of H1N1 and seasonal influenza vaccinations between veterans and non-veterans in the United States, 2010

    PubMed Central

    2013-01-01

    Background Veterans of the U.S. armed forces tend to be older and have more chronic health problems than the general adult population, which may place them at greater risk of complications from influenza. Despite Centers for Disease Control and Prevention (CDC) recommendations, seasonal influenza vaccination rates for the general adult population remain well below the national goal of 80%. Achieving this goal would be facilitated by a clearer understanding of which factors influence vaccination. Methods Using the 2010 U.S. National Health Interview Survey (NHIS), this study estimates models of two types of vaccinations (H1N1 and seasonal flu), assesses if the correlates differ for these vaccinations, and analyses the distribution of the correlates by veteran status. Results Veterans, women, non-Hispanic whites, non-smokers, those at high risk, educated, with health insurance, and who use clinics as a usual source of care were more likely to receive both types of vaccinations. Those who were older, married, and with higher income were more likely to get vaccinated for seasonal flu, but not for H1N1. Age and number of children living in the household were found to have different effects for H1N1 compared to seasonal flu. Conclusion Veterans are more likely to get vaccinated for seasonal influenza and H1N1 compared to the general population. This might be due to Veterans having better access to care or Veterans participating in better health care practices. Future studies should examine potential differences in flu vaccination use among Veterans using Veterans Affairs (VA) health care system vs. non-VA users. PMID:24252569

  15. 78 FR 54956 - Proposed Information Collection (Board of Veterans' Appeals Voice of the Veteran Appellant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... AFFAIRS Code 8320-01 Proposed Information Collection (Board of Veterans' Appeals Voice of the Veteran... Board of Veterans' Appeals Voice of the Veteran Appellant Surveys'' in any correspondence. During the... use of other forms of information technology. Title: Board of Veterans' Appeals Voice of the...

  16. 5 CFR 337.304 - Veterans' preference.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Veterans' preference. 337.304 Section 337... Alternative Rating and Selection Procedures § 337.304 Veterans' preference. In this subpart: (a) Veterans' preference must be applied as prescribed in 5 U.S.C. 3319(b) and (c)(2); (b) Veterans' preference points...

  17. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 U.S.C. 1722(a); (h) Veterans of the Mexican border period or of World War I; (i) Veterans solely... disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or released from... associated with service in the Southwest Asia theater of operations during the Persian Gulf War, as...

  18. 38 CFR 52.50 - Eligible veterans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... specified under 38 U.S.C. 1722(a); (h) Veterans of the Mexican Border period or of World War I; (i) Veterans...-connected disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or... disorder associated with service in the Southwest Asia theater of operations during the Gulf War,...

  19. 38 CFR 52.50 - Eligible veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... specified under 38 U.S.C. 1722(a); (h) Veterans of the Mexican Border period or of World War I; (i) Veterans...-connected disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or... disorder associated with service in the Southwest Asia theater of operations during the Gulf War,...

  20. 38 CFR 52.50 - Eligible veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... specified under 38 U.S.C. 1722(a); (h) Veterans of the Mexican Border period or of World War I; (i) Veterans...-connected disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or... disorder associated with service in the Southwest Asia theater of operations during the Gulf War,...

  1. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 U.S.C. 1722(a); (h) Veterans of the Mexican border period or of World War I; (i) Veterans solely... disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or released from... associated with service in the Southwest Asia theater of operations during the Persian Gulf War, as...

  2. 38 CFR 52.50 - Eligible veterans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... specified under 38 U.S.C. 1722(a); (h) Veterans of the Mexican Border period or of World War I; (i) Veterans...-connected disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or... disorder associated with service in the Southwest Asia theater of operations during the Gulf War,...

  3. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 U.S.C. 1722(a); (h) Veterans of the Mexican border period or of World War I; (i) Veterans solely... disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or released from... associated with service in the Southwest Asia theater of operations during the Persian Gulf War, as...

  4. 38 CFR 52.50 - Eligible veterans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... specified under 38 U.S.C. 1722(a); (h) Veterans of the Mexican Border period or of World War I; (i) Veterans...-connected disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or... disorder associated with service in the Southwest Asia theater of operations during the Gulf War,...

  5. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 U.S.C. 1722(a); (h) Veterans of the Mexican border period or of World War I; (i) Veterans solely... disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or released from... associated with service in the Southwest Asia theater of operations during the Persian Gulf War, as...

  6. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 U.S.C. 1722(a); (h) Veterans of the Mexican border period or of World War I; (i) Veterans solely... disabilities; (b) Veterans who are former prisoners of war; (c) Veterans who were discharged or released from... associated with service in the Southwest Asia theater of operations during the Persian Gulf War, as...

  7. Sexual self-esteem and psychosocial functioning in military veterans after cancer.

    PubMed

    Syme, Maggie L; Delaney, Eileen; Wachen, Jennifer Schuster; Gosian, Jeffrey; Moye, Jennifer

    2013-01-01

    Little is known about the sexual well-being of male Veteran cancer survivors, or the relationship of sexual concerns to psychosocial adaptation postcancer. This study examined the association between sexual self-esteem and psychosocial concerns in male Veteran cancer survivors. Forty-one male survivors were recruited from a Veterans Affairs (VA) hospital to participate in a pilot study addressing cancer survivorship care for Veterans. Sixty- to 90-minute interviews were conducted, assessing sociodemographic, medical, stress/burden (cancer-related posttraumatic stress disorder [PTSD], depression), and resource (social support, post-traumatic growth) variables. Twenty-one (51.2%) Veteran cancer survivors reported lowered sexual self-esteem as a result of cancer, which corresponded to significantly higher levels of depression and cancer-related PTSD. The lowered sexual self-esteem group also indicated significantly lower social support. Veteran cancer survivors with lowered sexual self-esteem tend to have higher levels of stress and lower levels of resources, putting them at risk for lowered quality of life. This increased risk highlights the importance of addressing sexual well-being in the survivorship care of Veterans.

  8. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China.

    PubMed

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-05-01

    Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P < 0.001). Syphilis infections significantly declined for FSWs (P < 0.001) but only to 7.3% for LTFSWs. HCV and intravenous drug use were uncommon in FSWs. HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P < 0.001). Condom use during the last sexual encounter increased for FSWs and CFSWs. Few clients reported sex with men or intravenous drug use. Clients

  9. Hmong Veterans' Service Recognition Act

    THOMAS, 113th Congress

    Sen. Murkowski, Lisa [R-AK

    2014-05-14

    05/14/2014 Read twice and referred to the Committee on Veterans' Affairs. (text of measure as introduced: CR S3031) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. Veterans and Military Family Health

    MedlinePlus

    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 ...

  11. House Committee on Veterans' Affairs

    MedlinePlus

    ... operations and activities. Read More Vets-Affairs-2.jpg Trials in Transparency Trials in Transparency is designed ... of Veterans Affairs officials. Read More VACities_Wide.jpg VA Accountability Watch Is VA Holding Its Executives ...

  12. Veterans' Benefits Act of 2011

    THOMAS, 112th Congress

    Rep. Runyan, Jon [R-NJ-3

    2011-06-24

    10/12/2011 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  13. Veterans Accountability Act of 2013

    THOMAS, 113th Congress

    Rep. Huelskamp, Tim [R-KS-1

    2013-04-26

    10/07/2013 Supplemental report filed by the Committee on Veterans' Affairs, H. Rept. 113-227, Part II. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Veterans Dog Training Therapy Act

    THOMAS, 111th Congress

    Rep. Brown, Henry E., Jr. [R-SC-1

    2009-10-21

    05/26/2010 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  15. 75 FR 61858 - Proposed Information Collection (Annual Certification of Veteran Status and Veteran-Relatives...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ...) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA) is announcing an opportunity for public... information needed to identify and properly protect VA benefit records. DATES: Written comments...

  16. 38 CFR 10.37 - Claim of widow not living with veteran at time of veteran's death.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... with veteran at time of veteran's death. 10.37 Section 10.37 Pensions, Bonuses, and Veterans' Relief... not living with veteran at time of veteran's death. If a veteran and widow were not living together at the time of the death of the veteran the widow will be required to establish: (a) That the...

  17. 38 CFR 10.37 - Claim of widow not living with veteran at time of veteran's death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... with veteran at time of veteran's death. 10.37 Section 10.37 Pensions, Bonuses, and Veterans' Relief... not living with veteran at time of veteran's death. If a veteran and widow were not living together at the time of the death of the veteran the widow will be required to establish: (a) That the...

  18. Investigating Veterans' Pre-, Peri-, and Post-Deployment Experiences as Potential Risk Factors for Problem Gambling.

    PubMed

    Whiting, Seth W; Potenza, Marc N; Park, Crystal L; McKee, Sherry A; Mazure, Carolyn M; Hoff, Rani A

    2016-06-01

    Background and aims Gambling disorder and its comorbid diagnoses are observed at higher rates in military veterans than in the general population. A significant research gap exists regarding the relationships of veterans' life and service experiences to problematic gambling. The present study explored pre-, peri-, and post-deployment factors associated with problem gambling in veterans. Methods Veterans of Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (n = 738; 463 males, and 275 females) completed questionnaires via structured telephone interview. We conducted bivariate and multinomial logistic regression analyses exploring associations among problem-gambling severity and socio-demographic variables, psychiatric comorbidities, and 10 scales of the Deployment Risk and Resilience Inventory measuring experiences pre-, peri-, and post-deployment. Results Approximately 4.2% of veterans indicated at-risk or probable pathological gambling (ARPG) post-deployment (two or more DSM-IV criteria for pathological gambling). Bivariate analyses found more severe gambling in males, higher frequencies of post-traumatic stress disorder, substance dependence, traumatic brain injury, panic disorder, and depression in veterans with ARPG, and higher general harassment during deployment, and lower social support and more stressful life events post-deployment in those with ARPG. In multivariable models, both post-deployment factors remained significantly associated with ARPG. Discussion The study suggests that problem gambling among veterans is related to service experiences, and particularly to life experiences post-deployment. Conclusions Adverse service and life experiences and lack of social support may contribute to the risk of problem gambling in military veterans. Investigation of how Veterans Affairs clinical settings may serve veterans following deployment to prevent behavioral addictions is warranted. PMID:27156377

  19. Cardiovascular risk profile of veteran men beginning androgen deprivation therapy.

    PubMed

    Williams, Lindsay; Hicks, Elisabeth; Kwan, Lorna; Litwin, Mark; Maliski, Sally

    2014-09-01

    We sought to describe the cardiovascular profile of veteran men before beginning androgen deprivation therapy (ADT), with the eventual benefit of targeting treatments to manage harmful cardiovascular side effects. We performed a secondary analysis with chi-square and Fisher's exact tests for associations between demographics and cardiovascular comorbidities on 375 veteran men diagnosed with prostate cancer. Those who were overweight and current smokers were more likely to be younger, whereas men with a systolic blood pressure >120 mmHg were more likely to be older (all P < 0.05). Men with total cholesterol 180 mg/dL were more likely to be identified in the Hispanic/other/unknown ethnicity category. Interventions to manage cardiovascular risk should focus on preventive lifestyle changes for younger men, and chronic disease management for older men. Men in the smaller Hispanic/other/unknown category are at risk for marginalization within the Veteran Administration system owing to their low numbers and should be closely monitored for cholesterol levels when receiving ADT.

  20. General Household Emergency Preparedness: A Comparison Between Veterans and Nonveterans

    PubMed Central

    Der-Martirosian, Claudia; Strine, Tara; Atia, Mangwi; Chu, Karen; Mitchell, Michael N.; Dobalian, Aram

    2015-01-01

    Background Despite federal and local efforts to educate the public to prepare for major emergencies, many US households remain unprepared for such occurrences. United States Armed Forces veterans are at particular risk during public health emergencies as they are more likely than the general population to have multiple health conditions. Methods This study compares general levels of household emergency preparedness between veterans and nonveterans by focusing on seven surrogate measures of household emergency preparedness (a 3-day supply of food, water, and prescription medications, a battery-operated radio and flashlight, a written evacuation plan, and an expressed willingness to leave the community during a mandatory evacuation). This study used data from the 2006 through 2010 Behavioral Risk Factor Surveillance System (BRFSS), a state representative, random sample of adults aged 18 and older living in 14 states. Results The majority of veteran and nonveteran households had a 3-day supply of food (88% vs 82%, respectively) and prescription medications (95% vs 89%, respectively), access to a working, battery-operated radio (82% vs 77%, respectively) and flashlight (97% vs 95%, respectively), and were willing to leave the community during a mandatory evacuation (91% vs 96%, respectively). These populations were far less likely to have a 3-day supply of water (61% vs 52%, respectively) and a written evacuation plan (24% vs 21%, respectively). After adjusting for various sociodemographic covariates, general health status, and disability status, households with veterans were significantly more likely than households without veterans to have 3-day supplies of food, water, and prescription medications, and a written evacuation plan; less likely to indicate that they would leave their community during a mandatory evacuation; and equally likely to have a working, battery-operated radio and fiashlight. Conclusion These findings suggest that veteran households appear to be

  1. Taking Healthy Steps: rationale, design and baseline characteristics of a randomized trial of a pedometer-based internet-mediated walking program in veterans with chronic obstructive pulmonary disease

    PubMed Central

    2014-01-01

    Background Low levels of physical activity are common in patients with chronic obstructive pulmonary disease (COPD), and a sedentary lifestyle is associated with poor outcomes including increased mortality, frequent hospitalizations, and poor health-related quality of life. Internet-mediated physical activity interventions may increase physical activity and improve health outcomes in persons with COPD. Methods/Design This manuscript describes the design and rationale of a randomized controlled trial that tests the effectiveness of Taking Healthy Steps, an Internet-mediated walking program for Veterans with COPD. Taking Healthy Steps includes an uploading pedometer, a website, and an online community. Eligible and consented patients wear a pedometer to obtain one week of baseline data and then are randomized on a 2:1 ratio to Taking Healthy Steps or to a wait list control. The intervention arm receives iterative step-count feedback; individualized step-count goals, motivational and informational messages, and access to an online community. Wait list controls are notified that they are enrolled, but that their intervention will start in one year; however, they keep the pedometer and have access to a static webpage. Discussion Participants include 239 Veterans (mean age 66.7 years, 93.7% male) with 155 randomized to Taking Healthy Steps and 84 to the wait list control arm; rural-living (45.2%); ever-smokers (93.3%); and current smokers (25.1%). Baseline mean St. George’s Respiratory Questionnaire Total Score was 46.0; 30.5% reported severe dyspnea; and the average number of comorbid conditions was 4.9. Mean baseline daily step counts was 3497 (+/- 2220). Veterans with COPD can be recruited to participate in an online walking program. We successfully recruited a cohort of older Veterans with a significant level of disability including Veterans who live in rural areas using a remote national recruitment strategy. Trial registration Clinical Trials.gov NCT01102777

  2. Characteristics of Veterans diagnosed with seizures within Veterans Health Administration.

    PubMed

    Rehman, Rizwana; Kelly, Pamela R; Husain, Aatif M; Tran, Tung T

    2015-01-01

    The purpose of this report is to describe the demographics of Veterans diagnosed with seizures and taking antiepileptic drugs (AEDs) within the Veterans Health Administration (VHA) during fiscal year (FY) 2011 (October 1, 2010, to September 30, 2011), particularly with regard to comorbid traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). Information collected included age; sex; Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OIF/OEF/OND) status; and relevant encounter diagnosis codes for seizures, TBI, and PTSD. During FY11, 87,377 Veterans with seizures on AEDs were managed within the VHA. Prevalence was 15.5 per 1,000, and annual incidence was 148.2 per 100,000. The percentages of comorbid TBI and PTSD were 15.8% and 24.1%, respectively. For OIF/OEF/OND Veterans, these percentages increased to 52.6% and 70.4%, respectively. PTSD and TBI are risk factors for both epilepsy and psychogenic nonepileptic seizures. Within the VHA, many Veterans experiencing seizures cannot be successfully treated with AEDs. The VHA Epilepsy Centers of Excellence promotes a multidisciplinary approach to increase and improve access to both epilepsy and mental health specialists for the care of epileptic and nonepileptic seizures. PMID:26745205

  3. Military Service Members and Veterans: In the Classroom and on the Police Force

    ERIC Educational Resources Information Center

    Olson, Dustin; Gabriel-Olson, Kirsten

    2012-01-01

    With the troop levels in Iraq decreasing and more service members being discharged, the number of veterans on campuses is steadily increasing. On average, these warriors-turning-college-students will be 24 or older, ethnic minorities, and first-generation college students. It is important to make sure that departments, campuses and communities are…

  4. The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

    ERIC Educational Resources Information Center

    Moore, Crystal Dea

    2010-01-01

    A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden,…

  5. Risk of Smoking and Receipt of Cessation Services Among Veterans Affairs Patients With Mental Disorders

    PubMed Central

    Duffy, Sonia A.; Kilbourne, Amy M.; Austin, Karen L.; Dalack, Gregory W.; Woltmann, Emily M.; Waxmonsky, Jeanette A.; Noonan, Devon

    2012-01-01

    Objective The purpose of this study was to determine rates of smoking and receipt of provider recommendations to quit smoking among patients with mental disorders treated in U.S. Department of Veterans Affairs (VA) treatment settings. Methods The authors conducted a secondary analysis of the yearly, cross-sectional 2007 Veterans Health Administration Outpatient Survey of Healthcare Experiences of Patients (N=224,193). Logistic regression was used to determine the independent association of mental health diagnosis and the dependent variables of smoking and receipt of provider recommendations to quit smoking. Results Patients with mental disorders had greater odds of smoking, compared with those without mental disorders (p<.05). Those with various mental disorders reported similar rates of receiving services (more than 60% to 80% reported receiving selected services), compared with those without these disorders, except that those with schizophrenia had more than 30% lower odds of receiving advice to quit smoking from their physicians (p<.05). Moreover, those who had co-occurring posttraumatic stress disorder or substance use disorders had significantly greater odds of reporting that they received advice to quit, recommendations for medications, and physician discussions of quitting methods, compared with those without these disorders (p<.05). Older patients, male patients, members of ethnic minority groups, those who were unmarried, those who were disabled or unemployed, and those living in rural areas had lower odds of receiving selected services (p<.05). Conclusions The majority of patients with mental disorders served by the VA reported receiving cessation services, yet their smoking rates remained high, and selected groups were at risk for receiving fewer cessation services, suggesting the continued need to disseminate cessation services. PMID:22337005

  6. 38 CFR 21.276 - Incarcerated veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Monetary Assistance Services § 21.276 Incarcerated veterans. (a) General. The provisions contained in this... local prison, jail, or other penal institution for a felony. It does not include any veteran who...

  7. The Mental Health Status of California Veterans.

    PubMed

    Tran, Linda Diem; Grant, David; Aydin, May

    2016-04-01

    Data from the California Health Interview Survey (CHIS) from 2011--2013 showed approximately 90,000 veterans had mental health needs and 200,000 reported serious thoughts of suicide during the 12 months prior to participating in CHIS. Although the proportion of veterans reporting mental health need or serious psychological distress was no higher than the general population, California veterans were more likely to report lifetime suicide ideation. This policy brief uses CHIS data to examine the mental health status, needs, and barriers to care among veterans in California. Veterans were more likely to receive mental health or substance use treatment than nonveterans, yet three of four veterans with mental health needs received either inadequate or no mental health care. Integrating mental and physical health services, increasing access to care, retaining veterans who seek mental health treatment, and reducing stigma are among the strategies that might improve the mental health of California's veterans. PMID:27416644

  8. The Mental Health Status of California Veterans.

    PubMed

    Tran, Linda Diem; Grant, David; Aydin, May

    2016-04-01

    Data from the California Health Interview Survey (CHIS) from 2011--2013 showed approximately 90,000 veterans had mental health needs and 200,000 reported serious thoughts of suicide during the 12 months prior to participating in CHIS. Although the proportion of veterans reporting mental health need or serious psychological distress was no higher than the general population, California veterans were more likely to report lifetime suicide ideation. This policy brief uses CHIS data to examine the mental health status, needs, and barriers to care among veterans in California. Veterans were more likely to receive mental health or substance use treatment than nonveterans, yet three of four veterans with mental health needs received either inadequate or no mental health care. Integrating mental and physical health services, increasing access to care, retaining veterans who seek mental health treatment, and reducing stigma are among the strategies that might improve the mental health of California's veterans.

  9. 38 CFR 12.8 - Unclaimed effects of veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Unclaimed effects of veterans. 12.8 Section 12.8 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS DISPOSITION OF VETERAN'S PERSONAL FUNDS AND EFFECTS Disposition of Veteran's Personal Funds and Effects...

  10. 77 FR 27252 - Veterans' Employment and Training; Veterans Workforce Investment Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-09

    ...' Employment and Training; Veterans Workforce Investment Program AGENCY: Veterans' Employment and Training... Opportunity Description The U.S. Department of Labor (USDOL), Veterans' Employment and Training Service (VETS... amended the training programs made available to veterans (see 29 U.S.C. 2913). WIA section 168...

  11. Suicidal behavior in war veterans.

    PubMed

    Rice, Timothy R; Sher, Leo

    2012-05-01

    Military veterans represent a unique, heterogeneous population with suicide prevalence rates, risk factors and preventative management needs that differ from those of the rest of community. Veterans worldwide receive high proportions of their healthcare from community providers, and sensitivity to these distinct needs is required for optimized care. An overview of the recent prevalence-study literature, with a focus upon statistical design, is presented in order to provide a critical orientation within this field with high levels of popular media attention. Attention to psychiatric comorbidity, subthreshold symptomology, select signature disorders of contemporary conflicts (namely, post-traumatic stress disorder and traumatic brain injury), and veteran life narratives before, within and beyond military service will guide our review of risk factor assessment and management strategies. This critical review of the literature provides an overview of this active field of neuropsychiatric research with a select focus upon these topics of special interest.

  12. Association of Sarcopenic Obesity with Higher Serum High-Sensitivity C-Reactive Protein Levels in Chinese Older Males--A Community-Based Study (Taichung Community Health Study-Elderly, TCHS-E).

    PubMed

    Yang, Chuan-Wei; Li, Chia-Ing; Li, Tsai-Chung; Liu, Chiu-Shong; Lin, Chih-Hsueh; Lin, Wen-Yuan; Lin, Cheng-Chieh

    2015-01-01

    The prevalence of obesity and sarcopenia is high among the elderly. The simultaneous occurrence of these two disorders results in sarcopenic obesity. Research suggests that inflammation has an important role in the pathogenesis of obesity and sarcopenia. This study explores the impact of sarcopenic obesity on inflammatory markers, including interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor-alpha (TNF-α). This study is a community-based cross-sectional study. The study sample consisted of 844 community-dwelling people aged 65 years and older (448 men and 396 women). Sarcopenia was characterized by low muscle mass (skeletal muscle index < 6.87 and 5.46 kg/m2 for men and women, respectively), and obesity was characterized by excess body fat (body fat percentage greater than the 60th percentile of the study sample by sex [27.82% in men and 37.61% in women]). Older individuals identified with sarcopenic obesity were those who had both sarcopenia and obesity. Inflammatory markers such as IL-6, hs-CRP, and TNF-α were measured. The prevalence rates of obesity only, sarcopenia only, and sarcopenic obesity were 32.94%, 11.85%, and 7.23%, respectively. No difference was observed in the serum levels of IL-6 and TNF-α among the four groups of combined sarcopenia and obesity status. After multivariate adjustment, the serum hs-CRP levels in the obesity only and in the sarcopenic obesity groups were 0.14 and 0.16 mg/dL among males, respectively, which were significantly higher than that in the normal group (P=0.012 and 0.036). Our results provide evidence that obesity and sarcopenic obesity are associated with increased levels of serum hs-CRP among males. PMID:26177029

  13. Disease Prevention in the Veterans Health Administration.

    PubMed

    Kinsinger, Linda S

    2015-01-01

    The burden of chronic diseases is substantial among veterans who are seen in the Veterans Health Administration (VHA) health care system. Healthy lifestyle interventions and clinical preventive services can help veterans improve their health and well-being. The VHA's National Center for Health Promotion and Disease Prevention supports policies, programs, resources, and training for VHA. PMID:26946870

  14. 38 CFR 3.401 - Veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... compensation payable by reason of need for aid and attendance or housebound status shall also be awarded for... claim additional disability compensation payable to a veteran by reason of the veteran's spouse's need....) (Authority: 38 U.S.C. 5110 (f), (n)) (c) Divorce of veteran and spouse. See § 3.501(d). (d)...

