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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. Social participation and self-rated health among older male veterans and non-veterans.

    PubMed

    Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan

    2016-08-01

    To examine self-rated health (SRH) and its association with social participation, along with physical and mental health indicators, among USA male veterans and non-veterans aged ≥65 years. The two waves of the National Health and Aging Trend Study provided data (n = 2845 at wave 1; n = 2235 at wave 2). Multilevel mixed effects generalized linear models were fit to test the hypotheses. Despite their older age, veterans did not differ from non-veterans in their physical, mental and cognitive health, and they had better SRH. However, black and Hispanic veterans had lower SRH than non-Hispanic white veterans. Formal group activities and outings for enjoyment were positively associated with better SRH for veterans, non-veterans and all veteran cohorts. Aging veterans, especially black and Hispanic veterans, require programs and services that will help increase their social connectedness. Geriatr Gerontol Int 2016; 16: 920-927. © 2015 Japan Geriatrics Society.

  3. Suicide risk and precipitating circumstances among young, middle-aged, and older male veterans.

    PubMed

    Kaplan, Mark S; McFarland, Bentson H; Huguet, Nathalie; Valenstein, Marcia

    2012-03-01

    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). 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. 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. 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.

  4. 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

  5. Dry eye syndrome, posttraumatic stress disorder, and depression in an older male veteran population.

    PubMed

    Fernandez, Cristina A; Galor, Anat; Arheart, Kristopher L; Musselman, Dominique L; Venincasa, Vincent D; Florez, Hermes J; Lee, David J

    2013-05-01

    To evaluate whether veterans with posttraumatic stress disorder (PTSD) or depression have differences in dry eye symptoms and signs compared to a population without these conditions. Male patients aged ≥50 years with normal eyelid, conjunctival, and corneal anatomy were recruited from the Miami Veterans Affairs Eye Clinic (N = 248). We compared dry eye symptoms (determined by the Dry Eye Questionnaire 5 [DEQ5] score) to tear film indicators obtained by clinical examination (i.e., tear osmolarity, corneal staining, tear breakup time, Schirmer's, meibomian gland quality, orifice plugging, lid vascularity) between patients with PTSD or depression and those without these conditions. Student's t-tests, χ(2) analyses, and linear and logistic regressions were used to assess differences between the groups. DEQ5 scores were higher in the PTSD (mean = 13.4; standard error [SE] = 1.1; n = 22) and depression (mean = 12.0; SE = 0.8; n = 40) groups compared to the group without these conditions (mean = 9.8; SE = 0.4; n = 186; P < 0.01 and P = 0.02, respectively). More patients in the PTSD and depression groups had severe dry eye symptoms, defined as a DEQ5 score ≥ 12 (77% and 63% vs. 41%; P < 0.01 and P = 0.02, respectively). No significant differences in tear film indicators were found among the three groups. Multivariable logistic regression indicated that a PTSD diagnosis (odds ratio [OR] = 4.08; 95% confidence interval [CI] = 1.10-15.14) and use of selective serotonin reuptake inhibitors (OR = 2.66; 95% CI = 1.01-7.00) were significantly associated with severe symptoms. Patients with PTSD have ocular surface symptoms that are not solely explained by tear indicators. Identifying underlying conditions associated with ocular discomfort is essential to better understand the mechanisms behind ocular pain in dry eye syndrome.

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

    PubMed

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

    2012-12-01

    This study examined the rates of anxiety and depressive disorders, physical illnesses, and health service use in male patients 55 years or older with a diagnosis of Parkinson disease who were seen at least twice at the 10 medical centers in the Veterans Affairs Healthcare Network of the South Central region of the United States. Of the 273 male patients diagnosed between October 1, 1997, and September 30, 2009, 62 (22.7%) had a depressive disorder. The overall prevalence of anxiety disorders was 12.8%; patients with comorbid depression had a 5-fold greater prevalence of anxiety disorders than those without depression (35.5% vs 6.2%, P<.0001). Patients with comorbid depression also had increased prevalence of all physical illnesses examined and more outpatient clinic and mental health visits. Patients with Parkinson disease and comorbid depression are more likely to have anxiety disorders and several physical illnesses, to be using antipsychotic and dementia medicines, and to have increased health service utilization than those without depression.

  7. Assessing Oral Hygiene in Hospitalized Older Veterans.

    PubMed

    Jennings, Andrea

    2015-01-01

    Poor oral health for all older adults can result in higher risk for heart disease, stroke, diabetes, and oral cancer. Findings from this study indicated older veterans needed to improve their oral hygiene habits but barriers to oral hygiene performance prevented them from receiving and performing oral hygiene measures.

  8. Neuropsychological Profile of Lifetime Traumatic Brain Injury in Older Veterans.

    PubMed

    Kaup, Allison R; Peltz, Carrie; Kenney, Kimbra; Kramer, Joel H; Diaz-Arrastia, Ramon; Yaffe, Kristine

    2017-01-01

    The aim of this study was to characterize the neuropsychological profile of lifetime traumatic brain injury (TBI) in older Veterans. Participants were 169 older Veterans [mean age=79.1 years (range, 51-97 years), 89% male, 92% Caucasian], 88 with lifetime TBI and 81 without TBI, living in Veterans' retirement homes in independent residence. TBI history was ascertained with the Ohio State TBI Identification Method structured interview. Cognition was assessed with neuropsychological tests: Raw scores were converted to Z-scores compared to age-corrected normative data and combined into five domain composite Z-scores (attention/working memory, learning/memory, language, processing speed, executive functioning). We investigated the association between TBI and performance in each cognitive domain in linear mixed effects models, with and without adjustment for demographics, medical comorbidities, and psychiatric variables. Compared to those without TBI, older Veterans with TBI had greater deficits in processing speed (estimate=-.52; p=.01; f 2=.08 in fully adjusted model) and executive functioning (estimate=-.41; p=.02; f 2=.06 in fully adjusted model) but performed similarly in the attention/working memory, learning/memory, and language domains (all p>.05). TBI-associated deficits were most prominent among individuals with multiple mild TBIs and those with any moderate-to-severe TBI, but were not clearly present among those with single mild TBI. The neuropsychological profile of lifetime TBI in older Veterans is characterized by slowed processing speed and executive dysfunction, especially among those with greater injury burden. This pattern may reflect long-standing deficits or a TBI-associated cognitive decline process distinct from Alzheimer's disease. (JINS, 2017, 23, 56-64).

  9. Age Differences in the Association of Social Support and Mental Health in Male U.S. Veterans: Results From the National Health and Resilience in Veterans Study.

    PubMed

    Weiner, Melissa R; Monin, Joan K; Mota, Natalie; Pietrzak, Robert H

    2016-04-01

    To examine the associations between multiple aspects of social support-perceived support, structural support, and community integration-and mental health difficulties in younger and older male veterans. Drawing from Socioemotional Selectivity Theory (SST), we hypothesized that greater support would be more strongly negatively related to mental health difficulties in older than younger veterans. Cross-sectional Web survey of younger and older male veterans recruited from a contemporary, nationally representative sample of veterans residing in the United States. Data were drawn from the National Health and Resilience in Veterans Study. Participants were 290 younger male veterans (mean age: 37.0 years, SD: 6.9, range: 21-46) and 326 older male veterans (mean age: 81.7 years, SD: 3.2, range: 78-96). Participants completed measures of sociodemographic and military characteristics, perceived and structural social support, community integration, and mental health difficulties. In contrast to SST, higher perceived support was associated with fewer mental health difficulties in younger but not older veterans. In line with SST, community integration was associated with fewer mental health difficulties in older but not younger veterans. Structural support was not associated with mental health difficulties in either group. Results of this study provide mixed support for SST and suggest that different aspects of social support may help promote the mental health of younger and older male U.S. veterans. Promotion of community engagement may help promote mental health in older veterans, whereas promotion of functional social support may help promote mental health in younger veterans. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  10. Age Differences in the Association of Social Support and Mental Health in Male U.S. Veterans: Results from the National Health and Resilience in Veterans Study

    PubMed Central

    Weiner, Melissa R.; Monin, Joan K.; Mota, Natalie; Pietrzak, Robert H.

    2015-01-01

    Objective To examine the associations between multiple aspects of social support—perceived support, structural support, and community integration—and mental health difficulties in younger and older male veterans. Drawing from Socioemotional Selectivity Theory (SST), we hypothesized that greater support would be more strongly negatively related to mental health difficulties in older than younger veterans. Design Cross-sectional web survey of younger and older male veterans drawn from a contemporary, nationally representative sample of veterans residing in the United States. Setting Data were drawn from the National Health and Resilience in Veterans Study (NHRVS). Participants Participants were 290 younger male veterans (mean age=37.0, SD=6.9, range=21–46) and 326 older male veterans (mean age=81.7, SD=3.2, range=78–96). Measurements Participants completed measures of socio-demographic and military characteristics, perceived and structural social support, community integration, and mental health difficulties. Results In contrast to SST, higher perceived support was associated with fewer mental health difficulties in younger but not older veterans. In line with SST, community integration was associated with fewer mental health difficulties in older but not younger veterans. Structural support was not associated with mental health difficulties in either group. Conclusion Results of this study provide mixed support for SST and suggest that different aspects of social support may help promote the mental health of younger and older male U.S. veterans. Promotion of community engagement may protect mental health in older veterans, while promotion of functional social support may protect mental health in younger veterans. PMID:26880612

  11. 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…

  12. The Impact of Veteran Status on Life-Space Mobility among Older Black and White Men in the Deep South.

    PubMed

    McCaskill, Gina M; Sawyer, Patricia; Burgio, Kathryn L; Kennedy, Richard; Williams, Courtney P; Clay, Olivio J; Brown, Cynthia J; Allman, Richard M

    2015-08-07

    To examine life-space mobility over 8.5 years among older Black and White male veterans and non-veterans in the Deep South. A prospective longitudinal study of community-dwelling Black and White male adults aged >65 years (N=501; mean age=74.9; 50% Black and 50% White) enrolled in the University of Alabama at Birmingham (UAB) Study of Aging. Data from baseline in-home assessments with follow-up telephone assessments of life-space mobility completed every 6 months were used in linear mixed-effects modeling analyses to examine life-space mobility trajectories. Life-space mobility. In comparison to veterans, non-veterans were more likely to be Black, single, and live in rural areas. They also reported lower income and education. Veterans had higher baseline life-space (73.7 vs 64.9 for non-veterans; P<.001). Race-veteran subgroup analyses revealed significant differences in demographics, comorbidity, cognition, and physical function. Relative to Black veterans, there were significantly greater declines in life-space trajectories for White non-veterans (P=.009), but not for White veterans (P=.807) nor Black non-veterans (P=.633). Mortality at 8.5 years was 43.5% for veterans and 49.5% for non-veterans (P=.190) with no significant differences by race-veteran status. Veterans had significantly higher baseline life-space mobility. There were significantly greater declines in life-space trajectories for White non-veterans in comparison to other race-veteran subgroups. Black veterans and non-veterans did not have significantly different trajectories.

  13. 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…

  14. 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…

  15. Older Military Veteran Care: Many Still Believe They Are Forgotten.

    PubMed

    Young, Cathy; Conard, Patricia L; Armstrong, Myrna L; Lacy, Darlene

    2017-06-01

    Almost 44% of our nation's 23 million men and women veterans are 65 years of age or older. Most are proud of their service, yet many believe their services for our country were forgotten, especially those in combat between 1950 and 1975. Further information to ultimately assist their holistic well-being will be important for nursing practice as countless older veterans are beginning to obtain more care within civilian facilities. Using the Korean War (1950-1953) as a backdrop to illustrate the interconnectiveness of older veteran physical, emotional, and spiritual concerns that can occur from a military deployment, the major purposes of this article are to provide a brief historical snapshot of that war and discuss prior-era military environmental situations that now are producing the lingering effects from their combat exposure. Relevant literature about the Korean War and Veterans was compiled. Some of these health risks for both the Korean men and women veterans are cold exposure, neurologic, and posttraumatic stress disorder concerns, as well as the need for hepatitis C and suicide assessments. To ultimately improve their bio-psycho-socio-spiritual well-being, prompt identification of the older military veteran, their lingering combat effects, and reminiscing will be important.

  16. An Analysis of Selected Characteristics of Napa College Veteran and Non-Veteran Male Students.

    ERIC Educational Resources Information Center

    Hagen, George; And Others

    In April 1973, it was proposed that Napa College implement a special remedial program designed to serve the needs of soon-to-be-discharged military personnel and veterans. This study was conducted to determine the need for such a program. The overriding hypothesis was that there was no significant difference between male veterans and non-veterans…

  17. Depression and Anxiety Symptoms in Male Veterans and Non-Veterans: The Health and Retirement Study

    PubMed Central

    Gould, Christine E.; Rideaux, Tiffany; Spira, Adam P.; Beaudreau, Sherry A.

    2014-01-01

    Objectives We examined whether Veteran status was associated with elevated depression and anxiety symptoms in men aged 50 and older after adjusting for sociodemographic factors. Methods Participants were 6,577 men aged 50 years and older who completed the 2006 wave of the Health and Retirement Study (HRS). Forty-nine percent of participants were Veterans. A randomly selected subset of participants completed the HRS Psychosocial Questionnaire (N = 2,957), which contained the anxiety items. Elevated depression and anxiety symptoms were determined based on brief versions of Center for Epidemiologic Studies – Depression Scale (CES-D total score ≥ 4) and Beck Anxiety Inventory (BAI total score ≥ 12). Results Elevated depression and anxiety symptoms were found in 11.0% and 9.9% of Veterans, respectively, compared with 12.8% and 12.3% of non-Veterans. Veteran status was not associated with increased odds of anxiety or depression symptoms in the multivariable-adjusted logistic regression analyses. Additional analyses indicated that Vietnam War Veterans were more than twice as likely as World War II or Korean War Veterans to have elevated depression symptoms (OR = 2.15, 95% CI: 1.54–3.00) or anxiety symptoms (OR = 2.12, 95% CI: 1.28–3.51). Conclusions In a community-based sample of men aged 50 and older, Veteran status was not associated with the presence of elevated depression and anxiety symptoms. Rather, these symptoms were associated with age, ethnicity, education, and medical conditions. Among Veterans, cohort effects accounted for differences in psychiatric symptoms. Including younger cohorts from the Global War on Terror may yield different results in future studies. PMID:25145943

  18. Age-related concerns of male veteran callers to a suicide crisis line.

    PubMed

    King, Deborah A; O'Riley, Alisa A; Thompson, Caitlin; Conwell, Yeates; He, Hua; Kemp, Janet

    2014-01-01

    In July 2007, the United States Department of Veterans Affairs (VA) partnered with the Department of Health and Human Services' Substance Abuse and Mental Health Service Administration (SAMHSA) to create the Veterans Crisis Line (VCL) in order to meet the unique needs of Veterans in distress. The current study utilized a mixed methods design to examine characteristics of male callers to the VCL. Results from qualitative analyses demonstrated that the majority of callers between April 1 and August 31, 2008 contacted the VCL with concerns related to mental health issues, suicide ideation, and substance abuse issues. Quantitative analyses demonstrated age differences associated with concerns presented by callers such that middle-aged and older callers were more likely to present with loneliness and younger callers were more likely to present with mental health concerns. The results of this study will help to inform future research designed to optimize the effectiveness of the VCL for suicide prevention in Veterans.

  19. Health services use of older veterans treated and released from veterans affairs medical center emergency departments.

    PubMed

    Hastings, Susan Nicole; Smith, Valerie A; Weinberger, Morris; Oddone, Eugene Z; Olsen, Maren K; Schmader, Kenneth E

    2013-09-01

    To determine predictors of repeat health service use in older veterans treated and released from the emergency department (ED). Retrospective cohort study. Veterans Affairs Medical Center (VAMC) EDs. Nationally representative sample of veterans aged 65 and older treated and released from one of 102 VAMC EDs between October 1, 2007, and June 30, 2008. Logistic regression models were used to examine the association between independent variables and primary outcomes (30-day repeat ED visits and hospital admissions). In 31,206 older veterans, ED diagnoses were commonly related to chronic conditions (22.5%), injuries and acute musculoskeletal conditions (19%), and infections (13.5%). Within 30 days, 22% of older veterans had returned to the ED (n = 4,779) or been hospitalized (n = 2,005). In adjusted models, factors associated with greater odds of repeat ED visits than injury were homelessness (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.3-2.1), previous ED visits (OR = 1.7, 95% CI = 1.6-1.8), previous hospitalization (OR = 1.3, 95% CI = 1.2-1.4), and index ED visit related to infection (1.2, 95% CI = 1.1-1.3). Odds of subsequent hospital admission were higher in veterans with previous hospitalization (OR = 2.5, 95% CI = 2.2-2.8), who were homeless (OR = 1.5, 95% CI = 1.1-2.0), who had aid and attendance benefits (OR = 1.5, 95% CI = 1.2-1.8), who were unmarried (OR = 1.2, 95% CI = 1.1-1.3), and who had an ED visit related to a chronic condition (OR = 1.4, 95% CI = 1.2-1.6) than in those with injury. A substantial proportion of older veterans treated and released from a VAMC ED returned to the ED or were hospitalized within 30 days. Intervening with high-risk older veterans after an ED visit may reduce unscheduled healthcare use. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  20. 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. (c) 2015 APA, all rights reserved).

  1. 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. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  2. Incarceration among male veterans: relative risk of imprisonment and differences between veteran and nonveteran inmates.

    PubMed

    Greenberg, Greg A; Rosenheck, Robert A

    2012-06-01

    Using data from national surveys of jail and prison inmates conducted in 2002 and 2004, the authors found that male veterans in the age group that entered military service in the early years of the All Volunteer Force (AVF) were at greater risk of incarceration than nonveterans of similar age and ethnicity, whereas veterans who enlisted in later years of the AVF had less risk of incarceration than nonveterans. Although White veterans tend to have greater risk of incarceration than nonveteran Whites, Black and Hispanic veterans were at less risk than their nonveteran peers, although they are at greater risk than White veterans. These patterns are best explained by changes over time and in differential effects across racial/ethnic groups of recruiting practices, accession standards, and in civilian employment opportunities rather than combat trauma or other adverse experiences in the military. For example, reductions in the relative risk for incarceration of veterans during the AVF appear to generally result from increases in recruit qualifications and socioeconomic status due to greater military pay, improved skill in recruiting, and higher accession standards.

  3. Sexual Homicide by Older Male Offenders.

    PubMed

    Myers, Wade C; Chan, Heng Choon Oliver; Mariano, Timothy Y; Safarik, Mark E; Geberth, Vernon J

    2017-07-01

    Recent research has expanded our understanding of sexual homicide offenders (SHOs). However, little exists beyond case reports for older SHOs. We characterized male SHOs ≥ 55 years, comparing them to typical adult male SHOs who are in their 20s. Analysis of 37 years (1976-2012) of US Supplementary Homicide Reports data provided a large SHO sample (N = 3453). Three case reports provide clinical context for the diverse nature and patterns of older SHOs. Only 32 older male SHOs and no older female SHOs were identified. Murders by older SHOs accounted for only 0.5% of US sexual homicides. Unlike typical SHOs that generally target young adult females, over two-thirds of older SHO victims were ≥40 years, and one-third were ≥55 years. Sexual homicides by older SHOs, like sexual homicide in general, decreased over the study period. These crimes, while exceedingly rare, do occur, warranting special consideration. © 2017 American Academy of Forensic Sciences.

  4. Prevalence and trends in psychotropic medication use among US male veterans, 1999-2010.

    PubMed

    Frenk, Steven M; Sautter, Jessica M; Paulose-Ram, Ryne

    2015-11-01

    Prior studies of psychotropic medication use among US veterans are limited in their ability to generalize estimates to the full veteran population and make comparisons with non-veterans. This study estimated the prevalence of psychotropic medication use and trends over time among male US veterans, compared their use of psychotropic medications with non-veteran males, and examined differences among veteran subpopulations. The data for our analysis came from the National Health and Nutrition Examination Survey (1999-2010), a cross-sectional, nationally representative study of the civilian, non-institutionalized US population. The percentage of male veterans who used any psychotropic medication increased from 10.4% in 1999-2002 to 14.3% in 2003-2006, then remained stable in 2007-2010 (14.0%). During the same time period, the percentage of non-veteran males who used psychotropic medications remained relatively stable (7.0%, 8.3%, and 9.2%, respectively). Veterans were more likely to use psychotropic medication, specifically antidepressants, than non-veterans. The percentage of non-Hispanic white veterans and veterans aged 60 years and over who used psychotropic medications increased between 1999-2002 and 2003-2006, but the percentages remained stable between 2003-2006 and 2007-2010. In 2003-2006 and 2007-2010, a higher percentage of non-Hispanic white veterans used psychotropic medications than non-Hispanic black veterans. This study found that the use of psychotropic medications and antidepressants was higher among male veterans than male non-veterans, and that prevalence of use increased between 1999-2002 and 2007-2010 for male veterans but remained relatively stable for non-veterans. There were significant variations in the use of psychotropic medications among veteran subpopulations. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Clinician Factors Associated With Prostate-Specific Antigen Screening in Older Veterans With Limited Life Expectancy.

    PubMed

    Tang, Victoria L; Shi, Ying; Fung, Kathy; Tan, Jessica; Espaldon, Roxanne; Sudore, Rebecca; Wong, Melisa L; Walter, Louise C

    2016-05-01

    Despite guidelines recommending against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, PSA screening remains common. To identify clinician characteristics associated with PSA screening rates in older veterans stratified by life expectancy. Cross-sectional study of 826 286 veterans 65 years or older eligible for PSA screening who had VA laboratory tests performed in 2011 in the VA health care system. The primary outcome was the percentage of men with a screening PSA test in 2011. Limited life expectancy was defined as age of at least 85 years with Charlson comorbidity score of 1 or greater or age of at least 65 years with Charlson comorbidity score of 4 or greater. Primary predictors were clinician characteristics including degree-training level, specialty, age, and sex. We performed log-linear Poisson regression models for the association between each clinician characteristic and PSA screening stratified by patient life expectancy and adjusted for patient demographics and clinician clustering. In 2011, 466 017 (56%) of older veterans received PSA screening, including 39% of the 203 717 men with limited life expectancy. After adjusting for patient demographics, higher PSA screening rates in patients with limited life expectancy was associated with having a clinician who was an older man and was no longer in training. The PSA screening rates ranged from 27% for men with a physician trainee to 42% for men with an attending physician (P < .001); 22% for men with a geriatrician to 82% for men with a urologist as their clinician (P < .001); 29% for men with a clinician 35 years or younger to 41% for those with a clinician 56 years or older (P < .001); and 38% for men with a female clinician older than 55 years vs 43% for men with a male clinician older than 55 years (P < .001). More than one-third of men with limited life expectancy received PSA screening. Men whose clinician was a physician trainee had

  6. Learning and Reaction Time Performance in Older Veterans: Relationship to Attitudes and Life Satisfaction.

    ERIC Educational Resources Information Center

    Milligan, W. L.; And Others

    1981-01-01

    Younger (age 20-35) veterans showed better performance on learning and psychomotor tasks than did older (age 55-70) veterans. Positive attitudes toward aging, and greater life satisfaction were associated with better performance on the behavioral tasks in the older group. Results suggest age-related behavior may be related to psychosocial…

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

    PubMed

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

    2015-01-01

    This study examined age-related differences in general medical and mental health risk factors for veterans participating in the U.S. Department of Veterans Affairs (VA) Grant Per Diem (GPD) transitional supportive housing program. The subpopulation of older homeless veterans is growing, and little is known about the implications of this fact for health care providers and for supportive programs intended to meet homeless veterans' needs. Data were obtained from the VA records of all veterans (N=40,820) who used the GPD program during fiscal years 2003 to 2009. Unconditional adjusted and unadjusted odds ratios for general medical and psychiatric characteristics were calculated and were the primary study focus. Significant predictors of homeless program completion assessed from univariate models were then evaluated in multivariate models. Younger (<55) and older (≥55) homeless veterans reported an equal number of days homeless before enrollment. Younger veterans averaged 19 fewer days in GPD. Older veterans had more general medical problems and approximately $500 more in program costs. Findings from this study indicate that older homeless veterans are at increased risk of serious medical problems. This group is especially vulnerable to experiencing negative consequences related to homelessness. Addressing these complex needs will allow the VA to provide enhanced care to older homeless veterans.

  8. Clinician Factors Associated with Prostate-Specific Antigen Screening in Older Veterans with Limited Life Expectancy

    PubMed Central

    Tang, Victoria L.; Shi, Ying; Fung, Kathy; Tan, Jessica; Espaldon, Roxanne; Sudore, Rebecca; Wong, Melisa L.; Walter, Louise C.

    2017-01-01

    Importance Despite guidelines recommending against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, PSA screening remains common. Objectives Identify clinician characteristics associated with PSA screening in older veterans stratified by life expectancy. Design and Setting Cross-sectional study in the VA healthcare system. Participants 826,286 veterans aged ≥65 years eligible for PSA screening that had VA laboratory tests performed in 2011. Main Outcomes and Measures The primary outcome was the percentage of men with a screening PSA in 2011. Limited life expectancy was defined as age ≥85 with Charlson comorbidity score ≥1 or age ≥65 with Charlson comorbidity score ≥4. Primary predictors were clinician characteristics including degree-training level, specialty, age, and gender. We performed log-Poisson regression models for the association between each clinician characteristic and PSA screening stratified by patient life expectancy and adjusted for patient demographics and clinician clustering. Results In 2011, 56% of older veterans received PSA screening, including 39% of the 203,717 men with limited life expectancy. After adjusting for patient demographics, higher PSA screening in patients with limited life expectancy was associated with having a clinician who was an older male and was no longer in training. PSA screening ranged from 27% for men with a physician trainee to 42% for men with a physician attending (p <0.0001); 22% for men with a geriatrician to 82% for men with a urologist as their clinician (p <0.0001); 29% for men with a clinician ≤35 years old to 41% for those with a clinician ≥56 years old (p <0.0001); and 38% for men with a female clinician older than 55 years versus 43% for men with a male clinician older than 55 years (p=0.0008). Conclusion and Relevance Over a third of men with limited life expectancy received PSA screening. Men whose clinician was a physician trainee had substantially lower

  9. Benefits, Costs, and Harms of Osteoporosis Screening in Male Veterans

    DTIC Science & Technology

    2013-10-01

    DXA screening is associated with a lower risk of fracture. b. To determine whether receipt of bisphosphonates is associated with a lower risk of...fracture. c. To determine whether receipt of bisphosphonates is associated with a lower risk of mortality. 2. Determine the harms of screening...and treatment strategies to prevent osteoporotic fractures in male veterans. a. To explore the impact of oral bisphosphonates on gastrointestinal

  10. Older Veteran Digital Disparities: Examining the Potential for Solutions Within Social Networks

    PubMed Central

    Hogan, Timothy P; Richardson, Lorilei M; Cioffari-Bailiff, Lisa; Harvey, Kimberly; Houston, Thomas K

    2016-01-01

    Background Older adults typically have less access to the Internet than other age groups, and older Veterans may use the Internet even less due to economic and geographic reasons. Objective To explore solutions to this problem, our study examined older Veterans’ reported ability to access technology through their close social ties. Methods Data were collected via mail survey from a sample of Veterans aged 65 years and older (N=266). Results Nearly half (44.0%, 117/266) of the sample reported having no Internet access. Yet, among those without current access, older Veterans reported having a median of 5 (IQR 7) close social ties with home Internet access. These older Veterans also reported that they would feel comfortable asking a median of 2 (IQR 4) social ties for help to access the Internet, and that a median of 2 (IQR 4) social ties would directly access the Internet for the older Veteran to help with health management. Conclusions Findings suggest that even older Veterans without current Internet access have at least two social ties with home Internet who could be called upon for technology support. Thus, older Veterans may be willing to call upon these “surrogate seekers” for technology assistance and support in health management. This has implications for the digital divide, technology design, and health care policy. PMID:27881361

  11. ADHD and nonsuicidal self-injury in male veterans with and without PTSD.

    PubMed

    Kimbrel, Nathan A; Wilson, Laura C; Mitchell, John T; Meyer, Eric C; DeBeer, Bryann B; Silvia, Paul J; Gratz, Kim L; Calhoun, Patrick S; Beckham, Jean C; Morissette, Sandra B

    2017-02-24

    The objective of the present research was to examine the association between ADHD symptoms and nonsuicidal self-injury (NSSI) in male Iraq/Afghanistan-era veterans with and without PTSD. Approximately 25% of veterans screened positive for clinically-significant levels of ADHD. Male veterans with PTSD were significantly more likely to report ADHD symptoms than male veterans without PTSD. In addition, as expected, ADHD was strongly associated with NSSI, even after accounting for the effects of demographic variables, PTSD, depression, and alcohol use disorder. Future work aimed at replicating and extending these findings in longitudinal studies of veterans is needed.

  12. Veterans Affairs Geriatric Scholars Program: Enhancing Existing Primary Care Clinician Skills in Caring for Older Veterans.

    PubMed

    Kramer, B Josea; Creekmur, Beth; Howe, Judith L; Trudeau, Scott; Douglas, Joseph R; Garner, Kimberly; Bales, Connie; Callaway-Lane, Carol; Barczi, Steven

    2016-11-01

    The Veterans Affairs Geriatric Scholars Program (GSP) is a continuing professional development program to integrate geriatrics into the clinical practices of primary care providers and select associated health professions that support primary care teams. GSP uses a blended program educational format, and the minimal requirements are to attend an intensive course in geriatrics, participate in an interactive workshop on quality improvement (QI), and initiate a local QI project to demonstrate application of new knowledge to benefit older veterans. Using a retrospective post/pre survey design, the effect of GSP on clinical practices and behaviors and variation of that effect on clinicians working in rural and nonrural settings were evaluated. Significant improvement was found in the frequency of using evidence-based brief standardized assessments, clinical decision-making, and standards of care. Significant subgroup differences were observed in peer-to-peer information sharing between rural and nonrural clinicians. Overall, 77% of the sample reported greater job satisfaction after participating in GSP. The program is a successful model for advancing postgraduate education in geriatrics and a model that might be replicated to increase access to quality health care, particularly in rural areas.

  13. Body image satisfaction among male military veterans with cancer.

    PubMed

    Raggio, Greer A; Naik, Aanand D; Moye, Jennifer

    2017-01-01

    Impaired body satisfaction is commonly reported among cancer patients. This study prospectively evaluated body image disturbance among male military veterans with head and neck or colorectal cancer. Patients ( N = 109) completed measures at three points post-diagnosis. Results showed about one-third of participants reporting body-related concerns. Endorsement did not change significantly during the study period. Predictors of worse body satisfaction included younger age, lower education, less social support, and weight loss. Results indicate a substantial minority of men with cancer endorsing body image disturbance, and highlight psychosocial circumstances and weight change as key considerations.

  14. Psychological resilience in older U.S. veterans: results from the national health and resilience in veterans study.

    PubMed

    Pietrzak, Robert H; Cook, Joan M

    2013-05-01

    Although a large body of empirical research has examined negative psychological outcomes in older veterans, relatively little is known about the prevalence and determinants of psychological resilience in this population. A nationally representative sample of 2,025 U.S. veterans aged 60 and older (mean = 71.0, standard deviation = 7.1, range = 60-96) completed a web-based survey as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of measures of lifetime potentially traumatic events, and current PTSD, major depression, and generalized anxiety symptoms was used to classify psychological outcomes. A three-group solution best fit the data: Control (low number of lifetime traumas, low current psychological distress; 60.4%); Resilient (high number of lifetime traumas, low current psychological distress; 27.5%); and distressed (high number of lifetime traumas, high current psychological distress; 12.1%). Among older veterans with a high number of traumas, 69.5% were in the Resilient group. Compared to the Distressed group, the Resilient group was more likely to have college or higher level of education, and to be married or living with a partner. They also scored higher on measures of emotional stability, social connectedness (i.e., secure attachment style, social support), protective psychosocial characteristics (e.g., community integration, purpose in life), and positive perceptions of the military's effect on one's life; and lower on measures of physical health difficulties and psychiatric problems, and openness to experiences. Among older U.S. veterans who have endured a high number of traumas in their lifetimes, nearly 70% are psychologically resilient in later life. Prevention efforts targeted toward bolstering social connectedness, community integration, and purpose in life may help promote psychological resilience in older veterans who endured a significant number of traumas in their lives. Published 2013. This article is a U

  15. Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalised older veterans.

    PubMed

    Wu, Li-Fen

    2011-08-01

    The purpose of this study was to use group integrative reminiscence as a nursing intervention to evaluate the immediate effects on self-esteem, life satisfaction and depressive symptoms for a special group named 'institutionalised older veterans' after a 12-week intervention. The study group comprised institutionalised older veterans with combat experience, including being wounded in war and who were twice forced to relocate. The group participants had lower life satisfaction, and greater use for mental health services and greater non-specific health complaints were reported from this group. Reminiscence therapy has been considered an effective nursing intervention, but the effects on institutionalised older veterans have not been studied. A quasi-experimental design and purposive sampling were conducted. A total of 74 participants were studied with pre- and post-tests to measure the effect of group integrative reminiscence therapy. The activity was held once weekly for 12 weeks. The Life Satisfaction Index A, self-esteem scale and Geriatric Depression Scale Short Form were used as research tools, and the t-test, Fisher's exact test and generalised estimating equation were used for data analysis. All participants were male, with an average age of 81·34 years old, 91·9% unmarried and were in bad health. After 12 weeks of intervention, the reminiscence groups significantly improved their self-esteem and life satisfaction and decreased depressive symptoms compared with control groups. Group integrative reminiscence revealed immediate effects on improving the self-esteem and life satisfaction of institutionalised older veterans, and depressive symptoms were also decreased. Moreover, a sense of positive self-value and belonging to the institution was produced. Group integrative reminiscence is an applicable nursing intervention for vulnerable persons such as institutionalised older veterans. A structured protocol based on the characteristics of the residents and the

  16. RESOLV: Development of a Telephone-Based Program Designed to Increase Socialization in Older Veterans

    ERIC Educational Resources Information Center

    Gould, Christine E.; Shah, Shruti; Brunskill, Sarah R.; Brown, Krista; Oliva, Nancy L.; Hosseini, Charissa; Bauer, Elizabeth; Huh, J. W. Terri

    2017-01-01

    We describe the development of a telephone-based program, Recreation, Education, and Socialization for Older Learning Veterans (RESOLV) that aims to connect Veterans with one another by phone and thereby reduce loneliness. The program was developed through a collaboration between VA and a community-based organization, Episcopal Senior Communities…

  17. Economic Well-Being Among Older-Adult Households: Variation by Veteran and Disability Status

    PubMed Central

    Wilmoth, Janet M.; London, Andrew S.; Heflin, Colleen M.

    2015-01-01

    This analysis uses data from the Survey of Income and Program Participation (SIPP) to examine whether veteran and disability statuses are jointly associated with household-level poverty and material hardship among older adults. Compared to households that do not include a person with a disability or veteran, disabled non-veteran households are more likely to be in poverty and to experience home hardship, medical hardship, and bill-paying hardship. Disabled veteran households are not significantly different in terms of poverty, but exhibit the highest odds of home hardship, medical hardship, bill-paying hardship, and food insufficiency. The implications for social work practice are discussed. PMID:25750998

  18. 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

  19. 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.

  20. Cardiovascular Disease Risk Factors Among Male Veterans, U.S., 2009-2012.

    PubMed

    Fryar, Cheryl D; Herrick, Kirsten; Afful, Joseph; Ogden, Cynthia L

    2016-01-01

    Cardiovascular disease remains an important cause of death in the U.S. where veterans of the U.S. Armed Forces represent a significant segment of the population. Limited national estimates of cardiovascular disease risk factors using physical measurements and reported veteran status in the U.S. civilian population have been reported. The purpose of this study was to compare the prevalence of cardiovascular disease risk factors among veteran and non-veteran men in the U.S. civilian population. Using data from the 2009-2012 National Health and Nutrition Examination Surveys, 1,107 veteran and 3,972 non-veteran men were identified for this study (analyzed in 2014-2015). Differences in hypertension, dsylipidemia, diabetes, obesity, and smoking between veterans and non-veterans were compared using chi-square and t-tests. Predicted prevalence from multivariable logistic regression models adjusted for age, race/Hispanic origin, and poverty level were used to assess whether previous military service was associated with having a cardiovascular disease risk factor. Veteran men were older than non-veteran men (59.9 years vs 43.4 years) and were more likely to be non-Hispanic white (79.9% vs 65.7%). Adjusted predicted prevalence estimates show that veterans were more likely than non-veterans to be obese (42.6% vs 33.7%, p<0.01). After adjustment for obesity, there was no difference in hypertension, dyslipidemia, diagnosed diabetes, or smoking between veteran and non-veteran men. This study identified a segment of the U.S. civilian population-veteran men-who have a higher prevalence for obesity, a risk factor associated with increased risk for other cardiovascular disease risk factors. Published by Elsevier Inc.

  1. 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.

  2. Effectiveness of acceptance and commitment therapy for depression: comparison among older and younger veterans.

    PubMed

    Karlin, Bradley E; Walser, Robyn D; Yesavage, Jerome; Zhang, Aimee; Trockel, Mickey; Taylor, C Barr

    2013-01-01

    Limited data exist on outcomes of older adults receiving psychotherapy for depression in real-world settings. Acceptance and Commitment Therapy for depression (ACT-D) offers potential utility for older individuals who may experience issues of loss, reduced control, and other life changes. The present article examines and compares outcomes of older and younger Veterans receiving ACT-D nationally in the U.S. Department of Veterans Affairs health care system. Patient outcomes were assessed using the Beck Depression Inventory-Second Edition and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised. Six hundred fifty-five Veterans aged 18-64 and 76 Veterans aged 65+ received ACT-D. Seventy-eight percent of older and 67% of younger patients completed all sessions or finished early. Mean depression scores declined from 28.4 (SD = 11.4) to 17.5 (SD = 12.0) in the older group and 30.3 (SD = 10.6) to 19.1 (SD = 14.3) in the younger group. Within-group effect sizes were d = .95 and d = 1.06 for the two age groups, respectively. Quality of life and therapeutic alliance also increased during treatment. The findings suggest that ACT-D is an effective and acceptable treatment for older Veterans treated in routine clinical settings, including those with high levels of depression.

  3. Psychological adaptation of the older homosexual male.

    PubMed

    Berger, R M

    1980-01-01

    Social, psychological, and demographic characteristics of older homosexual males were examined through analysis of the questionnaire responses of 112 homosexual men 40 years of age or older. Few of the negative stereotypes that usually characterize descriptions of this group were supported. Most respondents were well adjusted and satisfied with their lives. Variables relating to good psychological adaptation included integration into the gay community, commitment to homosexuality, a low concern with concealment of sexual preference, a current exclusive relationship, and a satisfactory sex life. There was some evidence to indicate that age is positively related to several aspects of psychological adaptation.

  4. 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.

  5. OLDER MALES, COGNITIVE FUNCTION, AND ALCOHOL CONSUMPTION

    PubMed Central

    McDougall, Graham J.; Becker, Heather; Areheart, Kristopher L.

    2008-01-01

    We investigated the question, how do older men who drink alcohol differ from those who do not drink on measures of cognitive function, memory, affect, and health? Of the nonprobability sample of male participants (N = 60), 35 (58%) of the males reported some degree of alcohol consumption. Eleven men had one or more drinks per day, 14 had one or more drinks per week, and 9 were occasional drinkers. The drinkers reported significantly less depression, had higher self-reported general health and vitality, and had higher cognitive performance, cognitive flexibility, and verbal memory, and greater knowledge of memory processes. PMID:16546934

  6. 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.

  7. Economic well-being among older-adult households: variation by veteran and disability status.

    PubMed

    Wilmoth, Janet M; London, Andrew S; Heflin, Colleen M

    2015-01-01

    This analysis uses data from the Survey of Income and Program Participation (SIPP) to examine whether veteran and disability statuses are jointly associated with poverty and material hardship among households that include an older adult. Compared to households that do not include a person with a disability or veteran, disabled nonveteran households are more likely to be in poverty and to experience home hardship, medical hardship, and bill-paying hardship. Disabled veteran households are not significantly different in terms of poverty, but exhibit the highest odds of home hardship, medical hardship, bill-paying hardship, and food insufficiency. The implications for social work practice are discussed.

  8. 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.

  9. Comparison of outcomes of homeless female and male veterans in transitional housing.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; McGuire, James F

    2012-12-01

    Homelessness among female veterans is of national concern, but there have been few studies of how they differ from male veterans or whether they have different outcomes. This study compared 59 female and 1,181 male participants in a multi-site study of three VA-funded transitional housing programs over a 1-year period following completion of an episode of treatment. At baseline, female participants were younger, reported more psychiatric symptoms, had shorter histories of homelessness,were less likely to have substance use disorders, and were less likely to be working than males. After controlling for these baseline differences, there were no overall gender differences in outcomes measures of housing, employment,substance use, physical and mental health, or quality of life. These results suggest homeless female veterans have different characteristics than male veterans, but benefit equally from transitional housing.

  10. Prevalence of Unplanned Hospitalizations Caused by Adverse Drug Reactions Among Older Veterans

    PubMed Central

    Marcum, Zachary A.; Amuan, Megan E.; Hanlon, Joseph T.; Aspinall, Sherrie L.; Handler, Steven M.; Ruby, Christine M.; Pugh, Mary Jo V.

    2011-01-01

    Objectives To describe the prevalence of unplanned hospitalizations caused by ADRs among older Veterans and examine the association between this outcome and polypharmacy after controlling for comorbidities and other patient characteristics. Design Retrospective cohort. Setting Veterans Affairs Medical Centers (VAMC). Participants 678 randomly selected unplanned hospitalizations of older (age ≥ 65 years) Veterans between 10/01/03 and 09/30/06. Measurements Naranjo ADR algorithm, ADR preventability, and polypharmacy (0–4, 5–8, and ≥ 9 scheduled medications). Results Seventy ADRs involving 113 drugs were determined in 68 (10%) older Veterans’ hospitalizations, of which 36.8% (25/68) were preventable. Extrapolating to the population of over 2.4 million older Veterans receiving care during the study period, 8,000 hospitalizations may have been unnecessary. The most common ADRs that occurred were bradycardia (n=6; beta blockers, digoxin), hypoglycemia (n=6; sulfonylureas, insulin), falls (n=6; antidepressants, ACE-inhibitors), and mental status changes (n=6; anticonvulsants, benzodiazepines). Overall, 44.8% of Veterans took ≥ 9 outpatient medications and 35.4% took 5–8. Using multivariable logistic regression and controlling for demographic, health status, and access to care variables, polypharmacy (≥ 9 and 5–8) was associated with an increased risk of ADR-related hospitalization (AOR 3.90, 95% CI 1.43–10.61 and AOR 2.85, 95% CI 1.03–7.85, respectively). Conclusion ADRs determined by a validated causality algorithm are a common cause of unplanned hospitalization among older Veterans, are frequently preventable, and are associated with polypharmacy. PMID:22150441

  11. 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…

  12. 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…

  13. Combat exposure, social relationships, and subjective well-being among middle-aged and older Veterans.

    PubMed

    Yang, Mai See; Burr, Jeffrey A

    2016-01-01

    This study described the association of subjective well-being with combat exposure and social relationships among middle-aged and older Veteran men in the USA. The stress-buffering hypothesis, which predicts social relationships may moderate the association between combat exposure and subjective well-being, was also examined. Data from the 2008 Health and Retirement Study (N = 2961) were used to estimate logistic regression models, focusing on three measures of subjective well-being: depression, life satisfaction, and self-reported health. In the fully adjusted models, there were no statistically significant relationships between combat exposure and the three indicators of subjective well-being. However, compared to Veterans who had lower scores on the social relationship index, Veterans who had higher scores were less likely to be depressed and less likely to report poor or fair health. Veterans who had higher scores on the social relationships index reported higher levels of life satisfaction than those Veterans who had lower scores. There was no evidence for a social relationships buffering effect. The results of this study demonstrated that combat exposure did not have a long-term relationship with subjective well-being. Longitudinal research designs with more comprehensive indicators of combat exposure may help researchers better understand some of the underlying complexity of this relationship. Complementary research with samples of women Veterans, as well as samples of Hispanic, and non-Black, non-White Veterans, is also needed.

  14. Duty, Honor, Country, Disparity: Race/Ethnic Differences in Health and Disability among Male Veterans

    PubMed Central

    Sheehan, Connor M.; Hummer, Robert A.; Moore, Brenda L.; Huyser, Kimberly R.; Butler, John Sibley

    2015-01-01

    Given their unique occupational hazards and sizable population, military veterans are an important population for the study of health. Yet veterans are by no means homogeneous, and there are unanswered questions regarding the extent of, and explanations for, racial and ethnic differences in veterans’ health. Using the 2010 National Survey of Veterans, we first documented race/ethnic differences in self-rated health and limitations in Activities of Daily Living among male veterans aged 30–84. Second, we examined potential explanations for the disparities, including socioeconomic and behavioral differences, as well as differences in specific military experiences. We found that Black, Hispanic, and other/multiple race veterans reported much worse health than White veterans. Using progressively adjusted regression models, we uncovered that the poorer self-rated health and higher levels of activity limitations among minority veterans compared to Whites was partially explained by differences in their socioeconomic status and by their military experiences. Minority veterans are a vulnerable population for poor health; future research and policy efforts should attempt to better understand and ameliorate their health disadvantages relative to White veterans. PMID:26783376

  15. 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

  16. 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.

  17. National evaluation of the effectiveness of cognitive behavioral therapy for insomnia among older versus younger veterans.

    PubMed

    Karlin, Bradley E; Trockel, Mickey; Spira, Adam P; Taylor, C Barr; Manber, Rachel

    2015-03-01

    Limited research has examined the effects of cognitive behavioral therapy for insomnia (CBT-I) among older adults (age >65 years) receiving treatment in real-world clinical settings and even less has examined effects on outcomes beyond reducing insomnia, such as improved quality of life. The current article examines and compares outcomes of older versus younger (age 18-64 years) veterans receiving CBT-I nationally in nonsleep specialty settings. Patient outcomes were assessed using the Insomnia Severity Index, Beck Depression Inventory-II, and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised. A total of 536 younger veterans and 121 older veterans received CBT-I; 77% of older and 64% of younger patients completed all sessions or finished early due to symptom relief. Mean insomnia scores declined from 19.5 to 9.7 in the older group and from 20.9 to 11.1 in the younger group. Within-group effect sizes were d = 2.3 and 2.2 for older and younger groups, respectively. CBT-I also yielded significant improvements in depression and quality of life for both age groups. High and increasing levels of therapeutic alliance were observed for both age groups. Older (and younger) patients receiving CBT-I from nonsleep specialists experienced large reductions in insomnia and improvements in depression and quality of life. Effects were similar for both age groups, and the rate of dropout was lower among older adults. The results provide strong support for the effectiveness and acceptability of CBT-I for older adults receiving care in routine treatment settings. Copyright © 2014 John Wiley & Sons, Ltd.

  18. Demographic characteristics associated with homelessness and risk among female and male veterans accessing VHA outpatient care.

    PubMed

    Montgomery, Ann Elizabeth; Dichter, Melissa E; Thomasson, Arwin M; Fu, Xiaoying; Roberts, Christopher B

    2015-01-01

    This study explored demographic influences on veterans' reports of homelessness or imminent risk of homelessness with a particular focus on gender. We analyzed data for a cohort of veterans who responded to the U.S. Department of Veterans Affairs (VA), Veterans Health Administration (VHA) universal screener for homelessness and risk during a 3-month period. Multinomial mixed effects models-stratified by gender-predicted veterans' reports of homelessness or risk based on age, race, marital status, and receipt of VA compensation. The proportion of positive screens-homelessness or risk-was 2.7% for females and 1.7% for males. Women more likely to report being at risk of homelessness were aged 35 to 54 years, Black, and unmarried; those more likely to experience homelessness were Black and unmarried. Among male veterans, the greatest predictors of both homelessness and risk were Black race and unmarried status. Among both genders, receiving VA disability compensation was associated with lesser odds of being homeless or at risk. The findings describe the current population of veterans using VHA health care services who may benefit from homelessness prevention or intervention services, identify racial differences in housing stability, and distinguish subpopulations who may be in particular need of intervention. Interventions to address these needs are described. Published by Elsevier Inc.

  19. 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

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

    PubMed

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

    2014-06-01

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

  1. 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.

  2. Problems in Sexual Functioning among Male OEF/OIF Veterans Seeking Treatment for Posttraumatic Stress

    PubMed Central

    Badour, Christal L.; Gros, Daniel F.; Szafranski, Derek D.; Acierno, Ron

    2015-01-01

    Objective Few studies have examined sexual dysfunction among Operations Enduring/Iraqi Freedom (OEF/OIF) veterans with posttraumatic stress disorder (PTSD). The present study investigated predictors of erectile dysfunction [ED] and self-reported sexual problems among 150 male combat veterans seeking outpatient treatment for PTSD within the Veterans Affairs healthcare system. Method Participants completed clinical interviews and several questionnaires including measures of sexual arousal and sexual desire. A medical records review was also conducted to document evidence of an ED diagnosis or associated medication use. Results An ED diagnosis was present for 12% of the sample, and 10% were taking associated medications. Sexual arousal problems were reported by sixty-two percent of partnered veterans. Sexual desire problems were endorsed by 63% of the total sample, and by 72% of partnered veterans. Age was the only significant predictor of ED diagnosis or medication use. Age, race, PTSD diagnosis (versus subclinical symptoms), depression, and social support predicted self-reported sexual arousal problems; while race, combat exposure, social support, and avoidance/numbing symptoms of PTSD predicted self-reported sexual desire problems. Conclusions Sexual problems are common among male OEF/OIF combat veterans seeking treatment for PTSD. Moreover, avoidance/numbing symptoms robustly predicted sexual desire problems. These findings highlight the importance of expanding assessment of sexual dysfunction and support the need for additional research in this area. PMID:25596624

  3. 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

  4. Male Veterans Coping With the Pendulum Swing of Rheumatiod Arthritis Pain: A Qualitative Study

    PubMed Central

    Beaton, Cleopatra; Hodge, Felicia; Nyamathi, Adeline; Weinreb, Ari; Mays, Vickie; Maliski, Sally

    2014-01-01

    This study describes the physical, psychological and social context of rheumatoid arthritis (RA) pain from the male veterans. A qualitative, descriptive design was employed using a purposive sampling to ensure representation of male veterans. Interviews were conducted with 12 male veterans of the VA Greater Los Angeles Healthcare System. Socio-demographic characteristics, clinical profiles and descriptors of rheumatoid pain experienced by male veterans’ since their diagnoses were gathered. Interviews were audio recorded and transcribed verbatim. Grounded Theory analysis techniques were used to identify concepts related to living with RA Pain. Six concepts related to RA pain adaptation emerged. Three concepts were associated with movement (keep moving, consequences of not moving, staying physically active) and three were related to emotion (thinking positive thoughts, doing jobs, focusing on male identity). The “keep moving” concept explained coping with chronic RA pain through three activity types: physical, cognitive and socio-economic activities. These activities fluctuated in intensity depending upon the disease stage and RA symptoms. The forward and backward pendulum swing described the unpredictable course and pain coping strategy of the veterans. Further studies are recommended to determine the transferability of our findings to other populations and to confirm the impact of continuous motion as an effective pain management strategy for RA. PMID:25530733

  5. Advanced Age and Disease Predict Lack of Symptomatic Improvement after Endovascular Iliac Treatment in Male Veterans

    PubMed Central

    Assi, Roland; Brownson, Kirstyn E.; Hall, Michael R.; Kuwahara, Go; Vasilas, Penny; Dardik, Alan

    2015-01-01

    Background: Endovascular angioplasty and stent placement is currently the most frequent treatment for iliac artery occlusive disease. However, despite a successful endovascular procedure, some patients do not experience symptomatic improvement and satisfaction with their care. This study seeks to identify patient-related factors associated with lack of symptomatic improvement after endovascular iliac artery treatment in male veterans. Methods: Retrospective review of patients treated with endovascular methods for iliac artery occlusive disease between January 2008 and July 2012 at VA Connecticut Healthcare System. Symptomatic improvement on the first post-operative visit was evaluated, with bilateral treatments counted separately. Results: Sixty-two patients had 91 iliac arteries treated with angioplasty and stent placement. Forty-seven (52 percent) legs had critical limb ischemia, and 77 (85 percent) had at least two-vessel distal runoff. Angiographic success was 100 percent. Patient-reported symptomatic improvement at the first post-operative visit was 55 percent (50/91). Lack of symptomatic improvement correlated with older age (OR 1.09 [1.03-1.17], p = 0.008), presence of critical limb ischemia (OR 3.03 [1.09-8.65], p = 0.034), and need for additional surgical intervention (OR 5.61 [1.65-17.36], p = 0.006). Survival, primary and secondary patency, and freedom from restenosis were comparable between patients who reported symptomatic improvement and those who did not. Conclusions: Despite angiographically successful revascularization, patients who are older or have critical limb ischemia who are treated with isolated endovascular iliac artery intervention are more likely to require additional interventions and less likely to experience symptomatic improvement. These patients may need more extensive infra-inguinal revascularization than isolated iliac angioplasty and stent placement, despite a preserved ankle-brachial index. Quality of life needs to be measured

  6. Body mass index in male Caucasian veterans with or without posttraumatic stress disorder.

    PubMed

    Kozaric-Kovacic, Dragica; Ilic, Mirjana Grubisic; Romic, Zeljko; Vidovic, Andjelko; Jendricko, Tihana; Pivac, Nela

    2009-11-13

    Obesity (defined as body mass index (BMI) higher than 30), is a serious and global public health problem, associated with increased morbidity and mortality and it represents a risk factor for developing various somatic and psychiatric disorders. Combat-related posttraumatic stress disorder (PTSD) is frequently associated with increased BMI which leads to overweight and obesity. We therefore evaluated BMI in the ethnically uniform Croatian male participants of the Caucasian origin, combat exposed veterans with or without PTSD, controlled for the effect of trauma, age, smoking, alcohol consumption, physical activity and comorbid psychiatric disorders, and in age matched healthy control subjects. BMI did not differ significantly between veterans with or without PTSD and healthy control subjects, or when participants were subdivided according to the age groups, BMI categories, or the presence of psychiatric disorders. Limitation of the study might be a small number of veterans with or without PTSD. Similar BMI was found in Croatian male veterans with or without PTSD, and age matched healthy control subjects. The data provided evidence of overweight and obesity in large number of veterans but also in healthy control subjects, and indicated that public health organizations should develop more effective strategies to prevent overweight and obesity.