  15. Echocardiogram Utilization among Rural and Urban Veterans

    ERIC Educational Resources Information Center

    Okrah, Kingston; Vaughan-Sarrazin, Mary; Kaboli, Peter; Cram, Peter

    2012-01-01

    Purpose: To compare echocardiography use among urban and rural veterans and whether differences could be accounted for by distance. Methods: We used Veterans Administration (VA) administrative data from 1999 to 2007 to identify regular users of the VA Healthcare System (VA users) who did and did not receive echocardiography. Each veteran was…

  16. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    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...

  17. D-Day for Veterans' Jobs

    ERIC Educational Resources Information Center

    Nathan, Robert R.

    1977-01-01

    Focuses on the unemployment problem among Vietnam veterans and on the various Federal and private employment programs open to these veterans. Discussion also covers labor force statistics, readjustment to civilian life, changes in the American economy, and the role of the Department of Defense and civilian employers in helping veterans to find…

  18. Posttraumatic Stress Disorder and Vietnam Veterans.

    ERIC Educational Resources Information Center

    Helwig, Andrew A.; Assa, Roberta

    1991-01-01

    Notes that many unemployed Vietnam veterans may be suffering from posttraumatic stress disorder (PTSD). Symptoms and behaviors of PTSD are reviewed to assist employment counselors in identifying clients with PTSD. Counseling and referral actions are suggested. Outlines four-phase approach used by many Veterans Centers in counseling veterans with…

  19. Psychosocial Readjustment of Canadian Vietnam Veterans.

    ERIC Educational Resources Information Center

    Stretch, Robert H.

    1991-01-01

    Examined the psychosocial readjustment of 164 Canadian Vietnam veterans. Found significantly greater rates of posttraumatic stress disorder (PTSD) compared with U.S. Vietnam veterans and evidence of other psychosocial adjustment problems. Suggests that problems are a result, in part, of prolonged isolation from other Vietnam veterans, lack of…

  20. Veterans Tell Elite Colleges: "We Belong"

    ERIC Educational Resources Information Center

    Sander, Libby

    2013-01-01

    About 16 percent of veterans use the GI Bill to attend private institutions, roughly the same proportion as students generally. But at the most highly selective colleges, veterans using the Post-9/11 GI Bill barely fill a single classroom--38 at Penn, 22 at Cornell, and at Princeton, just one. The sparse numbers do not go unnoticed, veterans say.…

  1. Health Care for North Carolina's Veterans.

    PubMed

    Hoffmann, Daniel F

    2015-01-01

    On March 3, 1865, President Lincoln established a national soldiers' and sailors' asylum. The Veterans Health Administration (VHA) evolved from facilities established for Civil War veterans of the Union Army, and today, VHA continues to meet veterans' changing medical, surgical, and quality-of-life needs by operating America's largest integrated health system. PMID:26946861

  2. California Veterans Receive Inadequate Treatment to Address their Mental Health Needs

    PubMed Central

    Tran, Linda Diem; Grant, David; Aydin, May

    2016-01-01

    Data from the 2011 to 2013 California Health Interview Survey (CHIS) were pooled to estimate prevalence of mental health need (serious psychological distress and impairment in one or more life domains), minimally adequate treatment (having four or more visits with a health professional in the past 12 months and use of prescription medication for mental health problems in the past 12 months), and suicide ideation among veterans living in California. Numbers and percentages were weighted to the CA population using a large sample size (N=6,952), and for comparison purposes, veterans and nonveterans were standardized to the age and gender distribution of veterans in the sample. Although differences in mental health need were similar between veterans and nonveterans after adjustment, over three-quarters of veterans did not receive minimally adequate treatment needed to address their mental health needs. Suicide ideation was significantly higher among veterans than nonveterans. Male veterans at all ages were more vulnerable to thinking about suicide compared to their nonveteran counterparts. PMID:27570802

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

    PubMed Central

    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

  4. Elderly Homeless Veterans in Los Angeles: Chronicity and Precipitants of Homelessness

    PubMed Central

    van den Berk-Clark, Carissa; McGuire, James

    2013-01-01

    Objectives. We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. Methods. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Results. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Conclusions. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population. PMID:24148059

  5. Supporting Student Veterans in Transition

    ERIC Educational Resources Information Center

    Rumann, Corey B.; Hamrick, Florence A.

    2009-01-01

    The purpose of this chapter is to offer frameworks and considerations for student affairs professionals seeking to serve the transition needs of the current generation of student veterans. The historical intersections of the military and higher education, particularly with respect to the effects of the draft on students and higher education,…

  6. The Veteran Student in 2010

    ERIC Educational Resources Information Center

    Hassan, Anthony M.; Jackson, Robert; Lindsay, Douglas R.; McCabe, Damian G.; Sanders, Joseph E., III

    2010-01-01

    The President of the United States promises to return servicemen and servicewomen back home from the war in the Middle East by 2011. This raises important questions about how the people in higher education will view and serve those who have worn the military uniform. As they watch the veterans who are making the transition from the battlefield to…

  7. Veterans Choice Act of 2014

    THOMAS, 113th Congress

    Sen. McCain, John [R-AZ

    2014-06-03

    06/03/2014 Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Notes: For further action, see H.R.3230, which became Public Law 113-146 on 8/7/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  8. Veterans Paralympic Act of 2013

    THOMAS, 113th Congress

    Sen. Boozman, John [R-AR

    2013-04-10

    06/12/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-111. (All Actions) Notes: For further action, see H.R.1402, which became Public Law 113-59 on 12/20/2013. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  9. Nursing advocacy for women veterans and suicide.

    PubMed

    Conard, Patricia L; Armstrong, Myrna L; Young, Cathy; Hogan, La Micha

    2015-03-01

    Little is known about suicide variables in women Veterans. The authors reviewed numerous applicable health care and military literary sources regarding suicide in this population. The current article describes the surrounding circumstances, military war/conflict culture, and potential effects on women Veterans, including major collection problems with current Veteran data. Women Veterans are increasingly reporting more behavioral health issues (e.g., posttraumatic stress disorder) and attempting suicide upon civilian reintegration. Outcomes from this literature review suggest the importance of nursing advocacy to create better rapport and communication with women Veterans from Vietnam, Gulf I, Iraq, and Afghanistan wars seeking care at civilian health facilities, as some may present with suicidal ideologies.

  10. Veteran Competencies for Undergraduate Nursing Education.

    PubMed

    Moss, Jacqueline A; Moore, Randy L; Selleck, Cynthia S

    2015-01-01

    Military Veterans comprise approximately 10% of the US population. Most Veterans do not receive their health care through Veterans Affairs facilities, are seen across the health care system, and their prior military service and associated health issues often go unrecognized. In this study, a modified Delphi design was used to develop a set of 10 Veteran Care Competencies and associated knowledge, skills, and attitudes for Undergraduate Nursing Education: Military and Veteran Culture, Post Traumatic Stress Disorder, Amputation and Assistive Devices, Environmental/Chemical Exposures, Substance Use Disorder, Military Sexual Trauma, Traumatic Brain Injury, Suicide, Homelessness, and Serious Illness Especially at the End of Life. PMID:26517342

  11. Veteran Competencies for Undergraduate Nursing Education.

    PubMed

    Moss, Jacqueline A; Moore, Randy L; Selleck, Cynthia S

    2015-01-01

    Military Veterans comprise approximately 10% of the US population. Most Veterans do not receive their health care through Veterans Affairs facilities, are seen across the health care system, and their prior military service and associated health issues often go unrecognized. In this study, a modified Delphi design was used to develop a set of 10 Veteran Care Competencies and associated knowledge, skills, and attitudes for Undergraduate Nursing Education: Military and Veteran Culture, Post Traumatic Stress Disorder, Amputation and Assistive Devices, Environmental/Chemical Exposures, Substance Use Disorder, Military Sexual Trauma, Traumatic Brain Injury, Suicide, Homelessness, and Serious Illness Especially at the End of Life.

  12. A pilot study of seeking safety therapy with OEF/OIF veterans.

    PubMed

    Norman, Sonya B; Wilkins, Kendall C; Tapert, Susan F; Lang, Ariel J; Najavits, Lisa M

    2010-03-01

    PTSD and substance use disorder (SUD) are highly prevalent among veterans returning from Iraq and Afghanistan (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF). Seeking Safety (SS) is a cognitive-behavioral psychotherapy for co-occurring PTSD/SUD. This pilot study with fourteen male OEF/OIF veterans suggests that SS may help to reduce alcohol use, PTSD, and depression in some participants at clinically significant levels, even when providing less than half of the full model. We emphasize several SS features as especially helpful: the case management component to help engage clients in further mental health and SUD care, offering PTSD as an entry point, and emphasis on community resources. Issues particular to veterans include reintegration to civilian life and supporting their connection with other veterans.

  13. Problems with veteran-family communication during operation enduring freedom/operation Iraqi freedom military deployment.

    PubMed

    Hinojosa, Ramon; Hinojosa, Melanie Sberna; Högnäs, Robin S

    2012-02-01

    Twenty Reserve component (Army and Marines) and Army National Guard male veterans of Operational Enduring Freedom/Operation Iraqi Freedom discuss their deployment and postdeployment family reintegration experiences. A Grounded Theory approach is used to highlight some of the ways in which family miscommunication during deployment can occur. Communication with civilian family members is affected by the needs of operational security, technical problems with communication tools, miscommunication between family members, or because veterans have "nothing new to say" to family back home. These communication difficulties may lead to an initial gulf of understanding between veterans and family members that can cause family strain during postdeployment family reintegration. We end with a discussion of veteran family reintegration difficulties.

  14. Reproductive health and pregnancy outcomes among French gulf war veterans

    PubMed Central

    Verret, Catherine; Jutand, Mathe-Aline; De Vigan, Catherine; Bégassat, Marion; Bensefa-Colas, Lynda; Brochard, Patrick; Salamon, Roger

    2008-01-01

    Background Since 1993, many studies on the health of Persian Gulf War veterans (PGWVs) have been undertaken. Some authors have concluded that an association exists between Gulf War service and reported infertility or miscarriage, but that effects on PGWV's children were limited. The present study's objective was to describe the reproductive outcome and health of offspring of French Gulf War veterans. Methods The French Study on the Persian Gulf War (PGW) and its Health Consequences is an exhaustive cross-sectional study on all French PGWVs conducted from 2002 to 2004. Data were collected by postal self-administered questionnaire. A case-control study nested in this cohort was conducted to evaluate the link between PGW-related exposures and fathering a child with a birth defect. Results In the present study, 9% of the 5,666 Gulf veterans who participated reported fertility disorders, and 12% of male veterans reported at least one miscarriage among their partners after the PGW. Overall, 4.2% of fathers reported at least one child with a birth defect conceived after the mission. No PGW-related exposure was associated with any birth defect in children fathered after the PGW mission. Concerning the reported health of children born after the PGW, 1.0% of children presented a pre-term delivery and 2.7% a birth defect. The main birth defects reported were musculoskeletal malformations (0.5%) and urinary system malformations (0.3%). Birth defect incidence in PGWV children conceived after the mission was similar to birth defect incidence described by the Paris Registry of Congenital Malformations, except for Down syndrome (PGWV children incidence was lower than Registry incidence). Conclusion This study did not highlight a high frequency of fertility disorders or miscarriage among French PGW veterans. We found no evidence for a link between paternal exposure during the Gulf War and increased risk of birth defects among French PGWV children. PMID:18442369

  15. Statin myalgia is not associated with reduced muscle strength, mass or protein turnover in older male volunteers, but is allied with a slowing of time to peak power output, insulin resistance and differential muscle mRNA expression.

    PubMed

    Mallinson, Joanne E; Marimuthu, Kanagaraj; Murton, Andrew; Selby, Anna; Smith, Kenneth; Constantin-Teodosiu, Dumitru; Rennie, Michael J; Greenhaff, Paul L

    2015-03-01

    Statins are associated with muscle myalgia and myopathy, which probably reduce habitual physical activity. This is particularly relevant to older people who are less active, sarcopaenic and at increased risk of statin myalgia. We hypothesised that statin myalgia would be allied to impaired strength and work capacity in older people, and determined whether differences aligned with divergences in lean mass, protein turnover, insulin sensitivity and the molecular regulation of these processes. Knee extensor strength and work output during 30 maximal isokinetic contractions were assessed in healthy male volunteers, nine with no statin use (control 70.4 ± 0.7 years) and nine with statin myalgia (71.5 ± 0.9 years). Whole body and leg glucose disposal, muscle myofibrillar protein synthesis (MPS) and leg protein breakdown (LPB) were measured during fasting (≈5 mU l(-1) insulin) and fed (≈40 mU l(-1) insulin + hyperaminoacidaemia) euglyceamic clamps. Muscle biopsies were taken before and after each clamp. Lean mass, MPS, LPB and strength were not different but work output during the initial three isokinetic contractions was 19% lower (P < 0.05) in statin myalgic subjects due to a delay in time to reach peak power output. Statin myalgic subjects had reduced whole body (P = 0.05) and leg (P < 0.01) glucose disposal, greater abdominal adiposity (P < 0.05) and differential expression of 33 muscle mRNAs (5% false discovery rate (FDR)), six of which, linked to mitochondrial dysfunction and apoptosis, increased at 1% FDR. Statin myalgia was associated with impaired muscle function, increased abdominal adiposity, whole body and leg insulin resistance, and evidence of mitochondrial dysfunction and apoptosis.

  16. Older Drivers

    MedlinePlus

    ... Affects Driving Tips for Safe Driving Making Your Vehicle Safe Regulations Affecting Older Drivers When Driving Skills ... Like drivers of any age, they use their vehicles to go shopping, do errands, and visit the ...

  17. 38 CFR 3.454 - Veterans disability pension.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Veterans disability pension. 3.454 Section 3.454 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... disability pension. Apportionment of disability pension will be as follows: (a) Where a veteran with...

  18. 38 CFR 60.6 - Condition of veteran.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Condition of veteran. 60.6 Section 60.6 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FISHER HOUSES AND OTHER TEMPORARY LODGING § 60.6 Condition of veteran. As a condition for...

  19. 38 CFR 60.6 - Condition of veteran.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Condition of veteran. 60.6 Section 60.6 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FISHER HOUSES AND OTHER TEMPORARY LODGING § 60.6 Condition of veteran. As a condition for...

  20. 13 CFR 120.360 - Which veterans are eligible?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... veterans: (a) Vietnam-era veterans who served for a period of more than 180 days between August 5, 1964... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Which veterans are eligible? 120... Special Purpose Loans Veterans Loan Program § 120.360 Which veterans are eligible? SBA may guarantee...

  1. 38 CFR 21.420 - Informing the veteran.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of adverse action. VA shall give the veteran a period of at least 30 days to indicate his or her... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Informing the veteran. 21.420 Section 21.420 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  2. 13 CFR 120.360 - Which veterans are eligible?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... veterans: (a) Vietnam-era veterans who served for a period of more than 180 days between August 5, 1964... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Which veterans are eligible? 120... Special Purpose Loans Veterans Loan Program § 120.360 Which veterans are eligible? SBA may guarantee...

  3. 38 CFR 21.272 - Veteran-student services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 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...

  4. 38 CFR 21.272 - Veteran-student services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 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...

  5. 38 CFR 21.272 - Veteran-student services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 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...

  6. Comparing clinical outcomes in HIV-infected and uninfected older men hospitalized with community-acquired pneumonia

    PubMed Central

    Barakat, LA; Juthani-Mehta, M; Allore, H; Trentalange, M; Tate, J; Rimland, D; Pisani, M; Akgün, KM; Goetz, MB; Butt, AA; Rodriguez-Barradas, M; Duggal, M; Crothers, K; Justice, AC; Quagliarello, VJ

    2016-01-01

    Objectives Outcomes of community–acquired pneumonia (CAP) among HIV-infected older adults are unclear. Methods Associations between HIV infection and three CAP outcomes (30-day mortality, readmission within 30 days post-discharge, and hospital length of stay [LOS]) were examined in the Veterans Aging Cohort Study (VACS) of male Veterans, age ≥ 50 years, hospitalized for CAP from 10/1/2002 through 08/31/2010. Associations between the VACS Index and CAP outcomes were assessed in multivariable models. Results Among 117 557 Veterans (36 922 HIV-infected and 80 635 uninfected), 1203 met our eligibility criteria. The 30-day mortality rate was 5.3%, the mean LOS was 7.3 days, and 13.2% were readmitted within 30 days of discharge. In unadjusted analyses, there were no significant differences between HIV-infected and uninfected participants regarding the three CAP outcomes (P > 0.2). A higher VACS Index was associated with increased 30-day mortality, readmission, and LOS in both HIV-infected and uninfected groups. Generic organ system components of the VACS Index were associated with adverse CAP outcomes; HIV-specific components were not. Among HIV-infected participants, those not on antiretroviral therapy (ART) had a higher 30-day mortality (HR 2.94 [95% CI 1.51, 5.72]; P = 0.002) and a longer LOS (slope 2.69 days [95% CI 0.65, 4.73]; P = 0.008), after accounting for VACS Index. Readmission was not associated with ART use (OR 1.12 [95% CI 0.62, 2.00] P = 0.714). Conclusion Among HIV-infected and uninfected older adults hospitalized for CAP, organ system components of the VACS Index were associated with adverse CAP outcomes. Among HIV-infected individuals, ART was associated with decreased 30-day mortality and LOS. PMID:25959543

  7. Rates and predictors of referral for individual psychotherapy, group psychotherapy, and medications among Iraq and Afghanistan veterans with PTSD.

    PubMed

    Mott, Juliette M; Barrera, Terri L; Hernandez, Caitlin; Graham, David P; Teng, Ellen J

    2014-04-01

    This study examined rates of referral for medication, individual psychotherapy, and group psychotherapy within a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty mental health clinic. Participants were 388 Iraq and Afghanistan veterans who were referred for PTSD treatment following a mental health evaluation required for all new VA enrollees. The majority of the sample was referred for medication (79 %), with comparatively fewer referrals for individual (39 %) or group psychotherapy (24 %). Forty percent of participants were referred for combined medication and psychotherapy. Patient demographic and clinical characteristics were examined to determine whether these variables predicted referral type. Female veterans and those with lower clinician ratings of overall functioning were more likely to be referred for individual therapy. Group psychotherapy referrals were more common in veterans who were older, unemployed, identified as an ethnic minority, and had a comorbid anxiety disorder. There were no significant predictors of medication referral.

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

    ERIC Educational Resources Information Center

    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. Reflections on the culture of veterans.

    PubMed

    Hobbs, Keynan

    2008-08-01

    Veterans, as a cultural group, present unique challenges to health care providers. Veteran culture includes health inequalities and health disparities related to posttraumatic stress disorder, depression, and substance abuse that must be understood in context to provide the best care possible to this population. Veterans are not, however, frequently viewed in terms of culturally competent nursing care. Changes in the approach to this population are necessary to provide effective, comprehensive, and compassionate care.

  10. Statin myalgia is not associated with reduced muscle strength, mass or protein turnover in older male volunteers, but is allied with a slowing of time to peak power output, insulin resistance and differential muscle mRNA expression

    PubMed Central

    Mallinson, Joanne E.; Marimuthu, Kanagaraj; Murton, Andrew; Selby, Anna; Smith, Kenneth; Constantin‐Teodosiu, Dumitru; Rennie, Michael J.

    2015-01-01

    Key points Statins cause muscle‐specific side effects, most commonly muscle aches/weakness (myalgia), particularly in older people. Furthermore, evidence has linked statin use to increased risk of type 2 diabetes. However, the mechanisms involved are unknown.This is the first study to measure muscle protein turnover rates and insulin sensitivity in statin myalgic volunteers and age‐matched, non‐statin users under controlled fasting and fed conditions using gold standard methods.We demonstrate in older people that chronic statin myalgia is not associated with deficits in muscle strength and lean mass or the dysregulation of muscle protein turnover compared to non‐statin users. Furthermore, there were no between‐group differences in blood or muscle inflammatory markers.Statin users did, however, show blunting of muscle power output at the onset of dynamic exercise, increased abdominal adiposity, whole body and leg insulin resistance, and clear differential expression of muscle genes linked to mitochondrial dysfunction and apoptosis, which warrant further investigation. Abstract Statins are associated with muscle myalgia and myopathy, which probably reduce habitual physical activity. This is particularly relevant to older people who are less active, sarcopaenic and at increased risk of statin myalgia. We hypothesised that statin myalgia would be allied to impaired strength and work capacity in older people, and determined whether differences aligned with divergences in lean mass, protein turnover, insulin sensitivity and the molecular regulation of these processes. Knee extensor strength and work output during 30 maximal isokinetic contractions were assessed in healthy male volunteers, nine with no statin use (control 70.4 ± 0.7 years) and nine with statin myalgia (71.5 ± 0.9 years). Whole body and leg glucose disposal, muscle myofibrillar protein synthesis (MPS) and leg protein breakdown (LPB) were measured during fasting (≈5 mU l−1 insulin

  11. Neuropsychological Function in a Case of Dandy-Walker Variant in a 68-Year-Old Veteran.

    PubMed

    Gross, Patricia L; Kays, Jill L; Shura, Robert D

    2016-01-01

    Dandy-Walker syndrome (DWS) is a congenital brain malformation that is characterized by partial or complete agenesis of the cerebellar vermis and cystic dilatation of the 4th ventricle that shifts ventrolaterally to displace the cerebellar hemispheres. This case is a 68-year-old male veteran with complaints of new-onset cognitive disorder who was found to have previously unsuspected DWS on head computed tomography. This is one of the first case studies to present complete neuropsychological test results in a veteran with DWS. Despite the level of abnormality on imaging, the veteran functioned well until onset of mild cognitive impairments in late adulthood.

  12. Latino Veterans with PTSD: A Systematic Review

    PubMed Central

    Pittman, James O. E.

    2014-01-01

    Latinos have a long history of military service with recent service including combat conditions and multiple deployments, which are highly associated with posttraumatic stress disorder (PTSD). Clinical acumen underscores the importance of culture in assessment and treatment, but there has been little scientific literature that investigates the unique needs of veteran Latinos with PTSD. The primary goal of this systematic review was to analyze the existing literature on Latino veterans with PTSD and to critically evaluate attention to cultural issues. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to guide this review. Peer-reviewed, research reports written in English on Latino Veterans with PTSD since 1980 were included; 20 were assessment related, and nine were treatment related. All studies were quantitative. Only 13 studies mentioned culture as part of the context for Latino veterans, and only seven included cultural factors as part of the study design. Present findings highlight a lack of research focused on understanding cultural factors related to the assessment and treatment of Latino veterans with PTSD. Culturally-informed research on Latino veterans from current wars, Latina veterans and Latino veteran treatment outcomes are necessary to provide culturally-appropriate care to this growing veteran subgroup. PMID:25379284

  13. 75 FR 78807 - Agency Information Collection (Notice to Department of Veterans Affairs of Veteran or Beneficiary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... Incarcerated in Penal Institution) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution, VA Form 21-4193. OMB Control... should be reduced or terminated when he or she is incarcerated in a penal institution in excess of...