  7. 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…

  8. Self-Reported Reproductive Outcomes Among Male and Female 1991 Gulf War Era US Military Veterans

    DTIC Science & Technology

    2005-07-14

    1998;4(2):211–9. 16.Smith TC, Gray GC, Knoke JD. Is systemic lupus erythematosus, amyotrophic lateral sclerosis, or fibromyalgia associated with Per...Suadicani P, Guldager B, Appleyard M, Gyntelberg F, Skakkebaek NE. Major reproductive health charac- teristics in male Gulf War Veterans. The Danish Gulf War

  9. 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…

  10. Examining weight and eating behavior by sexual orientation in a sample of male veterans.

    PubMed

    Bankoff, Sarah M; Richards, Lauren K; Bartlett, Brooke; Wolf, Erika J; Mitchell, Karen S

    2016-07-01

    Eating disorders are understudied in men and in sexual minority populations; however, extant evidence suggests that gay men have higher rates of disordered eating than heterosexual men. The present study examined the associations between sexual orientation, body mass index (BMI), disordered eating behaviors, and food addiction in a sample of male veterans. Participants included 642 male veterans from the Knowledge Networks-GfK Research Panel. They were randomly selected from a larger study based on previously reported trauma exposure; 96% identified as heterosexual. Measures included the Eating Disorder Diagnostic Scale, the Yale Food Addiction Scale, and self-reported height and weight. Heterosexual and sexual minority men did not differ significantly in terms of BMI. However, gay and bisexual men (n=24) endorsed significantly greater eating disorder symptoms and food addiction compared to heterosexual men. Our findings that sexual minority male veterans may be more likely to experience eating disorder and food addiction symptoms compared to heterosexual male veterans highlight the importance of prevention, assessment, and treatment efforts targeted to this population. Published by Elsevier Inc.

  11. 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…

  12. 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…

  13. 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

  14. Psychotherapy for depression in older veterans via telemedicine: a randomised, open-label, non-inferiority trial.

    PubMed

    Egede, Leonard E; Acierno, Ron; Knapp, Rebecca G; Lejuez, Carl; Hernandez-Tejada, Melba; Payne, Elizabeth H; Frueh, B Christopher

    2015-08-01

    Many older adults with major depression, particularly veterans, do not have access to evidence-based psychotherapy. Telemedicine could increase access to best-practice care for older adults facing barriers of mobility, stigma, and geographical isolation. We aimed to establish non-inferiority of behavioural activation therapy for major depression delivered via telemedicine to same-room care in largely male, older adult veterans. In this randomised, controlled, open-label, non-inferiority trial, we recruited veterans (aged ≥58 years) meeting DSM-IV criteria for major depressive disorder from the Ralph H Johnson Veterans Affairs Medical Center and four associated community outpatient-based clinics in the USA. We excluded actively psychotic or demented people, those with both suicidal ideation and clear intent, and those with substance dependence. The study coordinator randomly assigned participants (1:1; block size 2-6; stratified by race; computer-generated randomisation sequence by RGK) to eight sessions of behavioural activation for depression either via telemedicine or in the same room. The primary outcome was treatment response according to the Geriatric Depression Scale (GDS) and Beck Depression Inventory (BDI; defined as a 50% reduction in symptoms from baseline at 12 months), and Structured Clinical Interview for DSM-IV, clinician version (defined as no longer being diagnosed with major depressive disorder at 12 months follow-up), in the per-protocol population (those who completed at least four treatment sessions and for whom all outcome measurements were done). Those assessing outcomes were masked. The non-inferiority margin was 15%. This trial is registered with ClinicalTrials.gov, number NCT00324701. Between April 1, 2007, and July 31, 2011, we screened 780 patients, and the study coordinator randomly assigned participants to either telemedicine (120 [50%]) or same-room treatment (121 [50%]). We included 100 (83%) patients in the per-protocol analysis in

  15. Exploring intimate partner violence status among male veterans and associated health outcomes.

    PubMed

    Cerulli, Catherine; Bossarte, Robert M; Dichter, Melissa E

    2014-01-01

    The World Health Organization has identified intimate partner violence (IPV) as a public health issue affecting both men and women, though significantly more information is available regarding female victimization. This study examines IPV through the lens of male victimization, focusing on a comparison of physical and mental health consequences among men who are and are not military veterans. Results from a secondary analysis of data from the Behavior Risk Factor Survey taken by 13,765 males indicated that all males, regardless of veteran status, should be screened for IPV victimization given the prevalence reported in this sample (9.5% to 12.5%). Furthermore, it was found that veteran status did affect prevalence of particular health consequences, such as depression, smoking, and binge drinking. Based on the specific comparisons examined in this study, implications for Veteran's Administration Health Services are discussed, as is the need for more research on IPV victimization rates for men and the particular health consequences that they suffer.

  16. Does social isolation predict hospitalization and mortality among HIV+ and uninfected older Veterans?

    PubMed Central

    Greysen, S. Ryan; Horwitz, Leora I.; Covinsky, Kenneth E.; Gordon, Kirsha; Ohl, Michael E.; Justice, Amy C.

    2013-01-01

    Background and Objectives Aging, HIV, and social isolation may affect acute care utilization and outcomes. Our objectives were to compare levels of social isolation in aging Veterans with and without HIV and determine associations with hospital admission and mortality. Study Design, Participants, and Setting The Veterans Aging Cohort Study (VACS) is a longitudinal study of HIV+ and uninfected Veterans at eight VA Medical Centers nationally. We analyzed data for 1,836 Veterans age ≥55 enrolled in VACS from 2002–2008. Measurements We created a Social Isolation Score (SIS) using baseline survey responses about: relationship status, number of friends/family and frequency of visits, and involvement in volunteer work, religious or self-help groups, or other community activities. We compared scores by age and HIV status and used multivariable regression to assess effects of social isolation scores on hospital admission and all-cause mortality. Results Mean SIS was higher for HIV+ patients with increasing difference by age (p=.01 for trend). Social isolation was also more prevalent for HIV+ (59%) compared to uninfected patients (51%; p<.001). In multivariable regression analysis of HIV+ and uninfected groups combined, adjusted for demographic and clinical features, isolation was independently associated with increased risk of incident hospitalization (HR=1.25, 95% CI=1.09–1.42) as well as risk of all-cause mortality (HR=1.28, 95% CI=1.06–1.54). Risk estimates calculated for HIV+ and uninfected groups separately were not significantly different. Conclusions Social isolation is associated with increased risk of hospitalization and death among both HIV+ and uninfected older Veterans. Despite similar effects in both groups, the population level impact of social isolation may be greater in those who are HIV+ because of the higher prevalence of social isolation, particularly among the oldest patients. PMID:23927911

  17. 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…

  18. 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…

  19. Intimate partner aggression perpetrated and sustained by male Afghanistan, Iraq, and Vietnam veterans with and without posttraumatic stress disorder.

    PubMed

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

    2010-09-01

    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 Afghanistan or Iraq veterans who served during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) and compare this aggression to that reported by Vietnam veterans with PTSD. Three groups were recruited, OEF/OIF veterans with PTSD (n = 27), OEF/OIF veterans without PTSD (n = 31), and Vietnam veterans with PTSD (n = 28). Though only a few comparisons reached significance, odds ratios suggested that male OEF/OIF veterans with PTSD were approximately 1.9 to 3.1 times more likely to perpetrate aggression toward their female partners and 1.6 to 6 times more likely to report experiencing female perpetrated aggression than the other two groups. Significant correlations among reports of violence perpetrated and sustained suggested many men may have been in mutually violent relationships. Taken together, these results suggest that partner aggression among Iraq and Afghanistan veterans with PTSD may be an important treatment consideration and target for prevention.

  20. 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

  1. Compulsive sexual behavior among male military veterans: prevalence and associated clinical factors.

    PubMed

    Smith, Philip H; Potenza, Marc N; Mazure, Carolyn M; McKee, Sherry A; Park, Crystal L; Hoff, Rani A

    2014-12-01

    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. 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. 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. This exploratory study suggests that CSB is prevalent amongst veterans returning from combat and is associated with childhood trauma and PTSD, particularly re-experiencing. 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.

  2. Clinical epidemiology of nocturnal leg cramps in male veterans.

    PubMed

    Haskell, S G; Fiebach, N H

    1997-04-01

    This article describes patients with nocturnal leg cramps concerning their age, medical problems, and medications, and reviews any medical evaluation performed for the complaint of nocturnal leg cramps. Provided is a retrospective chart review of 50 patients who took quinine sulfate for nocturnal leg cramps. These patients were identified through computerized pharmacy records. A control group was chosen from age-matched patients who took medications other than quinine during the study period. In a university-affiliated Veterans Administration hospital, patients with nocturnal leg cramps had a significantly higher median number of medical problems than controls. Cardiovascular diseases and neurological diseases were significantly more common in patients with nocturnal leg cramps (cases) than in those without (controls) (82% versus 64% and 36% versus 18%, respectively). The most striking differences between patients with cramps and controls were peripheral vascular disease (34% versus 12%, P = 0.09) and peripheral neurological deficit (12% versus 0%, P = 0.012). Patients with nocturnal leg cramps were prescribed significantly more medications than were controls, but no specific medication or type of medication was prescribed more frequently to patients with cramps (other than quinine). Results suggested that men with nocturnal leg cramps have greater medical comorbidity and are prescribed more medications than age-matched control patients. Unlike in previous studies, no evidence was found that specific medications, such as diuretics, betaagonists, or calcium-channel antagonists are associated with nighttime cramps. The significantly increased frequency of peripheral vascular disease and peripheral neurologic deficits in patients with nocturnal leg cramps raised the possibility that these problems contribute to the occurrence of cramps. Although the size of the study and its methodologic limitations preclude definitive conclusions, areas for research to clarify the

  3. Antibiotic Resistance of Helicobacter pylori Among Male United States Veterans.

    PubMed

    Shiota, Seiji; Reddy, Rita; Alsarraj, Abeer; El-Serag, Hashem B; Graham, David Y

    2015-09-01

    The most recent information published on resistance of Helicobacter pylori to antibiotics in a large population in the United States is more than 10 years old. We assessed the susceptibility of H pylori to antibiotics among patients in a large metropolitan hospital, as well as demographic, clinical, and lifestyle factors associated with antimicrobial resistance. We performed a cross-sectional study of a random sample of 656 patients (90.2% men) from a cohort of 1559 undergoing esophagogastroduodenoscopy with collection of gastric biopsies from 2009 through 2013 at the Houston Veterans Affairs Medical Center. We performed culture analyses of gastric tissues to detect H pylori. The minimum inhibitory concentrations of amoxicillin, clarithromycin, metronidazole, levofloxacin, and tetracycline were determined by the Epsilometer test. Logistic regression analysis was performed to estimate the association between risk factors and antimicrobial resistance. Biopsies from 135 subjects (20.6%) tested positive for H pylori; 128 of these were from men (94.8%). Only 65 strains were susceptible to all 5 antibiotics. The prevalence of resistance to levofloxacin was 31.3% (95% confidence interval [CI], 23.1%-39.4%), to metronidazole it was 20.3% (95% CI, 13.2%-27.4%), to clarithromycin it was 16.4% (95% CI, 9.9%-22.9%), and to tetracycline it was 0.8% (95% CI, 0.0%-2.3%). No isolate was resistant to amoxicillin. Clarithromycin resistance increased from 9.1% in 2009-2010 to 24.2% in 2011-2013. In multivariate analysis, prior treatment of H pylori infection and use of fluoroquinolones were significantly associated with clarithromycin and levofloxacin resistance, respectively. H pylori resistance to clarithromycin increased between 2009 and 2013; resistance to metronidazole remains high in infected men in the United States. The high frequency of resistance to levofloxacin is a new and concerning finding. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. 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)

  5. Facility-Level Variation in Potentially Inappropriate Prescribing for Older Veterans

    PubMed Central

    Gellad, Walid F.; Good, Chester B.; Amuan, Megan E.; Marcum, Zachary A.; Hanlon, Joseph T.; Pugh, Mary Jo V.

    2012-01-01

    Objectives The National Committee for Quality Assurance (NCQA) developed two measures of potentially inappropriate prescribing: exposure to high-risk medications in the elderly (HRME) and drug-disease interactions (Rx-DIS). Both HRME and Rx-DIS exposures are prevalent in Veterans Affairs (VA) facilities, but the extent to which they vary by facility is unknown. We describe facility-level variation in these quality measures and identify facility characteristics associated with high-quality prescribing. Design Cross-sectional. Setting VA Healthcare System. Participants Veterans ≥ 65 years of age with at least one inpatient or outpatient visit in 2005-2006 (n=2,023,477; HRME exposure) and a sub-sample with a history of falls or hip fractures, dementia, or chronic renal failure (n=305,059; Rx-DIS exposure). Measurements Incident use of any high-risk medication (iHRME) and incident drug-disease interactions (iRx-DIS); facility-level rates and facility-level predictors of iHRME and iRx-DIS exposure, adjusting for differences in patient characteristics. Results Overall, 94,692(4.7%) Veterans had iHRME exposure. At the facility-level, iHRME exposure ranged from 1.56% at the lowest facility to 12.76% at the highest (median 4.73%). In the sub-sample, 9,803(3.2%) Veterans had iRx-DIS exposure, with a facility-level range from 1.30% to 5.85% (median 3.21%). In adjusted analyses, patients seen in facilities with formal geriatric education had lower odds of iHRME (OR=0.86, 95%CI=0.77-0.96) and iRx-DIS (OR=0.95, 95%CI=0.88-1.01). Patients seen in facilities caring for fewer older patients had greater odds of iHRME (OR=1.54, 95%CI=1.35-1.75) and iRx-DIS exposure (OR=1.22, 95%CI=1.11-1.33). Conclusion Substantial variation in the quality of prescribing for older adults exists across VA facilities, even after adjusting for patient characteristics. Our findings support the idea that higher quality prescribing is found in facilities caring for a larger number of older patients and

  6. Prevalence and Degree of Hearing Loss Among Males in the Beaver Dam Cohort: A Comparison of Veterans and Non-Veterans

    PubMed Central

    Wilson, Richard H.; Noe, Colleen M.; Cruickshanks, Karen J.; Wiley, Terry L.; Nondahl, David M.

    2010-01-01

    The Epidemiology of Hearing Loss Study (EHLS) conducted in Beaver Dam, Wisconsin, was a population-based study that focused on the prevalence of hearing loss among 3,753 participants between 1993 and 1996. This paper reports the results of several auditory measures from 999 veteran and 590 non-veteran males 48 to 92 years of age included in the EHLS. The auditory measures included pure-tone thresholds, tympanometry and acoustic reflexes, word recognition in quiet and in competing message, and the Hearing Handicap Inventory for the Elderly (HHIE-S). Hearing loss in the auditory domains of pure-tone thresholds, word recognition in quiet, and word recognition in competing message increased with age but were not significantly different for the veterans and non-veterans. There were no significant differences between participant groups on the HHIE-S with mixed differences regarding hearing-aid usage. PMID:20848364

  7. Patterns of Hospice Care Among Military Veterans and Non-veterans

    PubMed Central

    Wachterman, Melissa W.; Lipsitz, Stuart R.; Simon, Steven R.; Lorenz, Karl A.; Keating, Nancy L.

    2014-01-01

    Context Historically, hospice use by veterans has lagged behind that of non-veterans. Little is known about hospice use by veterans at a population level. Objectives To determine whether veteran and non-veteran hospice users differ by demographics, primary diagnosis, location of care, and service utilization. Methods Using the 2007 National Home and Hospice Care Survey, we identified 483 veteran and 932 non-veteran male hospice users representing 287,620 hospice enrollees nationally. We used chi-square and t-tests to compare veterans and non-veterans by demographic characteristics, primary diagnosis, and location of hospice care. We used multivariate regression to assess for differences in hospice diagnosis and location of care, adjusting for demographic and clinical factors. We also compared length of stay and number of visits by hospice personnel between veterans and non-veterans using multivariate regression. Results Veteran hospice users were older than non-veterans (77.0 vs. 74.3 years, P = 0.02) but did not differ by other demographics. In adjusted analyses, cancer was a more common primary diagnosis among veterans than non-veterans (56.4% vs. 48.4%; P = 0.02), and veteran hospice users were more likely than non-veterans to receive hospice at home (68.4% vs. 57.6%; P = 0.007). The median adjusted length of stay and number of nurse or social worker visits did not differ by veteran status (all P > 0.10), but veterans received fewer home health aide visits than non-veterans (one every 5.3 days vs. one every 3.7 days; P = 0.002). Conclusion Although veteran and non-veteran hospice users were similar on most demographic measures, important differences in hospice referral patterns and utilization exist. PMID:24275325

  8. Patterns of hospice care among military veterans and non-veterans.

    PubMed

    Wachterman, Melissa W; Lipsitz, Stuart R; Simon, Steven R; Lorenz, Karl A; Keating, Nancy L

    2014-07-01

    Historically, hospice use by veterans has lagged behind that of non-veterans. Little is known about hospice use by veterans at a population level. To determine whether veteran and non-veteran hospice users differ by demographics, primary diagnosis, location of care, and service utilization. Using the 2007 National Home and Hospice Care Survey, we identified 483 veteran and 932 non-veteran male hospice users representing 287,620 hospice enrollees nationally. We used chi-square and t-tests to compare veterans and non-veterans by demographic characteristics, primary diagnosis, and location of hospice care. We used multivariate regression to assess for differences in hospice diagnosis and location of care, adjusting for demographic and clinical factors. We also compared length of stay and number of visits by hospice personnel between veterans and non-veterans using multivariate regression. Veteran hospice users were older than non-veterans (77.0 vs. 74.3 years, P = 0.02) but did not differ by other demographics. In adjusted analyses, cancer was a more common primary diagnosis among veterans than non-veterans (56.4% vs. 48.4%; P = 0.02), and veteran hospice users were more likely than non-veterans to receive hospice at home (68.4% vs. 57.6%; P = 0.007). The median adjusted length of stay and number of nurse or social worker visits did not differ by veteran status (all P > 0.10), but veterans received fewer home health aide visits than non-veterans (one every 5.3 days vs. one every 3.7 days; P = 0.002). Although veteran and non-veteran hospice users were similar on most demographic measures, important differences in hospice referral patterns and utilization exist. Published by Elsevier Inc.

  9. 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.

  10. Present and past influences on current smoking among HIV-positive male veterans.

    PubMed

    Reisen, Carol A; Bianchi, Fernanda T; Cohen-Blair, Hannah; Liappis, Angelike P; Poppen, Paul J; Zea, Maria Cecilia; Benator, Debra A; Labriola, Ann M

    2011-08-01

    Cigarette smoking has become an important influence of morbidity and mortality for HIV-positive individuals in the era of highly active antiretroviral therapy. Although smoking is common among military personnel and veterans, the lasting impact of military service on smoking at a later stage of life has not been examined. The current study investigated present and past influences on current smoking among HIV-positive male veterans. Participants were 200 HIV-positive men served by the Veterans Affairs Medical Center. A survey was administered via audio-enhanced computer-assisted self-interview, and additional information was extracted from the computerized patient record system. Logistic regression was performed to test hypotheses concerning the participants' current situations as well as characteristics of their past military service. Having smokers in one's environment, being more depressed, and having used alcohol or drugs were associated with having smoked in the previous 30 days, whereas stronger endorsement of attitudes stating adverse effects of smoking was linked to lower likelihood of smoking. Neither having been in a military conflict nor the length of the military service was significantly related to current smoking. Remote experiences in the military did not have a sustained effect on smoking behavior years later. Implications of this study for the development of smoking cessation programs targeting HIV-positive veterans include the importance of altering attitudes about tobacco, treating underlying depression, addressing social influence, decreasing substance use, and increasing awareness of the heightened vulnerability to a variety of negative consequences of smoking among infected individuals.

  11. Unsheltered Homelessness Among Veterans: Correlates and Profiles.

    PubMed

    Byrne, Thomas; Montgomery, Ann Elizabeth; Fargo, Jamison D

    2016-02-01

    We identified correlates of unsheltered status among Veterans experiencing homelessness and described distinct subgroups within the unsheltered homeless Veteran population using data from a screening instrument for homelessness that is administered to all Veterans accessing outpatient care at a Veterans Health Administration (VHA) facility. Correlates of unsheltered homelessness included male gender, white race, older age, lower levels of VHA eligibility, substance use disorders, frequent use of VHA inpatient and infrequent use of VHA outpatient services, and residing in the West. We identified six distinct subgroups of unsheltered Veterans; the tri-morbid frequent users represented the highest need group, but the largest group was comprised of Veterans who made highly infrequent use of VHA healthcare services. Differences between sheltered and unsheltered Veterans and heterogeneity within the unsheltered Veteran population should be considered in targeting housing and other interventions.

  12. Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans

    PubMed Central

    Chassé, Kathleen

    2017-01-01

    Physical function performance tests, including sit to stand tests and Timed Up and Go, assess the functional capacity of older adults. Their ability to predict falls warrants further investigation. The objective was to determine if a modified 30-second Sit to Stand test that allowed upper extremity use and Timed Up and Go test predicted falls in institutionalized Veterans. Fifty-three older adult Veterans (mean age = 91 years, 49 men) residing in a long-term care hospital completed modified 30-second Sit to Stand and Timed Up and Go tests. The number of falls over one year was collected. The ability of modified 30-second Sit to Stand or Timed Up and Go to predict if participants had fallen was examined using logistic regression. The ability of these tests to predict the number of falls was examined using negative binomial regression. Both analyses controlled for age, history of falls, cognition, and comorbidities. The modified 30-second Sit to Stand was significantly (p < 0.05) related to if participants fell (odds ratio = 0.75, 95% confidence interval = 0.58, 0.97) and the number of falls (incidence rate ratio = 0.82, 95% confidence interval = 0.68, 0.98); decreased repetitions were associated with increased number of falls. Timed Up and Go was not significantly (p > 0.05) related to if participants fell (odds ratio = 1.03, 95% confidence interval = 0.96, 1.10) or the number of falls (incidence rate ratio = 1.01, 95% confidence interval = 0.98, 1.05). The modified 30-second Sit to Stand that allowed upper extremity use offers an alternative method to screen for fall risk in older adults in long-term care. PMID:28464024

  13. Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans.

    PubMed

    Applebaum, Eva V; Breton, Dominic; Feng, Zhuo Wei; Ta, An-Tchi; Walsh, Kayley; Chassé, Kathleen; Robbins, Shawn M

    2017-01-01

    Physical function performance tests, including sit to stand tests and Timed Up and Go, assess the functional capacity of older adults. Their ability to predict falls warrants further investigation. The objective was to determine if a modified 30-second Sit to Stand test that allowed upper extremity use and Timed Up and Go test predicted falls in institutionalized Veterans. Fifty-three older adult Veterans (mean age = 91 years, 49 men) residing in a long-term care hospital completed modified 30-second Sit to Stand and Timed Up and Go tests. The number of falls over one year was collected. The ability of modified 30-second Sit to Stand or Timed Up and Go to predict if participants had fallen was examined using logistic regression. The ability of these tests to predict the number of falls was examined using negative binomial regression. Both analyses controlled for age, history of falls, cognition, and comorbidities. The modified 30-second Sit to Stand was significantly (p < 0.05) related to if participants fell (odds ratio = 0.75, 95% confidence interval = 0.58, 0.97) and the number of falls (incidence rate ratio = 0.82, 95% confidence interval = 0.68, 0.98); decreased repetitions were associated with increased number of falls. Timed Up and Go was not significantly (p > 0.05) related to if participants fell (odds ratio = 1.03, 95% confidence interval = 0.96, 1.10) or the number of falls (incidence rate ratio = 1.01, 95% confidence interval = 0.98, 1.05). The modified 30-second Sit to Stand that allowed upper extremity use offers an alternative method to screen for fall risk in older adults in long-term care.

  14. Root cause analysis of serious adverse events among older patients in the Veterans Health Administration.

    PubMed

    Lee, Alexandra; Mills, Peter D; Neily, Julia; Hemphill, Robin R

    2014-06-01

    Preventable adverse events are more likely to occur among older patients because of the clinical complexity of their care. The Veterans Health Administration (VHA) National Center for Patient Safety (NCPS) stores data about serious adverse events when a root cause analysis (RCA) has been performed. A primary objective of this study was to describe the types of adverse events occurring among older patients (age > or = 65 years) in Department of Veterans Affairs (VA) hospitals. Secondary objectives were to determine the underlying reasons for the occurrence of these events and report on effective action plans that have been implemented in VA hospitals. In a retrospective, cross-sectional review, RCA reports were reviewed and outcomes reported using descriptive statistics for all VA hospitals that conducted an RCA for a serious geriatric adverse event from January 2010 to January 2011 that resulted in sustained injury or death. The search produced 325 RCA reports on VA patients (age > or = 65 years). Falls (34.8%), delays in diagnosis and/or treatment (11.7%), unexpected death (9.9%), and medication errors (9.0%) were the most commonly reported adverse events among older VA patients. Communication was the most common underlying reason for these events, representing 43.9% of reported root causes. Approximately 40% of implemented action plans were judged by local staff to be effective. The RCA process identified falls and communication as important themes in serious adverse events. Concrete actions, such as process standardization and changes to communication, were reported by teams to yield some improvement. However, fewer than half of the action plans were reported to be effective. Further research is needed to guide development and implementation of effective action plans.

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

    PubMed Central

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

    2017-01-01

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

  16. Pattern of cognitive impairment in older veterans with posttraumatic stress disorder evaluated at a memory disorders clinic.

    PubMed

    Scott Mackin, R; Lesselyong, Julia A; Yaffe, Kristine

    2012-06-01

    We determined the pattern of clinically significant cognitive impairment (CI) among older veterans with posttraumatic stress disorder (PTSD) evaluated in a memory disorders clinic. Data were collected from 19 ethnically diverse veterans. Cognitive functioning in six domains (verbal learning, memory, attention, language, executive functioning, and information processing speed) was assessed. The majority of veterans (57%) demonstrated CI on a measure of single trial list learning, 44% exhibited CI on short delay memory for lists, and 31% exhibited CI in long delay memory for lists. CI on measures of memory for stories (14%) and executive functioning (6%) were less common, and none of the participants demonstrated CI on measures of attention, language, or information processing speed. CI on measures of single trial list learning and memory for lists are common in older patients with PTSD evaluated in a memory disorders clinic and are likely to contribute to functional deficits. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Self-reported ill health in male UK Gulf War veterans: a retrospective cohort study

    PubMed Central

    Simmons, Rebecca; Maconochie, Noreen; Doyle, Pat

    2004-01-01

    Background Forces deployed to the first Gulf War report more ill health than veterans who did not serve there. Many studies of post-Gulf morbidity are based on relatively small sample sizes and selection bias is often a concern. In a setting where selection bias relating to the ill health of veterans may be reduced, we: i) examined self-reported adult ill health in a large sample of male UK Gulf War veterans and a demographically similar non-deployed comparison group; and ii) explored self-reported ill health among veterans who believed that they had Gulf War syndrome. Methods This study uses data from a retrospective cohort study of reproduction and child health in which a validated postal questionnaire was sent to all UK Gulf War veterans (GWV) and a comparison cohort of Armed Service personnel who were not deployed to the Gulf (NGWV). The cohort for analysis comprises 42,818 males who responded to the questionnaire. Results We confirmed that GWV report higher rates of general ill health. GWV were significantly more likely to have reported at least one new medical symptom or disease since 1990 than NGWV (61% versus 37%, OR 2.7, 95% CI 2.5–2.8). They were also more likely to report higher numbers of symptoms. The strongest associations were for mood swings (OR 20.9, 95%CI 16.2–27.0), memory loss/lack of concentration (OR 19.6, 95% CI 15.5–24.8), night sweats (OR 9.9, 95% CI 6.5–15.2), general fatigue (OR 9.6, 95% CI 8.3–11.1) and sexual dysfunction (OR 4.6, 95%CI 3.2–6.6). 6% of GWV believed they had Gulf War syndrome (GWS), and this was associated with the highest symptom reporting. Conclusions Increased levels of reported ill health among GWV were confirmed. This study was the first to use a questionnaire which did not focus specifically on the veterans' symptoms themselves. Nevertheless, the results are consistent with those of other studies of post-Gulf war illness and thus strengthen overall findings in this area of research. Further examination

  18. 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…

  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. PTSD and Obesity in Younger and Older Veterans: Results from the Mind Your Heart Study

    PubMed Central

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

    2015-01-01

    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. PMID:26210650

  1. 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. Published by Elsevier Ireland Ltd.

  2. Inmate-on-Inmate Victimization Among Older Male Prisoners

    ERIC Educational Resources Information Center

    Kerbs, John J.; Jolley, Jennifer M.

    2007-01-01

    Research on the safety and victimization of older prisoners has been limited. This study examines quantitative and qualitative victimization data gathered from face-to-face interviews with 65 male prisoners (ages 50 and above) confined in a state-level prison system. Both victimization rates and narrative descriptions of psychological, property,…

  3. Racial Differences in Medication Use Among Older Long-stay Veteran Nursing Home Care Unit Patients

    PubMed Central

    Hanlon, Joseph T.; Wang, Xiaoqiang; Good, C. Bernie; Rossi, Michelle I.; Stone, Roslyn A.; Semla, Todd P.; Cunningham, Francesca E.; Handler, Steven M.

    2009-01-01

    Objective To examine racial differences in medication use by older long-stay Veterans Affairs Nursing Home Care Unit (NHCU) patients. Design Longitudinal study Settings 133 VA NHCUs Participants Three thousand four hundred and eighty veterans aged 65 years admitted or older between January 1, 2004 and June 30, 2005 for 90 days or more. Main Outcomes Measures Prevalence of those taking 9+ medications (i.e., polypharmacy) and medications from specific therapeutic medication classes. Racial differences were determined using 0.05 level chi-squared tests. Results The sample consisted of 14.3% who were black. Blacks compared to whites (all comparisons p<0.05 except where noted otherwise) were younger (13.6% vs 17.4%, 85+ years of age), had less depression (22.24 vs 29.79%), less allergies (9.82% vs 20.36%), and a similar rate of moderate to severe pain (22.65% vs 24.05; p=0.49). The percent of polypharmacy was similar by race (blacks 73.35 vs whites 75.18%; p=0.62) as was the prevalence of medication class use with the exceptions that blacks were less likely than whites to take central nervous system (CNS) medications (75.75% vs 80.14%; p=0.02) and antihistamines (13.03% vs 16.8%; p=0.04). Specifically, blacks were less likely than whites to receive a selective serotonin reuptake inhibitor (SSRI) antidepressant (20.84% vs. 27.17%; p<0.01) or a second generation antihistamine (3.41% vs 6.51%; p<0.01) but more likely than whites to receive opioids (14.63% vs. 11.27%; p=0.03). Conslusions There appears to be racial differences in the overall use of antihistamines and CNS medications and some of their subclasses. PMID:19555154

  4. Long-term Metformin Therapy and Monitoring for Vitamin B12 Deficiency Among Older Veterans.

    PubMed

    Kancherla, Vijaya; Elliott, John L; Patel, Birju B; Holland, N Wilson; Johnson, Theodore M; Khakharia, Anjali; Phillips, Lawrence S; Oakley, Godfrey P; Vaughan, Camille P

    2017-05-01

    To examine the association between long-term metformin therapy and serum vitamin B12 monitoring. Retrospective cohort study. A single Veterans Affairs Medical Center (VAMC), 2002-2012. Veterans 50 years or older with either type 2 diabetes and long-term metformin therapy (n = 3,687) or without diabetes and no prescription for metformin (n = 13,258). We determined diabetes status from outpatient visits, and defined long-term metformin therapy as a prescription ≥500 mg/d for at least six consecutive months. We estimated the proportion of participants who received a serum B12 test and used multivariable logistic regression, stratified by age, to evaluate the association between metformin use and serum B12 testing. Only 37% of older adults with diabetes receiving metformin were tested for vitamin B12 status after long-term metformin prescription. The mean B12 concentration was significantly lower in the metformin-exposed group (439.2 pg/dL) compared to those without diabetes (522.4 pg/dL) (P = .0015). About 7% of persons with diabetes receiving metformin were vitamin B12 deficient (<170 pg/dL) compared to 3% of persons without diabetes or metformin use (P = .0001). Depending on their age, metformin users were two to three times more likely not to receive vitamin B12 testing compared to those without metformin exposure, after adjusting for sex, race and ethnicity, body mass index, and number of years treated at the VAMC. Long-term metformin therapy is significantly associated with lower serum vitamin B12 concentration, yet those at risk are often not monitored for B12 deficiency. Because metformin is first line therapy for type 2 diabetes, clinical decision support should be considered to promote serum B12 monitoring among long-term metformin users for timely identification of the potential need for B12 replacement. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  5. Use of Antipsychotics among Older Residents in Veterans Administration Nursing Homes

    PubMed Central

    Gellad, WF; Aspinall, SL; Handler, SM; Stone, RA; Castle, N; Semla, TP; Good, CB; Fine, MJ; Dysken, M; Hanlon, JT

    2013-01-01

    Background Antipsychotic medications are commonly prescribed to nursing home residents despite their well-established adverse event profiles. Because little is known about their use in Veterans Administration(VA) nursing homes (i.e., Community Living Centers(CLCs)), we assessed the prevalence and risk factors for their use in older residents of VA CLCs. Methods This cross-sectional study included 3,692 Veterans ≥age 65 who were admitted between January 2004-June 2005 to one of 133 VA CLCs and had a stay of ≥90 days. We used VA Pharmacy Benefits Management data to examine antipsychotic use and VA Medical SAS datasets and the Minimum Data Set to identify evidence-based indications for antipsychotic use (e.g., schizophrenia, dementia with psychosis). We used multivariable logistic regression with generalized estimating equations to identify factors independently associated with antipsychotic use. Results Overall, 948/3,692(25.7%) residents used an antipsychotic, of which 59.3% had an evidence-based indication for use. Residents with aggressive behavior (odds ratio[OR]=2.74, 95% confidence interval[CI]=2.04-3.67) and polypharmacy (9+ drugs; OR=1.84, 95%CI=1.41-2.40) were more likely to receive antipsychotics, as were users of antidepressants (OR=1.37, 95%CI=1.14-1.66), anxiolytic/hypnotics (OR=2.30, 95%CI=1.64-3.23) or drugs for dementia (OR=1.52, 95%CI=1.21-1.92). Those residing in Alzheimer's/dementia special care units were also more likely to use an antipsychotic (OR=1.66, 95%CI=1.26-2.21). Veterans with dementia but no documented psychosis were as likely as those with an evidence-based indication to receive an antipsychotic (OR=1.10, 95%CI=0.82-1.47). Conclusions Antipsychotic use is common in older VA CLC residents, including those without a documented evidence-based indication for use. Further quality improvement efforts are needed to reduce potentially inappropriate antipsychotic prescribing. PMID:23047785

  6. Present and Past Influences on Current Smoking Among HIV-Positive Male Veterans

    PubMed Central

    Bianchi, Fernanda T.; Cohen-Blair, Hannah; Liappis, Angelike P.; Poppen, Paul J.; Zea, Maria Cecilia; Benator, Debra A.; Labriola, Ann M.

    2011-01-01

    Introduction: Cigarette smoking has become an important influence of morbidity and mortality for HIV-positive individuals in the era of highly active antiretroviral therapy. Although smoking is common among military personnel and veterans, the lasting impact of military service on smoking at a later stage of life has not been examined. The current study investigated present and past influences on current smoking among HIV-positive male veterans. Methods: Participants were 200 HIV-positive men served by the Veterans Affairs Medical Center. A survey was administered via audio-enhanced computer-assisted self-interview, and additional information was extracted from the computerized patient record system. Results: Logistic regression was performed to test hypotheses concerning the participants’ current situations as well as characteristics of their past military service. Having smokers in one's environment, being more depressed, and having used alcohol or drugs were associated with having smoked in the previous 30 days, whereas stronger endorsement of attitudes stating adverse effects of smoking was linked to lower likelihood of smoking. Neither having been in a military conflict nor the length of the military service was significantly related to current smoking. Conclusions: Remote experiences in the military did not have a sustained effect on smoking behavior years later. Implications of this study for the development of smoking cessation programs targeting HIV-positive veterans include the importance of altering attitudes about tobacco, treating underlying depression, addressing social influence, decreasing substance use, and increasing awareness of the heightened vulnerability to a variety of negative consequences of smoking among infected individuals. PMID:21436293

  7. Incidence and Determinants of Traumatic Intracranial Bleeding Among Older Veterans Receiving Warfarin for Atrial Fibrillation

    PubMed Central

    Dodson, John A.; Petrone, Andrew; Gagnon, David R.; Tinetti, Mary E.; Krumholz, Harlan M.; Gaziano, J. Michael

    2017-01-01

    Importance Traumatic intracranial bleeding, which is most commonly attributable to falls, is a common concern among clinicians who are hesitant to prescribe oral anticoagulants to older adults with atrial fibrillation. Objective To describe the incidence and risk factors for traumatic intracranial bleeding in a large cohort of older adults who are newly prescribed warfarin. Design Retrospective cohort study. Setting Department of Veterans Affairs (VA). Participants 31,951 Veterans with atrial fibrillation aged ≥75 years who were new referrals to VA anticoagulation clinics (warfarin therapy) between 1/1/2001–12/31/2012. Patients with comorbid conditions requiring warfarin were excluded. Main Outcomes and Measures The primary outcome was traumatic intracranial bleeding. Secondary outcomes included any intracranial bleeding and stroke. We used ICD-9-CM codes to identify incidence rates of these outcomes following warfarin initiation, using VA administrative data (in-system hospitalizations) and Medicare fee-for-service claims data (out-of-system hospitalizations). Clinical characteristics, laboratory, and pharmacy data were extracted from the VA electronic medical record. For traumatic intracranial bleeding, Cox proportional hazards regression was used to determine predictors of interest selected a priori based on prior known associations. Results Mean patient age was 81.1 ± 4.1 years, and comorbidities were common (hypertension 82.5%, coronary artery disease 42.6%, diabetes 33.8%). Over the study period, the incidence rate of traumatic intracranial bleeding was 4.8 per 1000 person-years. In unadjusted models, significant predictors for traumatic intracranial bleeding included dementia, fall within past year, anemia, depression, abnormal renal/liver function, anticonvulsant use, labile INR, and antihypertensive medication. After adjusting for potential confounders, the remaining significant predictors were dementia (HR 1.76, 95% CI 1.26–2.46), anemia (HR 1

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

    PubMed

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

    2017-09-01

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

  9. Nicotine dependence and psychiatric and substance use comorbidities in a sample of American Indian male veterans.

    PubMed

    Dickerson, Daniel L; O'Malley, Stephanie S; Canive, Jose; Thuras, Paul; Westermeyer, Joseph

    2009-01-01

    American Indians and Alaska Natives have the highest rates of nicotine dependence in the U.S. However, studies analyzing associations between nicotine dependence and psychiatric and substance use disorders in these groups have been limited. This study analyzes the co-occurrence of current and lifetime DSM-III-R nicotine dependence with psychiatric and substance use disorders in a community sample of 480 American Indian male veterans. Lifetime nicotine dependence (23.3%) was associated with all lifetime disorders studied, including alcohol use and drug use disorders, affective and anxiety disorders, PTSD, pathological gambling and antisocial personality disorder. Current nicotine dependence was present in 19% of the sample and significantly associated with current affective and gambling disorder. Substantial co-morbidity exists between nicotine dependence and other substance abuse and psychiatric disorders among this sample of American Indian male veterans, particularly for lifetime diagnoses. Screening for all psychiatric disorders among American Indian/Alaska Native smokers may be warranted. Although these results are similar to those observed among the general U.S. population, unique risk factors exist among American Indians/Alaska Natives which may require further attention. Specific public health and clinical interventions to reduce the rate of nicotine dependence among American Indians/Alaska Natives are recommended.

  10. Patterns of Treatment Utilization Before Suicide Among Male Veterans With Substance Use Disorders

    PubMed Central

    Conner, Kenneth R.; Roeder, Kathryn M.; Blow, Frederic C.; Austin, Karen; Valenstein, Marcia

    2012-01-01

    Objectives. We sought to describe the extent and nature of contact with the health care system before suicide among veterans with substance use disorders (SUDs). Methods. We examined all male Veterans Health Administration patients who died by suicide between October 1, 1999, and September 30, 2007, and who had a documented SUD diagnosis during the 2 years before death (n = 3132). Results. Over half (55.5%; n = 1740) of the male patients were seen during the month before suicide, and 25.4% (n = 796) were seen during the week before suicide. In examining those with a medical visit in the year before suicide (n = 2964), most of the last visits before suicide (56.6%; n = 1679) were in a general medical setting, 32.8% (n = 973) were in a specialty mental health setting, and 10.5% (n = 312) were in SUD treatment. Conclusions. Men with SUDs who died from suicide were frequently seen in the month before their death. Most were last seen in general medical settings, although a substantial minority of those with SUDs was seen in specialty mental health settings. PMID:22390610

  11. 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…

  12. Choice of Initial Antiepileptic Drug for Older Veterans: Possible Pharmacokinetic Drug Interactions With Existing Medications

    PubMed Central

    Pugh, Mary Jo V.; VanCott, Anne C.; Steinman, Michael A.; Mortensen, Eric M.; Amuan, Megan E.; Wang, Chen-Pin; Knoefel, Janice E.; Berlowitz, Dan R.

    2014-01-01

    Objectives Identify clinically-meaningful potential drug-drug interactions with antiepileptic drugs (AED-PDI), the AEDs and co-administered drugs commonly associated with AED-PDI, and characteristics of patients with increased likelihood of AED-PDI exposure. Design Five-year retrospective cohort study of veterans with new-onset epilepsy. Setting National VA and Medicare databases. Participants Veterans age 66 years and older with a new diagnosis of epilepsy between October 1, 1999-September 30, 2004 (N=9,682). Measurements We restricted AED-PDI to clinically-meaningful potential drug interactions identified by prior literature review. AED-PDI were identified using participants' date of initial AED prescription and overlapping concomitant medications. Logistic regression analysis identified factors associated with AED-PDI including demographic characteristics, chronic disease states and diagnostic setting. Results AED-PDI exposure was found in 45.5% (4,406/9,682); phenytoin, a drug with many potential drug interactions, was the most commonly prescribed AED. Cardiovascular drugs, lipid-lowering medications and psychotropic agents were the most commonly co-administered AED-PDI medications. Individuals at higher likelihood of AED-PDI exposure had 1) hypertension (OR=1.46, 99% CI 1.24-1.82), 2) hypercholesterolemia (OR=1.40, 99% CI 1.24-1.57) and 3) were diagnosed in emergency or primary care vs. Neurology settings (emergency OR: 1.30 99% CI=1.08-1.58; primary care OR: 1.29 99% CI 1.12-1.49). Conclusion Exposure to AED-PDI was substantial, but less common in epilepsy patients diagnosed in a neurology setting. Because potential outcomes associated with AED-PDI include stroke and myocardial infarction in a population already at elevated risk, clinicians should closely monitor blood pressure, coagulation, and lipid measures to minimize adverse effects of AED-PDI. Interventions to reduce AED-PDI may improve patient outcomes. PMID:20398114

  13. Perceived Effectiveness, Self-efficacy, and Social Support for Oral Appliance Therapy Among Older Veterans With Obstructive Sleep Apnea.

    PubMed

    Carballo, Nancy J; Alessi, Cathy A; Martin, Jennifer L; Mitchell, Michael N; Hays, Ron D; Col, Nananda; Patterson, Emily S; Jouldjian, Stella; Josephson, Karen; Fung, Constance H

    2016-11-01

    Obstructive sleep apnea is a prevalent sleep disorder among older adults. Oral appliances are increasingly prescribed as therapy for obstructive sleep apnea. Adherence to oral appliance therapy is highly variable. Based on value-expectancy theory and other social-psychological theories, adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. We examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy. We mailed surveys to all patients aged ≥65 years who had been prescribed oral appliance therapy for obstructive sleep apnea over the prior 36 months at a Veterans Affairs medical center. We examined frequencies of responses to items that assessed perceived effectiveness, self-efficacy, and social support for nightly use of oral appliances from friends, family, or health care staff. Thirty-nine individuals responded (response rate, 30%; mean [SD] age 71.4 [SD 6.3] years; 97% male). Thirty-six percent of the respondents perceived regular use of oral appliance therapy to be effective in managing obstructive sleep apnea; 39% agreed that they felt confident about using oral appliances regularly; 41% felt supported by people in their life in using oral appliance therapy; and 38% agreed that health care staff would help them to use their oral appliance regularly. These rates represented less than half of respondents despite the finding that 65% of patients believed that they would use their oral appliance regularly. Although oral appliance therapy is increasingly prescribed for obstructive sleep apnea, only about one third of older adults prescribed it perceived it to be an effective treatment, were confident about oral appliance use, and/or believed that they would receive needed support. Future research is needed to better understand older adults' perceptions so that interventions can be designed to improve the

  14. 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.

  15. Explanation for low prevalence of PTSD among older Finnish war veterans: social solidarity and continued significance given to wartime sufferings.

    PubMed

    Hautamäki, A; Coleman, P G

    2001-05-01

    A relatively low rate of Post-Traumatic Stress Disorder (PTSD) (<10%), has been reported among Finnish veterans of World War II. Possible explanations for this are explored by means of depth interviews with 30 veterans (mean age of 77 years), staying at a Disabled Veterans Hospital and at a Rehabilitation Centre, drawing on an Attachment Theory perspective. The Impact of Event Scale, the General Health Questionnaire, as well as health survey, medical problems, and war experience questions, were administered as part of the interview. A low rate of PTSD symptomatology was also reported in this sample alongside a relatively high level of subjective well-being. Without exception, they spoke freely about the war, often with emotion. Themes that received emphasis in their accounts included the Finnish fighting spirit and the strong reciprocal bonds of loyalty that were felt during the war. The war now featured prominently as part of their integrity as old men, representing a honourable task that they had been called on to fulfil. The significance they attributed to the war had not waned with time. Although this study of older war veterans, in common with other such studies, does not consider the less resilient who have not survived to old age, it does suggest that the strong community spirit built up in the war and continued in Finnish veterans' association after the war together with the continuing esteem of Finnish society, has contributed to the high levels of well-being expressed by the survivors.

  16. Cognitive Behavioral Therapy for Insomnia in Older Veterans Using Nonclinician Sleep Coaches: Randomized Controlled Trial

    PubMed Central

    Alessi, Cathy; Martin, Jennifer L.; Fiorentino, Lavinia; Fung, Constance H.; Dzierzewski, Joseph M.; Rodriguez Tapia, Juan C.; Song, Yeonsu; Josephson, Karen; Jouldjian, Stella; Mitchell, Michael N.

    2017-01-01

    OBJECTIVES To test a new cognitive behavioral therapy for insomnia (CBT-I) program designed for use by nonclinicians. DESIGN Randomized controlled trial. SETTING Department of Veterans Affairs healthcare system. PARTICIPANTS Community-dwelling veterans aged 60 and older who met diagnostic criteria for insomnia of 3 months duration or longer (N = 159). INTERVENTION Nonclinician “sleep coaches” delivered a five-session manual-based CBT-I program including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy (individually or in small groups), with weekly telephone behavioral sleep medicine supervision. Controls received five sessions of general sleep education. MEASUREMENTS Primary outcomes, including self-reported (7-day sleep diary) sleep onset latency (SOL-D), wake after sleep onset (WASO-D), total wake time (TWT-D), and sleep efficiency (SE-D); Pittsburgh Sleep Quality Index (PSQI); and objective sleep efficiency (7-day wrist actigraphy, SE-A) were measured at baseline, at the posttreatment assessment, and at 6- and 12-month follow-up. Additional measures included the Insomnia Severity Index (ISI), depressive symptoms (Patient Health Questionnaire-9 (PHQ-9)), and quality of life (Medical Outcomes Study 12-item Short-form Survey version 2 (SF-12v2)). RESULTS Intervention subjects had greater improvement than controls between the baseline and posttreatment assessments, the baseline and 6-month assessments, and the baseline and 12-month assessments in SOL-D (−23.4, −15.8, and −17.3 minutes, respectively), TWT-D (−68.4, −37.0, and −30.9 minutes, respectively), SE-D (10.5%, 6.7%, and 5.4%, respectively), PSQI (−3.4, −2.4, and −2.1 in total score, respectively), and ISI (−4.5, −3.9, and −2.8 in total score, respectively) (all P < .05). There were no significant differences in SE-A, PHQ-9, or SF-12v2. CONCLUSION Manual-based CBT-I delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia

  17. Cognitive Behavioral Therapy for Insomnia in Older Veterans Using Nonclinician Sleep Coaches: Randomized Controlled Trial.

    PubMed

    Alessi, Cathy; Martin, Jennifer L; Fiorentino, Lavinia; Fung, Constance H; Dzierzewski, Joseph M; Rodriguez Tapia, Juan C; Song, Yeonsu; Josephson, Karen; Jouldjian, Stella; Mitchell, Michael N

    2016-09-01

    To test a new cognitive behavioral therapy for insomnia (CBT-I) program designed for use by nonclinicians. Randomized controlled trial. Department of Veterans Affairs healthcare system. Community-dwelling veterans aged 60 and older who met diagnostic criteria for insomnia of 3 months duration or longer (N = 159). Nonclinician "sleep coaches" delivered a five-session manual-based CBT-I program including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy (individually or in small groups), with weekly telephone behavioral sleep medicine supervision. Controls received five sessions of general sleep education. Primary outcomes, including self-reported (7-day sleep diary) sleep onset latency (SOL-D), wake after sleep onset (WASO-D), total wake time (TWT-D), and sleep efficiency (SE-D); Pittsburgh Sleep Quality Index (PSQI); and objective sleep efficiency (7-day wrist actigraphy, SE-A) were measured at baseline, at the posttreatment assessment, and at 6- and 12-month follow-up. Additional measures included the Insomnia Severity Index (ISI), depressive symptoms (Patient Health Questionnaire-9 (PHQ-9)), and quality of life (Medical Outcomes Study 12-item Short-form Survey version 2 (SF-12v2)). Intervention subjects had greater improvement than controls between the baseline and posttreatment assessments, the baseline and 6-month assessments, and the baseline and 12-month assessments in SOL-D (-23.4, -15.8, and -17.3 minutes, respectively), TWT-D (-68.4, -37.0, and -30.9 minutes, respectively), SE-D (10.5%, 6.7%, and 5.4%, respectively), PSQI (-3.4, -2.4, and -2.1 in total score, respectively), and ISI (-4.5, -3.9, and -2.8 in total score, respectively) (all P < .05). There were no significant differences in SE-A, PHQ-9, or SF-12v2. Manual-based CBT-I delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  18. Combat Exposure in Early Adulthood Interacts with Recent Stressors to Predict PTSD in Aging Male Veterans.

    PubMed

    Sachs-Ericsson, Natalie; Joiner, Thomas E; Cougle, Jesse R; Stanley, Ian H; Sheffler, Julia L

    2016-02-01

    Combat is a risk factor for posttraumatic stress disorder (PTSD); however, less is known about how exposure to combat in early adulthood may contribute to the development of PTSD as the individual ages. Prior exposure to trauma may "sensitize" people to respond more intensely to subsequent stressors. Further, aging initiates new challenges that may undermine previous coping strategies. Over the life course combat veterans may be more reactive to new stressors and thus be more vulnerable to PTSD. This study draws on the two waves of the National Comorbidity Survey (NCS-1) and NCS-2 (10-year follow-up). Participants were male (noncombat N = 620 and combat N = 107) and 50-65 years of age at Wave-2. At baseline, participants were assessed for exposure to wartime combat, number of Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses in the past year, and life-time PTSD. At follow-up, PTSD occurring between waves was determined. A measure of recent life stressors was also obtained. Using logistic regression analyses, combat predicted PTSD at follow-up (controlling for baseline demographics, number of DSM diagnoses in the past year, life-time PTSD). Recent life stressors were also associated with PTSD. Importantly, the effect of combat on PTSD was significant at high levels, but not low levels, of recent life stress. Veterans who have experienced combat may be more reactive to new stressors, and in turn be more vulnerable to PTSD. Combat veterans should be regularly assessed for current stressors and PTSD. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. 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

  20. Veterans and Homelessness

    DTIC Science & Technology

    2007-05-31

    assistance ( Homeless Veterans Reintegration Program and Compensated Work Therapy program), transitional housing (Grant and Per Diem and Loan... homelessness . Another emerging issue is the needs of female veterans , whose numbers are increasing. Women veterans face challenges that could...male veterans to be single parents. Few homeless programs for veterans have the facilities to provide separate accommodations for women and women

  1. Religiousness/spirituality and mental health among older male inmates.

    PubMed

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

    2008-10-01

    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 the state of Alabama. Inmates older than age 50 who passed a cognitive screening completed face-to-face interviews lasting between 30 and 60 min. Due to the low literacy rates of the participants, we administered all measures orally with response cards to facilitate understanding. Nearly 70% of the inmates were incarcerated for murder or sexual crimes. There were no racial/ethnic differences in reported religiousness/spirituality, demographic characteristics, or mental health. We found an association between self-reported years of incarceration and experienced forgiveness. Three regression models examined whether inmates' self-reported religiousness/spirituality influenced anxiety, depression, and desire for hastened death. We found that having a greater number of daily spiritual experiences and not feeling abandoned by God were associated with better emotional health. Future studies, perhaps using longitudinal or case-control methodology, should examine whether increased daily spiritual experiences and decreased feelings of abandonment by God foster better mental health among older inmates.