  14. Patient reported determinants of health: a qualitative analysis of veterans with chronic obstructive pulmonary disease.

    PubMed

    Panos, Ralph J; Krywkowski-Mohn, Sara M; Sherman, Susan N; Lach, Laura A

    2013-06-01

    Although COPD is a common disorder of veterans who receive care from the Veterans Healthcare Administration (VHA), the perceptions of veterans with COPD about their disease, its effects on their lives, and their interactions with the VHA have not been determined. Utilizing qualitative methodology, we conducted focus groups of veterans with COPD at the Cincinnati VA Medical Center. Participants were selected by systematic sampling from the top quintile of veterans stratified by the cost of healthcare utilization related to a primary diagnosis of COPD and grouped by age and use of supplemental oxygen. All 42 participants were male and had a mean age of 65 years. Analysis of the focus group transcripts demonstrated five major themes: 1) Physical and Functional Limitations: work and employment constraints, recreation restrictions, limits on activities of daily living, reduced sexuality, concerns about housing and finances, and physical symptoms; 2) Restricted Social Interactions/Altered Social Networks: altered relationships with friends and family and reliance upon family and care givers; 3) Emotional Effects: reduced self-worth, vulnerability, depression, perseverance and adaptation, hopelessness, fear, pride, and lack of control; 4) Limitations in the Understanding of COPD: unawareness of diagnosis, triggers and reaction to disease manifestations, COPD management; and 5) Complex Healthcare Interactions. COPD pervasively and extensively affects all aspects of veterans' lives and causes significant consequences for their care and management. PMID:23537003

  15. Dioxins and dibenzofurans in adipose tissue of U. S. Vietnam veterans and controls

    SciTech Connect

    Kang, H.K.; Watanabe, K.K.; Breen, J.; Remmers, J.; Conomos, M.

    1990-08-01

    Concern about the adverse effects of exposure to Agent Orange is for the most part attributable to its toxic contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). A total of 40 Vietnam veterans, 80 non-Vietnam veterans and 80 civilian men were selected from males born between 1936 and 1954 and their adipose tissues were analyzed for 17 2,3,7,8-substituted dioxins and dibenzofurans. TCDD levels were log normally distributed and the mean level of 2,3,7,8-TCDD in adipose tissue of the Vietnam veterans (13.4 ppt) was not significantly different from that of the non-Vietnam veterans (12.5 ppt) or civilian men (15.8 ppt). Adjusting for demographic variables did not change the conclusions. The study results suggest that heavy exposure to Agent Orange for most Vietnam veterans was very unlikely and that there is no readily available and reliable indirect method of assessing exposure to Agent Orange for Vietnam veterans.

  16. 75 FR 14633 - Homeless Veterans' Reintegration Into Employment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Veterans' Employment and Training Service Homeless Veterans' Reintegration Into Employment AGENCY: Veterans' Employment... placement services (including job readiness and literacy and skills training) to expedite the...

  17. Expanded HIV Testing in the US Department of Veterans Affairs, 2009–2011

    PubMed Central

    Halloran, CNS, James; Pedati, Caitlin; Dursa, Erin K.; Durfee, Janet; Martinello, Richard; Davey, Victoria; Ross, David

    2013-01-01

    Objectives. We measured HIV testing and seropositivity among veterans in Veterans Affairs (VA) care for calendar years 2009 through 2011 and analyzed 2011 results by patient demographics. Methods. We performed a repeated-measures cross-sectional study using standardized electronic data extraction from the VA electronic health records for all veterans with at least 1 outpatient visit during 2009 through 2011. We analyzed testing rates and seropositivity by demographic characteristics for 2011. Results. Of veterans with an outpatient visit, 20.0% had an HIV test in 2011, compared with 9.2% in 2009. Documented HIV testing rates were highest in women and Blacks. Of confirmed positive test results, 67.0% were in outpatients older than 50 years. Seropositivity was highest among men aged 30 to 49 years, women aged 50 to 69 years, and Black outpatients of both genders. Implementation of an electronic clinical reminder was associated with higher testing rates. Conclusions. The significant effect of an electronic clinical reminder suggests that such decision support tools can substantially increase testing rates. The frequency of positive test results in older individuals suggests the need for additional work to define optimum approaches to HIV testing in this population. PMID:24134344

  18. Affect and psychiatric symptoms in a veteran polytrauma clinic.

    PubMed

    Kraal, A Zarina; Waldron-Perrine, Brigid; Pangilinan, Percival H; Bieliauskas, Linas A

    2015-02-01

    Although the relationship between negative affect and psychiatric symptoms has been well-demonstrated in research, less is known about positive affect relative to negative affect, and its relationship to psychiatric symptoms, especially among veterans. This study examined how levels of positive and negative affect are associated with symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Data were collected in a veteran polytrauma clinic; analyses were conducted using data from 94 veterans (87 males) with and without a mild traumatic brain injury (mTBI) diagnosis. Results demonstrate that positive and negative affect were separate dimensions and that both were independently related to each symptom measure. After removing the contribution of negative affect from symptom reports, strong relationships remained between positive affect and psychiatric symptoms. Furthermore, the magnitude of the associations for positive affect and for negative affect with symptoms of depression, anxiety, and PTSD were not impacted by a mTBI diagnosis. Altogether, findings suggest that both positive and negative affect should be uniquely considered when conceptualizing, assessing, and treating returning service members; in addition, positive affect may be an appropriate target of assessment and interventions of persons who have experienced polytrauma.

  19. Coming Home: A Group-Based Approach for Assisting Military Veterans in Transition

    ERIC Educational Resources Information Center

    Westwood, Marvin J.; McLean, Holly; Cave, Douglas; Borgen, William; Slakov, Paul

    2010-01-01

    This study is an evaluation of the Veterans Transition Program, a residential, group-based program designed to assist the transition of military personnel back into Canadian society by aiding with their personal and career readjustment. Participants in the program included 18 male soldiers who experienced varying degrees of combat-related trauma.…

  20. Mental Health Issues in Recently Returning Women Veterans: Implications for Practice

    ERIC Educational Resources Information Center

    Carlson, Bonnie E.; Stromwall, Layne K.; Lietz, Cynthia A.

    2013-01-01

    Increasing numbers of women are found in the military, and they are now performing roles very similar to those of male service members. More returning servicewomen and veterans have been exposed to stressful and traumatic experiences, such as combat and difficult living circumstances, and military sexual trauma is common. These experiences have…

  1. Women and the U.S. Military: Invisible Soldier and Veteran. An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Wagner, Christine

    1991-01-01

    Examines the literature on women's experiences in the military and the Veterans Administration. Places special emphasis on women who served in Vietnam. Finds the amount of literature minimal compared to information available about male experiences. Argues that the available literature is a useful teaching tool that illustrates discrimination…

  2. Gender Differences in Predictors of Suicidal Thoughts and Attempts Among Homeless Veterans that Abuse Substances

    ERIC Educational Resources Information Center

    Benda, Brent B.

    2005-01-01

    This study of 315 male and 310 female homeless military veterans in a V.A. inpatient program designed to treat substance abusers, many of whom also suffer psychiatric disorders, was designed to examine gender differences in factors associated with the odds of having suicidal thoughts, and of attempting suicide, in comparison to being nonsuicidal.…

  3. Echocardiogram Utilization Among Rural and Urban Veterans

    PubMed Central

    Okrah, Kingston; Vaughan-Sarrazin, Mary; Kaboli, Peter; Cram, Peter

    2011-01-01

    Purpose To compare echocardiography use among urban and rural veterans and whether differences could be accounted for by distance. Methods We used Veterans Administration (VA) administrative data from 1999 to 2007 to identify regular users of the VA Healthcare System (VA users) who did and did not receive echocardiography. Each veteran was categorized as residing in urban, rural or highly rural areas using RUCA codes. Poisson regression was used to compare echocardiography utilization rates among veterans residing in each area after adjusting for demographics, comorbidities, clustering of patients within VA networks and distance to the nearest VA medical center offering echocardiography. Findings Our study included 22.7 million veterans of whom 1.3 million (5.7%) received at least one echocardiogram. Of echocardiography recipients, 69.2% lived in urban, 22.0% in rural and 8.8% in highly rural areas. In analyses adjusting for patient demographics, comorbidities, and clustering, utilization of echocardiography was modestly lower for highly rural and rural veterans compared with urban veterans (42.0 vs 40.1 vs 43.1 echocardiograms per 1,000 VA users per year for highly rural, rural and urban, respectively; P < .001). After further adjusting for distance, echocardiography utilization was somewhat higher for veterans in highly rural and rural areas than it was for urban areas (44.9 vs 41.8 vs 40.8 for highly rural, rural and urban, respectively; P < .001). Conclusions Echocardiography utilization among rural and highly rural veterans was marginally lower than for urban veterans, but these differences can be accounted for by the greater distance of more rural veterans from facilities offering echocardiograms. PMID:22236338

  4. Acute Respiratory Tract Infection Visits of Veterans With Spinal Cord Injuries and Disorders: Rates, Trends, and Risk Factors

    PubMed Central

    Smith, Bridget M; Evans, Charlesnika T; Kurichi, Jibby E; Weaver, Frances M; Patel, Nayna; Burns, Stephen P

    2007-01-01

    Background/Objectives: Respiratory complications are a major cause of illness and death in persons with spinal cord injuries and dysfunction (SCI&Ds). The objectives of this study were to examine rates of outpatient visits over 5 years for acute respiratory tract infections (ARIs), including pneumonia and influenza (P&I), lower respiratory tract infections (LRIs), and upper respiratory tract infections (URIs), in veterans with SCI&Ds and to determine whether individual characteristics were associated with the number of annual visits for each type of ARI. Methods: This was a longitudinal (fiscal years 1998–2002) study of ARI visits at the Veterans Health Administration (VA) in 18,693 veterans with SCI&Ds. To examine the associations between time, patient characteristics, and annual number of ARI visits, we used random effect negative binomial models. Results: Veterans with SCI&Ds had a total of 11,113 ARI visits over the 5-year period. There was a slightly decreasing trend for LRI visits over time (P < 0.01) but no significant change for other ARIs over time. There were 30 to 35 pneumonia visits and 21 to 30 acute bronchitis visits per 1,000 SCI&D veterans per year. Older veterans were more likely than younger to have P&I visits and less likely to have URI visits (P < 0.01). Veterans with paraplegia had fewer P&I visits than subjects with tetraplegia (IRR = 0.58; CI = 0.51–0.67). Conclusions: Visit rates for ARIs are stable for veterans with SCI&Ds. Identifying risk factors associated with ARI visits is an important first step to improve prevention and treatment of ARIs and to improve the health of veterans with SCI&Ds. PMID:17853657

  5. 77 FR 3843 - Agency Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... AFFAIRS Agency Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing Survey) Under OMB Review AGENCY: Board of Veterans' Appeals, Department of Veterans Affairs. ACTION... notice announces that the Board of Veterans' Appeals (BVA), Department of Veterans Affairs, will...

  6. 76 FR 70827 - Proposed Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... AFFAIRS Proposed Information Collection (Board of Veterans' Appeals Customer Satisfaction With Hearing Survey Card) Activity; Comment Request AGENCY: Board of Veterans' Appeals, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Board of Veterans' Appeals (BVA), Department of Veterans Affairs (VA),...

  7. Injured brain regions associated with anxiety in Vietnam veterans.

    PubMed

    Knutson, Kristine M; Rakowsky, Shana T; Solomon, Jeffrey; Krueger, Frank; Raymont, Vanessa; Tierney, Michael C; Wassermann, Eric M; Grafman, Jordan

    2013-03-01

    Anxiety negatively affects quality of life and psychosocial functioning. Previous research has shown that anxiety symptoms in healthy individuals are associated with variations in the volume of brain regions, such as the amygdala, hippocampus, and the bed nucleus of the stria terminalis. Brain lesion data also suggests the hemisphere damaged may affect levels of anxiety. We studied a sample of 182 male Vietnam War veterans with penetrating brain injuries, using a semi-automated voxel-based lesion-symptom mapping (VLSM) approach. VLSM reveals significant associations between a symptom such as anxiety and the location of brain lesions, and does not require a broad, subjective assignment of patients into categories based on lesion location. We found that lesioned brain regions in cortical and limbic areas of the left hemisphere, including middle, inferior and superior temporal lobe, hippocampus, and fusiform regions, along with smaller areas in the inferior occipital lobe, parahippocampus, amygdala, and insula, were associated with increased anxiety symptoms as measured by the Neurobehavioral Rating Scale (NRS). These results were corroborated by similar findings using Neuropsychiatric Inventory (NPI) anxiety scores, which supports these regions' role in regulating anxiety. In summary, using a semi-automated analysis tool, we detected an effect of focal brain damage on the presentation of anxiety. We also separated the effects of brain injury and war experience by including a control group of combat veterans without brain injury. We compared this control group against veterans with brain lesions in areas associated with anxiety, and against veterans with lesions only in other brain areas. PMID:23328629

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

    PubMed

    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.

  9. Meeting the Needs of Women Veterans

    ERIC Educational Resources Information Center

    Baechtold, Margaret; De Sawal, Danielle M.

    2009-01-01

    The number of women veterans attending college is increasing. This suggests that campus professionals need to become aware of how issues associated with mental health, sexual assault, and gender identity may influence how women veterans make the transition into the higher education environment. This chapter addresses the special needs of women…

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

    ERIC Educational Resources Information Center

    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…

  11. Veterans with Disabilities in Postsecondary Education

    ERIC Educational Resources Information Center

    Madaus, Joseph W.; Miller, Wayne K., II; Vance, Mary Lee

    2009-01-01

    Over the past 60 years, veterans with disabilities have been a catalyst in the development of services for students with disabilities in higher education. Current converging factors, including anticipated large numbers of veterans with disabilities enrolling in postsecondary education, Office for Civil Rights directives, and the passage of the…

  12. Cost, Convenience Drive Veterans' College Choices

    ERIC Educational Resources Information Center

    Field, Kelly

    2008-01-01

    When Senator Jim Webb, a Democrat from Virginia, introduced his "21st-Century GI Bill" last year, he predicted that it would give veterans of the wars in Iraq and Afghanistan the same educational opportunities that World War II veterans received under the original GI Bill of Rights, signed into law more than a half century ago. Webb's bill, which…

  13. Veterans as Adult Learners in Composition Courses

    ERIC Educational Resources Information Center

    Navarre Cleary, Michelle; Wozniak, Kathryn

    2013-01-01

    Considering veterans in the context of research on adult and nontraditional students in college writing classes, this article proposes Malcolm Knowles's six principles for adult learning as an asset-based heuristic for investigating how writing programs and writing teachers might build upon existing resources to support veteran students.

  14. 75 FR 69327 - Veterans Day, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ....) [FR Doc. 2010-28609 Filed 11-9-10; 11:15 am] Billing code 3195-W1-P ... 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...

  15. 77 FR 67533 - Veterans Day, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... thirty-seventh. (Presidential Sig.) [FR Doc. 2012-27630 Filed 11-9-12; 8:45 am] Billing code 3295-F3 ... 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...

  16. 78 FR 67285 - Veterans Day, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-08

    ... thirty- eighth. (Presidential Sig.) [FR Doc. 2013-27093 Filed 11-7-13; 11:15 am] Billing code 3295-F4 ... November 8, 2013 Part IV The President Proclamation 9055--Veterans Day, 2013 #0; #0; #0; Presidential... Documents#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 9055 of November 5, 2013 Veterans Day,...

  17. 76 FR 69079 - Veterans Day, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ... America the two hundred and thirty-sixth. (Presidential Sig.) [FR Doc. 2011-28997 Filed 11-4-11; 11:15 am...--Veterans Day, 2011 #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 76, No. 215... 8751 of November 3, 2011 Veterans Day, 2011 By the President of the United States of America...

  18. 77 FR 20273 - Vietnam Veterans Day

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... thirty-sixth. (Presidential Sig.) [FR Doc. 2012-8162 Filed 4-2-12; 11:15 am] Billing code 3295-F2-P ... April 3, 2012 Part IV The President Proclamation 8789--Vietnam Veterans Day Memorandum of March 30, 2012... ] Proclamation 8789 of March 29, 2012 Vietnam Veterans Day By the President of the United States of America...

  19. 77 FR 4471 - Tribal Veterans Cemetery Grants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-30

    ... Frank Salvas, Director of Veterans Cemetery Grants Service, National Cemetery Administration (41E... proposed rulemaking in the Federal Register (76 FR 28925), that proposed to amend regulations in 38 CFR... obtain a grant to establish, expand, or improve a veterans cemetery that meets VA's national...

  20. Geothermal conversion at Veterans Hospital, Boise, Idaho

    NASA Astrophysics Data System (ADS)

    Engen, I. A.; Metzger, S. W.

    1982-02-01

    A geothermal resource near the Veterans Administration Hospital facilities in Boise, Idaho, has been used since the turn of the century for space heating of homes. A plan for using this resource in some of the Veterans Hospital facilities is discussed. Preliminary cost estimates are presented, economic evaluation criteria are given, and heating system alternatives for the facilities are compared.

  1. Traumatic brain injury among North Carolina's veterans.

    PubMed

    Hooker, James Stewart; Moore, Daniel P

    2015-04-01

    This article describes the difficulty of diagnosing traumatic brain injury (TBI), treatment protocols provided through the military, an alternative therapy with scientific evidence of its effectiveness in repairing injured brain tissue, challenges faced by brain-injured veterans seeking community reintegration, and state services that are available to help veterans.

  2. 4 CFR 2.6 - Veterans' preference.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Veterans' preference. 2.6 Section 2.6 Accounts GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL SYSTEM PURPOSE AND GENERAL PROVISION § 2.6 Veterans' preference. (a) GAO will provide preference, for any individual who would be a preference eligible in the executive branch, in...

  3. Faculty Attitudes and Behaviors towards Student Veterans

    ERIC Educational Resources Information Center

    Gonzalez, Carlene A.; Elliott, Marta

    2016-01-01

    According to the U.S. Department of Education (2013), approximately 11% of undergraduate students reported having a disability in the 2007-2008 academic year. Of these students, veterans reported having disabilities more than their non-veteran counterparts (5% vs. 3%). This study investigates faculty members' attitudes and behaviors toward student…

  4. Honoring Our Veterans through Poetry Prewriting.

    ERIC Educational Resources Information Center

    Woolley, Jill

    This lesson uses the informational power of the Internet for a prewriting activity. Through various Internet sites, students gather information about the history and celebration practices associated with Veterans Day. Following the prewriting activity, students write content-rich poems that honor veterans. During the 45-minute prewriting session,…

  5. Symptom Patterns Among Gulf War Registry Veterans

    PubMed Central

    Hallman, William K.; Kipen, Howard M.; Diefenbach, Michael; Boyd, Kendal; Kang, Han; Leventhal, Howard; Wartenberg, Daniel

    2003-01-01

    Objectives. We identify symptom patterns among veterans who believe they suffer from Gulf War–related illnesses and characterize groups of individuals with similar patterns. Methods. A mail survey was completed by 1161 veterans drawn from the Gulf War Health Registry. Results. An exploratory factor analysis revealed 4 symptom factors. A K-means cluster analysis revealed 2 groups: (1) veterans reporting good health and few moderate/severe symptoms, and (2) veterans reporting fair/poor health and endorsing an average of 37 symptoms, 75% as moderate/severe. Those in Cluster 2 were more likely to report having 1 or more of 24 medical conditions. Conclusions. These findings are consistent with previous investigations of symptom patterns in Gulf War veterans. This multisymptom illness may be more fully characterized by the extent, breadth, and severity of symptoms reported. PMID:12660208

  6. Posttraumatic stress disorder among black Vietnam veterans.

    PubMed

    Allen, I M

    1986-01-01

    Because of racism in the military and racial and social upheaval in the United States during the Vietnam War years, as well as limited opportunities for blacks in the postwar period, black veterans of the Vietnam War often harbor conflicting feelings about their wartime experiences and have difficulty rationalizing brutality against the Vietnamese. As a result, black veterans suffer from posttraumatic stress disorder (PTSD) at a higher rate than white veterans. Diagnosis and treatment of PTSD in black veterans is complicated by the tendency to misdiagnose black patients, by the varied manifestations of PTSD, and by patients' frequent alcohol and drug abuse and medical, legal, personality, and vocational problems. The author presents his and others' recommendations about ways to treat black veterans with PTSD.

  7. Experiences of Veterans Transitioning to Postsecondary Education

    PubMed Central

    Howell, Dana M.; Shordike, Anne

    2016-01-01

    An increasing number of U.S. military veterans are entering postsecondary education with problems attributed to deployed military service. The primary objective of this research was to describe the lived experiences of student veterans transitioning from active military service to postsecondary education. Phenomenological interviews were performed with 13 student veterans who had transitioned from military deployment to postsecondary education. An overall essential meaning of “emerging in college culture” was manifested from three themes, supported by rich textural and structural descriptions of student veterans’ experiences: (1) repurposing military experiences for life as a student veteran, (2) reconstructing civilian identity, and (3) navigating postsecondary context and interactions. These findings highlight implications that may facilitate occupational therapists’ efforts in supporting the needs of student veterans. PMID:27767948

  8. Nursing advocacy for women veterans and suicide.

    PubMed

    Conard, Patricia L; Armstrong, Myrna L; Young, Cathy; Hogan, La Micha

    2015-03-01

    Little is known about suicide variables in women Veterans. The authors reviewed numerous applicable health care and military literary sources regarding suicide in this population. The current article describes the surrounding circumstances, military war/conflict culture, and potential effects on women Veterans, including major collection problems with current Veteran data. Women Veterans are increasingly reporting more behavioral health issues (e.g., posttraumatic stress disorder) and attempting suicide upon civilian reintegration. Outcomes from this literature review suggest the importance of nursing advocacy to create better rapport and communication with women Veterans from Vietnam, Gulf I, Iraq, and Afghanistan wars seeking care at civilian health facilities, as some may present with suicidal ideologies. PMID:25751826

  9. Aging, Depression, and Wisdom: A Pilot Study of Life-Review Intervention and PTSD Treatment With Two Groups of Vietnam Veterans.

    PubMed

    Daniels, Lori R; Boehnlein, James; McCallion, Phillip

    2015-01-01

    Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide.

  10. Aging, Depression, and Wisdom: A Pilot Study of Life-Review Intervention and PTSD Treatment With Two Groups of Vietnam Veterans.