  2. Needs and Concerns of Male Combat Veterans with Mild Traumatic Brain Injury

    DTIC Science & Technology

    2013-01-01

    his second deployment was to Afghanistan. Four of the Veterans were married, and four lived with their parents or friends. All had gradu- ated from...Veterans reported living dependently with their parents . Though all of the Veterans received healthcare coverage through the VA, only two received the...commitments and appointments. Additionally, some of the Veterans had a spouse or parents accompany them to medical appointments. Other strategies

  3. 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.

  4. 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

  5. Efficacy of Wii-Fit on Static and Dynamic Balance in Community Dwelling Older Veterans: A Randomized Controlled Pilot Trial

    PubMed Central

    Dubbert, Patricia M.

    2017-01-01

    Background/Objectives. Balance problems are well-established modifiable risk factors for falls, which are common in older adults. The objective of this study was to establish the efficacy of a Wii-Fit interactive video-game-led physical exercise program to improve balance in older Veterans. Methods. A prospective randomized controlled parallel-group trial was conducted at Veterans Affairs Medical Center. Thirty community dwelling Veterans aged 68 (±6.7) years were randomized to either the exercise or control groups. The exercise group performed Wii-Fit program while the control group performed a computer-based cognitive program for 45 minutes, three days per week for 8-weeks. The primary (Berg Balance Scale (BBS)) and secondary outcomes (fear of falling, physical activity enjoyment, and quality of life) were measured at baseline, 4 weeks, and 8 weeks. Results. Of 30 randomized subjects, 27 completed all aspects of the study protocol. There were no study-related adverse events. Intent-to-treat analysis showed a significantly greater improvement in BBS in the exercise group (6.0; 95% CI, 5.1–6.9) compared to the control group (0.5; 95% CI, −0.3–1.3) at 8 weeks (average intergroup difference (95% CI), 5.5 (4.3–6.7), p < 0.001) after adjusting for baseline. Conclusion. This study establishes that the Wii-Fit exercise program is efficacious in improving balance in community dwelling older Veterans. This trial is registered with ClinicalTrials.gov Identifier NCT02190045. PMID:28261500

  6. 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…

  7. Not supposed to feel this: traditional masculinity in psychotherapy with male veterans returning from Afghanistan and Iraq.

    PubMed

    Lorber, William; Garcia, Hector A

    2010-09-01

    Traditional masculine socialization presents challenges in psychotherapy, for example, by decreasing the likelihood of help-seeking and by making emotion-laden content more difficult to address. While this has been established in civilian populations, more intense forms of masculine socialization found in military settings may amplify such issues in male veteran populations. Male veterans returning from and Afghanistan (OEF) and Iraq (OIF) exhibit strong traditional masculine socialization and generally present in a unique manner. It is posited that OEF/OIF male veterans' unique presentation is in large part because of an interaction between high degrees of endorsement of traditional masculine gender role norms, relative youth, recency of distressing events, and recent experience in the social context of the military where traditional masculinity is reinforced. The impact of these variables on the psychotherapeutic process for male OEF/OIF veterans is significant and likely adds to ambivalence about change and increases dropout from psychotherapy. Modifications of traditional psychotherapeutic approaches designed to address traditional masculine gender role norms and their many interactions with other variables are discussed.

  8. Predictors of Cognitive Decline in Older Adult Type 2 Diabetes from the Veterans Affairs Diabetes Trial.

    PubMed

    Zimering, Mark B; Knight, Jeffrey; Ge, Ling; Bahn, Gideon

    2016-01-01

    Cognitive decline disproportionately affects older adult type 2 diabetes. We tested whether randomized intensive (INT) glucose-lowering reduces the rate(s) of cognitive decline in adults with advanced type 2 diabetes (mean: age, 60 years; diabetes duration, 11 years) from the Veterans Affairs Diabetes Trial. A battery of neuropsychological tests [digit span, digit symbol substitution (DSym), and Trails-making Test-Part B (TMT-B)] was administered at baseline in ~1700 participants and repeated at year 5. Thirty-seven risk factors were evaluated as predictors of cognitive decline in multivariable regression analyses. The mean age-adjusted DSym or TMT-B declined significantly in all study participants (P < 0.001). Randomized INT glucose-lowering did not significantly alter the rate of cognitive decline. The final model of risk factors associated with 5-year decline in age-adjusted TMT-B included as significant predictors: longer baseline diabetes duration (beta = -0.028; P = 0.0057), lower baseline diastolic blood pressure (BP; beta = 0.028; P = 0.002), and baseline calcium channel blocker medication use (beta = -0.639; P < 0.001). Higher baseline pulse pressure was significantly associated with decline in age-adjusted TMT-B suggesting a role for both higher systolic and lower diastolic BPs. Baseline thiazide diuretic use (beta = -0.549; P = 0.015) was an additional significant predictor of 5-year decline in age-adjusted digit symbol score. Post-baseline systolic BP-lowering was significantly associated (P < 0.001) with decline in TMT-B performance. There was a significant inverse association between post-baseline plasma triglyceride-lowering (P = 0.045) and decline in digit symbol substitution task performance. A 5-year period of randomized INT glucose-lowering did not significantly reduce the rate of cognitive decline in older-aged adults with type 2 diabetes. Systolic and diastolic BPs as well as plasma triglycerides

  9. Characteristics and Behaviors of Older Male Anabolic Steroid Users.

    PubMed

    Ip, Eric J; Trinh, Karen; Tenerowicz, Michael J; Pal, Jai; Lindfelt, Tristan A; Perry, Paul J

    2015-10-01

    To compare and contrast the characteristics of 2 groups of men ≥40 years old: reported anabolic-androgenic steroid (AAS) users and nonusers. Cross-sectional survey. Thirty-eight online fitness, weight lifting, bodybuilding, and steroid Web sites. A total of 67 male AAS users and 76 male nonusers ≥40 years old. Demographics, utilization of AAS and other performance-enhancing agents (PEAs), exercise patterns, history of illicit drugs and alcohol use, and psychiatric traits/diagnoses. The majority of AAS users ≥40 years old were caucasian (92.5%), heterosexual (97.0%), and classified themselves as recreational exercisers (79.1%). AAS users took more PEAs (11.5 ± 5.6 vs 4.6 ± 2.7; P < .001), were more likely to binge drink (47.8% vs 29.0%; P = .025), report heavy alcohol use (21.0% vs 7.9%; P = .031), meet criteria for substance dependence disorder (27.4% vs 4.0%; P < .001), and report an anxiety disorder diagnosis (12.0% vs 2.6%; P = .046) than nonusers. AAS misuse is prevalent among older men and is associated with polypharmacy, more aggressive alcohol use, and a higher incidence of substance dependence and anxiety disorders compared to nonusers. This information may help clinicians and researchers identify and develop appropriate intervention strategies for AAS abuse among older men. © The Author(s) 2014.

  10. 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. (c) 2015 APA, all rights reserved).

  11. Formative evaluation of the telecare fall prevention project for older veterans

    PubMed Central

    2011-01-01

    Background Fall prevention interventions for community-dwelling older adults have been found to reduce falls in some research studies. However, wider implementation of fall prevention activities in routine care has yielded mixed results. We implemented a theory-driven program to improve care for falls at our Veterans Affairs healthcare facility. The first project arising from this program used a nurse advice telephone line to identify patients' risk factors for falls and to triage patients to appropriate services. Here we report the formative evaluation of this project. Methods To evaluate the intervention we: 1) interviewed patient and employee stakeholders, 2) reviewed participating patients' electronic health record data and 3) abstracted information from meeting minutes. We describe the implementation process, including whether the project was implemented according to plan; identify barriers and facilitators to implementation; and assess the incremental benefit to the quality of health care for fall prevention received by patients in the project. We also estimate the cost of developing the pilot project. Results The project underwent multiple changes over its life span, including the addition of an option to mail patients educational materials about falls. During the project's lifespan, 113 patients were considered for inclusion and 35 participated. Patient and employee interviews suggested support for the project, but revealed that transportation to medical care was a major barrier in following up on fall risks identified by nurse telephone triage. Medical record review showed that the project enhanced usual medical care with respect to home safety counseling. We discontinued the program after 18 months due to staffing limitations and competing priorities. We estimated a cost of $9194 for meeting time to develop the project. Conclusions The project appeared feasible at its outset but could not be sustained past the first cycle of evaluation due to insufficient

  12. Formative evaluation of the telecare fall prevention project for older veterans.

    PubMed

    Miake-Lye, Isomi M; Amulis, Angel; Saliba, Debra; Shekelle, Paul G; Volkman, Linda K; Ganz, David A

    2011-05-23

    Fall prevention interventions for community-dwelling older adults have been found to reduce falls in some research studies. However, wider implementation of fall prevention activities in routine care has yielded mixed results. We implemented a theory-driven program to improve care for falls at our Veterans Affairs healthcare facility. The first project arising from this program used a nurse advice telephone line to identify patients' risk factors for falls and to triage patients to appropriate services. Here we report the formative evaluation of this project. To evaluate the intervention we: 1) interviewed patient and employee stakeholders, 2) reviewed participating patients' electronic health record data and 3) abstracted information from meeting minutes. We describe the implementation process, including whether the project was implemented according to plan; identify barriers and facilitators to implementation; and assess the incremental benefit to the quality of health care for fall prevention received by patients in the project. We also estimate the cost of developing the pilot project. The project underwent multiple changes over its life span, including the addition of an option to mail patients educational materials about falls. During the project's lifespan, 113 patients were considered for inclusion and 35 participated. Patient and employee interviews suggested support for the project, but revealed that transportation to medical care was a major barrier in following up on fall risks identified by nurse telephone triage. Medical record review showed that the project enhanced usual medical care with respect to home safety counseling. We discontinued the program after 18 months due to staffing limitations and competing priorities. We estimated a cost of $9194 for meeting time to develop the project. The project appeared feasible at its outset but could not be sustained past the first cycle of evaluation due to insufficient resources and a waning of local

  13. Use of Boosted Protease Inhibitors Reduces Kaposi Sarcoma Incidence Among Male Veterans With HIV Infection

    PubMed Central

    Kowalkowski, Marc A.; Kramer, Jennifer R.; Richardson, Peter R.; Suteria, Insia; Chiao, Elizabeth Y.

    2015-01-01

    Background. Kaposi sarcoma (KS) incidence has decreased since combination antiretroviral therapy (cART). However, effects of cART type and duration on KS remain difficult to interpret secondary to KS-associated immune reconstitution inflammatory syndrome (IRIS). Methods. We performed a retrospective study of Veterans Affairs Human Immunodeficiency Virus Clinical Case Registry data from 1985 to 2010. We analyzed the relationship between cART regimens and KS using multivariable Poisson regression, stratified or adjusted for timing around cART initiation. KS was identified by ≥1 inpatient or ≥2 outpatient International Classification of Diseases, Ninth Revision codes (176.0–9). Percent of cART on specific regimen and total duration on specific regimen were examined. Results. There were 341 KS cases among 25 529 HIV-infected male veterans (incidence rate = 2.02/1000 person-years). Stratified by years after starting cART, every additional 10% time on boosted protease inhibitors (BPIs) was associated with reduced KS incidence in the third year of cART (incidence rate ratio [IRR] = 0.79; 95% confidence interval [CI], .69–.90). Months on BPIs was associated with lower KS incidence (P = .02). KS incidence was lower at 12–23 (IRR = 0.47; 95% CI, .23–.95) and ≥36 (IRR = 0.14; 95% CI, .02–1.00) months on BPIs compared with <6 months. Longer duration on other regimens was not associated with decreased KS incidence. Conclusions. Lower KS incidence was observed with longer BPI use, after accounting for potential IRIS and other factors. Future research should evaluate newer cART regimens and long-term benefits of PI-based cART on KS in other cohorts and prospective studies. PMID:25586682

  14. Heart rate recovery, exercise capacity, and mortality risk in male veterans.

    PubMed

    Kokkinos, Peter; Myers, Jonathan; Doumas, Michael; Faselis, Charles; Pittaras, Andreas; Manolis, Athanasios; Kokkinos, John Peter; Narayan, Puneet; Papademetriou, Vasilios; Fletcher, Ross

    2012-04-01

    Both impaired heart rate recovery (HRR) and low fitness are associated with higher mortality risk. In addition, HRR is influenced by fitness status. The interaction between HRR, mortality, and fitness has not been clearly defined. Thus, we sought to evaluate the association between HRR and all-cause mortality and to assess the effects of fitness on this association. Treadmill exercise testing was performed in 5974 male veterans for clinical reasons at two Veterans Affairs Medical Centers (Washington, DC and Palo Alto, CA). HRR was calculated at 1 and 2 min of recovery. All-cause mortality was determined over a mean 6.2-year follow-up period. Mortality risk was significantly and inversely associated with HRR, only at 2 min. A cut-off value of 14 beats/min at 2 min recovery was the strongest predictor of mortality for the cohort (hazard ratio = 2.4; CI 1.6-3.5). The mortality risk was overestimated when exercise capacity was not considered. When both low fitness and low HRR were present (≤6 metabolic equivalents and ≤14 beats/min), mortality risk was approximately seven-fold higher compared to the High-fit + High-HRR group (>6 metabolic equivalents and >14 beats/min). HRR at 2 min post exercise is strongly and inversely associated with all-cause mortality. Exercise capacity affects HRR-associated mortality substantially and should be considered when applying HRR to estimate mortality.

  15. 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

  16. Sexual Problems Predict PTSD and Depression Symptom Change Among Male OEF/OIF Veterans Completing Exposure Therapy.

    PubMed

    Badour, Christal L; Gros, Daniel F; Szafranski, Derek D; Acierno, Ron

    2016-01-01

    A growing literature documents frequent sexual problems among Operations Enduring/Iraqi Freedom (OEF/OIF) veterans with post-traumatic stress disorder (PTSD). However, there has been no examination of how (1) sexual problems may be affected by evidenced-based psychotherapy for PTSD or (2) how the presence of sexual problems might impact effectiveness of evidenced-based psychotherapy for PTSD. As such, the present study investigated associations among symptoms of PTSD, depression, and problems with sexual desire and arousal among 45 male OEF/OIF veterans receiving behavioral activation and therapeutic exposure (BA-TE), an evidence-based behavior therapy targeting co-occurring symptoms of PTSD and depression. Participants completed clinical interviews and several questionnaires including measures of sexual arousal, sexual desire, PTSD symptoms, and depression symptoms at baseline and after completion of 8 sessions of BA-TE treatment. A records review was also conducted to assess for relevant medication use. Overall, sexual desire and sexual arousal problems did not improve during the course of treatment. Moreover, veterans with co-occurring sexual problems at baseline evidenced significantly less improvement in symptoms of PTSD and depression across treatment as compared to veterans without sexual problems. These findings suggest that veterans with co-occurring symptoms of PTSD and sexual problems may require additional assessment and treatment considerations in order to improve their treatment outcomes for both primary psychiatric symptoms as well as sexual problems. Future research on combination treatments of medication for sexual problems and psychotherapy for PTSD is needed.

  17. Mental health and other risk factors for jail incarceration among male veterans.

    PubMed

    Greenberg, Greg A; Rosenheck, Robert A

    2009-03-01

    Data derived from the 2002 Survey of Inmates in Local Jails and the 2000 National Survey of Veterans show that having mental health problems in addition to such sociodemographic characteristics as being a member of a minority group, not being married, having less education, and being younger are risk factors for incarceration among veterans, as they are for the general population. As in previous studies veterans who served during the Vietnam Era and to an even greater extent, those who served in the early years of the All Volunteer Force were at greater risk of incarceration than veterans from the most recent period of the AVF, after controlling for age and other factors.

  18. Elevated late-night salivary cortisol levels in elderly male type 2 diabetic veterans.

    PubMed

    Liu, Hau; Bravata, Dena M; Cabaccan, Josel; Raff, Hershel; Ryzen, Elisabeth

    2005-12-01

    Late-night salivary cortisol (LNSC) is reportedly highly accurate for the diagnosis of Cushing's syndrome (CS). However, diagnostic thresholds for abnormal results are based on healthy, young populations and limited data are available on its use in elderly populations with chronic medical conditions. The purpose of this study was to evaluate LNSC levels in elderly male veterans with and without diabetes. Prospective evaluation of LNSC levels in male veterans. One hundred and fifty-four participants with type 2 diabetes and 52 participants without diabetes. Participants underwent outpatient LNSC (2300 h) testing. Participants with elevated LNSC (> or = 4.3 nmol/l) underwent secondary testing, including 24-h urine free cortisol (24UFC, > 60 microg/day) and dexamethasone suppression testing (DST, serum cortisol > 50 nmol/l). Participants with positive secondary testing had a morning ACTH level analysed and either pituitary or adrenal imaging performed. One hundred and forty-one diabetics and 46 controls (mean age 61 years) returned samples (91% overall). Average LNSC levels (nmol/l) in diabetics were significantly higher than in nondiabetics [median (interquartile range): 2.6 (1.8-4.1) vs. 1.6 (1.0-2.0)] and in those aged > or = 60 compared to < 60 [2.7 (2.0-4.3) vs. 1.9 (1.4-2.9)] (P < 0.001 for both). Thirty-one participants required secondary testing. Seventy-nine per cent of participants who underwent secondary testing had normal 24UFC and DST. No cases of CS have been diagnosed to date. Increasing age [odds ratio (OR) 2.0 per decade], current diabetes mellitus (OR 4.4), and elevated blood pressure (OR 1.3 per 10 mmHg increase in systolic blood pressure) were associated with abnormal LNSC results (P < 0.05 for each). LNSC has been shown to be sensitive and specific in diagnosing CS in certain high-risk populations, primarily the young and middle-aged. The development of age- and comorbidity-adjusted thresholds may be warranted for LNSC testing in elderly subjects

  19. 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…

  20. 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…

  1. The health and social needs of older male prisoners.

    PubMed

    Hayes, Adrian J; Burns, Alistair; Turnbull, Pauline; Shaw, Jenny J

    2012-11-01

    This study aimed to quantify the health and social needs of older male prisoners in the North West of England, to determine whether their needs were being met, and to explore an age cut-off for this group. Data were collected by interview and case note review. Areas covered included physical health, mental health, personality disorder, cognitive impairment and social need. A total of 262 prisoners were included in the study. Over 90% had a physical health disorder, most commonly hypertension and osteoarthritis. A total of 61% had a mental disorder, most commonly major depressive disorder and alcohol misuse disorder. There were few differences within age bands for physical health problem or health/social need, but those aged 50-59 years had more mental disorder, including mental illness, substance misuse disorder and personality disorder. Older prisoners have a high level of health need and a different profile to the rest of the prison population. Fifty appears to be a useful age over which to define this group, and service provision should reflect this in a national management strategy. Copyright © 2012 John Wiley & Sons, Ltd.

  2. 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…

  3. 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…

  4. 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…

  5. 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. Copyright © American Academy of Addiction Psychiatry.

  6. Exercise capacity and all-cause mortality in male veterans with hypertension aged ≥70 years.

    PubMed

    Faselis, Charles; Doumas, Michael; Pittaras, Andreas; Narayan, Puneet; Myers, Jonathan; Tsimploulis, Apostolos; Kokkinos, Peter

    2014-07-01

    Aging, even in otherwise healthy subjects, is associated with declines in muscle mass, strength, and aerobic capacity. Older individuals respond favorably to exercise, suggesting that physical inactivity plays an important role in age-related functional decline. Conversely, physical activity and improved exercise capacity are associated with lower mortality risk in hypertensive individuals. However, the effect of exercise capacity in older hypertensive individuals has not been investigated extensively. A total of 2153 men with hypertension, aged ≥70 years (mean, 75 ± 4) from the Washington, DC, and Palo Alto Veterans Affairs Medical Centers, underwent routine exercise tolerance testing. Peak workload was estimated in metabolic equivalents (METs). Fitness categories were established based on peak METs achieved, adjusted for age: very-low-fit, 2.0 to 4.0 METs (n=386); low-fit, 4.1 to 6.0 METs (n=1058); moderate-fit, 6.1 to 8.0 METs (n=495); high-fit >8.0 METs (n=214). Cox proportional hazard models were applied after adjusting for age, body mass index, race, cardiovascular disease, cardiovascular medications, and risk factors. All-cause mortality was quantified during a mean follow-up period of 9.0 ± 5.5 years. There were a total of 1039 deaths or 51.2 deaths per 1000 person-years of follow-up. Mortality risk was 11% lower (hazard ratio, 0.89; 95% confidence interval, 0.86-0.93; P<0.001) for every 1-MET increase in exercise capacity. When compared with those achieving ≤4.0 METs, mortality risk was 18% lower (hazard ratio, 0.82; 95% confidence interval, 0.70-0.95; P=0.011) for the low-fit, 36% for the moderate-fit (hazard ratio, 0.64; 95% confidence interval, 0.52-0.78; P<0.001), and 48% for the high-fit individuals (hazard ratio, 0.52; 95% confidence interval, 0.39-0.69; P<0.001). These findings suggest that exercise capacity is associated with lower mortality risk in elderly men with hypertension. © 2014 American Heart Association, Inc.

  7. Lifestyle and health-related risk factors and risk of cognitive aging among older veterans.

    PubMed

    Yaffe, Kristine; Hoang, Tina D; Byers, Amy L; Barnes, Deborah E; Friedl, Karl E

    2014-06-01

    Lifestyle and health-related factors are critical components of the risk for cognitive aging among veterans. Because dementia has a prolonged prodromal phase, understanding effects across the life course could help focus the timing and duration of prevention targets. This perspective may be especially relevant for veterans and health behaviors. Military service may promote development and maintenance of healthy lifestyle behaviors, but the period directly after active duty has ended could be an important transition stage and opportunity to address some important risk factors. Targeting multiple pathways in one intervention may maximize efficiency and benefits for veterans. A recent review of modifiable risk factors for Alzheimer's disease estimated that a 25% reduction of a combination of seven modifiable risk factors including diabetes, hypertension, obesity, depression, physical inactivity, smoking, and education/cognitive inactivity could prevent up to 3 million cases worldwide and 492,000 cases in the United States. Lifestyle interventions to address cardiovascular health in veterans may serve as useful models with both physical and cognitive activity components, dietary intervention, and vascular risk factor management. Although the evidence is accumulating for lifestyle and health-related risk factors as well as military risk factors, more studies are needed to characterize these factors in veterans and to examine the potential interactions between them.

  8. Veterans and Homelessness

    DTIC Science & Technology

    2009-06-26

    homelessness . They are more likely to have experienced sexual abuse than women in the general population and are more likely than male veterans to be...single parents. Few homeless programs for veterans have the facilities to provide separate accommodations for women and women with children. Veterans ...23 Homeless Veterans Reintegration Program

  9. Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in veterans affairs health care.

    PubMed

    Maguen, Shira; Ren, Li; Bosch, Jeane O; Marmar, Charles R; Seal, Karen H

    2010-12-01

    We examined gender differences in sociodemographic, military service, and mental health characteristics among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. We evaluated associations between these sociodemographic and service characteristics and depression and posttraumatic stress disorder (PTSD) diagnoses. In a retrospective, cross-sectional study, we used univariate descriptive statistics and log binominal regression analyses of Department of Veterans Affairs (VA) administrative data on 329 049 OEF and OIF veterans seeking VA health care from April 1, 2002, through March 31, 2008. Female veterans were younger and more likely to be Black and to receive depression diagnoses than were male veterans, who were more frequently diagnosed with PTSD and alcohol use disorders. Older age was associated with a higher prevalence of PTSD and depression diagnoses among women but not among men. Consideration of gender differences among OEF and OIF veterans seeking health care at the VA will facilitate more targeted prevention and treatment services for these newly returning veterans.

  10. 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

  11. 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.

  12. Isoniazid Toxicity among an Older Veteran Population: A Retrospective Cohort Study

    PubMed Central

    Vinnard, Christopher; Gopal, Anand; Linkin, Darren R.; Maslow, Joel

    2013-01-01

    Background: our objective was to determine the incidence of toxicity among veterans initiating isoniazid therapy for latent tuberculosis infection (LTBI) and determine whether advancing age was a risk factor for toxicity. Methods: we performed a retrospective cohort study among all adults initiating isoniazid treatment for LTBI at a Veterans Medical Center from 1999 to 2005. We collected data on patient demographics, co-morbidities, site of initiation, and treatment outcome. Results: 219 patients initiated isoniazid therapy for LTBI during the period of observation, and the completion of therapy was confirmed in 100 patients (46%). Among 18/219 patients (8%) that discontinued therapy due to a documented suspected toxicity, the median time to onset was 3 months (IQR 1–5 months). In an adjusted Cox regression model, there was no association between discontinuation due to suspected toxicity and advancing age (HR 1.03, 95% CI 0.99, 1.07). In contrast, hepatitis C infection was a significant predictor of cessation due to toxicity in the adjusted analysis (HR 3.03, 95% CI 1.08, 8.52). Conclusions: cessation of isoniazid therapy due to suspected toxicity was infrequently observed among a veteran population and was not associated with advancing age. Alternative LTBI treatment approaches should be further examined in the veteran population. PMID:23365735

  13. Isoniazid Toxicity among an Older Veteran Population: A Retrospective Cohort Study.

    PubMed

    Vinnard, Christopher; Gopal, Anand; Linkin, Darren R; Maslow, Joel

    2013-01-01

    our objective was to determine the incidence of toxicity among veterans initiating isoniazid therapy for latent tuberculosis infection (LTBI) and determine whether advancing age was a risk factor for toxicity. we performed a retrospective cohort study among all adults initiating isoniazid treatment for LTBI at a Veterans Medical Center from 1999 to 2005. We collected data on patient demographics, co-morbidities, site of initiation, and treatment outcome. 219 patients initiated isoniazid therapy for LTBI during the period of observation, and the completion of therapy was confirmed in 100 patients (46%). Among 18/219 patients (8%) that discontinued therapy due to a documented suspected toxicity, the median time to onset was 3 months (IQR 1-5 months). In an adjusted Cox regression model, there was no association between discontinuation due to suspected toxicity and advancing age (HR 1.03, 95% CI 0.99, 1.07). In contrast, hepatitis C infection was a significant predictor of cessation due to toxicity in the adjusted analysis (HR 3.03, 95% CI 1.08, 8.52). cessation of isoniazid therapy due to suspected toxicity was infrequently observed among a veteran population and was not associated with advancing age. Alternative LTBI treatment approaches should be further examined in the veteran population.

  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. 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.…

  16. 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.…

  17. Sexual Problems Predict PTSD and Depression Symptom Change Among Male OEF/OIF Veterans Completing Exposure Therapy

    PubMed Central

    Badour, Christal L.; Gros, Daniel F.; Szafranski, Derek D.; Acierno, Ron

    2017-01-01

    Objective A growing literature documents frequent sexual problems among Operations Enduring/Iraqi Freedom (OEF/OIF) veterans with posttraumatic stress disorder (PTSD). However, there has been no examination of how 1) sexual problems may be affected by evidenced-based psychotherapy for PTSD, or 2) how the presence of sexual problems might impact effectiveness of evidenced-based psychotherapy for PTSD. As such, the present study investigated associations among symptoms of PTSD, depression, and problems with sexual desire and arousal among 45 male OEF/OIF veterans receiving Behavioral Activation and Therapeutic Exposure (BA-TE), an evidence-based behavior therapy targeting co-occurring symptoms of PTSD and depression. Method Participants completed clinical interviews and several questionnaires including measures of sexual arousal, sexual desire, PTSD symptoms, and depression symptoms at baseline and after completion of 8-sessions of BA-TE treatment. A records review was also conducted to assess for relevant medication use. Results Overall, sexual desire and sexual arousal problems did not improve during the course of treatment. Moreover, veterans with co-occurring sexual problems at baseline evidenced significantly less improvement in symptoms of PTSD and depression across treatment as compared to veterans without sexual problems. Conclusions These findings suggest that veterans with co-occurring symptoms of PTSD and sexual problems may require additional assessment and treatment considerations in order to improve their treatment outcomes for both primary psychiatric symptoms as well as sexual problems. Future research on combination treatments of medication for sexual problems and psychotherapy for PTSD is needed. PMID:27997327

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

    PubMed

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

    2012-01-01

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

  19. Impaired right inferior frontal gyrus response to contextual cues in male veterans with PTSD during response inhibition.

    PubMed

    van Rooij, Sanne J H; Rademaker, Arthur R; Kennis, Mitzy; Vink, Matthijs; Kahn, René S; Geuze, Elbert

    2014-09-01

    Posttraumatic stress disorder (PTSD) is often associated with impaired fear inhibition and decreased safety cue processing; however, studies capturing the cognitive aspect of inhibition and contextual cue processing are limited. In this fMRI study, the role of contextual cues in response inhibition was investigated. Male medication-naive war veterans with PTSD, male control veterans (combat controls) and healthy nonmilitary men (healthy controls) underwent fMRI while performing the stop-signal anticipation task (SSAT). The SSAT evokes 2 forms of response inhibition: reactive inhibition (outright stopping) and proactive inhibition (anticipation of stopping based on contextual cues). We enrolled 28 veterans with PTSD, 26 combat controls and 25 healthy controls in our study. Reduced reactive inhibition was observed in all veterans, both with and without PTSD, but not in nonmilitary controls, whereas decreased inhibition of the left pre/postcentral gyrus appeared to be specifically associated with PTSD. Impaired behavioural proactive inhibition was also specific to PTSD. Furthermore, the PTSD group showed a reduced right inferior frontal gyrus response during proactive inhibition compared with the combat control group. Most patients with PTSD had comorbid psychiatric disorders, but such comorbidity is common in patients with PTSD. Also, the education level (estimate of intelligence) of participants, but not of their parents, differed among the groups. Our findings of reduced proactive inhibition imply that patients with PTSD show reduced contextual cue processing. These results complement previous findings on fear inhibition and demonstrate that contextual cue processing in patients with PTSD is also reduced during cognitive processes, indicating a more general deficit.

  20. Differential Risk for Homelessness Among US Male and Female Veterans With a Positive Screen for Military Sexual Trauma.

    PubMed

    Brignone, Emily; Gundlapalli, Adi V; Blais, Rebecca K; Carter, Marjorie E; Suo, Ying; Samore, Matthew H; Kimerling, Rachel; Fargo, Jamison D

    2016-06-01

    Military sexual trauma (MST) is associated with adverse physical and mental health outcomes following military separation. Recent research suggests that MST may be a determinant in several factors associated with postdeployment homelessness. To evaluate MST as an independent risk factor for homelessness and to determine whether risk varies by sex. A retrospective cohort study of US veterans who used Veterans Health Administration (VHA) services between fiscal years 2004 and 2013 was conducted using administrative data from the Department of Defense and VHA. Included in the study were 601 892 US veterans deployed in Iraq or Afghanistan who separated from the military between fiscal years 2001 and 2011 and subsequently used VHA services. Positive response to screen for MST administered in VHA facilities. Administrative evidence of homelessness within 30 days, 1 year, and 5 years following the first VHA encounter after last deployment. The mean (SD) age of the 601 892 participants was 38.9 (9.4) years, 527 874 (87.7%) were male, 310 854 (51.6%) were white, and 382 361 (63.5%) were enlisted in the Army. Among veterans with a positive screen for MST, rates of homelessness were 1.6% within 30 days, 4.4% within 1 year, and 9.6% within 5 years, more than double the rates of veterans with a negative MST screen (0.7%, 1.8%, and 4.3%, respectively). A positive screen for MST was significantly and independently associated with postdeployment homelessness. In regression models adjusted for demographic and military service characteristics, odds of experiencing homelessness were higher among those who screened positive for MST compared with those who screened negative (30-day: adjusted odds ratio [AOR], 1.89; 95% CI, 1.58-2.24; 1-year: AOR, 2.27; 95% CI, 2.04-2.53; and 5-year: AOR, 2.63; 95% CI, 2.36-2.93). Military sexual trauma screen status remained independently associated with homelessness after adjusting for co-occurring mental health and substance abuse diagnoses

  1. Perfluoroalkyl substances in older male anglers in Wisconsin.

    PubMed

    Christensen, Krista Y; Raymond, Michelle; Thompson, Brooke A; Anderson, Henry A

    2016-05-01

    Perfluoroalkyl substances (PFAS) are an emerging class of contaminants. Certain PFAS are regulated or voluntarily limited due to concern about environmental persistence and adverse health effects, including thyroid disease and to dyslipidemia. The major source of PFAS exposure in the general population is seafood. In this analysis we examine PFAS levels and their determinants, as well as associations between PFAS levels and self-reported health outcomes, in a group of older male anglers in Wisconsin with high fish consumption. A biomonitoring study of male anglers aged 50 and older living in Wisconsin collected detailed information on fish consumption, demographics and self-reported health outcomes, along with hair and blood samples for biomarker analysis. Sixteen different PFAS were extracted from serum samples. Regression models were used to identify factors (demographic characteristics and fish consumption habits) associated with PFAS biomarker levels in blood, as well as associations between PFAS and self-reported health outcomes, adjusting for potential confounders. Seven PFAS were detected in at least 30% of participants and were used in subsequent analyses (PFDA, PFHpS, PFHxS, PFNA, PFOA, PFOS, PFuDA). The PFAS with the highest levels were PFOS, followed by PFOA, PFHxS and PFNA (medians of 19.0, 2.5, 1.8 and 1.4ng/mL). In general, increasing age was associated with higher PFAS levels, while increasing BMI were associated with lower PFAS levels. Greater alcohol consumption was associated with higher levels of PFHpS, PFHxS and PFOA. Associations with smoking and employment did not show a consistent pattern. Associations between fish consumption and PFAS were generally weak, with the exception of notably higher PFDA and PFHpS with both other locally-caught fish, and restaurant-purchased fish. Regarding associations with health outcomes, PFuDA, PFNA and PFDA were all associated with increased risk of pre-diabetes and/or diabetes. PFHpS was associated with a

  2. Changes in characteristics of veterans using the VHA health care system between 1996 and 1999

    PubMed Central

    Liu, Chuan-Fen; Maciejewski, Matthew L; Sales, Anne EB

    2005-01-01

    Background The Department of Veterans Affairs' Veterans Health Administration (VHA) provides a health care safety net to veterans. This study examined changes in characteristics of veterans using the VHA health care system between 1996 and 1999 when VHA implemented major organizational changes to improve access of ambulatory care and to provide care to more veterans. Methods The study used two cross-sectional samples of the Medical Expenditures Panel Survey (MEPS), a national representative survey, in 1996 and 1999. The 1996 MEPS survey included 1,944 veterans and the 1999 MEPS survey included 1,974 veterans. There were 534 veterans and 740 veterans who used VHA services in 1996 and 1999, respectively. Results The proportion of veterans using the VHA system increased from 12.4% in 1996 to 14.6% in 1999. In both years, veterans were more likely to use VHA care if they were older, male, less educated, uninsured, unemployed, and in fair or poor health status. Only two variables, marital status and income, were different between the two years. Married veterans were more likely to use VHA care in 1999, but not in 1996. Veterans with higher incomes had greater odds of using VHA care in 1996, but there was no significant association between income and VHA use in 1999. Conclusion Characteristics of VHA users did not fundamentally change despite the reorganization of VHA health care delivery system and changes in eligibility and enrollment policy. The VHA system maintains its safety net mission while attracting more veterans. PMID:15836789

  3. Telephone-Delivered Cognitive-Behavioral Therapy for Older, Rural Veterans with Depression and Anxiety in Home-Based Primary Care.

    PubMed

    Barrera, Terri L; Cummings, Jeremy P; Armento, Maria; Cully, Jeffrey A; Bush Amspoker, Amber; Wilson, Nancy L; Mallen, Michael J; Shrestha, Srijana; Kunik, Mark E; Stanley, Melinda A

    2017-01-01

    Rural, homebound older adults are at increased risk for anxiety and depression and have limited access to mental health services. These individuals face many barriers to receiving evidence-based mental health treatment and would benefit from interventions that increase access to and efficiency of care. The aim of this study was to evaluate use of a telephone-delivered, modular, cognitive behavioral therapy (CBT) intervention for both late-life depression and anxiety delivered to rural, homebound Veterans. Three cases are presented to illustrate the flexible adaptation of the intervention for use among older Veterans enrolled in home-based primary care, with varying symptom presentations and functional limitations. The Veterans received 7 to 9 sessions of the CBT intervention, with ordering of skill modules based on symptom presentation and determined collaboratively between patient and therapist. The three Veterans showed improvement in depression and/or anxiety symptoms following treatment and provided positive feedback regarding their experiences in this program. These results suggest that telephone-delivered CBT is acceptable to older adults and can be tailored to individual patient needs. Clinicians should consider telephone-delivered CBT as an alternate mode of therapy to increase access to mental health care for rural, homebound individuals with depression and anxiety.

  4. Risk Exposures in Early Life and Mortality at Older Ages: Evidence from Union Army Veterans

    PubMed Central

    Su, Dejun

    2010-01-01

    This study examines the relation between risk exposures in early life and hazard of mortality among 11,978 Union Army veterans aged 50 and over in 1900. Veterans’ risk exposures prior to enlistment–as approximated by birth season, country of origin, residential region, city size, and height at enlistment–significantly influence their chance of survival after 1900. These effects are robust irrespective of whether or not socioeconomic well-being circa 1900 has been taken into account; however, they are sensitive to the particular age periods that have been selected for survival analysis. Whereas some of the effects such as being born in Ireland and coming from big cities became fully unfolded in the first decade after 1900 and then dissipated over time, the effects of birth season, being born in Germany, residential region in the U.S., and height at enlistment were more salient in the post-1910 periods. Height at enlistment shows a positive association with risk of mortality in the post-1910 periods. Compared to corresponding findings from more recent cohorts, the exceptional rigidity of the effects of risk exposures prior to enlistment on old-age mortality among the veterans highlights the harshness of living conditions early in their life. PMID:20209063

  5. The comparative effectiveness of cognitive processing therapy for male veterans treated in a VHA posttraumatic stress disorder residential rehabilitation program.

    PubMed

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

    2011-10-01

    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. Participants were 2 cohorts of male patients in the same program treated with either CPT (n = 104) or TAU (n = 93; prior to the implementation of CPT). Cohorts were compared on changes from pre- to posttreatment using the PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993) and other measures of symptoms and functioning. Minorities represented 41% of the sample, and the mean age was 52 years (SD = 9.22). The CPT group was significantly younger and less likely to receive disability benefits for PTSD; however, these variables were not related to outcome. Analyses of covariance controlling for intake symptom levels and cohort differences revealed that CPT participants evidenced more symptom improvement at discharge than TAU participants on the PCL, F(3, 193) = 15.32, p < .001, b = 6.25, 95% CI [3.06, 9.44], and other measures. In addition, significantly more patients treated with CPT were classified as "recovered" or "improved" at discharge, χ2(1, N = 197) = 4.93, p = .032. There is still room for improvement, as substantial numbers of veterans continue to experience significant symptoms even after treatment with CPT in a residential program. However, CPT appears to produce significantly more symptom improvement than treatment conducted before the implementation of CPT. The implementation of this empirically supported treatment in VHA settings is both feasible and sustainable and is likely to improve care for male veterans with military-related PTSD.

  6. 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

  7. Older Veterans: Growing Numbers and Changing Needs. Hearing before the Subcommittee on Human Services of the Select Committee on Aging, House of Representatives, Ninety-Eighth Congress, Second Session (Bound Brook, New Jersey).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Aging.

    This Congressional report contains the testimony presented at a hearing focusing on the need for expanding available medical facilities and services for older U.S. veterans in New Jersey. Included among those agencies and organizations represented at the hearing were the following: the Veterans Administration; the Division of Health Policy…

  8. Characteristics and Incidence of Chronic Illness in Community-Dwelling Predominantly Male U.S. Veteran Centenarians.

    PubMed

    Kheirbek, Raya Elfadel; Fokar, Ali; Shara, Nawar; Bell-Wilson, Leakie K; Moore, Hans J; Olsen, Edwin; Blackman, Marc R; Llorente, Maria D

    2017-09-01

    To assess the incidence of chronic illness and its effect on veteran centenarians. Retrospective longitudinal cohort study. United States Veterans Affairs Corporate Data Warehouse (CDW). Community-dwelling veterans born between 1910 and 1915 who survived to at least age 80 (N = 86,892; 31,121 octogenarians, 52,420 nonagenarians, 3,351 centenarians). The Kaplan-Meier method was used to estimate cumulative incidence of chronic conditions according to age group. Incidence rates were compared using the log-rank test. Cox proportional hazards models were used to estimate unadjusted hazard ratios. Ninety-seven percent of Centenarians were male, 88.0% were white, 31.8% were widowed, 87.5% served in World War II, and 63.9% did not have a service-related disability. The incidence rates of chronic illnesses were higher in octogenarians than centenarians (atrial fibrillation, 15.0% vs 0.6%, P < .001; heart failure, 19.3% vs 0.4%, P < .001; chronic obstructive pulmonary disease, 17.9% vs 0.6%, P < .001; hypertension, 29.6% vs 3.0%, P < .001; end-stage renal disease, 7.2% vs 0.1%, P < .001; malignancy, 14.1% vs 0.6%, P < .001; diabetes mellitus, 11.1% vs 0.4%, P < .001; stroke, 4.6% vs 0.4%, P < .001) and in nonagenarians than centenarians (atrial fibrillation, 13.2% vs 3.5%, P < .001; heart failure, 15.8% vs 3.3%, P < .001; chronic obstructive pulmonary disease, 11.8% vs 3.5%, P < .001; hypertension, 27.2% vs 12.8%, P < .001; end-stage renal disease, 11.9% vs 4.5%, P < .001; malignancy, 8.6% vs 2.3%, P < .001; diabetes mellitus, 7.5% vs 2.2%, P < .001; and stroke, 3.5% vs 1.3%, P < .001). In a large cohort of predominantly male community-dwelling elderly veterans, centenarians had a lower incidence of chronic illness than those in their 80s and 90s, demonstrating similar compression of morbidity and extension of health span observed in other studies. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  9. 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…

  10. 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…

  11. 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…

  12. Posttraumatic stress disorder and functioning and quality of life outcomes in a nationally representative sample of male Vietnam veterans.

    PubMed

    Zatzick, D F; Marmar, C R; Weiss, D S; Browner, W S; Metzler, T J; Golding, J M; Stewart, A; Schlenger, W E; Wells, K B

    1997-12-01

    Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD and functioning and quality of life remains incompletely understood. The authors undertook an archival analysis of data from the National Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSD at the time of the interview with the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. They examined the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, currently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions. The risks of poorer outcome were significantly higher in subjects with PTSD than in subjects without PTSD in five of the six domains. For the outcome domains of physical limitations, not working, compromised physical health, and diminished well-being, these significantly higher risks persisted even in the most conservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders. The suffering associated with combat related-PTSD extends beyond the signs and symptoms of the disorder to broader areas of functional and social morbidity. The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multiply afflicted patients.

  13. Sedentary Time in Male and Female Masters and Recreational Athletes Aged 55 and Older.

    PubMed

    McCracken, Heather; Dogra, Shilpa

    2017-05-22

    The purpose of this study was to quantify sedentary time among recreational and Masters (competitive) athletes aged 55 and older. A cross-sectional survey including questions on demographics, sport participation, as well as a short form of the International Physical Activity Questionnaire, and the Measure of Older Adult's Sedentary Time questionnaire was administered (n=203). Male Masters athletes reported more time spent in vigorous intensity physical activity and less TV time than recreational athletes. Among females, being a Masters athlete was associated with being more sedentary than being a recreational athlete, while among males, being a recreational athlete was associated with being more sedentary. The intensity and duration that older Masters and recreational athletes spent in their sport was inversely associated with the amount of sedentary time accumulated. Future research using inclinometers is needed to further elucidate sedentary time in older male and female athletes.

  14. Veterans and Homelessness

    DTIC Science & Technology

    2013-11-29

    programs), employment assistance ( Homeless Veterans Reintegration Program and Compensated Work Therapy program), and transitional housing (Grant and Per...increasing. Women veterans face challenges that could contribute to their risks of homelessness . They are more likely to have experienced sexual trauma...than women in the general population and are more likely than male veterans to be single parents. Historically, few homeless programs for veterans have

  15. 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. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  16. Prewar factors in combat-related posttraumatic stress disorder: structural equation modeling with a national sample of female and male Vietnam veterans.

    PubMed

    King, D W; King, L A; Foy, D W; Gudanowski, D M

    1996-06-01

    Structural equation modeling was used to examine relationships among prewar factors, dimensions of war-zone stress, and current posttraumatic stress disorder (PTSD) symptomatology using data from 1,632 female and male participants in the National Vietnam Veterans Readjustment Study. For men, previous trauma history (accidents, assaults, and natural disasters) directly predicted PTSD and also interacted with war-zone stressor level to exacerbate PTSD symptoms for high combat-exposed veterans. Male veterans who entered the war at a younger age displayed more symptoms. Family instability, childhood antisocial behavior, and age had indirect effects on PTSD for men. For women, indirect prewar effects emanated from family instability. More attention should be given to critical developmental conditions, especially family instability and earlier trauma exposure, in conceptualizing PTSD in adults.

  17. 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.

  18. Trajectory of cost overtime after psychotherapy for depression in older Veterans via telemedicine.

    PubMed

    Egede, Leonard E; Gebregziabher, Mulugeta; Walker, Rebekah J; Payne, Elizabeth H; Acierno, Ron; Frueh, B Christopher

    2017-01-01

    Little evidence exists regarding the costs of telemedicine, especially considering changes over time. This analysis aimed to analyze trajectory of healthcare cost before, during, and after a behavioral activation intervention delivered via telepsychology and same-room delivery to elderly Veterans with depression. 241 participants were randomly assigned into one of two study groups: behavioral activation for depression via telemedicine or via same-room treatment. Patients received 8 weeks of weekly 60-min individual sessions of behavioral activation for depression. Primary outcomes were collected at 12-months. Inpatient, outpatient, pharmacy, and total costs were collected from VA Health Economics Resource Center (HERC) datasets for FY 1998-2014 and compared between the two treatment groups. Generalized mixed models were used to investigate the trajectories over time. Overall cost, as well as, outpatient and pharmacy cost show increasing trend over time. Unadjusted and adjusted trajectories over time for any cost were not different between the two treatment groups. There was a significant overall increasing trend over time for outpatient (p<0.001) and total cost (p<0.001) but not for inpatient (p=0.543) or pharmacy cost (p=0.084). Generalizability to younger, healthier populations may be limited due to inclusion criteria for study participants. Healthcare costs before, during, and after intervention did not differ between the telemedicine and in-person delivery methods. Outpatient costs accounted for most of the increasing trend of cost over time. These results support policies to use both telehealth and in-person treatment modalities to effectively and efficiently provide high quality care. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Psychosocial Functioning and Health-Related Quality of Life Associated with Posttraumatic Stress Disorder in Male and Female Iraq and Afghanistan War Veterans: The VALOR Registry.

    PubMed

    Fang, Shona C; Schnurr, Paula P; Kulish, Andrea L; Holowka, Darren W; Marx, Brian P; Keane, Terence M; Rosen, Raymond

    2015-12-01

    during treatment of PTSD for both male and female OEF/OIF veterans.

  20. 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…

  1. 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…

  2. Risk Factors for Homelessness Among US Veterans

    PubMed Central

    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

  3. 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. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Consequences of PTSD for the work and family quality of life of female and male U.S. Afghanistan and Iraq War veterans.

    PubMed

    Vogt, Dawne; Smith, Brian N; Fox, Annie B; Amoroso, Timothy; Taverna, Emily; Schnurr, Paula P

    2017-03-01

    Although it is well established that combat-related PTSD can lead to reduced quality of life, less is known about the relative effect of PTSD on different aspects of former service members' post-military readjustment. Moreover, research on female veterans' reintegration experiences is limited. This study aimed to document the work and family quality of life of post-9/11 male and female veterans and evaluate the gender-specific impact of PTSD on veterans' work and family outcomes. A national sample of 524 post-9/11 veterans completed mailed surveys as part of a longitudinal study. Descriptive and regression-based analyses were gender-stratified and weighted to enhance representativeness to the larger population. With a few notable exceptions, the majority of post-9/11 U.S. veterans reported high work and family quality of life. PTSD was not associated with either employment or relationship status; however, it did predict poorer work and family functioning and satisfaction for both men and women, with the most consistent negative effects on intimate relationships. Several gender differences were found, primarily with respect to work experiences. Although most post-9/11 veterans appear to be doing well in both their work and family lives, results support the need for interventions that can mitigate the negative effect of PTSD and other associated mental health conditions on several aspects of work and family quality of life. Findings contribute to research suggesting both similarities and differences in the post-military readjustment of male and female post-9/11 veterans and underscore the need for additional consideration of the unique work-related challenges women experience following military service.

  5. 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…

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

    PubMed

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

    2016-06-01

    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].

  7. 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

  8. Non-suicidal self-injury among psychiatric outpatient adolescent offspring of Croatian posttraumatic stress disorder male war veterans: Prevalence and psychosocial correlates.

    PubMed

    Boričević Maršanić, Vlatka; Aukst Margetić, Branka; Ožanić Bulić, Suzana; Đuretić, Irena; Kniewald, Hrvoje; Jukić, Tatjana; Paradžik, Ljubica

    2015-05-01

    The children of male veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk of emotional and behavioral problems. However, no studies have examined non-suicidal self-injury (NSSI) in this population of youth. To determine the prevalence and psychosocial correlates of lifetime NSSI in a sample of psychiatric outpatient adolescent offspring of Croatian PTSD male veterans. Consecutive outpatient adolescent offspring of Croatian male PTSD veterans, aged 12 to 18 years, were assessed on the Deliberate Self Harm Inventory, the Youth Self-Report, the Family Assessment Device, the Parental Bonding Instrument and the Demographics Questionnaire. Of the whole sample, 52.7% of adolescents reported NSSI at least once during their lifetime. Lifetime NSSI was significantly associated with internalizing symptoms (adjusted odds ratio (OR) = 2.14; 95% confidence interval (CI): 1.04-4.42, p = .040), poor family functioning (adjusted OR = 6.54; 95% CI: 2.02-21.22, p = .002), lower maternal and paternal care (adjusted OR = 0.47; 95% CI: 0.40-0.56, p = .000 and adjusted OR = 0.82; 95% CI: 0.73-0.91, p = .000, respectively) and higher paternal control (adjusted OR = 1.84; 95% CI: 1.59-2.14, p = .000) in multivariate analysis. No association was found between lifetime NSSI and any of the socio-demographic variables. NSSI is a significant clinical problem in outpatient adolescent offspring of PTSD male veterans, which may be influenced by clinical and family factors. Interventions aimed at reducing internalizing symptoms and improving family functioning and parental behaviors are needed in the treatment of adolescent offspring of male PTSD veterans engaging in NSSI. © The Author(s) 2014.

  9. 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

  10. Predictors of mental health care use among male and female veterans deployed in support of the wars in Afghanistan and Iraq.

    PubMed

    Di Leone, Brooke A L; Vogt, Dawne; Gradus, Jaimie L; Street, Amy E; Giasson, Hannah L; Resick, Patricia A

    2013-05-01

    What factors predict whether Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans who need mental health care receive that care? The present research examined factors associated with a need for care, sociodemographic characteristics, deployment experiences, and perceptions of care as gender-specific predictors of overall mental health care use and Veterans Affairs (VA) mental health care use for male and female OEF/OIF veterans (N = 1,040). Only veterans with a probable need for mental health care, as determined by scores on self-report measures of mental health symptomatology, were included in the sample. Overall, predictors of service use were similar for women and men. A notable exception was the finding that lower income predicted use of both overall and VA mental health care for women, but not men. In addition, sexual harassment was a unique predictor of VA service use for women, whereas non-White race was predictive of VA service use for men only. Knowledge regarding the factors that are associated with use of mental health care (broadly and at VA) is critical to ensuring that veterans who need mental health care receive it. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  11. Stance limb kinetics of older male athletes endurance running performance.