    PubMed

    Daniels, Lori R; Boehnlein, James; McCallion, Phillip

    2015-01-01

    Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide. PMID:25751708

  11. Gender Differences in Service Utilization among OEF/OIF Veterans with PTSD after a Brief Cognitive-Behavioral Intervention to Increase Treatment Engagement: A Mixed Methods Study

    PubMed Central

    Gallegos, Autumn M.; Wolff, Kristina B.; Streltzov, Nicholas; Adams, Leslie B.; Carpenter-Song, Elizabeth; Nicholson, Joanne; Stecker, Tracy

    2015-01-01

    Purpose Women veterans of Iraq and Afghanistan (OEF/OIF) have a moderately higher risk of developing post-traumatic stress disorder (PTSD) than male veterans. However, gender disparities in treatment engagement may prevent women veterans from initiating the care they need. Understanding gender differences in predictors of and barriers to treatment is essential to improving engagement and mental health outcomes. The purpose of this study was to examine gender differences in treatment utilization after a brief, Cognitive-Behavioral Therapy (CBT) intervention among male and female OEF/OIF veterans. Methods Participants were randomly assigned to either the intervention or control conditions. Intervention participants received the telephone-based CBT intervention. Participants were 35 female and 238 male OEF/OIF veterans who screened positive for PTSD and had never initiated PTSD treatment. Participants were asked about treatment utilization, beliefs about PTSD treatment, and symptoms at months 1, 3, and 6 months subsequent to the baseline telephone assessment. The PTSD Checklist-Military Version was used to assess PTSD and the Patient’s Health Questionnaire was used to assess symptoms of depression. Findings Female veterans who received an intervention were significantly more likely to have attended treatment over the six-month follow-up period than male veterans who received an intervention (χ2 = 7.91, df = 3, OR = 3.93, p = 0.04). Conclusions The CBT intervention may be a critical mechanism to engage female veterans in treatment. Further research is needed to understand how to engage male veterans with PTSD in treatment. PMID:26051022

  12. Death, Suicide, and the Older Adult.

    ERIC Educational Resources Information Center

    Kastenbaum, Robert

    1992-01-01

    Notes characteristics of older adults at high risk for suicide (male, living alone, living in low-income transient urban area, depression). Provides converging perspectives on death and suicide from standpoints of external observer and older adult. Interprets statistical pattern and critiques current policy proposals for limiting society's…

  13. Deployment Experiences, Social Support, and Mental Health: Comparison of Black, White, and Hispanic U.S. Veterans Deployed to Afghanistan and Iraq.

    PubMed

    Muralidharan, Anjana; Austern, David; Hack, Samantha; Vogt, Dawne

    2016-06-01

    Compared to their White counterparts, Black and Hispanic Vietnam-era, male, combat veterans in the United States have experienced discrimination and increased trauma exposure during deployment and exhibited higher rates of postdeployment mental health disorders. The present study examined differences in deployment experiences and postdeployment mental health among male and female Black, Hispanic, and White veterans deployed in support of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq. Data were drawn from a national survey of veterans (N = 924) who had returned from deployment within the last 2 years. Ethnoracial minority veterans were compared to White veterans of the same gender on deployment experiences and postdeployment mental health. The majority of comparisons did not show significant differences; however, several small group differences did emerge (.02 < η(2) < .04). Ethnoracial minority veterans reported greater perceived threat in the warzone and more family-related concerns and stressors during deployment than White veterans of the same gender. Minority female veterans reported higher levels of postdeployment symptoms of anxiety than their White counterparts, which were accounted for by differences in deployment experience. These differences call for ongoing monitoring. PMID:27191777

  14. Deployment Experiences, Social Support, and Mental Health: Comparison of Black, White, and Hispanic U.S. Veterans Deployed to Afghanistan and Iraq.

    PubMed

    Muralidharan, Anjana; Austern, David; Hack, Samantha; Vogt, Dawne

    2016-06-01

    Compared to their White counterparts, Black and Hispanic Vietnam-era, male, combat veterans in the United States have experienced discrimination and increased trauma exposure during deployment and exhibited higher rates of postdeployment mental health disorders. The present study examined differences in deployment experiences and postdeployment mental health among male and female Black, Hispanic, and White veterans deployed in support of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq. Data were drawn from a national survey of veterans (N = 924) who had returned from deployment within the last 2 years. Ethnoracial minority veterans were compared to White veterans of the same gender on deployment experiences and postdeployment mental health. The majority of comparisons did not show significant differences; however, several small group differences did emerge (.02 < η(2) < .04). Ethnoracial minority veterans reported greater perceived threat in the warzone and more family-related concerns and stressors during deployment than White veterans of the same gender. Minority female veterans reported higher levels of postdeployment symptoms of anxiety than their White counterparts, which were accounted for by differences in deployment experience. These differences call for ongoing monitoring.

  15. An exploratory pilot investigation of neurosteroids and self-reported pain in female Iraq/Afghanistan-era Veterans.

    PubMed

    Naylor, Jennifer C; Kilts, Jason D; Strauss, Jennifer L; Szabo, Steven T; Dunn, Charlotte E; Wagner, H Ryan; Hamer, Robert M; Shampine, Lawrence J; Zanga, Joseph R; Marx, Christine E

    2016-01-01

    Female Veterans are the most rapidly growing segment of new users of the Veterans Health Administration (VHA), and a significant proportion of female Veterans receiving treatment from VHA primary care providers report persistent pain symptoms. Currently, available data characterizing the neurobiological underpinnings of pain disorders are limited. Preclinical data suggest that neurosteroids may be involved in the modulation of pain symptoms, potentially via actions at gamma-aminobutyric acid (GABA) and N-methyl-D-aspartate (NMDA) receptors. Dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) are neurosteroids that modulate inhibitory GABA receptors and excitatory NMDA receptors, producing complex neuronal effects. Emerging evidence from male Iraq/Afghanistan-era Veterans suggests that reductions in neurosteroid levels are associated with increased pain symptoms and that neurosteroids may be promising biomarker candidates. The current exploratory study thus examined associations between self-reported pain symptoms in 403 female Iraq/Afghanistan-era Veterans and serum DHEAS and DHEA levels. Serum DHEAS levels were inversely correlated with low back pain in female Veterans (Spearman r = -0.103; p = 0.04). Nonparametric analyses indicate that female Veterans reporting moderate/extreme low back pain demonstrated significantly lower DHEAS levels than those reporting no/little low back pain (|Z| = 2.60; p = 0.009). These preliminary findings support a role for DHEAS in pain physiology of low back pain and the rationale for neurosteroid therapeutics in pain analgesia. PMID:27533747

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

    PubMed Central

    Blosnich, John R.; Dichter, Melissa E.

    2015-01-01

    Abstract Background: 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. Methods: 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. Results: 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. Conclusions: 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. PMID:26390379

  17. Chemical sensitivity in symptomatic Cambodia veterans.

    PubMed

    Bischoff, Erik W M A; Soetekouw, Patricia M M B; De Vries, Maaike; Scheepers, Paul T I; Bleijenberg, Gijs; van der Meer, Jos W M

    2003-12-01

    Following their participation in a United Nations peacekeeping operation in Cambodia (1992-1993), Dutch veterans complained of symptoms similar to those reported by Gulf War veterans. The authors conducted a matched case-control study to evaluate 76 symptomatic and 32 matched asymptomatic Cambodia veterans on the basis of data collected by postal questionnaire. The number of symptomatic veterans who reported having used insect repellants that contained N,N,-diethyl-meta-toluamide (DEET) during the mission in Cambodia was significantly higher, compared with asymptomatic veterans. The percentage of veterans who reported feeling ill following brief exposures to chemicals such as paint or pesticides was equal in both groups, but the percentage was low compared with the results of other studies of Multiple Chemical Sensitivity Syndrome. The current study was limited by self-report and time delay (potential recall bias) between deployment to Cambodia and the time of survey. Nevertheless, the study results did not support the hypothesis that symptoms in the total group of Cambodia veterans could be related to Multiple Chemical Sensitivity Syndrome. PMID:15859508

  18. 38 CFR 12.6 - Cases of living veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... OF VETERAN'S PERSONAL FUNDS AND EFFECTS Disposition of Veteran's Personal Funds and Effects on Facility Upon Death, Or Discharge, Or Unauthorized Absence, and of Funds and Effects Found on Facility § 12.6 Cases of living veterans. (a) Except as provided in § 12.8, effects of veterans absent...

  19. Panel Discussion Outline: The Vietnam Veterans' Needs and Assessments.

    ERIC Educational Resources Information Center

    Little, Robert H.; And Others

    The comments of six panelists are presented as transcribed at a workshop conducted by the National Association of Veterans Program Administrators in order to examine the special needs of Vietnam Era veterans. First, Robert Chapman discusses the employment, counseling, and information needs of disadvantaged veterans, including disabled veterans,…

  20. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 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..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in...

  1. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in...

  2. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 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..., upon notice of the death, present them to the Secretary, who shall pay to the bank, in...

  3. 38 CFR 21.328 - Two veteran cases-dependents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Two veteran cases-dependents. 21.328 Section 21.328 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS.... Chapter 31 Authorization of Subsistence Allowance and Training and Rehabilitation Services § 21.328...

  4. 78 FR 28292 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review of VA's approach to and programs addressing 1990-1991 Gulf War Veterans' illnesses. The third...

  5. 76 FR 65321 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review of VA's approach to and programs addressing 1990-1991 Gulf War Veterans' illnesses. The second...

  6. 75 FR 16577 - Gulf War Veterans' Illnesses Task Force

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review of VA's approach to and programs addressing 1990-1991 Gulf War Veterans' illnesses. The Gulf...

  7. 38 CFR 21.155 - Services to a veteran's family.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... family. 21.155 Section 21.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS.... Chapter 31 Special Rehabilitation Services § 21.155 Services to a veteran's family. (a) General. VA shall provide services to a veteran's family which are necessary to the implementation of the...

  8. 76 FR 33788 - Homeless Veterans' Reintegration Into Employment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-09

    ...' Employment and Training Service Homeless Veterans' Reintegration Into Employment AGENCY: Veterans' Employment... Veterans Reintegration Program through fiscal year (FY) 2011 and indicates: ``The Secretary of Labor shall... training) to expedite the reintegration of homeless veterans into the labor force.'' HVRP grants...

  9. 38 CFR 3.656 - Disappearance of veteran.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....656 Disappearance of veteran. (a) When any veteran has disappeared for 90 days or more and his or her... spouse, children and parents, effective the day following the date of last payment to the veteran if a... the presumption of death under § 3.212. (d) When any veteran has disappeared for 90 days or more...

  10. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Redemption because of veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... Certificates Under Section 502 of the World War Adjusted Compensation Act § 11.84 Redemption because of...

  11. 38 CFR 11.84 - Redemption because of veteran's death.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Redemption because of veteran's death. 11.84 Section 11.84 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... Certificates Under Section 502 of the World War Adjusted Compensation Act § 11.84 Redemption because of...

  12. Lessons of Liberty: Veterans Day 2001 Teacher's Guide.

    ERIC Educational Resources Information Center

    Department of Veterans Affairs, Washington, DC.

    This teacher's guide helps teachers plan a class program for Veterans Day. The guide contains the following components (many with activities): "History of Veterans Day"; "Veterans Day National Ceremony"; "Suggested Veterans Day Programs"; "America's Wars (Statistics)"; "Fly Your Flag Regularly and Correctly"; "Respecting Your Flag"; "Correct…

  13. 38 CFR 3.656 - Disappearance of veteran.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....656 Disappearance of veteran. (a) When any veteran has disappeared for 90 days or more and his or her... spouse, children and parents, effective the day following the date of last payment to the veteran if a... the presumption of death under § 3.212. (d) When any veteran has disappeared for 90 days or more...

  14. Veterans and Community Colleges: They Need Each Other

    ERIC Educational Resources Information Center

    Johnson, Walter D.

    1975-01-01

    Reports a study of characteristics of veterans in community colleges and reviews governmental benefits for veterans and for educational institutions enrolling veterans. To help veterans, community colleges should establish day-care centers, housing and employment assistance, more occupationally oriented courses, better scheduling for part-time…

  15. 38 CFR 3.656 - Disappearance of veteran.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....656 Disappearance of veteran. (a) When any veteran has disappeared for 90 days or more and his or her... spouse, children and parents, effective the day following the date of last payment to the veteran if a... the presumption of death under § 3.212. (d) When any veteran has disappeared for 90 days or more...

  16. Posttraumatic Stress Disorder Among Army Nurse Corps Vietnam Veterans.

    ERIC Educational Resources Information Center

    Stretch, Robert H.; And Others

    1985-01-01

    Investigated posttraumatic stress disorder (PTSD) among Army nurse veterans. Analysis of questionnaire data (N=712) revealed a current PTSD rate for Vietnam veteran nurses of 3.3 percent. This rate is comparable to that found among nonnurse active duty Army Vietnam veterans and is much lower than estimates for civilian Vietnam veterans.…

  17. Voices from Vietnam: Veterans' Oral Histories in the Classroom.

    ERIC Educational Resources Information Center

    Hagopian, Patrick

    2000-01-01

    Discusses accounts given by Vietnam War veterans addressing issues such as the wannabe phenomenon, where not all people claiming to be veterans actually served in Vietnam, and the cultural script of the veteran. Highlights how oral histories are used by teachers and students. Describes a project where students interviewed Vietnam veterans. (CMK)

  18. 38 CFR 21.155 - Services to a veteran's family.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... Chapter 31 Special Rehabilitation Services § 21.155 Services to a veteran's family. (a) General. VA shall provide services to a veteran's family which are necessary to the implementation of the veteran's rehabilitation plan. The term family includes the veteran's immediate family, legal guardian, or any...

  19. Supporting Student Veteran Transition to College and Academic Success

    ERIC Educational Resources Information Center

    Kirchner, Michael J.

    2015-01-01

    Veterans enrolled in college face unique challenges compared with those of traditional students. Their experiences and perspectives, coupled with battling stereotypes and entering an unstructured college setting, contribute toward what can be a difficult transition. Student veteran organizations, veteran resource centers, veteran-specific…

  20. Psychiatric symptoms of Turkish combat-injured non-professional veterans

    PubMed Central

    Güloğlu, Berna

    2016-01-01

    Background It is well-known that exposure to combat puts individuals at risk for developing adverse psychological problems, including posttraumatic stress disorder (PTSD), depression, anxiety, and health-related behaviour problems and that the presence of combat-related injury increases the risk for psychopathology. Little is known, however, about the consequences of combat among conscripted soldiers fighting against terrorism in their homeland. Objective The main aim of the current study was to examine the prevalence of probable PTSD, severity of PTSD symptoms, depression, anxiety, and PTSD-related functional impairment among Turkish combat-injured, non-professional veterans. In addition, investigated were also the possible differences among the symptoms of PTSD, depression, and anxiety of the veterans by the frequency of current cigarette and alcohol use. Methods A total of 366 male veterans were assessed by using a demographic information form, which obtained information about injury status and health behaviours, the Posttraumatic Stress Diagnostic Scale (PDS), and the Brief Symptom Inventory (BSI). Symptom frequency and multivariate analysis of variances (MANOVA) were used to analyse the data. Results The prevalence of probable PTSD was 46.7% (171) among Turkish veterans while 16.4% experienced severe depression and 18% experienced severe anxiety. “Upset at reminders (65.8%)” was the most common PTSD symptom. “Responsibilities related to home (48.4%)” was the most frequently reported PTSD-related functional impairment. Results indicated that veterans who smoke more than half a pack per day scored significantly higher in severity of PTSD symptoms, depression, and anxiety. Contrary to expectations, there was no significant difference in symptoms of PTSD, depression, and anxiety related to the frequency of current alcohol use. Conclusion Turkish non-professional veterans with physical injuries have serious psychiatric problems an average of 13 years after

  1. Innovative Efforts to Address Homelessness Among Veterans.

    PubMed

    O'Toole, Thomas P; Pape, Lisa

    2015-01-01

    Ending homelessness among veterans has been a goal of the Department of Veterans Affairs for some time, and it is now becoming a reality in many communities. Unprecedented strides have been made through the rapid implementation of evidence-based innovations, capacity building, and a comprehensive strategic focus on 4 goals: prevention, moving veterans into permanent housing, providing the population-tailored care and services needed to keep them housed, and providing the supports necessary to allow them to recover and be productive members of their communities. PMID:26946863

  2. Readjustment of Urban Veterans: A Mental Health and Substance Use Profile of Iraq and Afghanistan Veterans in Higher Education

    ERIC Educational Resources Information Center

    Aikins, Ross D.; Golub, Andrew; Bennett, Alexander S.

    2015-01-01

    Objective: To identify the prevalence of substance use and mental health problems among veterans and student service members/veterans (SSM/V) returning from Iraq and Afghanistan to New York City's low-income neighborhoods. Participants: A sample of 122 veterans attending college and 116 veterans not enrolled recruited using respondent-driven…

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

    PubMed

    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.

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

    PubMed

    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. PMID:25643558

  5. Prevalence of Major Eye Diseases Among US Civil War Veterans, 1890–1910

    PubMed Central

    Sloan, Frank A.; Belsky, Daniel W.; Boly, Idrissa A.

    2013-01-01

    Objectives To estimate the prevalence of major eye diseases and low vision or blindness in a national sample of male US Union Army veterans from 1890 to 1910 and to compare these prevalence rates with contemporary rates for the same diseases and visual status. Design Longitudinal histories of 16 022 white Union Army veterans receiving disability pensions from 1890 to 1910 were developed from pension board examination records. Prevalence rates of trachoma, corneal opacities, cataract, diseases of the retina and optic nerve, and low vision or blindness were calculated in 1895 and 1910. Changes in prevalence by age were examined. Results By 1910, 11.9% of veterans had low vision or were blind in both eyes. Prevalence of cataract increased with age, resulting in 13.1% of veterans having had cataract in one or both eyes. Rates of trachoma were 3.2% in 1895 and 4.8% in 1910. Rates of corneal opacity were 3.0% and 5.1%, respectively. Glaucoma was rarely diagnosed from 1890 to 1910, but diseases of the optic nerve were reported in 2.0% of veterans in 1895 and 3.6% in 1910. Conclusions This study documents substantial reductions in the prevalence of low vision or blindness and changes in the composition of eye diseases from an era in which there were few effective therapies for eye diseases to the present. PMID:18268217

  6. The Veterans Aging Cohort Study (VACS) Index is associated with concurrent risk for neurocognitive impairment

    PubMed Central

    MARQUINE, María J.; UMLAUF, Anya; ROONEY, Alexandra; FAZELI, Pariya L.; GOUAUX, Ben; WOODS, Steven Paul; LETENDRE, Scott L.; ELLIS, Ronald J.; GRANT, Igor; MOORE, David J.

    2014-01-01

    Objective The Veterans Aging Cohort Study (VACS) Index is predictive of mortality, and combines age, traditional HIV biomarkers (HIV-1 plasma RNA and current CD4 count) and non-HIV biomarkers (indicators of renal and liver function, anemia, and Hepatitis C co-infection). We examined the association between the VACS Index and HIV-associated neurocognitive impairment (NCI). Design and Methods Participants included 601 HIV-infected adults enrolled in cohort studies at the UCSD HIV Neurobehavioral Research Program (Ages: 18-76 years; 88% male; 63% White; Median current CD4=364; 63% on antiretroviral therapy; AIDS=64%). Biomarkers used in calculating the VACS Index were measured in prospectively collected blood samples using conventional laboratory methods. NCI was defined using global and seven domain deficit scores. Results Higher VACS Index scores were associated with concurrent risk for global NCI (p<.001; OR=1.21, CI=1.12-1.32), even when adjusting for psychiatric comorbidities. This relation was statistically significant for most cognitive domains in adjusted models. Furthermore, the VACS Index predicted concurrent NCI beyond nadir CD4 and estimated duration of infection. Older age, lower hemoglobin and lower CD4 counts were the VACS components most strongly linked to NCI. Conclusions The findings extend prior research on the potential usefulness of the VACS Index in predicting HIV-associated outcomes to include NCI. Although the effect size was relatively small, our findings suggest that demographic information, HIV-disease factors, and common comorbidities might each play important roles in the clinical manifestation of cognitive impairment among HIV-infected individuals. Additional research is needed to determine if a more sensitive and specific index can be developed. PMID:24442225

  7. Access to care for transgender veterans in the Veterans Health Administration: 2006-2013.

    PubMed

    Kauth, Michael R; Shipherd, Jillian C; Lindsay, Jan; Blosnich, John R; Brown, George R; Jones, Kenneth T

    2014-09-01

    A 2011 Veterans Health Administration directive mandated medically necessary care for transgender veterans. Internal education efforts informed staff of the directive and promoted greater access to care. For fiscal years 2006 through 2013, we identified 2662 unique individuals with International Classification of Diseases, Ninth Revision diagnoses related to transgender status in Veterans Health Administration medical records, with 40% of new cases in the 2 years following the directive. A bottom-up push for services by veterans and top-down education likely worked synergistically to speed implementation of the new policy and increase access to care. PMID:25100417

  8. Fear of falling (FF): Psychosocial and physical factors among institutionalized older Chinese men in Taiwan.

    PubMed

    Chu, Chin-Liang; Liang, Chih-Kuang; Chow, Philip C; Lin, Yu-Te; Tang, Kwong-Yui; Chou, Ming-Yueh; Chen, Liang-Kung; Lu, Ti; Pan, Chih-Chuan

    2011-01-01

    Fear of falling (FF) can have multiple adverse consequences in the elderly. Although there are various fall prevention programs, little is known of FF and its associated characteristics. This study examined FF-associated physical and psychosocial factors in older Chinese men living in a veterans home in southern Taiwan. Subjects with a recent episode of delirium, of bed-ridden or wheelchair-bound status, severe hearing impairment or impaired cognition were excluded. Overall, 371 residents (mean age 82.1 ± 5.11 years, all males) participated. The prevalence of FF was 25.3%. Univariate analysis revealed that subjects in the FF group were older age, having lower education level, poorer sitting and standing balance, poorer activities of daily living (ADL), more depressive symptoms, higher chances of using walking aids, neurologic diseases, and a history of fall within the past 6 months. Logistic regression showed that depressive symptoms (odds ratio = OR = 6.73, 95%CI: 3.03-14.93, p < 0.001), activities of daily living (OR = 2.48, 95%CI: 1.08-5.71, p = 0.033), history of fall in the past 6 months (OR = 2.47, 95%CI: 1.04-5.9, p = 0.041), and neurological diseases (OR = 2.75, 95%CI: 1.15-6.56, p = 0.023) were all independent risk factors for FF.

  9. Sleep Disorders 6 Times Higher Among Veterans

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159985.html Sleep Disorders 6 Times Higher Among Veterans Post-traumatic ... 20, 2016 WEDNESDAY, July 20, 2016 (HealthDay News) -- Sleep disorders are six times more likely among American ...

  10. Veterans Opportunity to Work Act of 2011

    THOMAS, 112th Congress

    Rep. Miller, Jeff [R-FL-1

    2011-07-07

    10/13/2011 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  11. Veterans Appeals Improvement Act of 2011

    THOMAS, 112th Congress

    Rep. Filner, Bob [D-CA-51

    2011-04-12

    06/06/2011 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  12. Assuring Quality Care for Veterans Act

    THOMAS, 111th Congress

    Rep. McNerney, Jerry [D-CA-11

    2010-04-27

    05/26/2010 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  13. Chiropractic Care Available to All Veterans Act

    THOMAS, 111th Congress

    Rep. Filner, Bob [D-CA-51

    2009-02-12

    05/25/2010 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  14. Veteran Access to Care Act of 2014

    THOMAS, 113th Congress

    Rep. Miller, Jeff [R-FL-1

    2014-06-09

    06/11/2014 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  15. Veterans Health Care Improvement Act of 2013

    THOMAS, 113th Congress

    Sen. McConnell, Mitch [R-KY

    2013-11-07

    11/07/2013 Read twice and referred to the Committee on Veterans' Affairs. (text of measure as introduced: CR S7929) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. The 1932 Veterans' Bonus March on Washington.

    ERIC Educational Resources Information Center

    Singer, Alan

    1990-01-01

    Illustrates an innovative approach to teaching the 1932 Veterans' Bonus March on Washington DC. The teacher used instructional packets with 1930 nostalgia, the Pete Seeger album, "American Industrial Ballads," and film clips. An instructional guide is included. (GG)

  17. Defense and Veterans Brain Injury Center

    MedlinePlus

    ... Headache Following Concussion/Mild TBI Clinical Recommendation DCoE Blog TBI Highlights Give Concussion the Red Card (link ... of TBI (link is external) Read more DCoE blog articles » Defense and Veterans Brain Injury Center Crisis ...

  18. Veterans Mobility Safety Act of 2015

    THOMAS, 112th Congress

    Rep. Walorski, Jackie [R-IN-2

    2015-09-10

    09/13/2016 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  19. Veterans Economic Opportunity Act of 2013

    THOMAS, 113th Congress

    Rep. Flores, Bill [R-TX-17

    2013-06-25

    10/29/2013 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  20. Veterans Conservation Corps Act of 2013

    THOMAS, 113th Congress

    Sen. Nelson, Bill [D-FL

    2013-06-27

    11/19/2013 Committee on Veterans' Affairs. Ordered to be reported with an amendment in the nature of a substitute favorably. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. 75 FR 14633 - Veterans Workforce Investment Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-26

    ... eligible veterans. Projects that support the President's commitment to ``Green Energy Jobs'' and propose a clear strategy for training and employment in the renewable energy economy, are considered unique...

  2. Ambiguity as Persuasion: The Vietnam Veterans Memorial.

    ERIC Educational Resources Information Center

    Foss, Sonja K.

    1986-01-01

    Identifies five features of the Vietnam Veterans Memorial that may account for its deep universal appeal. Suggests the memorial's effectiveness may recommend it as a model for contemporary anti-war rhetoric. (MS)

  3. Putting Veterans Funding First Act of 2013

    THOMAS, 113th Congress

    Sen. Begich, Mark [D-AK

    2013-05-13

    11/19/2013 Committee on Veterans' Affairs. Ordered to be reported with an amendment in the nature of a substitute favorably. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  4. 38 CFR 63.3 - Eligible veterans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VA health care under 38 CFR 17.36 or 17.37; and (3) Have a serious mental illness and/or substance... worker, or addiction specialist). (b) Priority veterans. In allocating HCHV program resources, VA...

  5. 38 CFR 63.3 - Eligible veterans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... VA health care under 38 CFR 17.36 or 17.37; and (3) Have a serious mental illness and/or substance... worker, or addiction specialist). (b) Priority veterans. In allocating HCHV program resources, VA...

  6. Paraoxonase in Persian Gulf War veterans.

    PubMed

    Hotopf, Matthew; Mackness, Michael Ian; Nikolaou, Vasilis; Collier, David A; Curtis, Charles; David, Anthony; Durrington, Paul; Hull, Lisa; Ismail, Khalida; Peakman, Mark; Unwin, Catherine; Wessely, Simon; Mackness, Bharti

    2003-07-01

    Serum paraoxonase (PON1) is responsible for the metabolism of organophosphates in serum, and PON1 activity is a major determinant of their toxicity in humans. There have been reports linking lowered PON1 activity to physical symptoms after deployment to the Persian Gulf War (PGW) of 1990 to 1991. Therefore, the object of this study was to determine (1) whether PON1 activity was decreased among symptomatic PGW veterans compared with asymptomatic PGW veterans and (2) to determine whether PGW veterans as a whole had lower PON1 activity compared with other military control groups. This was a case control study nested in occupational cohort study of military personnel. Four groups of military personnel were identified from a large epidemiological study of health effects of deployment to the PGW and Bosnia: (1) symptomatic PGW veterans, n = 115; (2) healthy PGW veterans, n = 95; (3) symptomatic Bosnia peacekeeping veterans, n = 52; and (4) symptomatic nondeployed military controls, n = 85. The main outcome measures were PON1 activity and genotype for PON1-55 and -192. We found significant differences in PON1 activity among these four groups, and although the two Gulf groups did not differ in PON1 activity, those deployed to the Gulf had significantly lower PON1 activity compared with the non-PGW groups (median difference = 70.9; 95% CI: 20.2, 121.5, P = 0.012). These differences were not explained by a range of potential confounders, or differences in PON1 coding region polymorphisms. PON1 activity is reduced in PGW veterans compared with military control groups. The effect is independent of ill health in PGW veterans. PMID:12855907

  7. 75 FR 2594 - Proposed Information Collection (Compensation and Pension Examination Program (CPEP) Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... Satisfaction Survey) Activity: Comment Request AGENCY: Veterans Health Administration, Department of Veterans...: Compensation and Pension Examination Program (CPEP) Veterans Satisfaction Survey, VA Form 10-0480. OMB...

  8. Occupational career and risk of mortality among US Civil War veterans.

    PubMed

    Su, Dejun

    2009-08-01

    Previous studies have extended the traditional framework on occupational disparities in health by examining mortality differentials from a career perspective. Few studies, however, have examined the relation between career and mortality in a historical U.S. population. This study explores the relation between occupational career and risk of mortality in old age among 7096 Union Army veterans who fought the American Civil War in the 1860s. Occupational mobility was commonplace among the veterans in the postbellum period, with 54% of them changing occupations from the time of enlistment to 1900. Among veterans who were farmers at enlistment, 46% of them changed to a non-farming occupation by the time of 1900. Results from the Cox Proportional Hazard analysis suggest that relative to the average mortality risk of the sample, being a farmer at enlistment or circa 1900 are both associated with a lower risk of mortality in old age, although the effect is more salient for veterans who were farmers at enlistment. Occupational immobility for manual labors poses a serious threat to chance of survival in old age. These findings still hold after adjusting for the effects of selected variables characterizing risk exposures during early life, wartime, and old age. The robustness of the survival advantage associated with being a farmer at enlistment highlights the importance of socioeconomic conditions early in life in chance of survival at older ages. PMID:19552993

  9. Risk of Hospitalized Bacterial Infections Associated with Biologic Treatment Among U.S. Veterans with Rheumatoid Arthritis

    PubMed Central

    Curtis, J.R.; Yang, S.; Patkar, N. M.; Chen, L.; Singh, J. A.; Cannon, G. W.; Mikuls, T.R.; Delzell, E.; Saag, K.G.; Safford, M.M.; DuVall, S.; Alexander, K.; Napalkov, P.; Winthrop, Kevin L; Burton, M.J.; Kamauu, A.; Baddley, J.W.

    2016-01-01

    Background The comparative risk of infection associated with non anti-TNF biologics are not well established. Our objective was to compare risk for hospitalized infections between anti-TNF and non-anti-TNF biologics in U.S. veterans with rheumatoid arthritis (RA). Methods Using 1998–2011 data from the U.S. Veteran’s Health Administration, we studied RA patients initiating rituximab, abatacept or anti-TNF therapy.. Exposure was based upon days supplied (injections) or usual dosing intervals (infusions). Treatment episodes were defined as new biologic use. Hazard ratios (HR, 95% CI) for hospitalization for a bacterial infection were estimated from Cox proportional hazards models, adjusting for potential confounders. Results Among 3152 unique RA patients contributing 4158 biologic treatment episodes to rituximab (n=596), abatacept (n=451), and anti-TNF (n−3111); patient mean age was 60 years, 87% were male. The most common infections were pneumonia(37%), skin/soft tissue(22%), urinary tract(9%), and bacteremia/sepsis(7%). Hospitalized infection rates/100 person-years (95% CI) were 4.4 (3.1, 6.4) for rituximab, 2.8 (1.7, 4.7) for abatacept and 3.0 (2.5, 3.5) for anti-TNF. Compared to etanercept, the adjusted rate of hospitalized infection was not different for adalimumab (HR 1.4, 0.9–2.2), abatacept (HR 1.1, 0.6–2.1), or rituximab (HR 1.4, 0.8–2.6) although was increased for infliximab (HR 2.3, 1.3–4.0). Infection risk was greater for those taking prednisone >7.5mg/day (HR=1.8, 1.3–2.7) and in the highest quartile of C-reactive protein (HR=2.3, 1.4–3.8) and ESR rate (HR= 4., 2.3–7.2)) compared to the lowest quartile. Conclusions In older, predominantly male US veterans with RA, the risk of hospitalized bacterial infections associated with rituximab or abatacept was similar to etanercept. PMID:24470378

  10. Factors Associated With High Frequency of Suicidal Ideation in Medically Ill Veterans.

    PubMed

    Wendell, Joel; Ratcliff, Chelsea G; Price, Elizabeth; Petersen, Nancy J; Dinapoli, Elizabeth A; Cully, Jeffrey A

    2016-09-01

    Suicide is a leading cause of death, and rates are especially high among medically ill, older individuals. Health-related psychosocial correlates of suicidal ideation (SI) may be particularly important for medically ill older adults as they may clarify who may benefit from interventions to reduce SI. This study examined whether demographic, physical health, and/or health-related psychosocial factors were associated with high frequency of SI in older, medically ill Veterans experiencing elevated anxiety or depression. This cross-sectional study included 302 Veterans with (1) a cardiopulmonary condition and functional impairment and (2) elevated symptoms of depression and/or anxiety. Participants were classified as having either no, low, or high SI, based on self-reported ideation, from the Patient Health Questionnaire-9. SI was reported in 26.8% of the full sample and high SI was reported by 12.6% of participants. Logistic regression analyses predicting high versus no SI found the odds of high SI increased 4.7 times (95% confidence interval, 2.6-8.3) for each 1-unit increase in maladaptive coping and 4.1 times (95% confidence interval, 1.2-14.3) for each 1-unit increase in physical health severity/functional limitations. Older, medically ill Veterans with comorbid depression and/or anxiety frequently reported SI and were at greater risk of experiencing a high frequency of SI if they engaged in maladaptive coping strategies and/or had high levels of functional impairment. Effective interventions to reduce SI for this population should focus on reducing maladaptive coping and minimizing negative behavioral, cognitive, and emotional reactions to functional limitations. PMID:27648503

  11. Conduct disorder, war zone stress, and war-related posttraumatic stress disorder symptoms in American Indian Vietnam veterans.

    PubMed

    Dillard, Denise; Jacobsen, Clemma; Ramsey, Scott; Manson, Spero

    2007-02-01

    This study examined whether conduct disorder (CD) was associated with war zone stress and war-related post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. Conduct disorder was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and if the association exists in other AI populations.

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ...) Line of Business Tracking Study); Activity Under OMB Review AGENCY: Veterans Benefits Administration... (VOV) Line of Business Tracking Study. a. Compensation and Pension (C&P) Service Surveys J.D. Power... business. Based on the numerous interviews conducted, JDPA has separated the Veterans experience with...

  13. 78 FR 37278 - Proposed Information Collection (Veterans Benefits Administration (VBA) Voice of the Veteran (VOV...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-20

    ... Veteran (VOV) measurement program for their lines of business: Compensation Service, Pension Service... services and ] will provide VA/VBA leadership with actionable and timely Veteran feedback on how VBA is... sample size, as approved and reviewed by VBA Leadership and statistician. Affected Public:...

  14. 78 FR 54957 - Proposed Information Collection (Board of Veterans' Appeals, Voice of the Veteran Call Center...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... AFFAIRS Proposed Information Collection (Board of Veterans' Appeals, Voice of the Veteran Call Center... level of satisfaction with the VIO Call Center experience. In addition, the data will be used by the Board to make improvements to the VIO Call Center operational processes and service delivery, which...

  15. THERAPEUTIC PARALYSIS IN VETERANS WITH COPD

    PubMed Central

    Mulhall, Aaron M; Lach, Laura A; Krzywkowski-Mohn, Sara M; Welge, Jeffrey A; Panos, Ralph J

    2013-01-01

    Summary Background Chronic Obstructive Pulmonary Disease (COPD) is a common disorder of Veterans that causes significant morbidity and mortality. To measure Veterans’ perceptions about COPD, the effect of COPD on their lives and health, and their needs for improved health, we performed a postal survey. Methods 3263 Veterans with a diagnosis of COPD who received care at the Cincinnati Veterans Affairs Medical Center in 2008 were stratified into quintiles by Veterans Health Administration - associated COPD healthcare cost and uniformly sampled. Results 493 of 1000 surveys (49%) were completed and returned. COPD had different effects on respondents in top and bottom quintiles (highest and lowest COPD-related cost) for: knowledge of COPD diagnosis (89% vs 73%, p=0.03); activities affected by breathing, including work (69% vs 45%), recreation (85% vs 62%), change in living arrangements (36% vs 16%), and increased need for help (54% vs 25%) (p<0.05 for all comparisons); emotional effect of respiratory symptoms, including depression (53% vs 30%), fear (41% vs 15%), and helplessness (49% vs 24%) (p<0.05 for all comparisons). 91% of Veterans were prescribed inhalers and one quarter had difficulties using them. 25% of Veterans did nothing when they had symptoms of an exacerbation. Conclusions COPD has profound effects on Veterans’ breathing related activities and generates many negative emotions. Primary care providers are critical in conveying the diagnosis of COPD and providing information about the disease and its management. Veterans with COPD adhere poorly to their medications, and report little instruction about COPD or its management. PMID:23827725

  16. Visceral and cutaneous hypersensitivity in Persian Gulf war veterans with chronic gastrointestinal symptoms.

    PubMed

    Dunphy, Rebecca C; Bridgewater, Lee; Price, Donald D; Robinson, Michael E; Zeilman, Charles J; Verne, G Nicholas

    2003-03-01

    Approximately 697000 United States military personnel participated in the Persian Gulf War (PGW) between August 1990 and March 1991. By April 1997, over 25% of veterans reported chronic health complaints of underdetermined etiology. Gastrointestinal symptoms were among the most frequently reported symptoms including abdominal pain and diarrhea. The objectives of this study were (1). to determine if PGW veterans chronic abdominal pain and diarrhea exhibit visceral and cutaneous hypersensitivity, (2). to determine if these differences in pain sensitivity are significantly associated with psychological stress. A total of 12 veterans (ten males, two females) (39+/-9 years) who were deployed to the Persian Gulf were enrolled. Seven civilians without prior military experience (five males, two females) and five veterans (five males) who had previously been deployed for active combat were enrolled as controls (35+/-9 years). All 12 PGW veterans reported chronic abdominal pain and diarrhea (negative diagnostic workup) that developed during their tour of duty in the Persian Gulf region. All patients completed a battery of psychological assessments and then randomly received experimental visceral (rectal distension of 35 and 55 mmHg for 30s) and cutaneous (immersion of right foot in 45 and 47 degrees C water for 30s) pain stimuli after which they rated their pain intensity and pain unpleasantness on a continuous visual analogue scale (M-VAS) scale. The trials were repeated and the mean M-VAS scores for the two trials were recorded for each subject. In comparison to controls, PGW subjects reported statistically significant higher mean ratings of pain intensity and pain unpleasantness in response to 35 and 55 mmHg rectal distention (P<0.001) and in response to 45 and 47 degrees C water immersion (P<0.001) of the hand and foot. Results of the hierarchical regressions indicated that the psychological measures (i.e. anxiety, somatic focus) accounted for a significant amount of

  17. Older People and HIV

    MedlinePlus

    ... Many older people believe that HIV only affects younger people Most older people get little training in ... diseases among older people, as they do for younger people. Physicians may not diagnose HIV infection in ...

  18. Injuries of veteran football (soccer) players in Germany.

    PubMed

    Hammes, Daniel; Aus Der Fünten, Karen; Kaiser, Stephanie; Frisen, Eugen; Dvorák, Jirí; Meyer, Tim

    2015-01-01

    There is a lack of injury data for the population of veteran football players. Therefore, a prospective study was conducted to investigate injury incidences and characteristics. Over one season, injuries and exposure of 18 teams (n = 265 players, age: 44.2±7.3 years, BMI: 26.6±3.2 kg/m(2)) were documented. Sixty-three players sustained a total of 88 injuries during the season. The incidence of training injuries (4.5 per 1000 hours) was significantly lower than of match injuries (24.7 per 1000 hours). The majority of injuries (n = 73; 83%) were located at the lower extremities, 52 (47%) were muscle injuries. The injury incidence of veteran football players is similar to other male football players of different skill levels and age groups, indicating a need for the implementation of preventive measures. Prevention programmes should consider the specific injury characteristics, with more muscle injuries in this population compared with younger football players.

  19. Pilot Investigation of PTSD, Autonomic Reactivity, and Cardiovascular Health in Physically Healthy Combat Veterans.

    PubMed

    Clausen, Ashley N; Aupperle, Robin L; Sisante, Jason-Flor V; Wilson, David R; Billinger, Sandra A

    2016-01-01

    Posttraumatic stress disorder (PTSD), and combat-related PTSD in particular, has been associated with increased rates of cardiovascular disease, and cardiovascular-related death. However, less research has examined possible factors that may link PTSD to poorer cardiovascular health in combat veteran populations. The current pilot study investigated whether psychological symptomology and autonomic reactivity to emotional scripts would relate to poorer cardiovascular health in combat veterans without a current diagnosis of cardiovascular disease. Male veterans (N = 24), who served in combat since Operation Iraqi Freedom, completed a semi-structured interview and self-report measures to assess psychological symptomology. Autonomic reactivity, measured using heart rate variability (HRV; low to high frequency ratio), was obtained during script-driven imagery of emotional memories. Cardiovascular health was assessed using flow-mediated dilation (FMD) of the brachial artery. Correlational analyses and discriminant analysis were used to assess the relationship between psychological symptoms (PTSD, depression, anger, as measured via self-report), autonomic reactivity to emotional scripts (HRV), and FMD. Overall, veterans in the current study showed poor cardiovascular health despite their relatively young age and lack of behavioral risk factors, with 15/24 exhibiting impaired FMD (FMD < 5%). Psychological symptomology was not associated with FMD; whereas autonomic reactivity to emotional (compared to neutral) scripts was found to relate to FMD. Autonomic reactivity to negative scripts correctly classified 76.5% of veterans as having impaired versus normative FMD. Results from this pilot study highlight the importance of cardiovascular screening with combat veterans despite psychological diagnosis. Results also support the need for longitudinal research assessing the use of autonomic reactivity to emotionally valenced stimuli as a potential risk factor for poorer

  20. Pilot Investigation of PTSD, Autonomic Reactivity, and Cardiovascular Health in Physically Healthy Combat Veterans

    PubMed Central

    Clausen, Ashley N.; Aupperle, Robin L.; Sisante, Jason-Flor V.; Wilson, David R.; Billinger, Sandra A.

    2016-01-01

    Posttraumatic stress disorder (PTSD), and combat-related PTSD in particular, has been associated with increased rates of cardiovascular disease, and cardiovascular-related death. However, less research has examined possible factors that may link PTSD to poorer cardiovascular health in combat veteran populations. The current pilot study investigated whether psychological symptomology and autonomic reactivity to emotional scripts would relate to poorer cardiovascular health in combat veterans without a current diagnosis of cardiovascular disease. Male veterans (N = 24), who served in combat since Operation Iraqi Freedom, completed a semi-structured interview and self-report measures to assess psychological symptomology. Autonomic reactivity, measured using heart rate variability (HRV; low to high frequency ratio), was obtained during script-driven imagery of emotional memories. Cardiovascular health was assessed using flow-mediated dilation (FMD) of the brachial artery. Correlational analyses and discriminant analysis were used to assess the relationship between psychological symptoms (PTSD, depression, anger, as measured via self-report), autonomic reactivity to emotional scripts (HRV), and FMD. Overall, veterans in the current study showed poor cardiovascular health despite their relatively young age and lack of behavioral risk factors, with 15/24 exhibiting impaired FMD (FMD < 5%). Psychological symptomology was not associated with FMD; whereas autonomic reactivity to emotional (compared to neutral) scripts was found to relate to FMD. Autonomic reactivity to negative scripts correctly classified 76.5% of veterans as having impaired versus normative FMD. Results from this pilot study highlight the importance of cardiovascular screening with combat veterans despite psychological diagnosis. Results also support the need for longitudinal research assessing the use of autonomic reactivity to emotionally valenced stimuli as a potential risk factor for poorer

  1. PTSD Symptoms and Family vs. Stranger Violence in Iraq and Afghanistan Veterans

    PubMed Central

    Sullivan, Connor P.; Elbogen, Eric B.

    2015-01-01

    As a diagnosis, posttraumatic stress disorder (PTSD) has been associated with violence committed by veterans in many studies; however, a potential link to specific PTSD symptoms has received relatively less attention. This paper examines the relationship between PTSD symptoms and different types of violent behavior in Iraq and Afghanistan veterans. Participants were randomly sampled from a roster of all separated U.S. military service members or national guard/reservists who served after September 11, 2001. Data were collected at baseline and 1-year follow-up from a national sample of N = 1,090 veterans, from 50 states and all military branches. Of these veterans, 13% reported aggression toward a family member and 9% toward a stranger during the 1-year study period. Anger symptoms at baseline predicted higher odds of family violence at follow-up, both severe (OR = 1.30, CI [1.13, 1.48], p < .0001) and any (OR= 1.28, CI [1.19, 1.37], p < .0001). PTSD flashback symptoms at baseline predicted higher odds of stranger violence at follow-up, both severe (OR = 1.26, CI [1.11, 1.42], p < .0001) and any (OR = 1.16, CI [1.05, 1.28], p = .0029). Analyses revealed that males were more likely to engage in stranger violence, whereas females were more likely to endorse aggression in the family context. The results provide limited support to the hypothesis that PTSD “flashbacks” in veterans are linked to violence. The differing multivariate models illustrate distinct veteran characteristics associated with specific types of violence. PMID:23646917

  2. Personality assessment inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: associations with aggression.

    PubMed

    Van Voorhees, Elizabeth E; Dennis, Paul A; Elbogen, Eric B; Clancy, Carolina P; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2014-01-01

    Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n's = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges.

  3. Personality Assessment Inventory Internalizing and Externalizing Structure in Veterans with Posttraumatic Stress Disorder: Associations with Aggression

    PubMed Central

    Van Voorhees, Elizabeth E.; Dennis, Paul A.; Elbogen, Eric B.; Clancy, Carolina P.; Hertzberg, Michael A.; Beckham, Jean C.; Calhoun, Patrick S.

    2015-01-01

    Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n’s = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges. PMID:25131806

  4. Quality of Life Among Veterans With Chronic Spinal Cord Injury and Related Variables

    PubMed Central

    Ebrahimzadeh, Mohammad Hosein; Soltani-Moghaddas, Seyed Hosein; Birjandinejad, Ali; Omidi-Kashani, Farzad; Bozorgnia, Shahram

    2014-01-01

    Background: In recent decades, the incidence of spinal cord injuries has increased. In a systemic review on epidemiology of traumatic spinal cord injury in developing countries reported 25.5/million cases per year. Objectives: To assess the quality of life (QOL) of the veterans among Iran-Iraq war with chronic spinal cord injuries (SCI) and to evaluate long-term impressions of SCI on their quality of life. Patients and Methods: Fifty-two veterans, all male, with chronic spinal cord injury from Iran-Iraq war (1980-1988) were interviewed and examined. The mean age of veterans at the time of interview was 49.3 years (38 to 80 years). Veterans were assessed by using a 36-item short-form (SF-36), hospital anxiety and depression scale (HADS) and the Barthel index. The presence or absence of pressure sores and spasticity were documented as well. Results: The mean age of veterans at the time of study was 49.3 years. Pearson's correlation test showed that depression and anxiety have a reverse association with mental component summary (MCS) scale and physical component summary (PCS) scale scores, respectively. Regression analysis showed a negative effect of depression and pressure sore on PCS. Moreover, no association was found between the duration of injury and age with quality of life. Conclusions: Lower QOL was found among veterans with chronic SCI. More researches on health-related quality of life (HRQOL) are needed to give us a better understanding of changes in life of patients with SCI and the ways to improve them. PMID:25147777

  5. Effects of Device-Facilitated Isometric Progressive Resistance Oropharyngeal Therapy on Swallowing and Health-Related Outcomes in Older Adults with Dysphagia.