    PubMed

    Diss, Ceri; Gittoes, Marianne J; Tong, Richard; Kerwin, David G

    2015-09-01

    The aim of this study was to examine the age-based, lower limb kinetics of running performances of endurance athletes. Six running trials were performed by 24 male athletes, who were distinguished by three age groupings (S35: 26-32 years, M50: 50-54 years, M60+: 60-68 years). Lower limb coordinate and ground reaction force data were collected using a nine camera infra-red system synchronised with a force plate. A slower anteroposterior (M ± SD S35 = 4.13 ± 0.54 m/s: M60+ = 3.34 ± 0.40 m/s, p < 0.05) running velocity was associated with significant (p < 0.05) decreases in step length and discrete vertical ground contact force between M60+and S35 athletes. The M60+athletes simultaneously generated a 32% and 42% reduction (p < 0.05) in ankle joint moment when compared to the M50 and S35 athletes and 72% (p < 0.05) reduction in knee joint stiffness when compared to S35 athletes. Age-based declines in running performance were associated with reduced stance phase force tolerance and generation that may be accounted for due to an inhibited force-velocity muscular function of the lower limb. Joint-specific coaching strategies customised to athlete age are warranted to maintain/enhance athletes' dynamic performance.

  12. Upper airway factors that protect against obstructive sleep apnoea in healthy older males.

    PubMed

    Carlisle, Thomas; Carthy, Elliott R; Glasser, Martin; Drivas, Peter; McMillan, Alison; Cowie, Martin R; Simonds, Anita K; Morrell, Mary J

    2014-09-01

    The prevalence of obstructive sleep apnoea (OSA) increases with age, yet the risk factors for OSA in older people remain poorly understood. This study aimed to define the age-related changes in upper airway morphology in carefully matched groups of healthy older (>60 years, n=11) and younger (<40 years, n=14) males, using direct (magnetic resonance imaging (MRI)) and indirect (acoustic reflection) imaging. The median (interquartile range) combined retropalatal and retroglossal pharyngeal length was greater in older than in younger males (older 8.8 (7.8-9.0) cm, younger 7.8 (7.0-8.3) cm; p=0.03), as was the soft palate cross-sectional area (older 43.1 (36.0-48.8) cm(2), younger 35.3 (30.5-40.5) cm(2); p=0.03), parapharyngeal fat pad diameter (older 1.7 (1.4-2.2) cm, younger 1.2 (1.0-1.8) cm; p=0.03) and cross-sectional area of the fat pads (older 13.8 (9.1-17.1) cm(2); younger 7.4 (5.9-13.0) cm(2); p=0.02) as measured by MRI. Using acoustic reflection, pharyngeal calibre (older 4.8 (3.8-6.6) cm(2), younger 3.4 (2.8-4.6) cm(2); p=0.03), pharyngeal volume (older 35.1 (30.9-55.4) cm(3), younger 27.2 (22.7-44.2) cm(3); p=0.04) and glottis area (older 2.7 (2.1-3.9) cm(2), younger 1.3 (1.1-1.9) cm(2); p=0.003) were also larger in older participants compared with younger participants. There was no difference in craniofacial measures between groups, including volumetric data and hyoid bone position. The larger pharyngeal calibre observed in older males may be compensating for an age-related enlargement in pharyngeal soft tissue that predisposes to OSA. ©ERS 2014.

  13. The effect of medical comorbidities on male and female Veterans' use of psychotherapy for PTSD.

    PubMed

    Breland, Jessica Y; Greenbaum, Mark A; Zulman, Donna M; Rosen, Craig S

    2015-04-01

    Posttraumatic stress disorder (PTSD) is associated with an increased risk for medical comorbidities that may prevent participation in psychotherapy. The present study investigated whether medical comorbidities were associated with lower initiation rates and fewer psychotherapy visits for PTSD. Because women are more likely to initiate psychotherapy after traumatic events, we also assessed whether relationships were weaker among women. Veterans (N=482, 47% women) recently diagnosed with PTSD completed a survey assessing demographics, mood, functional status, and interest in treatment. Data on medical comorbidities, psychotherapy visits, antidepressant prescriptions, and service connection were assessed longitudinally through administrative files. Logistic and negative binomial regressions assessed associations between number of medical comorbidities in the 2 years before the survey and the initiation and number of psychotherapy visits for PTSD in the year after the survey. All analyses were stratified by sex and controlled for survey and administrative variables. The relationship between medical comorbidities and number of psychotherapy visits was stronger among women than among men. A greater number of medical comorbidities was associated with significantly fewer psychotherapy visits in the total sample [incidence rate ratio: 0.91; 95% confidence interval (CI): 0.83, 1.00] and among women (incidence rate ratio: 0.87; 95% CI: 0.77, 0.99), but not among men (95% CI: 0.75, 1.01). Medical comorbidities were not associated with the initiation of psychotherapy among men or women. Addressing medical comorbidities may help individuals remain in psychotherapy for PTSD. Medical comorbidities may play a larger role in the number of psychotherapy visits among women than men.

  14. A Study of Male Veterans' Beliefs toward Domestic Violence in a Batterers Intervention Program

    ERIC Educational Resources Information Center

    Craig, Mary E.; Robyak, James; Torosian, Elaine J.; Hummer, John

    2006-01-01

    Domestic violence in intimate relationships is a ubiquitous social problem. This study addresses a gap in the research literature on batterers intervention programs with heterosexual male batterers by evaluating whether or not self-reported attitudes about partner abuse and sexist beliefs could be modified over time as a result of participation in…

  15. Effects of 12 Weeks Resistance Training on Serum Irisin in Older Male Adults.

    PubMed

    Zhao, Jiexiu; Su, Zhongjun; Qu, Chaoyi; Dong, Yanan

    2017-01-01

    Background: To assess the effects of resistance training on circulating irisin concentration in older male adults, and to investigate the association between resistance training induced alteration of irisin and body fat. Methods: Seventeen older adults (mean age is 62.1 years old) were randomized into old control group (male, n = 7), and old training group (male, n = 10). The control group has no any exercise intervention. The resistance training group underwent leg muscle strength and core strength training program two times/wk, 55 min/class for 12 weeks. Before and after the intervention, we evaluated serum irisin level and body composition. Results: Serum irisin level was significantly increased in the resistance training group after the 12 weeks intervention period (P < 0.01), but not in the control group. In the resistance training group, the reduction in whole-body fat percent was negatively correlated with the increase in serum irisin level (r = -0.705, P < 0.05). Conclusion: After the 12 weeks intervention, circulating irisin levels were significantly elevated in the older adults. In summary, serum irisin may be involved in the regulation of body fat in older male adults.

  16. Effects of 12 Weeks Resistance Training on Serum Irisin in Older Male Adults

    PubMed Central

    Zhao, Jiexiu; Su, Zhongjun; Qu, Chaoyi; Dong, Yanan

    2017-01-01

    Background: To assess the effects of resistance training on circulating irisin concentration in older male adults, and to investigate the association between resistance training induced alteration of irisin and body fat. Methods: Seventeen older adults (mean age is 62.1 years old) were randomized into old control group (male, n = 7), and old training group (male, n = 10). The control group has no any exercise intervention. The resistance training group underwent leg muscle strength and core strength training program two times/wk, 55 min/class for 12 weeks. Before and after the intervention, we evaluated serum irisin level and body composition. Results: Serum irisin level was significantly increased in the resistance training group after the 12 weeks intervention period (P < 0.01), but not in the control group. In the resistance training group, the reduction in whole-body fat percent was negatively correlated with the increase in serum irisin level (r = −0.705, P < 0.05). Conclusion: After the 12 weeks intervention, circulating irisin levels were significantly elevated in the older adults. In summary, serum irisin may be involved in the regulation of body fat in older male adults. PMID:28382004

  17. In their own words: older male prisoners' health beliefs and concerns for the future.

    PubMed

    Loeb, Susan J; Steffensmeier, Darrell; Myco, Priscilla M

    2007-01-01

    U.S. prisons are experiencing an exponential growth in inmates aged 50 years and older, a group with disproportionately high disease burden. The purpose of this study was to examine, in largely exploratory terms, the health beliefs and concerns of older male inmates and the health challenges they anticipate facing upon their return to the community. Results indicate that there is much to be gained from the assessments and insights of older prisoners with regard to health changes that occur during incarceration, health programs that they desire, the reasons for their confidence (or lack thereof) in health self-management, and fears about their health upon release. Geriatric nurses are well positioned to heed these important insights of inmates and translate them into steps for 1) preventing many of the health deteriorations experienced by older prisoners and 2) advocating for more seamless health care when incarcerated offenders transition back into the community.

  18. Bone health evaluation in a veteran population: a need for the Fracture Risk Assessment Tool (FRAX).

    PubMed

    Ackman, Jamie M; Lata, Paul F; Schuna, Arthur A; Elliott, Mary E

    2014-10-01

    Approximately 2 million men in the United States have osteoporosis, but men are seldom evaluated or treated to prevent fracture. In the expanding veteran population, the fracture risk assessment tool, FRAX, could help reduce fracture risk. However, it is unknown how many veterans would meet the FRAX treatment threshold. To determine the proportion of untreated veterans who should be considered for osteoporosis treatment according to the Fracture Risk Assessment Tool (FRAX) among a randomly selected sample of older veterans receiving care at one Veterans Hospital and to determine the proportion of veterans in the sample who had received treatment. A retrospective review of 150 randomly selected charts from male veterans at least 70 years of age and female veterans at least 65 years of age receiving primary care at the William S. Middleton Memorial Veterans Hospital, Madison, WI, between January 1, 2007, and October 1, 2010. This study focused on men, but women were included per institutional review board policy. Charts from 147 men and 3 women were reviewed; 25 men had received osteoporosis treatment. Of 122 untreated men, 74 (61%) met FRAX treatment criteria, including 14 who had fractured. Although bone density testing is recommended by the National Osteoporosis Foundation for men at least 70 years old, only 21 (17%) untreated men had been tested. Most veterans who met FRAX criteria were not treated, including some who had had fractures. The VA should consider recommending FRAX to identify veterans at high risk for fracture. © The Author(s) 2014.

  19. 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.

  20. Treatment of female veterans with posttraumatic stress disorder: the role of comfort in a predominantly male environment.

    PubMed

    Fontana, Alan; Rosenheck, Robert

    2006-01-01

    This study examines the role of women's comfort in coming for treatment of posttraumatic stress disorder in a predominantly male environment. Consecutive admissions (N = 224) to the Department of Veterans Affairs (VA)'s Women's Stress Disorder Treatment Teams were enrolled in an outcome study from July 1998 through June 2000. Women reported that they were somewhat comfortable in coming to the VA for their mental health care. For women who had no prior experience with the VA, comfort increased with their exposure to the treatment program. Further, for this group of women, comfort level was related significantly to their commitment to working in therapy and the regularity of their attendance in treatment over time. There were no significant changes in comfort level for women who had prior contact with the VA. Comfort level was unrelated to satisfaction and only minimally related to clinical outcomes. The primary role of women's comfort level, therefore, appeared to be as a facilitator of their participation in the therapeutic process.

  1. Association of Admission to Veterans Affairs Hospitals vs Non-Veterans Affairs Hospitals With Mortality and Readmission Rates Among Older Men Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia.

    PubMed

    Nuti, Sudhakar V; Qin, Li; Rumsfeld, John S; Ross, Joseph S; Masoudi, Frederick A; Normand, Sharon-Lise T; Murugiah, Karthik; Bernheim, Susannah M; Suter, Lisa G; Krumholz, Harlan M

    2016-02-09

    Little contemporary information is available about comparative performance between Veterans Affairs (VA) and non-VA hospitals, particularly related to mortality and readmission rates, 2 important outcomes of care. To assess and compare mortality and readmission rates among men in VA and non-VA hospitals. Cross-sectional analysis involving male Medicare fee-for-service beneficiaries aged 65 years or older hospitalized between 2010 and 2013 in VA and non-VA acute care hospitals for acute myocardial infarction (AMI), heart failure (HF), or pneumonia using the Medicare Standard Analytic Files and Enrollment Database together with VA administrative claims data. To avoid confounding geographic effects with health care system effects, we studied VA and non-VA hospitals within the same metropolitan statistical area (MSA). Hospitalization in a VA or non-VA hospital in MSAs that contained at least 1 VA and non-VA hospital. For each condition, 30-day risk-standardized mortality rates and risk-standardized readmission rates for VA and non-VA hospitals. Mean aggregated within-MSA differences in mortality and readmission rates were also assessed. We studied 104 VA and 1513 non-VA hospitals, with each condition-outcome analysis cohort for VA and non-VA hospitals containing at least 7900 patients (men; ≥65 years), in 92 MSAs. Mortality rates were lower in VA hospitals than non-VA hospitals for AMI (13.5% vs 13.7%, P = .02; -0.2 percentage-point difference) and HF (11.4% vs 11.9%, P = .008; -0.5 percentage-point difference), but higher for pneumonia (12.6% vs 12.2%, P = .045; 0.4 percentage-point difference). In contrast, readmission rates were higher in VA hospitals for all 3 conditions (AMI, 17.8% vs 17.2%, 0.6 percentage-point difference; HF, 24.7% vs 23.5%, 1.2 percentage-point difference; pneumonia, 19.4% vs 18.7%, 0.7 percentage-point difference, all P < .001). In within-MSA comparisons, VA hospitals had lower mortality rates for AMI (percentage

  2. Association of Admission to Veterans Affairs Hospitals Versus non-Veterans Affairs Hospitals with Mortality and Readmission Rates Among Older Men Hospitalized with Acute Myocardial Infarction, Heart Failure, and Pneumonia

    PubMed Central

    Nuti, Sudhakar V.; Qin, Li; Rumsfeld, John S.; Ross, Joseph S.; Masoudi, Frederick A.; Normand, Sharon-Lise T.; Murugiah, Karthik; Bernheim, Susannah M.; Suter, Lisa G.; Krumholz, Harlan M.

    2017-01-01

    Importance Little contemporary information is available about comparative performance between Veterans Affairs (VA) and non-VA hospitals, particularly related to mortality and readmission rates, 2 important outcomes of care. Objective To assess and compare mortality and readmission rates among men in VA and non-VA hospitals. To avoid confounding geographic effects with health care system effects, we studied VA and non-VA hospitals within the same metropolitan statistical area (MSA). Design Cross-sectional analysis between 2010 and 2013 Setting Medicare Standard Analytic Files and Enrollment Database Participants Male Medicare Fee-for-Service beneficiaries aged 65 or older hospitalized between 2010 and 2013 in VA and non-VA acute care hospitals for acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Exposures Hospitalization in a VA or non-VA hospital in urban MSAs that contained at least 1 VA and non-VA hospital Main Outcomes and Measures For each condition, 30-day risk-standardized mortality rates and risk-standardized readmission rates for VA and non-VA hospitals. Mean-aggregated within-MSA differences in mortality and readmission rates were also assessed. Results We studied 104 VA and 1,513 non-VA hospitals, with each condition-outcome analysis cohort for VA and non-VA hospitals containing at least 7,900 patients, in 92 MSAs. Mortality rates were lower in VA hospitals than non-VA hospitals for AMI (13.5% vs. 13.7%, p=0.02; −0.2 percentage point difference) and HF (11.4% vs. 11.9%, p=0.008; −0.5 percentage point difference), but higher for pneumonia (12.6% vs. 12.2%, p<0.05; 0.4 percentage point difference). In contrast, readmission rates were higher in VA hospitals for all 3 conditions (AMI: 17.8% vs. 17.2%, 0.6 percentage point difference; HF: 24.7% vs. 23.5%, 1.2 percentage point difference; pneumonia: 19.4% vs. 18.7%, 0.7 percentage point difference, all p<0.001). In within-MSA comparisons, VA hospitals had lower mortality rates for AMI

  3. A study of male veterans' beliefs toward domestic violence in a batterers intervention program.

    PubMed

    Craig, Mary E; Robyak, James; Torosian, Elaine J; Hummer, John

    2006-09-01

    Domestic violence in intimate relationships is a ubiquitous social problem. This study addresses a gap in the research literature on batterers intervention programs with heterosexual male batterers by evaluating whether or not self-reported attitudes about partner abuse and sexist beliefs could be modified over time as a result of participation in a Batterers Intervention Program (BIP). Using the Inventory of Beliefs about Partner Abuse (IBAPA) to measure attitudes toward domestic violence and the Ambivalent Sexism Inventory (ASI) to measure sexist beliefs, results of the study provide empirical support for the notion that participation in BIPs affects the self-reported beliefs about their rights to physically and emotionally abuse their partner. These self-reported scores were adjusted for response bias by the long version of the Marlowe-Crowne Social Desirability Scale (MCD). Response bias and how it is treated in self-report measures with batterers is also discussed.

  4. Association between Alcohol Screening Scores and Mortality in Black, Hispanic, and White Male Veterans

    PubMed Central

    Williams, Emily C.; Bradley, Katharine A.; Gupta, Shalini; Harris, Alex H.S.

    2012-01-01

    Background AUDIT-C alcohol screening scores are associated with mortality, but whether or how associations vary across race/ethnicity is unknown. Methods Self-reported black (n=13,068), Hispanic (n=9,466), and white (n=182,688) male VA outpatients completed the AUDIT-C via mailed survey. Logistic regression models evaluated whether race/ethnicity modified the association between AUDIT-C scores (0, 1–4, 5–8, and 9–12) and mortality after 24 months, adjusting for demographics, smoking, and comorbidity. Results Adjusted mortality rates were 0.036, 0.033, and 0.054, for black, Hispanic, and white patients with AUDIT-C scores of 1–4, respectively. Race/ethnicity modified the association between AUDIT-C scores and mortality (p=0.0022). Hispanic and white patients with scores of 0, 5–8, and 9–12 had significantly increased risk of death compared to those with scores of 1–4; Hispanic ORs: 1.93, 95% CI 1.50–2.49; 1.57, 1.07–2.30; 1.82, 1.04–3.17, respectively; white ORs: 1.34, 95% CI 1.29–1.40; 1.12, 1.03–1.21; 1.81, 1.59–2.07, respectively. Black patients with scores of 0 and 5–8 had increased risk relative to scores of 1–4 (ORs 1.28, 1.06–1.56 and 1.50, 1.13–1.99), but there was no significant increased risk for scores of 9–12 (ORs 1.27, 0.77–2.09). Post-hoc exploratory analyses suggested an interaction between smoking and AUDIT-C scores might account for some of the observed differences across race/ethnicity. Conclusions Among male VA outpatients, associations between alcohol screening scores and mortality varied significantly depending on race/ethnicity. Findings could be integrated into systems with automated risk calculators to provide demographically-tailored feedback regarding medical consequences of drinking. PMID:22676340

  5. The consequences of antisocial behavior in older male siblings for younger brothers and sisters.

    PubMed

    Snyder, Jim; Bank, Lew; Burraston, Bert

    2005-12-01

    The contribution of younger male and female siblings' conflict and involvement in deviant activities with their older brothers to younger siblings' adolescent adjustment problems was examined in the context of parenting. Ineffective parenting during younger siblings' childhood had no direct effects on adjustment but facilitated their exposure to older brothers' deviant peers and activities. The effect of sibling conflict on adjustment was mediated by younger siblings' coparticipation in deviant activities with their older brothers during adolescence. Early sibling conflict and coparticipation in deviant activities synergistically increased the risk for younger siblings' adolescent adjustment problems. These empirical relations held in the context of parental discipline of younger siblings during adolescence. Sibling relationships entail a set of iterative social processes that strongly influence risk for adolescent antisocial behavior, drug use, sexual behavior, and traumatic experience. Variations in sibling influence were observed conditional on the gender combination of the sibling pair and on sibling age differences. Copyright 2006 APA, all rights reserved).

  6. Comparison of health related quality of life between two groups of veteran and non-veteran spinal cord injured patients.

    PubMed

    Salamati, Payman; Rostami, Reza; Saadat, Soheil; Taheri, Taher; Tajabadi, Maryam; Ranjbari, Ghazale; Naji, Zohrehsadat; Jafarpour, Saba; Rahimi-Movaghar, Vafa

    2015-01-01

    Patients with spinal cord injury (SCI) have a lower health related quality of life (HRQOL) compared to both healthy controls and the normal population. The aim of this study was to compare HRQOL between two groups of veteran and non-veteran SCI patients. All male paraplegic non-veterans who had sustained complete SCI before 1988 and were residents of Tehran province (Iran), and a similar group of SCI veterans who consecutively participated in a health screening program were enrolled in this study. Patients fewer than 35 and older than 65 years of age were not included in this study. The participants were interviewed based on the Persian version of SF-36 questionnaire by two psychologists. Eight sub-scales and two physical and mental component summaries of the instrument were assessed. We used chi-square, odds ratio, Mann-Whitney U, independent t-test and linear regression for analysis. Overall, 25 veterans and 22 non-veterans were enrolled in the study. The mean age, time since injury and the presence of comorbid illnesses were not significantly different between the two groups (P>0.05). A greater number of veterans were married (p= 0.003) and employed (p= 0.047). On average, veterans had more years of formal education than non-veterans (p= 0.001). The mean (SD) bodily pain sub-scale was 72.73(31.253) for non-veterans and 49.7 (28.287) for veterans (p=0.011). Absence of comorbid illnesses was associated with a better physical component summary (p< 0.001). Employment was associated with a better mental component summary (p= 0.022). We did not find any differences in HRQOL between the two groups except for the bodily pain sub-scale. Further studies with larger sample sizes are recommended.

  7. Comparison of health related quality of life between two groups of veteran and non-veteran spinal cord injured patients

    PubMed Central

    Salamati, Payman; Rostami, Reza; Saadat, Soheil; Taheri, Taher; Tajabadi, Maryam; Ranjbari, Ghazale; Naji, Zohrehsadat; Jafarpour, Saba; Rahimi-Movaghar, Vafa

    2015-01-01

    Background: Patients with spinal cord injury (SCI) have a lower health related quality of life (HRQOL) compared to both healthy controls and the normal population. The aim of this study was to compare HRQOL between two groups of veteran and non-veteran SCI patients. Methods: All male paraplegic non-veterans who had sustained complete SCI before 1988 and were residents of Tehran province (Iran), and a similar group of SCI veterans who consecutively participated in a health screening program were enrolled in this study. Patients fewer than 35 and older than 65 years of age were not included in this study. The participants were interviewed based on the Persian version of SF-36 questionnaire by two psychologists. Eight sub-scales and two physical and mental component summaries of the instrument were assessed. We used chi-square, odds ratio, Mann-Whitney U, independent t-test and linear regression for analysis. Results: Overall, 25 veterans and 22 non-veterans were enrolled in the study. The mean age, time since injury and the presence of comorbid illnesses were not significantly different between the two groups (P>0.05). A greater number of veterans were married (p= 0.003) and employed (p= 0.047). On average, veterans had more years of formal education than non-veterans (p= 0.001). The mean (SD) bodily pain sub-scale was 72.73(31.253) for non-veterans and 49.7 (28.287) for veterans (p=0.011). Absence of comorbid illnesses was associated with a better physical component summary (p< 0.001). Employment was associated with a better mental component summary (p= 0.022). Conclusion: We did not find any differences in HRQOL between the two groups except for the bodily pain sub-scale. Further studies with larger sample sizes are recommended. PMID:26157716

  8. 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

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

    PubMed

    Scott, Lionel D; McMillen, J Curtis; Snowden, Lonnie R

    2015-02-01

    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.

  10. 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

  11. 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

  12. 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.

  13. Prevalence of vitamin D deficiency and association with functional status in newly admitted male veteran nursing home residents.

    PubMed

    Kojima, Gotaro; Tamai, Anna; Masaki, Kamal; Gatchell, Gregory; Epure, James; China, Craig; Ross, G Webster; Petrovitch, Helen; Tanabe, Marianne

    2013-11-01

    To provide the first report on prevalence of vitamin D deficiency in newly admitted nursing home (NH) residents and associations with functional disabilities and chronic diseases. Retrospective chart review. Nursing home (NH). Male veterans newly admitted to a NH for rehabilitation, skilled-nursing care, intermediate care, or respite care between January 2011 and June 2012. Total serum 25-hydroxyvitamin D (25(OH)D) levels were measured on admission. Vitamin D supplement users and those without 25(OH)D measurement within 7 days of admission were excluded, leaving an analytical sample of 104 residents. Vitamin D deficiency was defined as 25(OH)D less than 20 ng/mL. Data were collected on age, ethnicity, season, body mass index (BMI), functional disability in activities of daily living (ADLs) (mobility, bathing, dressing, toileting, continence, and feeding), and prevalent chronic diseases. Prevalence of vitamin D deficiency was 49.0%. In multivariate logistic regression models adjusted for age, ethnicity, and BMI, vitamin D deficiency was significantly associated with number of ADL disabilities (odds ratio (OR) = 1.4 for each 1-point increase in ADL disability score, P = .03) and prevalent diabetes mellitus (OR = 3.0, P = .03). In regression models using each ADL disability as a separate variable, only disability in feeding (OR = 4.7, P = .05) and diabetes mellitus (OR = 2.9, P = .04) remained significant. Almost half the individuals entering the NH and not taking vitamin D supplements had vitamin D deficiency. Greater number of ADL disabilities, disability in feeding, and prevalent diabetes mellitus were independently associated with vitamin D deficiency. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  14. Pyridostigmine bromide and the long-term subjective health status of a sample of over 700 male Reserve Component Gulf War era veterans.

    PubMed

    Schumm, Walter R; Reppert, Earl J; Jurich, Anthony P; Bollman, Stephan R; Webb, Farrell J; Castelo, Carlos S; Stever, James C; Kaufman, Mark; Deng, Liang-Yu; Krehbiel, Michelle; Owens, Barbara L; Hall, Carolyn A; Brown, Beverlyn F Cay; Lash, Jeanne F; Fink, Carol J; Crow, Janet R; Bonjour, Gabriele N

    2002-06-01

    Data from a 1996-1997 survey of approximately 700 Reserve Component male veterans indicate that the consumption of pyridostigmine bromide pills, used as a pretreatment for potential exposure to the nerve agent Soman, was a significant predictor of declines in reported subjective health status after the war, even after controlling for a number of other possible factors. Reported reactions to vaccines and other medications also predicted declines in subjective health. While higher military rank generally predicted better health during and after the war, educational attainment, minority status, number of days in theater, and age generally did not predict changes in subjective health. Although servicemembers were directed to take three pills a day, veterans reported a range of compliance--less than a fourth (24%) followed the medical instructions compared to 61% who took fewer than three pills daily and 6% who took six or more pills a day. Implications for use of pyridostigmine bromide are discussed.

  15. Resilience-recovery factors in post-traumatic stress disorder among female and male Vietnam veterans: hardiness, postwar social support, and additional stressful life events.

    PubMed

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

    1998-02-01

    Structural equation modeling procedures were used to examine relationships among several war zone stressor dimensions, resilience-recovery factors, and post-traumatic stress disorder symptoms in a national sample of 1,632 Vietnam veterans (26% women and 74% men). A 9-factor measurement model was specified on a mixed-gender subsample of the data and then replicated on separate subsamples of female and male veterans. For both genders, the structural models supported strong mediation effects for the intrapersonal resource characteristic of hardiness, postwar structural and functional social support, and additional negative life events in the postwar period. Support for moderator effects or buffering in terms of interactions between war zone stressor level and resilience-recovery factors was minimal.