    PubMed

    Rogus-Pulia, Nicole; Rusche, Nicole; Hind, Jacqueline A; Zielinski, Jill; Gangnon, Ronald; Safdar, Nasia; Robbins, JoAnne

    2016-02-01

    Swallowing disorders (dysphagia) are associated with malnutrition, aspiration pneumonia, and mortality in older adults. Strengthening interventions have shown promising results, but the effectiveness of treating dysphagia in older adults remains to be established. The Swallow STRengthening OropharyNGeal (Swallow STRONG) Program is a multidisciplinary program that employs a specific approach to oropharyngeal strengthening-device-facilitated (D-F) isometric progressive resistance oropharyngeal (I-PRO) therapy-with the goal of reducing health-related sequelae in veterans with dysphagia. Participants completed 8 weeks of D-F I-PRO therapy while receiving nutritional counseling and respiratory status monitoring. Assessments were completed at baseline, 4, and 8 weeks. At each visit, videofluoroscopic swallowing studies were performed. Dietary and swallowing-related quality of life questionnaires were administered. Long-term monitoring for 6-17 months after enrollment allowed for comparison of pneumonia incidence and hospitalizations to the 6-17 months before the program. Veterans with dysphagia confirmed with videofluoroscopy (N = 56; 55 male, 1 female; mean age 70) were enrolled. Lingual pressures increased at anterior (effect estimate = 92.5, P < .001) and posterior locations (effect estimate = 85.4, P < .001) over 8 weeks. Statistically significant improvements occurred on eight of 11 subscales of the Quality of Life in Swallowing Disorders (SWAL-QOL) Questionnaire (effect estimates = 6.5-19.5, P < .04) and in self-reported sense of effort (effect estimate = -18.1, P = .001). Higher Functional Oral Intake Scale scores (effect estimate = 0.4, P = .02) indicated that participants were able to eat less-restrictive diets. There was a 67% reduction in pneumonia diagnoses, although the difference was not statistically significant. The number of hospital admissions decreased significantly (effect estimate = 0.96; P = .009) from before to after enrollment. Findings suggest

  6. 76 FR 64184 - Advisory Committee on Women Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... Veterans Health Strategic Health Care Group; and briefings on mental health, women Veterans' legislative issues, women Veterans' research, rural health, and homeless initiatives for women Veterans. No time will... to health care, rehabilitation, compensation, outreach, and other programs and...

  7. Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: case-cohort study

    PubMed Central

    Saitz, Richard; Ganoczy, Dara; Ilgen, Mark A; Bohnert, Amy S B

    2015-01-01

    Objective To study the association between benzodiazepine prescribing patterns including dose, type, and dosing schedule and the risk of death from drug overdose among US veterans receiving opioid analgesics. Design Case-cohort study. Setting Veterans Health Administration (VHA), 2004-09. Participants US veterans, primarily male, who received opioid analgesics in 2004-09. All veterans who died from a drug overdose (n=2400) while receiving opioid analgesics and a random sample of veterans (n=420 386) who received VHA medical services and opioid analgesics. Main outcome measure Death from drug overdose, defined as any intentional, unintentional, or indeterminate death from poisoning caused by any drug, determined by information on cause of death from the National Death Index. Results During the study period 27% (n=112 069) of veterans who received opioid analgesics also received benzodiazepines. About half of the deaths from drug overdose (n=1185) occurred when veterans were concurrently prescribed benzodiazepines and opioids. Risk of death from drug overdose increased with history of benzodiazepine prescription: adjusted hazard ratios were 2.33 (95% confidence interval 2.05 to 2.64) for former prescriptions versus no prescription and 3.86 (3.49 to 4.26) for current prescriptions versus no prescription. Risk of death from drug overdose increased as daily benzodiazepine dose increased. Compared with clonazepam, temazepam was associated with a decreased risk of death from drug overdose (0.63, 0.48 to 0.82). Benzodiazepine dosing schedule was not associated with risk of death from drug overdose. Conclusions Among veterans receiving opioid analgesics, receipt of benzodiazepines was associated with an increased risk of death from drug overdose in a dose-response fashion. PMID:26063215

  8. The mental health needs of military service members and veterans.

    PubMed

    Lazar, Susan G

    2014-09-01

    The prevalence in active duty military service members of 30-day DSM-IV psychiatric disorders, including posttraumatic stress disorders and major depressive disorder, is greater than among sociodemographically-matched civilians. Only 23-40% of returning military who met strict criteria for any mental health problem in 2004 had received professional help in the past year. One-fourth of Regular Army soldiers meet criteria for a 30-day DSM-IV mental disorder, two-thirds of whom report a pre-enlistment age of onset. Both pre- and post-enlistment age of onset are predictors of severe role impairment which was reported by 12.8% of respondents. In addition, three-fifths of those with severe role impairment had at least one psychiatric diagnosis. The number of deployments, especially three or more, is positively correlated with all disorders, especially major depressive disorder, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and intermittent explosive disorder. Patients with posttraumatic stress disorder and major depressive disorder frequently have comorbidity with other psychiatric diagnoses and an increased death rate from homicide, injury, and cardiovascular disease, and are at increased risk of medical illness, smoking and substance abuse, decreased employment and work productivity, marital and family dysfunction and homelessness. Active duty suicides have increased from a rate lower than among civilians to one exceeding that in civilians in 2008. Suicides among veterans climbed to 22 per day in 2010 with male veterans having twice the risk of dying from suicide as their civilian counterparts. Associated extremely high costs of psychiatric illness in decreased productivity and increased morbidity and mortality can be ameliorated with appropriate treatment which is not yet fully available to veterans in need. In addition, Veterans Administration/Department of Defense treatment guidelines to date do not recognize the need for intensive

  9. The mental health needs of military service members and veterans.

    PubMed

    Lazar, Susan G

    2014-09-01

    The prevalence in active duty military service members of 30-day DSM-IV psychiatric disorders, including posttraumatic stress disorders and major depressive disorder, is greater than among sociodemographically-matched civilians. Only 23-40% of returning military who met strict criteria for any mental health problem in 2004 had received professional help in the past year. One-fourth of Regular Army soldiers meet criteria for a 30-day DSM-IV mental disorder, two-thirds of whom report a pre-enlistment age of onset. Both pre- and post-enlistment age of onset are predictors of severe role impairment which was reported by 12.8% of respondents. In addition, three-fifths of those with severe role impairment had at least one psychiatric diagnosis. The number of deployments, especially three or more, is positively correlated with all disorders, especially major depressive disorder, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and intermittent explosive disorder. Patients with posttraumatic stress disorder and major depressive disorder frequently have comorbidity with other psychiatric diagnoses and an increased death rate from homicide, injury, and cardiovascular disease, and are at increased risk of medical illness, smoking and substance abuse, decreased employment and work productivity, marital and family dysfunction and homelessness. Active duty suicides have increased from a rate lower than among civilians to one exceeding that in civilians in 2008. Suicides among veterans climbed to 22 per day in 2010 with male veterans having twice the risk of dying from suicide as their civilian counterparts. Associated extremely high costs of psychiatric illness in decreased productivity and increased morbidity and mortality can be ameliorated with appropriate treatment which is not yet fully available to veterans in need. In addition, Veterans Administration/Department of Defense treatment guidelines to date do not recognize the need for intensive

  10. Veteran internet use and engagement with health information online.

    PubMed

    Houston, Thomas K; Volkman, Julie E; Feng, Hua; Nazi, Kim M; Shimada, Stephanie L; Fox, Susannah

    2013-04-01

    Veterans represent a unique population in need of accessing health services online. Data from a random-digit dialed survey conducted by the Pew Research Center's Internet & American Life Project were used to assess differences in online use of health information among Veterans in the Veterans Health Administration (VHA) of the U.S. Department of Veteran Affairs (VA), Veterans not in VA, and non-Veterans. This survey of 3,001 U.S. citizens oversampled lower-income households. Questions assessed Veteran status and use of VA health care services, self-reported Internet use and Internet searching for health-related information, and social engagement related to health online. Overall results suggest Veterans represent an opportune population to utilize personal health records and health services via the Internet. Veterans in VA are more likely to search for health issues related to Alzheimer's disease and memory loss (odds ratio = 3.07; confidence interval = 1.41-8.28) compared to Veterans not in VA. Veterans receiving VA health care also reported higher proportions of social engagement related to health about tracking diet, weight, and exercise than Veterans not in VA, although not statistically significant. Veterans in VA are using the Internet for health information, and there is an opportunity to engage them more.

  11. Review of American Indian veteran telemental health.

    PubMed

    Shore, Jay; Kaufmann, L Jeanne; Brooks, Elizabeth; Bair, Byron; Dailey, Nancy; Richardson, W J Buck; Floyd, James; Lowe, Jeff; Nagamoto, Herbert; Phares, Robert; Manson, Spero

    2012-03-01

    Rural American Indian veterans have unique healthcare needs and face numerous barriers to accessing healthcare services. Over the past decade, the Department of Veterans Affairs in conjunction with the University of Colorado Denver has turned to the promising field of telemental health to develop a series of videoconferencing-based clinics to reach this vulnerable population and improve mental healthcare services. The ongoing development, implementation, and expansion of these clinics have been assessed as part of a program improvement. The outcomes of these assessments have been documented in a series of published articles, controlled studies, program and case reports, and model descriptions. This article summarizes a decade of experience with the American Indian Telemental Health Clinics, the clinic model, and the literature arising from these clinics and presents lessons learned while establishing, maintaining, and evaluating these clinics. The ability to tailor the clinics to individual sites and cultures and to provide various services has been critical to the operation of the clinics. Culturally specific care through culturally knowledgeable providers, onsite tribal outreach workers, and collaboration with community services has proven essential in operating the clinics, as well as building rapport, trust, and engagement with the target patient population. It is hoped that the lessons learned and practices presented here can not only assist others working to improve the care for rural Native veterans but also serve as a model in the use of telemental health services for improving care and access to rural veteran and non-veteran populations.

  12. Longitudinal Analysis of the Relationship between Symptoms and Quality of Life in Veterans Treated for Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Schnurr, Paula P.; Hayes, Andrew F.; Lunney, Carole A.; McFall, Miles; Uddo, Madeline

    2006-01-01

    This study examined how change in posttraumatic stress disorder (PTSD) symptoms relates to change in quality of life. The sample consisted of 325 male Vietnam veterans with chronic PTSD who participated in a randomized trial of group psychotherapy. Latent growth modeling was used to test for synchronous effects of PTSD symptom change on…

  13. Traditional Machismo and Caballerismo as Correlates of Posttraumatic Stress Disorder, Psychological Distress, and Relationship Satisfaction in Hispanic Veterans

    ERIC Educational Resources Information Center

    Herrera, Catherine J.; Owens, Gina P.; Mallinckrodt, Brent

    2013-01-01

    An online survey was used to examine 45 Hispanic male veterans' traditional machismo and caballerismo as correlates of posttraumatic stress disorder (PTSD), psychological distress, and relationship satisfaction. Higher traditional machismo was associated with higher PTSD severity and distress and lower relationship satisfaction. Psychometric…

  14. Tribal Veterans Representative (TVR) training program: the effect of community outreach workers on American Indian and Alaska Native Veterans access to and utilization of the Veterans Health Administration.

    PubMed

    Kaufmann, L Jeanne; Buck Richardson, W J; Floyd, James; Shore, Jay

    2014-10-01

    American Indians and Alaska Natives serve at the highest rate of any US race or ethnic group, yet are the most underserved population of Veterans and do not take advantage of the Department of Veterans Affairs (VA) benefits and services. Barriers to seeking care include stigma, especially for mental health issues; distance to care; and lack of awareness of benefits and services they are entitled to receive. In response to this underutilization of the VA, an innovative program--the Tribal Veterans Representative (TVR) program--was developed within the VA to work with American Indians and Alaska Natives in rural and remote areas. The TVR goes through extensive training every year; is a volunteer, a Veteran and tribal community member who seeks out unenrolled Native Veterans, provides them with information on VA health care services and benefits, and assists them with enrollment paperwork. Being from the community they serve, these outreach workers are able to develop relationships and build rapport and trust with fellow Veterans. In place for over a decade in Montana, this program has enrolled a countless number of Veterans, benefiting not only the individual, but their family and the community as well. Also resulting from this program, are the implementation of Telemental Health Clinics treating Veterans with PTSD, a transportation program helping Veterans get to and from distant VA facilities, a Veteran Resource Center, and a Veteran Tribal Clinic. This program has successfully trained over 800 TVRs, expanded to other parts of the country and into remote areas of Alaska.

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

    PubMed

    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. PMID:17615833

  16. Improvements in VA health services for women veterans.

    PubMed

    Weiss, T W

    1995-01-01

    Since the early 1980s, health care for women veterans in the Department of Veterans Affairs (VA) has improved considerably, although problems still remain. The lack of privacy for women at many VA facilities and the provision of incomplete physical examinations for women continue to be problematic issues. A 1992 congressional appropriation of $7.5 million has substantially increased the awareness of women veterans health care in the VA. This appropriation, from Public Law 102-585, Veterans Health Care Act of 1992, Title I-Women Veterans Health Programs, has allowed VA to expand services for women veterans. Using these funds, VA has established eight comprehensive women veterans health centers, 23 full-time women veterans coordinators, and four regional stress disorder teams. This paper describes these and other important new initiatives and discusses how they will serve as the foundation on which VA expands care for women within the context of a changing health care system.

  17. 38 CFR 3.1007 - Hospitalized incompetent veterans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... equaled or exceeded the statutory maximum, and the veteran dies before payment of amounts withheld or not... incompetency. The term dies before payment includes cases in which a check was issued and the veteran...

  18. 38 CFR 3.1007 - Hospitalized incompetent veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... equaled or exceeded the statutory maximum, and the veteran dies before payment of amounts withheld or not... incompetency. The term dies before payment includes cases in which a check was issued and the veteran...

  19. 38 CFR 3.1007 - Hospitalized incompetent veterans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... equaled or exceeded the statutory maximum, and the veteran dies before payment of amounts withheld or not... incompetency. The term dies before payment includes cases in which a check was issued and the veteran...

  20. 38 CFR 3.1007 - Hospitalized incompetent veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... equaled or exceeded the statutory maximum, and the veteran dies before payment of amounts withheld or not... incompetency. The term dies before payment includes cases in which a check was issued and the veteran...

  1. 38 CFR 3.1007 - Hospitalized incompetent veterans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... equaled or exceeded the statutory maximum, and the veteran dies before payment of amounts withheld or not... incompetency. The term dies before payment includes cases in which a check was issued and the veteran...

  2. Veterans on Campus: A Handbook for Programs, Services, Staffing and Assistance.

    ERIC Educational Resources Information Center

    Betts, Lee John, Ed.

    A handbook to provide information that will aid in establishing bondage between veterans and those professional people providing service for returning servicemen and women is presented. Topics discussed include: Vietnam veteran; organizing to serve the veteran; a veterans Outreach Program; veterans with special needs--minority veterans, academic…

  3. 77 FR 65056 - Advisory Committee on Minority Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... AFFAIRS Advisory Committee on Minority Veterans, Notice of Meeting The Department of Veterans Affairs (VA... Minority Veterans will meet on November 14-16, 2012, at the Department of Veterans Affairs, 810 Vermont... minority Veterans; to assess the needs of minority Veterans; and to evaluate whether VA...

  4. 78 FR 68503 - Advisory Committee on Minority Veterans; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... AFFAIRS Advisory Committee on Minority Veterans; Notice of Meeting The Department of Veterans Affairs (VA... Minority Veterans will meet on December 9-11, 2013, at the Department of Veterans Affairs, 810 Vermont... and services to minority Veterans; assess the needs of minority Veterans; and evaluate whether...

  5. 77 FR 64851 - Advisory Committee on Minority Veterans, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-23

    ... AFFAIRS Advisory Committee on Minority Veterans, Notice of Meeting The Department of Veterans Affairs... Advisory Committee on Minority Veterans will meet on November 14- 15, 2012, at the Department of Veterans... benefits and services to minority Veterans; to assess the needs of minority Veterans; and to...

  6. The Influence of Older Siblings on the Sex-Typed Toy Play of Young Children.

    ERIC Educational Resources Information Center

    Nash, Alison; Fraleigh, Kimberly

    To examine the influence of older siblings on the sex-typed toy play of younger siblings, a study was undertaken of 60 children, 2 to 5 years old, with equal numbers of boys and girls with older brothers, older sisters, and no older siblings. Children's toy collections were inventoried and classified into conventionally male toys, or toys of the…

  7. Secondary traumatization of partners of war veterans: The role of boundary ambiguity.

    PubMed

    Dekel, Rachel; Levinstein, Yoav; Siegel, Alana; Fridkin, Shimon; Svetlitzky, Vlad

    2016-02-01

    The existing literature has shown that war veterans' posttraumatic stress disorder (PTSD) symptoms are associated with a higher level of distress in their female partners. However, less agreement exists regarding the sources of this distress and the mechanism by which this process occurs. The current study examined the consequences of Israeli war veterans' PTSD on their female partners, as manifested by the females' PTSD symptoms, mental health status, and functioning, while taking into account females' earlier traumatic events. Using the theory of ambiguous loss, it also suggested boundary ambiguity as a mediating variable by which the PTSD of the male veteran is transmitted to his female partner. Participants were 300 men who had served in the 2006 Israel-Lebanon War and their female partners. Results revealed direct associations between males' PTSD and their female partners' PTSD, functioning, and mental health. In addition, boundary ambiguity mediated the association between males' PTSD and females' adjustment. Finally, females' own earlier traumatic events were directly associated with their own PTSD symptoms. Implications of this model for intervention and research are further discussed.

  8. New light on the health of Vietnam veterans

    SciTech Connect

    Gochfield, M. )

    1988-12-01

    This editorial describes the controversy between the Department of Defense, the Veterans Administration, and veterans exposed to the herbicide Agent Orange. Although Congress has mandated that epidemiologic studies of adverse health effects be performed in Vietnam veterans, the Centers for Disease Control has declined to perform the studies because of lack of documentation of exposure.This issue provides epidemiological studies which will redirect attention to the veterans, their health and their exposures.

  9. Iraq and Afghanistan War Veterans with Reintegration Problems: Differences by Veterans Affairs Healthcare User Status.

    PubMed

    Sayer, Nina A; Orazem, Robert J; Noorbaloochi, Siamak; Gravely, Amy; Frazier, Patricia; Carlson, Kathleen F; Schnurr, Paula P; Oleson, Heather

    2015-07-01

    We studied 1,292 Iraq and Afghanistan War veterans who participated in a clinical trial of expressive writing to estimate the prevalence of perceived reintegration difficulty and compare Veterans Affairs (VA) healthcare users to nonusers in terms of demographic and clinical characteristics. About half of participants perceived reintegration difficulty. VA users and nonusers differed in age and military background. Levels of mental and physical problems were higher in VA users. In multivariate analysis, military service variables and probable traumatic brain injury independently predicted VA use. Findings demonstrate the importance of research comparing VA users to nonusers to understand veteran healthcare needs.

  10. Prescription Opioid Use Among Seriously Mentally Ill Veterans Nationally in the Veterans Health Administration.

    PubMed

    Mathew, Nickie; Rosenheck, Robert A

    2016-02-01

    Frequent prescription opioid use has been recognized as a growing problem but there have been no studies specifically among veterans with serious mental illness (SMI). National data from the Veterans Health Administration (VHA) during Fiscal Year 2012 show that VHA patients with SMI receive more opioid prescriptions than other veterans. Additionally, high numbers of opioid prescriptions is associated with greater use of anxiolytics/sedative-hypnotics, drug dependence and COPD-all of which pose an increased risk of respiratory depression and falls and warrant substantial caution and improved coordination between mental health and non-mental health prescribers to evaluate risk-benefit tradeoffs. PMID:26374435

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

    PubMed

    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.

  12. Veterans' Transitions to Community College: A Case Study

    ERIC Educational Resources Information Center

    Wheeler, Holly A.

    2012-01-01

    Veterans on college campuses are not new; however, the recent influx of veterans returning home from war-time service present challenges to the colleges they attend. The purpose of this qualitative case study was to examine the transition process experienced by veterans leaving military service and attending community college for the first time.…

  13. 38 CFR 17.39 - Certain Filipino veterans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of these VA health care benefits, the standards described in 38 CFR 3.42(c) will be accepted as proof... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Certain Filipino veterans... Enrollment Provisions and Medical Benefits Package § 17.39 Certain Filipino veterans. (a) Any...

  14. 38 CFR 17.39 - Certain Filipino veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of these VA health care benefits, the standards described in 38 CFR 3.42(c) will be accepted as proof... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Certain Filipino veterans... Enrollment Provisions and Medical Benefits Package § 17.39 Certain Filipino veterans. (a) Any...

  15. 38 CFR 17.39 - Certain Filipino veterans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of these VA health care benefits, the standards described in 38 CFR 3.42(c) will be accepted as proof... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Certain Filipino veterans... Enrollment Provisions and Medical Benefits Package § 17.39 Certain Filipino veterans. (a) Any...

  16. 38 CFR 17.39 - Certain Filipino veterans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of these VA health care benefits, the standards described in 38 CFR 3.42(c) will be accepted as proof... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Certain Filipino veterans... Enrollment Provisions and Medical Benefits Package § 17.39 Certain Filipino veterans. (a) Any...

  17. 38 CFR 12.1 - Designee cases; competent veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DISPOSITION OF VETERAN'S PERSONAL FUNDS AND EFFECTS Disposition of Veteran's Personal Funds and Effects on Facility Upon Death, Or Discharge, Or Unauthorized Absence, and of Funds and Effects Found on Facility § 12... Department of Veterans Affairs to deliver his or her funds and effects in event of death. He or she may...

  18. Veteran-Students in Transition at a Midwestern University

    ERIC Educational Resources Information Center

    Schiavone, Vincent; Gentry, Debra

    2014-01-01

    One of the fastest-growing subpopulations of nontraditional college students is military veterans who enroll in institutions of higher education following their returns from deployment. Although much research has been conducted on veteran-students, much of that work has focused on issues such as veterans' finances or academic achievement,…

  19. 48 CFR 52.222-35 - Equal Opportunity for Veterans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... veteran who served on active duty in the U.S. military, ground, naval, or air service, during a war or in... under the Vietnam Era Veterans' Readjustment Assistance Act of 1972 (the Act), as amended (38 U.S.C... and a contract of $100,000 or more to have an affirmative action program for veterans. See 41 CFR...

  20. 48 CFR 52.222-35 - Equal Opportunity for Veterans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... veteran who served on active duty in the U.S. military, ground, naval, or air service, during a war or in... under the Vietnam Era Veterans' Readjustment Assistance Act of 1972 (the Act), as amended (38 U.S.C... and a contract of $100,000 or more to have an affirmative action program for veterans. See 41 CFR...

  1. 48 CFR 52.222-35 - Equal Opportunity for Veterans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... veteran who served on active duty in the U.S. military, ground, naval, or air service, during a war or in... under the Vietnam Era Veterans' Readjustment Assistance Act of 1972 (the Act), as amended (38 U.S.C... and a contract of $100,000 or more to have an affirmative action program for veterans. See 41 CFR...

  2. 48 CFR 52.222-35 - Equal Opportunity for Veterans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... veteran who served on active duty in the U.S. military, ground, naval, or air service, during a war or in... under the Vietnam Era Veterans' Readjustment Assistance Act of 1972 (the Act), as amended (38 U.S.C... and a contract of $100,000 or more to have an affirmative action program for veterans. See 41 CFR...

  3. Deserving Design: The New Generation of Student Veterans

    ERIC Educational Resources Information Center

    Branker, Cheryl

    2009-01-01

    Thousands of veterans with disabilities have become students since their return from combat. Many such veterans, though, are finding that their combat experiences often create an undeserving imbalance for them as they trade ammunition for education. And many colleges, where these veterans attend, are finding that they are ill prepared to level the…

  4. Coming Home: Student Veterans' Articulation of College Re-Enrollment

    ERIC Educational Resources Information Center

    Livingston, Wade G.; Havice, Pamela A.; Cawthon, Tony W.; Fleming, David S.

    2011-01-01

    This study described student veterans' navigation of college re-enrollment. Fifteen participants interviewed at one institution were less likely to seek academic support and more inclined to pursue social support in the form of associating with fellow veterans with whom they felt more comfortable. They downplayed or hid their veteran status from…

  5. 38 CFR 21.272 - Veteran-student services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... with the veteran's physical condition. (Authority: 38 U.S.C. 3104(a)(4), 3108(f), 3485) (c) Utilization... out under the supervision of a VA employee; (2) Preparation and processing of necessary VA papers and...), 3485) (f) Veteran reduces rate of training. In the event the veteran reduces his or her training...

  6. Marital Adjustment, Parental Functioning, and Emotional Sharing in War Veterans

    ERIC Educational Resources Information Center

    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…

  7. Writing with Veterans in a Community Writing Group

    ERIC Educational Resources Information Center

    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…

  8. 32 CFR Appendix D to Part 724 - Veterans' Benefits

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Veterans' Benefits D Appendix D to Part 724... BOARD Pt. 724, App. D Appendix D to Part 724—Veterans' Benefits 91 Stat. 1106 Pub. L. 95-126, Oct. 8, 1977 95th Congress An Act To deny entitlement to veterans' benefits to certain persons who...

  9. 38 CFR 21.400 - Veterans' Advisory Committee on Rehabilitation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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...

  10. 38 CFR 21.400 - Veterans' Advisory Committee on Rehabilitation.

    Code of Federal Regulations, 2010 CFR

    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...

  11. Searching the Soul: Veterans and Their Arts and Crafts

    ERIC Educational Resources Information Center

    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.…

  12. Military Veterans' Midlife Career Transition and Life Satisfaction

    ERIC Educational Resources Information Center

    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…

  13. Colleges Can Improve Outcomes for Veterans and the Economy

    ERIC Educational Resources Information Center

    McGovern, Thomas M.

    2012-01-01

    Veterans play a critical role in the U.S. economy. For many returning veterans, education is the first step to successfully reentering civilian life and the workforce. Since the inception of the first GI Bill (Servicemen's Readjustment Act) in 1944, higher education has been responding to the needs of military students. Veterans are dedicated…

  14. 75 FR 24514 - Supportive Services for Veteran Families Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ..., Supportive Services for Veteran Families Program Office (116), National Center on Homelessness Among Veterans... veteran families who are transitioning (including, but not limited to, transitioning from homelessness to... homelessness to permanent housing, and (2) ensure, to the extent practicable, that the supportive...

  15. 48 CFR 52.222-37 - Employment Reports on Veterans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... medal veterans, and recently separated veterans. (2) The total number of new employees hired during the... accordance with 41 CFR 60-300.42), voluntary self-disclosure by employees, or actual knowledge of veteran... the Secretary of Labor, on— (1) The total number of employees in the contractor's workforce, by...

  16. 48 CFR 52.222-37 - Employment Reports on Veterans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... medal veterans, and recently separated veterans. (2) The total number of new employees hired during the... accordance with 41 CFR 60-300.42), voluntary self-disclosure by employees, or actual knowledge of veteran... the Secretary of Labor, on— (1) The total number of employees in the contractor's workforce, by...

  17. 38 CFR 3.1001 - Hospitalized competent veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... within 5 years after the death of the veteran. If, however, any person otherwise entitled is under legal disability at the time of the veteran's death, the 5-year period will run from the date of termination or... a running award under § 3.551(b) which are payable in a lump sum after the veteran's death....

  18. 38 CFR 3.1001 - Hospitalized competent veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... within 5 years after the death of the veteran. If, however, any person otherwise entitled is under legal disability at the time of the veteran's death, the 5-year period will run from the date of termination or... a running award under § 3.551(b) which are payable in a lump sum after the veteran's death....

  19. 38 CFR 3.656 - Disappearance of veteran.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) Amount of compensation payable to the veteran at the time of disappearance, subject to authorized... the presumption of death under § 3.212. (d) When any veteran has disappeared for 90 days or more and... entitled to receive may be paid to or for the spouse or children. The status of the veteran at the time...

  20. Latent Classes of PTSD Symptoms in Vietnam Veterans

    ERIC Educational Resources Information Center

    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…

  1. Use of Psychotherapy by Rural and Urban Veterans

    ERIC Educational Resources Information Center

    Cully, Jeffrey A.; Jameson, John P.; Phillips, Laura L.; Kunik, Mark E.; Fortney, John C.

    2010-01-01

    Purpose: To examine whether differences exist between rural and urban veterans in terms of initiation of psychotherapy, delay in time from diagnosis to treatment, and dose of psychotherapy sessions. Methods: Using a longitudinal cohort of veterans obtained from national Veterans Affairs databases (October 2003 through September 2004), we extracted…

  2. A Century of Veterans: Researching History through Our Local Cemetery

    ERIC Educational Resources Information Center

    Downey, Lindsey B.

    2008-01-01

    It is vital for young students to see how the lives of the veterans connect to their own lives. In this article, the author describes a project of making history come alive. The project started with a visit to the Otterbein Cemetery mausoleum to learn about the U.S. military veterans interred there. These veterans represented a century of U.S.…

  3. MISSION GRADUATION: A Student Military and Veteran Organization

    ERIC Educational Resources Information Center

    Whikehart, John

    2010-01-01

    Mission Graduation, a student military and veteran organization, is designed to meet the needs of military service students, veterans, and their families enrolled at Ivy Tech Community College. Mission Graduation, funded by a grant, brings awareness to the student veteran organization, provides transition programming and ongoing assistance, and…

  4. 20 CFR 652.100 - Services for veterans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Services for veterans. 652.100 Section 652.100 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ESTABLISHMENT AND FUNCTIONING OF STATE EMPLOYMENT SERVICES Services for Veterans § 652.100 Services for veterans. Services...

  5. 20 CFR 652.100 - Services for veterans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Services for veterans. 652.100 Section 652.100 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ESTABLISHMENT AND FUNCTIONING OF STATE EMPLOYMENT SERVICES Services for Veterans § 652.100 Services for veterans. Services...

  6. Veteran satisfaction and treatment preferences in response to a posttraumatic stress disorder specialty clinic orientation group.

    PubMed

    Schumm, Jeremiah A; Walter, Kristen H; Bartone, Anne S; Chard, Kathleen M

    2015-06-01

    To maximize accessibility to evidence-based treatments for posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs (VA) has widely disseminated cognitive processing therapy (CPT) and prolonged exposure (PE) therapy to VA clinicians. However, there is a lack of research on veteran preferences when presented with a range of psychotherapy and medication options. This study uses a mixed-method approach to explore veteran satisfaction with a VA PTSD specialty clinic pre-treatment orientation group, which provides education about available PTSD treatment options. This study also tested differences in treatment preference in response to the group. Participants were 183 US veterans. Most were White, male, and referred to the clinic by a VA provider. Results indicated high satisfaction with the group in providing an overview of services and helping to inform treatment choice. Most preferred psychotherapy plus medications (63.4%) or psychotherapy only (30.1%). Participants endorsed a significantly stronger preference for CPT versus other psychotherapies. PE was significantly preferred over nightmare resolution therapy and present-centered therapy, and both PE and cognitive-behavioral conjoint therapy were preferred over virtual reality exposure therapy. Results suggest that by informing consumers about evidence-based treatments for PTSD, pre-treatment educational approaches may increase consumer demand for these treatment options.

  7. Family composition and symptom severity among Veterans with comorbid PTSD and substance use disorders.

    PubMed

    Jobe-Shields, Lisa; Flanagan, Julianne C; Killeen, Therese; Back, Sudie E

    2015-11-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur and affect a substantial proportion of military Veterans. Although the impact of parental PTSD and SUD on child development is well-documented, little is known about the influence of family composition on PTSD/SUD symptom severity. The present study investigated children in the home as an independent risk factor for symptom severity in a sample of treatment-seeking Veterans (N = 94; 92% male) with comorbid PTSD/SUD. Twenty-seven percent of the sample had minor children (age 18 or younger) living in the home. Veterans with children in the home evidenced significantly higher PTSD symptomatology as measured by the Clinical Administered PTSD Scale (CAPS; M = 82.65 vs. M = 72.17; t = -2.18; p < .05), and reported using marijuana more frequently than Veterans without children in the home (34% vs. 13% of past 60 days; t = -2.35, p < .05). In a multivariate model, having children in the home accounted for unique variance (ΔR(2) = .07) in PTSD severity after accounting for a range of covariates; however, having children in the home did not account for unique variance in substance use. Directions for future research as well as potential clinical implications for parents seeking treatment for PTSD/SUD are discussed.

  8. Health, wartime stress, and unit cohesion: evidence from Union Army veterans.

    PubMed

    Costa, Dora L; Kahn, Matthew E

    2010-02-01

    We find that Union Army veterans of the American Civil War who faced greater wartime stress (as measured by higher battlefield mortality rates) experienced higher mortality rates at older ages, but that men who were from more cohesive companies were statistically significantly less likely to be affected by wartime stress. Our results hold for overall mortality, mortality from ischemic heart disease and stroke, and new diagnoses of arteriosclerosis. Our findings represent one of the first long-run health follow-ups of the interaction between stress and social networks in a human population in which both stress and social networks are arguably exogenous.

  9. Health, Wartime Stress, and Unit Cohesion: Evidence From Union Army Veterans

    PubMed Central

    COSTA, DORA L.; KAHN, MATTHEW E.

    2010-01-01

    We find that Union Army veterans of the American Civil War who faced greater wartime stress (as measured by higher battlefield mortality rates) experienced higher mortality rates at older ages, but that men who were from more cohesive companies were statistically significantly less likely to be affected by wartime stress. Our results hold for overall mortality, mortality from ischemic heart disease and stroke, and new diagnoses of arteriosclerosis. Our findings represent one of the first long-run health follow-ups of the interaction between stress and social networks in a human population in which both stress and social networks are arguably exogenous. PMID:20355683

  10. Survey of Aging Veterans: A Study of the Means, Resources and Future Expectations of Veterans Aged 55 and Over.

    ERIC Educational Resources Information Center

    Veterans Administration, Washington, DC. Office of Information Management and Statistics.

    A national survey of the needs, resources, and future expectations of veterans aged 55 and over produced findings that the Veterans Administration (VA) will use over the next decade to plan facilities and programs to meet those needs. Findings indicated veterans had a higher educational level and were less likely to be at the lower end of the…

  11. 38 CFR 21.8012 - Vocational training program for certain children of Vietnam veterans and veterans with covered...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and covered birth defects. 21.8012 Section 21.8012 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... and Covered Birth Defects General § 21.8012 Vocational training program for certain children of Vietnam veterans and veterans with covered service in Korea—spina bifida and covered birth defects....

  12. 38 CFR 21.8012 - Vocational training program for certain children of Vietnam veterans and veterans with covered...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and covered birth defects. 21.8012 Section 21.8012 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... and Covered Birth Defects General § 21.8012 Vocational training program for certain children of Vietnam veterans and veterans with covered service in Korea—spina bifida and covered birth defects....

  13. 38 CFR 21.8012 - Vocational training program for certain children of Vietnam veterans and veterans with covered...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and covered birth defects. 21.8012 Section 21.8012 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... and Covered Birth Defects General § 21.8012 Vocational training program for certain children of Vietnam veterans and veterans with covered service in Korea—spina bifida and covered birth defects....

  14. 38 CFR 21.8012 - Vocational training program for certain children of Vietnam veterans and veterans with covered...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and covered birth defects. 21.8012 Section 21.8012 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... and Covered Birth Defects General § 21.8012 Vocational training program for certain children of Vietnam veterans and veterans with covered service in Korea—spina bifida and covered birth defects....

  15. The Post-9/11 GI Bill: Insights from Veterans Using Department of Veterans Affairs Educational Benefits

    ERIC Educational Resources Information Center

    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…

  16. No association between the serotonin transporter linked polymorphic region polymorphism and severity of posttraumatic stress disorder symptoms in combat veterans with or without comorbid depression.

    PubMed

    Kovacic Petrovic, Zrnka; Nedic Erjavec, Gordana; Nikolac Perkovic, Matea; Peraica, Tina; Pivac, Nela

    2016-10-30

    Since both posttraumatic stress disorder (PTSD) and depression are associated with disturbances in the serotoninergic system, the aim of the study was to determine the association between severity of PTSD symptoms, serotonin transporter polymorphism (5-HTTLPR) and platelet serotonin (5-HT) concentration, in male combat veterans with PTSD (n = 325), who were subdivided according to presence of comorbid depression. The methodological approach included the psychiatric diagnostic interviews and rating scales (SCID for DSM-IV, HDRS, CAPS), polymerase chain reaction for 5-HTTLPR genotyping and spectrophotofluorometric method for measuring the platelet 5-HT concentration. PTSD veterans without depression had more severe PTSD symptoms, and less severe depressive symptoms, than PTSD veterans with depression. 5-HTTLPR genotype frequencies did not differ between veterans with mild, moderate and severe PTSD symptoms, and between depressed and non-depressed PTSD veterans. No significant association was found between the severity of PTSD symptoms and 5-HTTLPR genotype. Platelet 5-HT concentration was similar in PTSD veterans, with or without comorbid depression, and between two groups subdivided according to the severity of PTSD symptoms or 5-HTTLPR genotype. The study confirmed, on ethnically homogenous groups of veterans with matched combat experience, a lack of association between the PTSD symptoms severity and 5-HTTLPR or platelet 5-HT concentration. PMID:27525827

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

    PubMed

    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.

  18. Mental Health Disorders and Treatment Seeking Among Veterans in Non-VA Facilities: Results and Implications from the Veterans’ Health Study

    PubMed Central

    Boscarino, Joseph A.; Hoffman, Stuart N.; Pitcavage, James M.; Urosevich, Thomas G.

    2015-01-01

    We surveyed 700 veterans who were outpatients in a non–Veterans Affairs (VA) multihospital system. Our objective was to assess the prevalence of mental disorders and service use among these veterans. The majority were Vietnam veterans (72.0%), and male (95.9%), and 40.4% reported recently using the VA for care. The prevalence of lifetime post-traumatic stress disorder (PTSD) was 9.6%, lifetime depression 18.4%, and lifetime mental health service use 50.1%. In multivariate analyses, significant factors associated with PTSD, depression, and mental health service use were low self-esteem, use of alcohol/drugs to cope, history of childhood adversity, high combat exposure, and low psychological resilience. VA service use was associated with greater mental health service use and combat exposure. With the exception of alcohol misuse, the mental health status of veterans seen in non-VA facilities appeared to be better than reported in past studies. Because most veterans have access to both VA and non-VA services, these findings have implications for veterans and outcomes research. PMID:26640743

  19. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed.

    PubMed

    Schubert, Cathy C; Myers, Laura J; Allen, Katie; Counsell, Steven R

    2016-07-01

    In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation.

  20. Implementing Geriatric Resources for Assessment and Care of Elders Team Care in a Veterans Affairs Medical Center: Lessons Learned and Effects Observed.

    PubMed

    Schubert, Cathy C; Myers, Laura J; Allen, Katie; Counsell, Steven R

    2016-07-01

    In a randomized clinical trial, Geriatric Resources for Assessment and Care of Elders (GRACE), a model of care that works in collaboration with primary care providers (PCPs) and patient-centered medical homes to provide home-based geriatric care management focusing on geriatric syndromes and psychosocial problems commonly found in older adults, improved care quality and reduced acute care use for high-risk, low-income older adults. To assess the effect of GRACE at a Veterans Affairs (VA) Medical Center (VAMC), veterans aged 65 and older from Marion County, Indiana, with PCPs from four of five VAMC clinics who were not on hospice or dialysis were enrolled in GRACE after discharge home from an acute hospitalization. After an initial home-based transition visit to GRACE enrollees, the GRACE team returned to conduct a geriatric assessment. Guided by 12 protocols and input from an interdisciplinary panel and the PCP, the GRACE team developed and implemented a veteran-centric care plan. Hospitalized veterans from the fifth clinic, who otherwise met enrollment criteria, served as a usual-care comparison group. Demographic, comorbidity, and usage data were drawn from VA databases. The GRACE and comparison groups were similar in age, sex, and burden of comorbidity, although predicted risk of 1-year mortality in GRACE veterans was higher. Even so, GRACE enrollment was associated with 7.1% fewer emergency department visits, 14.8% fewer 30-day readmissions, 37.9% fewer hospital admissions, and 28.5% fewer total bed days of care, saving the VAMC an estimated $200,000 per year after program costs during the study for the 179 veterans enrolled in GRACE. Having engaged, enthusiastic VA leadership and GRACE staff; aligning closely with the medical home; and accommodating patient acuity were among the important lessons learned during implementation. PMID:27305428

  1. Dignified Burial of Veterans Act of 2012

    THOMAS, 112th Congress

    Rep. Bilirakis, Gus M. [R-FL-9

    2012-06-29

    06/29/2012 Referred to the House Committee on Veterans' Affairs. (All Actions) Notes: For further action, see S.3202, which became Public Law 112-260 on 1/10/2013. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  2. Patterns of Drug Usage Among Vietnam Veterans.

    ERIC Educational Resources Information Center

    Fisher, Allan H., Jr.; And Others

    A factor analysis was performed on an intercorrelation matrix of reported drug usage frequencies for seven drug categories at two consecutive periods of time. Subjects were 1,010 Army Vietnam veterans in pay grade E6 or below, aged 26 years or less. Retrospective reporting identified drug usage prior to a tour of Vietnam and during the tour. Four…

  3. Helping Student Servicemembers and Veterans Succeed

    ERIC Educational Resources Information Center

    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;…

  4. Veterans Advancing Clean Energy and Climate

    ScienceCinema

    Kopser, Joseph; Marr, Andrea; Perez-Halperin, Elizabeth; Eckstein, Robin; Moniz, Ernest

    2016-07-12

    The Champions of Change series highlights ordinary Americans who are doing extraordinary things in their communities to out-innovate, out-educate and out-build the rest of the world. On November 5, 2013, the White House honored 12 veterans and leaders who are using the skills they learned in the armed services to advance the clean energy economy.

  5. Veterans Advancing Clean Energy and Climate

    SciTech Connect

    Kopser, Joseph; Marr, Andrea; Perez-Halperin, Elizabeth; Eckstein, Robin; Moniz, Ernest

    2013-11-11

    The Champions of Change series highlights ordinary Americans who are doing extraordinary things in their communities to out-innovate, out-educate and out-build the rest of the world. On November 5, 2013, the White House honored 12 veterans and leaders who are using the skills they learned in the armed services to advance the clean energy economy.

  6. Research Battles: Survival Tips From a Veteran.

    PubMed

    Isaacs, Linda L

    2015-10-01

    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.

  7. AccessComputing: Building Capacity for Veterans

    ERIC Educational Resources Information Center

    DO-IT, 2009

    2009-01-01

    A series of activities have been undertaken to increase the participation of veterans with disabilities in computing and information technology (IT) postsecondary education and career fields. These activities were coordinated by the Alliance for Access to Computing Careers ("AccessComputing"), led by the Department of Computer Science and…

  8. Veteran Teachers: Commitment, Resilience and Quality Retention

    ERIC Educational Resources Information Center

    Day, Christopher; Gu, Qing

    2009-01-01

    Whilst much research on teachers' lives has focussed on their early years in the profession, much less attention has been paid to those in their later years, so called "veteran" teachers. Yet, many of these are likely to hold positions of responsibility in the school, receive greater remuneration and have experienced the impact of more policy and…

  9. The Postwar Home Front: Memorializing Veterans.

    ERIC Educational Resources Information Center

    Drake, Sarah E.

    2002-01-01

    Offers background information on Veterans Day in the United States. Presents a lesson drawing upon the "Teaching Talking History" program, "Memorializing War." Provides ideas for discussion and focuses on having students analyze documents to study memorials. Uses the Gettysburg Address and three other primary sources. (CMK)

  10. 5 CFR 315.707 - Disabled veterans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Conversion to Career or Career-Conditional Employment From Other Types of... disabled veteran who meets the conditions below to career or career-conditional employment from a...

  11. 5 CFR 315.707 - Disabled veterans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Conversion to Career or Career-Conditional Employment From Other Types of... disabled veteran who meets the conditions below to career or career-conditional employment from a...

  12. 5 CFR 315.707 - Disabled veterans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Conversion to Career or Career-Conditional Employment From Other Types of... disabled veteran who meets the conditions below to career or career-conditional employment from a...

  13. 38 CFR 3.501 - Veterans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... a veteran without dependents. (iii) Upon readmission to hospital, domiciliary, or nursing home care... of such readmission. (3) Section 3.552(b) Upon readmission to hospital care within 6 months of a..., the day preceding the date of such readmission. (4) Section 3.551(d) (i) Last day of the...

  14. 38 CFR 3.501 - Veterans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... a veteran without dependents. (iii) Upon readmission to hospital, domiciliary, or nursing home care... of such readmission. (3) Section 3.552(b) Upon readmission to hospital care within 6 months of a..., the day preceding the date of such readmission. (4) Section 3.551(d) (i) Last day of the...

  15. 38 CFR 3.501 - Veterans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... a veteran without dependents. (iii) Upon readmission to hospital, domiciliary, or nursing home care... of such readmission. (3) Section 3.552(b) Upon readmission to hospital care within 6 months of a..., the day preceding the date of such readmission. (4) Section 3.551(d) (i) Last day of the...

  16. Posttraumatic stress disorder in combat veterans.

    PubMed

    Lawson, Nicole R

    2014-05-01

    Posttraumatic stress disorder (PTSD) affects up to 18% of combat veterans, many of whom will seek care from clinicians outside the military healthcare system. This article reviews the epidemiology, risk factors, symptoms, diagnosis, treatment, and referral options for PTSD so that PAs in primary care can recognize and appropriately manage patients with PTSD.

  17. 38 CFR 3.401 - Veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Disabilities—(1) Section 4.29 of this chapter. Date of entrance into hospital, after 21 days of continuous... established. (Authority: 38 U.S.C. 501; 5110(b)(1), (3)) (2) Date of departure from hospital, institution, or... awards (§ 3.852)—(1) Chief officer of non-Department of Veterans Affairs hospital or institution....

  18. Adapted Sport Programs for Veterans with Disabilities

    ERIC Educational Resources Information Center

    Goff, Mandy

    2012-01-01

    The Paralympic games began as a way for World War II veterans to take part in elite-level competition. Thanks to various disability-sport organizations, men and women who have served in the military are still using sport as a form of rehabilitation and a way to transition into their new life.

  19. Transitions: Combat Veterans as College Students

    ERIC Educational Resources Information Center

    Ackerman, Robert; DiRamio, David; Garza Mitchell, Regina L.

    2009-01-01

    The experience of war makes those who fight a special group within the general population. The purpose of this study was to investigate how combat veterans who become college students make the transition to campus life, in order to identify how administrators can acknowledge and support them. A total of six women and 19 men were interviewed; 24…

  20. 38 CFR 3.501 - Veterans.

    Code of Federal Regulations, 2010 CFR

    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...

  1. 5 CFR 315.707 - Disabled veterans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Conversion to Career or Career-Conditional Employment From Other Types of... disabled veteran who meets the conditions below to career or career-conditional employment from a...

  2. 5 CFR 315.707 - Disabled veterans.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....707 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Conversion to Career or Career-Conditional Employment From Other Types of... disabled veteran who meets the conditions below to career or career-conditional employment from a...

  3. Reaction of Vietnam veterans to the Persian Gulf War.

    PubMed

    Kobrick, F R

    1993-08-01

    The notion that veterans' war experiences can be reawakened on exposure to subsequent wars has not received the attention it merits by mental health professionals. A current or recent war can significantly affect veterans; in particular, some Vietnam veterans have had intense reactions to the Persian Gulf War. This article reviews the evolution of the concept of combat-related posttraumatic stress disorder and analyzes reports of Vietnam veterans' reactions to the Persian Gulf War. A case study of a Vietnam veteran whose traumatic memories were reawakened with the onset of the Persian Gulf War is presented, and implications for social work practice are discussed.

  4. Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care

    PubMed Central

    Brown, George R.; Shipherd, PhD, Jillian C.; Kauth, Michael; Piegari, Rebecca I.; Bossarte, Robert M.

    2013-01-01

    Objectives. We estimated the prevalence and incidence of gender identity disorder (GID) diagnoses among veterans in the Veterans Health Administration (VHA) health care system and examined suicide risk among veterans with a GID diagnosis. Methods. We examined VHA electronic medical records from 2000 through 2011 for 2 official ICD-9 diagnosis codes that indicate transgender status. We generated annual period prevalence estimates and calculated incidence using the prevalence of GID at 2000 as the baseline year. We cross-referenced GID cases with available data (2009–2011) of suicide-related events among all VHA users to examine suicide risk. Results. GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons). The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population. Conclusions. The prevalence of GID diagnosis nearly doubled over 10 years among VHA veterans. Research is needed to examine suicide risk among transgender veterans and how their VHA utilization may be enhanced by new VA initiatives on transgender care. PMID:23947310

  5. The concentration of hospital care for black veterans in Veterans Affairs hospitals: implications for clinical outcomes.

    PubMed

    Jha, Ashish K; Stone, Roslyn; Lave, Judith; Chen, Huanyu; Klusaritz, Heather; Volpp, Kevin

    2010-01-01

    Where minorities receive their care may contribute to disparities in care, yet, the racial concentration of care in the Veterans Health Administration is largely unknown. We sought to better understand which Veterans Affairs (VA) hospitals treat Black veterans and whether location of care impacted disparities. We assessed differences in mortality rates between Black and White veterans across 150 VA hospitals for any of six conditions (acute myocardial infarction, hip fracture, stroke, congestive heart failure, gastrointestinal hemorrhage, and pneumonia) between 1996 and 2002. Just 9 out of 150 VA hospitals (6% of all VA hospitals) cared for nearly 30% of Black veterans, and 42 hospitals (28% of all VA hospitals) cared for more than 75% of Black veterans. While our findings show that overall mortality rates were comparable between minority-serving and non-minority-serving hospitals for four conditions, mortality rates were higher in minority-serving hospitals for acute myocardial infarction (AMI) and pneumonia. The ratio of mortality rates for Blacks compared with Whites was comparable across all VA hospitals. In contrast to the private sector, there is little variation in the degree of racial disparities in 30-day mortality across VA hospitals, although higher mortality among patients with AMI and pneumonia requires further investigation.

  6. The concentration of hospital care for black veterans in Veterans Affairs hospitals: implications for clinical outcomes.

    PubMed

    Jha, Ashish K; Stone, Roslyn; Lave, Judith; Chen, Huanyu; Klusaritz, Heather; Volpp, Kevin

    2010-01-01

    Where minorities receive their care may contribute to disparities in care, yet, the racial concentration of care in the Veterans Health Administration is largely unknown. We sought to better understand which Veterans Affairs (VA) hospitals treat Black veterans and whether location of care impacted disparities. We assessed differences in mortality rates between Black and White veterans across 150 VA hospitals for any of six conditions (acute myocardial infarction, hip fracture, stroke, congestive heart failure, gastrointestinal hemorrhage, and pneumonia) between 1996 and 2002. Just 9 out of 150 VA hospitals (6% of all VA hospitals) cared for nearly 30% of Black veterans, and 42 hospitals (28% of all VA hospitals) cared for more than 75% of Black veterans. While our findings show that overall mortality rates were comparable between minority-serving and non-minority-serving hospitals for four conditions, mortality rates were higher in minority-serving hospitals for acute myocardial infarction (AMI) and pneumonia. The ratio of mortality rates for Blacks compared with Whites was comparable across all VA hospitals. In contrast to the private sector, there is little variation in the degree of racial disparities in 30-day mortality across VA hospitals, although higher mortality among patients with AMI and pneumonia requires further investigation. PMID:20946426

  7. Mindfulness as a Weight Loss Treatment for Veterans

    PubMed Central

    Stanton, Michael V.; Matsuura, Justin; Fairchild, Jennifer Kaci; Lohnberg, Jessica A.; Bayley, Peter J.

    2016-01-01

    Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.S. and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments. PMID:27574603

  8. Mindfulness as a Weight Loss Treatment for Veterans.

    PubMed

    Stanton, Michael V; Matsuura, Justin; Fairchild, Jennifer Kaci; Lohnberg, Jessica A; Bayley, Peter J

    2016-01-01

    Despite substantial evidence for their effectiveness in treating disordered eating and obesity, mindfulness-based treatments have not been broadly implemented among Veterans. A number of reviews have reported mindfulness to be beneficial in promoting healthy eating behaviors and weight loss among non-Veteran samples. We discuss this approach in the context of the Veterans Affairs system, the largest integrated healthcare provider in the U.S. and in the context of Veterans, among whom obesity is at epidemic proportions. In this article, we discuss what is known about treating obesity using a mindfulness approach, mindfulness interventions for Veterans, a new pilot mindfulness-based weight loss program designed for Veterans, and future directions for this type of obesity treatment in Veterans. We conclude that this population may be uniquely poised to benefit from mindfulness-based treatments. PMID:27574603

  9. PTSD symptoms and pain in Canadian military veterans: the mediating roles of anxiety, depression, and alcohol use.

    PubMed

    Irwin, Kara C; Konnert, Candace; Wong, May; O'Neill, Thomas A

    2014-04-01

    Symptoms of posttraumatic stress disorder (PTSD) and pain are often comorbid among veterans. The purpose of this study was to investigate to what extent symptoms of anxiety, depression, and alcohol use mediated the relationship between PTSD symptoms and pain among 113 treated male Canadian veterans. Measures of PTSD, pain, anxiety symptoms, depression symptoms, and alcohol use were collected as part of the initial assessment. The bootstrapped resampling analyses were consistent with the hypothesis of mediation for anxiety and depression, but not alcohol use. The confidence intervals did not include zero and the indirect effect of PTSD on pain through anxiety was .04, CI [.03, .07]. The indirect effect of PTSD on pain through depression was .04, CI [.02, .07]. These findings suggest that PTSD and pain symptoms among veterans may be related through the underlying symptoms of anxiety and depression, thus emphasizing the importance of targeting anxiety and depression symptoms when treating comorbid PTSD and pain patients.

  10. Emotion Recognition Ability Test Using JACFEE Photos: A Validity/Reliability Study of a War Veterans' Sample and Their Offspring.

    PubMed

    Castro-Vale, Ivone; Severo, Milton; Carvalho, Davide; Mota-Cardoso, Rui

    2015-01-01

    Emotion recognition is very important for social interaction. Several mental disorders influence facial emotion recognition. War veterans and their offspring are subject to an increased risk of developing psychopathology. Emotion recognition is an important aspect that needs to be addressed in this population. To our knowledge, no test exists that is validated for use with war veterans and their offspring. The current study aimed to validate the JACFEE photo set to study facial emotion recognition in war veterans and their offspring. The JACFEE photo set was presented to 135 participants, comprised of 62 male war veterans and 73 war veterans' offspring. The participants identified the facial emotion presented from amongst the possible seven emotions that were tested for: anger, contempt, disgust, fear, happiness, sadness, and surprise. A loglinear model was used to evaluate whether the agreement between the intended and the chosen emotions was higher than the expected. Overall agreement between chosen and intended emotions was 76.3% (Cohen kappa = 0.72). The agreement ranged from 63% (sadness expressions) to 91% (happiness expressions). The reliability by emotion ranged from 0.617 to 0.843 and the overall JACFEE photo set Cronbach alpha was 0.911. The offspring showed higher agreement when compared with the veterans (RR: 41.52 vs 12.12, p < 0.001), which confirms the construct validity of the test. The JACFEE set of photos showed good validity and reliability indices, which makes it an adequate instrument for researching emotion recognition ability in the study sample of war veterans and their respective offspring. PMID:26147938

  11. Emotion Recognition Ability Test Using JACFEE Photos: A Validity/Reliability Study of a War Veterans' Sample and Their Offspring.

    PubMed

    Castro-Vale, Ivone; Severo, Milton; Carvalho, Davide; Mota-Cardoso, Rui

    2015-01-01

    Emotion recognition is very important for social interaction. Several mental disorders influence facial emotion recognition. War veterans and their offspring are subject to an increased risk of developing psychopathology. Emotion recognition is an important aspect that needs to be addressed in this population. To our knowledge, no test exists that is validated for use with war veterans and their offspring. The current study aimed to validate the JACFEE photo set to study facial emotion recognition in war veterans and their offspring. The JACFEE photo set was presented to 135 participants, comprised of 62 male war veterans and 73 war veterans' offspring. The participants identified the facial emotion presented from amongst the possible seven emotions that were tested for: anger, contempt, disgust, fear, happiness, sadness, and surprise. A loglinear model was used to evaluate whether the agreement between the intended and the chosen emotions was higher than the expected. Overall agreement between chosen and intended emotions was 76.3% (Cohen kappa = 0.72). The agreement ranged from 63% (sadness expressions) to 91% (happiness expressions). The reliability by emotion ranged from 0.617 to 0.843 and the overall JACFEE photo set Cronbach alpha was 0.911. The offspring showed higher agreement when compared with the veterans (RR: 41.52 vs 12.12, p < 0.001), which confirms the construct validity of the test. The JACFEE set of photos showed good validity and reliability indices, which makes it an adequate instrument for researching emotion recognition ability in the study sample of war veterans and their respective offspring.

  12. Racial Disparities in All-Cause Mortality Among Veterans with Type 2 Diabetes

    PubMed Central

    Lynch, Cheryl P.; Gebregziabher, Mulugeta; Echols, Carrae; Gilbert, Gregory E.; Zhao, Yumin

    2010-01-01

    BACKGROUND Racial differences in mortality among veterans with diabetes are less well characterized than those in the general population. OBJECTIVE To examine racial differences in all-cause mortality in a large sample of veterans with diabetes. DESIGN A retrospective cohort. PARTICIPANTS Participants comprised 8,812 veterans with type 2 diabetes. MEASUREMENTS The main outcome measure was time to death. The main predictor was race/ethnicity. Other risk factors (or covariates) included age, gender, marital status, employment, glycosylated hemoglobin (HgbA1c), and several ICD-9 coded physical and mental health comorbidities. RESULTS Average follow-up was 4.5 years; 64% of veterans were non-Hispanic whites (NHW), 97% male, and 84% at least 50 years old. The overall mortality rate was 15% and was significantly lower for non-Hispanic blacks (NHB). Baseline HgbA1c values also differed for NHW (mean = 7.05) and NHB (mean = 7.65) (p < 0.001). In sequentially-built models NHB race was associated with a lower risk of mortality with HR ranging 0.80-0.92. After adjusting for all significant covariates, the risk of mortality remained lower for NHB (HR = 0.84, 95% CI: 0.75, 0.94). Increased mortality risk was associated with age, not being employed or retired, poor glycemic control, cancer, Coronary Heart Disease (CHD), and anxiety disorder; while a lower risk was associated with being female and ever being married. CONCLUSIONS The risk of death among NHB veterans with diabetes remained significantly lower than that of NHW after controlling for important confounding variables. Future studies in the VA need to examine detailed contributions of patient, provider and system-level factors on racial differences in mortality in adults with diabetes, especially if the findings of this study are replicated at other sites or using national VA data. PMID:20532659

  13. Deployment-Related TBI, Persistent Postconcussive Symptoms, PTSD, and Depression in OEF/OIF Veterans

    PubMed Central

    Morissette, Sandra B.; Woodward, Matthew; Kimbrel, Nathan A.; Meyer, Eric C.; Kruse, Marc I.; Dolan, Sara; Gulliver, Suzy Bird

    2016-01-01

    Objective A substantial proportion of the more than 2 million service members who have served in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have experienced a traumatic brain injury (TBI). Understanding the long-term impact of TBI is complicated by the non-specific nature of postconcussive symptoms (PCS) and the high rates of co-occurrence among TBI, posttraumatic stress disorder (PTSD), and depression. The goal of the present research was to examine the relations among TBI, persistent PCS, and symptoms of PTSD and depression among returning OEF/OIF Veterans. Design Two-hundred and thirteen OEF/OIF Veterans (87% male) completed a semi-structured screening interview assessing deployment-related TBI and current, persistent PCS. Participants also completed self-report measures of combat exposure and current symptoms of PTSD and depression. Results Nearly half (46%) of sampled Veterans screened positive for TBI, the majority of whom (85%) reported at least one persistent PCS after removing PCS that overlapped with PTSD and depression. Veterans with deployment-related TBI reported higher levels of combat exposure and symptoms of PTSD and depression. Structural equation modeling was used to assess the fit of three models of the relationships among TBI, combat exposure, persistent PCS, PTSD, and depression. Consistent with hypotheses, the best fitting model was one in which the effects of TBI on both PTSD and depression were fully mediated by non-overlapping persistent PCS. Implications These findings highlight the importance of addressing persistent PCS in order to facilitate the functional recovery of returning war Veterans. PMID:22121940

  14. Preliminary Evidence of Increased Hippocampal Myelin Content in Veterans with Posttraumatic Stress Disorder

    PubMed Central

    Chao, Linda L.; Tosun, Duygu; Woodward, Steven H.; Kaufer, Daniela; Neylan, Thomas C.

    2015-01-01

    Recent findings suggest the formation of myelin in the central nervous system by oligodendrocytes is a continuous process that can be modified with experience. For example, a recent study showed that immobilization stress increased oligodendrogensis in the dentate gyrus of adult rat hippocampus. Because changes in myelination represents an adaptive form of brain plasticity that has a greater reach in the adult brain than other forms of plasticity (e.g., neurogenesis), the objective of this “proof of concept” study was to examine whether there are differences in myelination in the hippocampi of humans with and without post-traumatic stress disorder (PTSD). We used the ratio of T1-weighted/T2-weighted magnetic resonance image (MRI) intensity to estimate the degree of hippocampal myelination in 19 male veterans with PTSD and 19 matched trauma-exposed male veterans without PTSD (mean age: 43 ± 12 years). We found that veterans with PTSD had significantly more hippocampal myelin than trauma-exposed controls. There was also found a positive correlation between estimates of hippocampal myelination and PTSD and depressive symptom severity. To our knowledge, this is the first study to examine hippocampal myelination in humans with PTSD. These results provide preliminary evidence for stress-induced hippocampal myelin formation as a potential mechanism underlying the brain abnormalities associated with vulnerability to stress. PMID:26696852

  15. Race/ethnicity and gender differences in mental health diagnoses among Iraq and Afghanistan veterans.

    PubMed

    Koo, Kelly H; Hebenstreit, Claire L; Madden, Erin; Seal, Karen H; Maguen, Shira

    2015-10-30

    Veterans who served in Operation Enduring Freedom (OEF; predominantly in Afghanistan) and Operations Iraqi Freedom and New Dawn (OIF and OND; predominantly in Iraq) and are enrolled in the VA are comprised of a growing cohort of women and higher proportions of racial/ethnic minorities than civilians. To compare rates of mental health disorders by race/ethnicity and gender for this diverse cohort, we conducted a retrospective analysis of existing records from OEF/OIF/OND veterans who were seen at the VA 10/7/01-8/1/2013 (N=792,663). We found that race/ethnicity was related to diagnoses of mental health disorders. Asian/Pacific Islanders (A/PIs) were diagnosed with all disorders at lower rates than whites, and American Indian/Alaska Native (AI/AN) males were diagnosed with most disorders at higher rates than white males. Research is needed to identify contributing factors to differential rates of diagnoses based on race/ethnicity and gender. A/PIs and AI/ANs have unique patterns of mental health diagnoses indicating they should be considered separately to present a comprehensive picture of veteran mental health.

  16. Race/ethnicity and gender differences in mental health diagnoses among Iraq and Afghanistan veterans.

    PubMed

    Koo, Kelly H; Hebenstreit, Claire L; Madden, Erin; Seal, Karen H; Maguen, Shira

    2015-10-30

    Veterans who served in Operation Enduring Freedom (OEF; predominantly in Afghanistan) and Operations Iraqi Freedom and New Dawn (OIF and OND; predominantly in Iraq) and are enrolled in the VA are comprised of a growing cohort of women and higher proportions of racial/ethnic minorities than civilians. To compare rates of mental health disorders by race/ethnicity and gender for this diverse cohort, we conducted a retrospective analysis of existing records from OEF/OIF/OND veterans who were seen at the VA 10/7/01-8/1/2013 (N=792,663). We found that race/ethnicity was related to diagnoses of mental health disorders. Asian/Pacific Islanders (A/PIs) were diagnosed with all disorders at lower rates than whites, and American Indian/Alaska Native (AI/AN) males were diagnosed with most disorders at higher rates than white males. Research is needed to identify contributing factors to differential rates of diagnoses based on race/ethnicity and gender. A/PIs and AI/ANs have unique patterns of mental health diagnoses indicating they should be considered separately to present a comprehensive picture of veteran mental health. PMID:26282226

  17. Vital status ascertainment through the files of the Department of Veterans Affairs and the Social Security Administration.

    PubMed

    Page, W F; Mahan, C M; Kang, H K

    1996-03-01

    Veterans of US military service are a valuable resource for epidemiologic studies, and the Department of Veterans Affairs (VA) files provide an effective way to gather mortality information on veterans, so long as these files provide reasonably complete death reporting. To determine the completeness of VA death reporting, we assembled an independent sample of known veteran deaths among males born between 1936 and 1955 and assessed the performance of VA death reporting in this sample. We also compared VA death ascertainment to Social Security Administration (SSA) ascertainment. Based on the more than 4300 deaths in our study, we found VA death reporting to be approximately 90% complete by itself and 96% complete when used in conjunction with SSA death reporting. In addition, we found no evidence that VA death reporting changed substantially after passage of the Omnibus Budget Reconciliation Act of 1981, which limited eligibility for VA death benefits. Because veterans make up a large segment of the US population, our findings have particular relevance for studies in which mortality is a primary end point. PMID:10068251

  18. Use of Health Care System-Supplied Aspirin by Veterans With Postoperative Heart Attack or Unstable Angina.

    PubMed

    Rivera, Cathleen M; Copeland, Laurel A; McNeal, Catherine J; Mortensen, Eric M; Pugh, Mary J; MacCarthy, Daniel J

    2015-10-01

    Evidence-based guidelines for the use of aspirin in secondary prevention of cardiovascular disease events are well established. Despite this, the prevalence of aspirin use for secondary prevention is suboptimal. The study aimed to determine the prevalence of aspirin use for secondary prevention of cardiovascular disease events when it is dispensed as a prescription, as is performed in the Veterans Affairs (VA) managed care system. VA patients who had undergone major surgery and experienced a postoperative myocardial infarction (MI) or unstable angina between the years 2005 and 2009 were identified from administrative databases. VA pharmacy records were used to determine whether a prescription for aspirin was filled after the postoperative MI or unstable angina. Multivariable logistic regression models estimated odd ratios of filling aspirin prescriptions for the predictors of interest. Of the 321,131 men and women veterans who underwent major surgery, 7,700 experienced a postoperative MI or unstable angina. Among those 7,700, 47% filled an aspirin prescription. Only 59% of veterans with no co-pay filled an aspirin prescription. Aspirin fills were more common in younger veterans, Blacks, Hispanics, males, hypertensive veterans, mentally ill patients, those with no co-pay and those prescribed antiplatelets/anticoagulants in addition to aspirin postoperatively. These findings suggest that the impact of dispensing aspirin as a prescription may not be significant in increasing the appropriate use of aspirin for secondary prevention. PMID:26351774

  19. Use of Health Care System-Supplied Aspirin by Veterans With Postoperative Heart Attack or Unstable Angina.

    PubMed

    Rivera, Cathleen M; Copeland, Laurel A; McNeal, Catherine J; Mortensen, Eric M; Pugh, Mary J; MacCarthy, Daniel J

    2015-10-01

    Evidence-based guidelines for the use of aspirin in secondary prevention of cardiovascular disease events are well established. Despite this, the prevalence of aspirin use for secondary prevention is suboptimal. The study aimed to determine the prevalence of aspirin use for secondary prevention of cardiovascular disease events when it is dispensed as a prescription, as is performed in the Veterans Affairs (VA) managed care system. VA patients who had undergone major surgery and experienced a postoperative myocardial infarction (MI) or unstable angina between the years 2005 and 2009 were identified from administrative databases. VA pharmacy records were used to determine whether a prescription for aspirin was filled after the postoperative MI or unstable angina. Multivariable logistic regression models estimated odd ratios of filling aspirin prescriptions for the predictors of interest. Of the 321,131 men and women veterans who underwent major surgery, 7,700 experienced a postoperative MI or unstable angina. Among those 7,700, 47% filled an aspirin prescription. Only 59% of veterans with no co-pay filled an aspirin prescription. Aspirin fills were more common in younger veterans, Blacks, Hispanics, males, hypertensive veterans, mentally ill patients, those with no co-pay and those prescribed antiplatelets/anticoagulants in addition to aspirin postoperatively. These findings suggest that the impact of dispensing aspirin as a prescription may not be significant in increasing the appropriate use of aspirin for secondary prevention.

  20. Physical and Mental Health Costs of Traumatic War Experiences Among Civil War Veterans

    PubMed Central

    Pizarro, Judith; Silver, Roxane Cohen; Prause, JoAnn

    2006-01-01

    Context Hundreds of thousands of soldiers face exposure to combat during wars across the globe. The health impact of traumatic war experiences has not been adequately assessed across the lifetime of these veterans. Objective Identify the role of traumatic war experiences in predicting post-war nervous and physical disease and mortality using archival data from military and medical records of veterans from the Civil War. Design An archival examination of military and medical records of Civil War veterans was conducted. Degree of trauma experienced (POW experience, percentage of company killed, being wounded, early age at enlistment), signs of lifetime physician-diagnosed disease, and age at death were recorded. Setting and Participants US Pension board surgeons conducted standardized medical examinations of Civil War veterans over their post-war lifetimes. Military records of 17,700 Civil War veterans were matched to post-war medical records. Main Outcome Measures Signs of physician-diagnosed disease including cardiac, gastrointestinal (GI), and nervous disease, and number of unique ailments within each disease; mortality. Results Military trauma was related to signs of disease and mortality. Greater percentage of company killed was associated with signs of post-war cardiac and GI disease (IRR=1.34, p<.02), co-morbid nervous and physical disease (IRR=1.51, p<.005), and greater number of unique ailments within each disease (IRR=1.14, p<.01). Younger soldiers (≤18 years old), compared to older enlistees (> 30 years old), showed higher mortality risk (HR=1.52, p<.005), signs of co-morbid nervous and physical disease (IRR=1.93, p<.005), and a greater number of unique ailments within each disease (IRR=1.32, p<.005), controlling for length of time lived and other covariates. Conclusions Greater exposure to death of military comrades and younger exposure to war trauma was related to signs of physician-diagnosed cardiac, GI and nervous disease, and a greater number of