  16. Predictors of Self-Efficacy and Self-Rated Health for Older Male Inmates

    PubMed Central

    Steffensmeier, Darrell; Kassab, Cathy

    2010-01-01

    Aims To examine: (1) the relationships between self-efficacy for health management and (a) health-promoting behaviors, (b) health-monitoring behaviors, and (c) self-rated health status in older male prisoners; and (2) the variations in self-rated health status and self-efficacy for health management by inmate characteristics of older men in prison. Background The graying of the inmate population around the globe can be attributed to increases in punitive crime control practices, life expectancy; and the aging baby boom generation. Older inmates are typically not a healthy group. Therefore, the needs of burgeoning numbers of older, sicker inmates are issues of international significance. Methods A descriptive, correlational, survey was conducted from late 2007 to mid-2008 with Bandura’s self-efficacy model as the guiding framework. Results/Findings Participants were 131 male inmates, age 50 and older. A significant positive relationship was found between self-efficacy for health management and the indexes measuring health-promoting behaviors (r=0.550; P<0.001), health-monitoring behaviors (r=0.323; P=0.001), and the single item rating for self-rated health (τb=0.411; P<0.001). There was a tendency for education to be positively related to self-rated health, but not self-efficacy (τb =0.140; P=0.054 and τb=0.105; P=0.122, respectively). Years of incarceration was not significantly related to self-rated health or self-efficacy. Conclusion These research findings support Bandura’s self-efficacy theoretical work and its applicability to health-related research in prisons. Nurses are front line health care providers in prison, who are in a key position to implement interventions that promote greater inmate self-efficacy for healthy behaviors and chronic disease management. PMID:21198807

  17. Military sexual trauma in US veterans: results from the National Health and Resilience in Veterans Study.

    PubMed

    Klingensmith, Katherine; Tsai, Jack; Mota, Natalie; Southwick, Steven M; Pietrzak, Robert H

    2014-10-01

    To evaluate the prevalence of military sexual trauma (MST) among US veterans, identify sociodemographic and military characteristics of MST, and examine the relationships between MST and psychiatric comorbidities, functioning/quality of life, and mental health treatment utilization. Data were analyzed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 1,484 US veterans conducted September-October 2013. Poststratification weights were applied to analyses to permit generalizability of results to the US veteran population. Outcomes measured include history of MST, trauma histories, lifetime and current DSM-IV mental disorders, functioning and quality of life, and utilization of mental health treatment. The overall prevalence of MST was 7.6% and was higher among female than male veterans (32.4% vs 4.8%) and younger than older veterans (22.8% among veterans aged 18-29 years vs 4.5% among veterans aged 60+ years). After adjustment for sociodemographic and military characteristics, MST was associated with elevated rates of current major depressive disorder, posttraumatic stress disorder, and generalized anxiety disorder (adjusted odds ratio [aOR] range, 2.19-3.12); past history of suicide attempt (aOR = 2.78) and current suicidal ideation (aOR = 2.19); and decreased mental and cognitive functioning and quality of life (Cohen d, 0.23-0.38). MST was also associated with increased current utilization of psychotropic medication (aOR = 3.70) and psychotherapy or counseling (aOR = 2.41), independent of psychiatric morbidities. 7.6% of US veterans screen positive for MST, with substantially higher rates among female and younger veterans. MST is associated with elevated rates of several psychiatric morbidities and suicidality, reduced functioning and quality of life, and increased mental health treatment utilization, independent of other sociodemographic, military, and mental health factors. These results suggest that

  18. Evaluating the Impact of Medication Safety Alerts on Prescribing of Potentially Inappropriate Medications for Older Veterans in an Ambulatory Care Setting.

    PubMed

    Vanderman, Adam J; Moss, Jason M; Bryan, William E; Sloane, Richard; Jackson, George L; Hastings, S Nicole

    2017-02-01

    Potentially inappropriate medications (PIMs) have been associated with poor outcomes in older adults. Electronic health record (EHR)-based interventions may be an effective way to reduce PIM prescribing. The main objective of this study was to evaluate changes in PIM prescribing to older adult veterans ≥65 years old in the ambulatory care setting preimplementation and postimplementation of medication alert messages at the point of computerized provider order entry (CPOE). Additional exploratory objectives included evaluating provider type and patient-provider relationship as a factor for change in PIM prescribing. A total of 1539 patients prealert and 1490 patients postalert were prescribed 1952 and 1897 PIMs, respectively. End points were reported as the proportion of new PIM orders of total new prescriptions. There was no significant difference in the rate of new PIMs prealert and postalert overall, 12.6% to 12.0% ( P = .13). However, there was a significant reduction in the rate of the top 10 most common newly prescribed PIMs, 9.0% to 8.3% ( P = .016), and resident providers prescribed fewer PIMs during both time periods. A simple, age-specific medication alert message during CPOE decreased the incidence of the most frequently prescribed PIMs in older adults receiving care in an ambulatory care setting.

  19. 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

  20. 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).

  1. "Strength at Home" Intervention for Male Veterans Perpetrating Intimate Partner Aggression: Perceived Needs Survey of Therapists and Pilot Effectiveness Study.

    PubMed

    Love, Allison R; Morland, Leslie A; Menez, Ursula; Taft, Casey; MacDonald, Alexandra; Mackintosh, Margaret-Anne

    2015-08-01

    Veteran and active duty populations evidence higher rates of intimate partner aggression (IPA) than comparable civilian groups, perhaps due in part to their unique service-related experiences. IPA offender treatment programs that take military background into consideration are not widely available, and it is unclear to what extent there is a perceived need for them among clinicians who serve service members and Veterans. Strength at Home (SAH) is a promising 12-session cognitive-behavioral group intervention designed to address IPA perpetration in military populations. While clinical support for SAH is emerging, the extent to which service members and Veterans find it appropriate and helpful is not yet known. Goals of the current study were threefold: (a) assess the perceived need for a military-specific IPA program among Veterans Administration and community domestic violence (DV) program providers; (b) conduct a pilot study to examine the feasibility and preliminary effectiveness of SAH in a sample drawn from a diverse, multicultural community; and (c) conduct focus groups to obtain participant feedback on the SAH protocol. Findings from the provider survey suggested a need for specialty programs to treat military personnel who perpetrate IPA of mildtomoderate severity. Results of the SAH pilot study (n = 6) indicated decreased psychological aggression and increased anger control from baseline to 6-month follow-up. Focus group feedback indicated participants found the program to be helpful and appropriate across a wide variety of ethno-cultural variables. As more service members and Veterans of the Iraq/Afghanistan war era reintegrate into our communities, it will become increasingly important for providers in both private and public sectors of care to understand the unique needs of this treatment population, and to have access to effective IPA treatment programs.

  2. Gene expression profiling of dilated cardiomyopathy in older male EP4 knockout mice

    PubMed Central

    Harding, Pamela; Yang, Xiao-Ping; Yang, James; Shesely, Ed; He, Quan

    2010-01-01

    Using a line of mice with cardiac-specific knockout (KO) of the EP4 receptor gene, experiments were designed to determine whether a cardiac phenotype developed with age. Cardiac function was assessed by echocardiography in 23- to 33-wk-old male and female KO and littermate controls (WT) mice. After echocardiography, hearts were removed to assess weight, and then some were further processed for histology [myocyte cross-sectional area (MCSA), interstitial collagen fraction (ICF), and macrophage infiltration] and some for extraction of total RNA and protein. Older male KO mice had reduced ejection fraction (EF) coupled with left ventricular dilatation. MCSA and infiltrating macrophages were not different between groups, but ICF increased by 39% in KO mice. In contrast to male KO mice, 30- to 32-wk-old female KO mice had only a slight reduction in EF. To understand gene expression differences between male WT and KO mice, we performed whole genome gene expression profiling (Illumina BeadChips) on hearts of 30-to 32-wk-old mice. Data indicated that 156 genes were overexpressed in the KO hearts more than twofold, including genes involved in remodeling, inflammation, and oxidative stress. Overexpressed chemokines/cytokines were further examined in hearts of 10- to 12-wk-old male KO mice, and we found that growth differentiation factor-15 (GDF-15) expression was higher in KO than in WT hearts. In conclusion, EP4 knockdown in cardiac myocytes in aged male KO mice is in part associated with increased fibrosis, reduced EF, and dilated cardiomyopathy. Early overexpression of GDF-15 in hearts of male KO mice may contribute to or be a marker of the disease phenotype. The absence of serious cardiac dysfunction in aged female mice suggests a sexual dimorphism in the phenotype. PMID:20008274

  3. Association between Time on Protease Inhibitors and the Incidence of Squamous Cell Carcinoma of the Anus among U.S. Male Veterans.

    PubMed

    Mbang, Pamela A; Kowalkowski, Marc A; Amirian, E Susan; Giordano, Thomas P; Richardson, Peter A; Hartman, Christine M; Chiao, Elizabeth Y

    2015-01-01

    Protease inhibitors (PIs) have been shown to have anti-tumor activity in addition to their antiretroviral properties. We sought to assess the association between PI use and the incidence of squamous cell carcinoma of the anus (SCCA) in HIV-infected individuals. We performed a retrospective cohort study among male US veterans diagnosed with HIV who were diagnosed between 1985 and 2010, using the Veterans Affairs HIV Clinical Case Registry (CCR). We calculated hazards ratios associated with PI use (both as percent time on PI and as 12-month intervals of PI use), utilizing time-dependent Cox models. We adjusted for risk factors, including age, race, year of enrolment into CCR, recent and nadir CD4, and percent time undetectable HIV viral load. A total of 28, 886 HIV-infected men met inclusion criteria. Of these, 373 were newly diagnosed with SCCA during the study period. In multivariate analysis, increasing percent time on PIs was associated with an increased risk of SCCA (aHR 1.07; 95% CI = 1.03-1.10 per 10% increase in time on PI). Poor immunologic recovery and virologic control, a history of condylomata acuminata, and CCR enrolment in the late combined antiretroviral therapy era were also associated with increased SCCA risk. Increasing percent time on a PI-based combined antiretroviral therapy regimen may be associated with an increased risk of developing SCCA in HIV-infected male US veterans. Future studies, better accounting for HIV control and treatment compliance, are necessary to further clarify this association.

  4. Association between Time on Protease Inhibitors and the Incidence of Squamous Cell Carcinoma of the Anus among U.S. Male Veterans

    PubMed Central

    Mbang, Pamela A.; Kowalkowski, Marc A.; Amirian, E. Susan; Giordano, Thomas P.; Richardson, Peter A.; Hartman, Christine M.; Chiao, Elizabeth Y.

    2015-01-01

    Protease inhibitors (PIs) have been shown to have anti-tumor activity in addition to their antiretroviral properties. We sought to assess the association between PI use and the incidence of squamous cell carcinoma of the anus (SCCA) in HIV-infected individuals. We performed a retrospective cohort study among male US veterans diagnosed with HIV who were diagnosed between 1985 and 2010, using the Veterans Affairs HIV Clinical Case Registry (CCR). We calculated hazards ratios associated with PI use (both as percent time on PI and as 12-month intervals of PI use), utilizing time-dependent Cox models. We adjusted for risk factors, including age, race, year of enrolment into CCR, recent and nadir CD4, and percent time undetectable HIV viral load. A total of 28, 886 HIV-infected men met inclusion criteria. Of these, 373 were newly diagnosed with SCCA during the study period. In multivariate analysis, increasing percent time on PIs was associated with an increased risk of SCCA (aHR 1.07; 95% CI = 1.03–1.10 per 10% increase in time on PI). Poor immunologic recovery and virologic control, a history of condylomata acuminata, and CCR enrolment in the late combined antiretroviral therapy era were also associated with increased SCCA risk. Increasing percent time on a PI-based combined antiretroviral therapy regimen may be associated with an increased risk of developing SCCA in HIV-infected male US veterans. Future studies, better accounting for HIV control and treatment compliance, are necessary to further clarify this association. PMID:26629701

  5. Disease management for depression and at-risk drinking via telephone in an older population of veterans.

    PubMed

    Oslin, David W; Sayers, Steven; Ross, Jennifer; Kane, Vince; Ten Have, Thomas; Conigliaro, Joseph; Cornelius, Jack

    2003-01-01

    The purpose of this study was to explore the efficacy in a primary care setting of a telephone-based disease management program for the acute management of depression and/or at-risk drinking. Veterans (N= 97) with depression and/or at-risk drinking were identified by systematic screening and assessment. Eligible subjects received either telephone disease management (TDM) program or usual care based on random assignment of their clinician. The TDM program consisted of regular contacts with each subject by a behavioral health specialist (BHS) to assist in assessment, education, support, and treatment planning. Symptomatic outcomes were assessed at 4 months. Overall response rates favored those assigned to TDM compared with those assigned to usual care (39.1% responded vs. 17.6%, p= 0.022). Response rates within the separate diagnostic groups also favored TDM, but this was only significant for depressive disorders. Although the sample size was modest and the sample was limited to veterans, findings strongly suggest that a telephone-based disease management program can improve outcomes for patients with a behavioral health problem. Findings also suggest that a health specialist can focus and manage patients with different diagnoses, thus expanding the role beyond just depression care. TDM may be a viable, low-cost, model for primary care clinicians to deliver manual guideline-adherent behavioral health care, especially in a VA clinical setting.

  6. Body mass index and functional status in community dwelling older Turkish males.

    PubMed

    Bahat, Gulistan; Muratlı, Sevilay; İlhan, Birkan; Tufan, Asli; Tufan, Fatih; Aydin, Yucel; Erten, Nilgun; Karan, Mehmet Akif

    2015-01-01

    Disability is utmost important on an aging population's health. Obesity is associated with increased risk for disability. On-the-other-hand, higher-BMI is reported as associated with better functionality in older people in some reports defined as "obesity paradox". There is some evidence on differential relationship between body weight status and functionality by living setting gender, and different populations. We studied the relation between body mass index and functionality in Turkish community dwelling older males accounting for the most confounding factors: age, multimorbidity, polypharmacy and nutritional status. This is a cross-sectional study in a geriatric outpatient clinic of a university hospital. Functionality was assessed with evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Nutrition was assessed by mini-nutritional assessment test. Two hundred seventy-four subjects comprised our study cohort. Mean age was 74.4 ± 7.1 years, BMI was 25.8 ± 4.4 kg/m(2). Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (B = 0.047 and B = 0.128, respectively) (p < 0.05) and better nutritional status (B = 1.94 and B = 3.05, respectively) (p < 0.001) but not with the total number of medications. Higher IADL score was associated with younger age and lower total number of diseases (B = 0.121, B = 0.595, respectively) (p < 0.05) while ADL was not. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling male older people. Our study recommends longitudinal studies with higher participants from different populations, genders and living settings are needed to comment more.

  7. Impact of Malnutrition on Physical, Cognitive Function and Mortality among Older Men Living in Veteran Homes by Minimum Data Set: A Prospective Cohort Study in Taiwan.

    PubMed

    Chen, L-Y; Liu, L-K; Hwang, A-C; Lin, M-H; Peng, L-N; Chen, L-K; Lan, C-F; Chang, P-L

    2016-01-01

    To evaluate the prevalence of malnutrition and its impact on mortality, functional decline and cognitive impairment among elder residents in long-term care settings. A prospective cohort study. Two veteran homes in Taiwan. A total of 1,248 male residents aged equal or more than 65 years. Charlson's comorbidity index (CCI), Minimum data set (MDS), resident assessment protocols (RAP), Activity of daily living-Hierarchy scale, Cognitive Performance Scale, MDS Social engagement scale. The mean age of participants is 83.1 ± 5.1 years, and the prevalence of malnutrition was 6.1%. Inadequate dietary content (57.9%) and unintentional weight loss (31.6%) account for the majority of malnutrition identified by MDS tool. Higher 18-month mortality rate (25% vs. 14.2%), higher baseline CCI (median 1 vs. 0), and higher baseline sum of RAP triggers (median 8.5 vs. 5) were noted among residents with malnutrition. Furthermore, malnutrition was shown predictive for functional decline (OR: 3.096, 95% CI: 1.715-5.587) and potential cognitive improvement (OR: 2.469, 95% CI: 1.188-5.128) among survivors after adjustment for age, body mass index and CCI. Malnutrition among elder men residing in veteran homes was associated with multimorbidities and higher care complexity, and was predictive for mortality and functional decline.

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

    PubMed

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

    2014-03-01

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

  9. Evidence-based psychotherapy (EBP) non-initiation among veterans offered an EBP for posttraumatic stress disorder.

    PubMed

    Keller, Stephanie M; Tuerk, Peter W

    2016-02-01

    Current efforts to disseminate evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) in Veterans Affairs Medical Centers (VAMCs) have made effective treatment options more available throughout the system. Yet many veterans identified as likely to benefit from such services choose not to utilize them. The evidence base regarding factors that contribute to treatment initiation among those offered EBPs is still in its early stages. The present study investigated clinical presentation, patient demographics, and environment of care factors as potential predictors of EBP treatment initiation among veterans offered such care. The sample consisted of 324 veterans (62% Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]; 77% male; age M = 42.95, SD = 12.57 years), who attended an intake evaluation at a VAMC outpatient PTSD Clinical Team, were diagnosed with PTSD, and offered a course of EBP. Overall, 72% of veterans (n = 232) who were offered an EBP initiated such treatment, and 28% of veterans (n = 92) did not initiate treatment. Veterans who initiated treatment were significantly older. Treatment initiation did not significantly differ by ethnicity, gender, or baseline PTSD severity. Significantly more veterans referred from mental health clinics initiated treatment than did veterans referred from primary care. This study examined treatment initiation among veterans who were offered EBP for PTSD. Rates of initiation differed across subgroups of veterans. Clinically, this suggests the need to tailor outreach efforts to younger veterans, OEF/OIF veterans, and veterans referred from primary care, and potentially including programming and education aimed at primary care referrers, to increase help-seeking. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Health-protective and Adverse Effects of the Apolipoprotein E ε2 Allele in Older Males

    PubMed Central

    Kulminski, Alexander M.; Ukraintseva, Svetlana V.; Arbeev, Konstantin G.; Manton, Kenneth G.; Oshima, Junko; Martin, George M.; Il'yasova, Dora; Yashin, Anatoli I.

    2009-01-01

    OBJECTIVES: To re-examine a health-protective role of the common Apolipoprotein E (APOE) polymorphism focusing on connections between the APOE ε2-containing genotypes and impairments in instrumental activities of daily living [IADL] in older (65+) males and females. To examine how these connections may be mediated by diagnosed coronary heart disease (CHD), Alzheimer's disease, colorectal cancer, macular degeneration (MD), and atherosclerosis. DESIGN: Retrospective cross-sectional study. SETTING: The unique disability-focused data from a genetic sub-sample of the 1999 National Long Term Care Survey linked with Medicare service use files. PARTICIPANTS: 1733 genotyped individuals interviewed on IADL disabilities. MEASUREMENTS: Indicators of IADL impairments, five geriatric disorders, and ε2-containing genotypes. RESULTS: The ε2/3 genotype is a major contributor to adverse associations between the ε2 allele and IADL disability in males [Odds Ratio (OR)=3.09, Confidence Interval (CI)=1.53-6.26)]. It shows, however, significant protective effects for CHD (OR=0.55, CI=0.33-0.92), while CHD is adversely associated with IADL disability (OR=2.18, CI=1.28-3.72). The presence of five diseases does not significantly alter the adverse association between ε2-containing genotypes and disability. Protective effects of the ε2/3 genotype for CHD (OR=0.52, CI=0.27-0.99) and deleterious effects for IADL (OR=3.50, CI=1.71-7.14) for males hold in multivariate models with both these factors included. No significant associations between the ε2-containing genotypes and IADL are found in females. CONCLUSIONS: The ε2 allele can play a dual role in males, protecting them against some health disorders, while promoting others. Strong adverse relationships with disability suggest that ε2-containing genotypes can be unfavorable factors for the health/well-being of aging males. PMID:18179501

  11. Folic Acid Supplementation Is Suboptimal in a National Cohort of Older Veterans Receiving Low Dose Oral Methotrexate

    PubMed Central

    Tonner, Chris; Miao, Yinghui; Yazdany, Jinoos; Gannon, Jacqueline; Boscardin, W. John; Daikh, David I.; Steinman, Michael A.

    2016-01-01

    Objectives Co-prescription of folic acid in patients receiving low dose oral methotrexate is recommended because it reduces adverse events and prolongs the use of methotrexate (MTX). However, little is known about how often new users of methotrexate are co-prescribed folic acid, and what factors are associated with its use. We aimed to determine the prevalence, predictors of, and persistence of folic acid use in a population-based cohort of MTX users with rheumatic diseases. Methods Using a national, administrative database of patients seen through the Veterans Health Administration (VHA) that included pharmacy and laboratory data, we performed an observational cohort study of veterans over 65 years old who were new users of MTX. We used log-binomial regression to identify independent predictors of folic acid use and Kaplan Meyer survival analysis to examine persistence of folic acid over time. Results We studied 2467 incident users of MTX. 27% of patients were not prescribed folic acid through the VHA pharmacy within 30 days of MTX initiation. Patients who did not see a rheumatologist were 23% less likely to receive folic acid compared to patients who did have a rheumatologist visit during the baseline period (RR (95% CI) 0.77 (0.72, 0.82). These results remained unchanged even after adjusting for demographic, clinical, and other factors (adjusted RR (95% CI) 0.78 (0.74, 0.85)). After 20 months, only 50% of patients continued to receive folic acid. Conclusions In a nationwide VHA cohort of new users of oral MTX, many patients did not receive folic acid or discontinued it over time. Rheumatologists were more likely to prescribe folic acid than other providers. These data highlight the need to improve patient safety for users of methotrexate by standardizing workflows for folic acid supplementation. PMID:27977768

  12. 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.

  13. Social Security Contributions and Return Migration Among Older Male Mexican Immigrants.

    PubMed

    Aguila, Emma; Vega, Alma

    2017-06-01

    For decades, scholars have studied the effects of immigration on the U.S. social security system. To date, this research has been primarily limited to migrants within the United States and does not consider those who return to their countries of origin. We estimate the proportion of male Mexican return migrants who contributed to the U.S. social security system and analyze their socioeconomic characteristics and migration histories. We also estimate the proportion that receive or expect to receive U.S. social security benefits. Using probit regression on the 2012 Mexican Health and Aging Study (MHAS), we describe the predictors of having contributed to the U.S. social security system among Mexican males in Mexico aged 50 years and older who at some point lived in the United States. We find that 32% of male return migrants reported having contributed to the U.S. social security system, but only 5% of those who contributed, received or expected to receive benefits. Those who reported having contributed spent more years in the United States and were more likely to be U.S. citizens or legal permanent residents than those who did not contribute. Immigrants often pay Old-Age, Survivors, and Disability Insurance taxes using legitimate or illegitimate social security numbers and return to their home countries without collecting U.S. social security benefits.

  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. All-cause mortality and risk factors in a cohort of retired military male veterans, Xi'an, China: an 18-year follow up study

    PubMed Central

    Sai, Xiao Y; He, Yao; Men, Ke; Wang, Bo; Huang, Jiu Y; Shi, Qiu L; Zhang, Lei; Li, Liang S; Choi, Bernard CK; Yan, Yong P

    2007-01-01

    Background Risk factors of all-cause mortality have not been reported in Chinese retired military veterans. The objective of the study was to examine the risk factors and proportional mortality in a Chinese retired military male cohort. Methods A total of 1268 retired military men aged 55 or older were examined physically and interviewed using a standard questionnaire in 1987. The cohort was followed up every two years and the study censored date was June30, 2005 with a follow-up of up to 18 years. Death certificates were obtained from hospitals and verified by two senior doctors. Data were entered (double entry) by Foxbase, and analysis was carried out by SAS for Windows 8.2. Multivariate Cox proportional hazard regression model was used to compute hazard ratio (HR) and 95% confidence interval (CI). Results The total person-years of follow-up was 18766.28. Of the initial cohort of 1268 men, 491 had died, 748 were alive and 29 were lost to follow up. Adjusted mortality (adjusted for age, blood pressure, body mass index, cholesterol, triglycerides, alcohol, exercise, and existing disease) was 2,616 per 100,000 person years. The proportional mortality of cancer, vascular disease and Chronic Obstructive Pulmonary Disease (COPD) were 39.71%, 28.10% and 16.90% respectively. Multivariate analysis showed that age, cigarettes per day, systolic blood pressure, triglyceride, family history of diseases (hypertension, stroke and cancer), existing diseases (stroke, diabetes and cancer), body mass index, and age of starting smoking were associated with all-cause mortality, HR (95%CI) was1.083(1.062–1.104), 1.026(1.013–1.039), 1.009(1.003–1.015), 1.002(1.001–1.003), 1.330(1.005–1.759), 1.330(1.005–1.759), 1.444(1.103–1.890), 2.237(1.244–4.022), 1.462(1.042–2.051), 2.079(1.051–4.115), 0.963(0.931–0.996)and 0.988(0.978–0.999)respectively. Compared with never-smokers, current smokers had increased risks of total mortality [HR 1.369(1.083–1.731)], CHD [HR 1

  16. Obstructive Sleep Apnea and Posttraumatic Stress Disorder among OEF/OIF/OND Veterans

    PubMed Central

    Colvonen, Peter J.; Masino, Tonya; Drummond, Sean P.A.; Myers, Ursula S.; Angkaw, Abigail C.; Norman, Sonya B.

    2015-01-01

    Objectives: This study examined: (a) the relationship between self-reported posttraumatic stress disorder (PTSD) symptoms and risk of obstructive sleep apnea (OSA) in a younger, Iraq and Afghanistan (OEF/OIF/OND) veteran sample seeking treatment for PTSD; and (b) the relationships between PTSD symptom scores and each risk factor of OSA (snoring, fatigue, high blood pressure/BMI). Methods: Participants were 195 Iraq and Afghanistan veterans presenting to a VA outpatient PTSD clinic for evaluation. Veterans were 21 to 59 years old (mean 33.40, SD 8.35) and 93.3% male (n = 182). Logistic regressions were run to examine whether veterans with greater PTSD symptom severity had an increased probability of screening as high risk for OSA, even after controlling for known risk factors (older age, positive smoking status, and use of CNS depressants). Results: Of 159 veterans screened, 69.2% were assessed as being at high risk for OSA. PTSD symptom severity increased the risk of screening positive for OSA. PTSD symptom severity increased risk of screening positive for snoring and fatigue, but not high blood pressure/BMI. Conclusions: OEF/OIF/OND veterans with PTSD screen as high risk for OSA at much higher rates than those seen in community studies and may not show all classic predictors of OSA (i.e., older and higher BMI). This study is the first to suggest that the Berlin may be a useful screener for OSA in a younger OEF/OIF/OND veteran population with PTSD. Screening of younger veterans with PTSD for OSA should be standard care, and polysomnography and OSA interventions should be readily available to younger veterans. Citation: Colvonen PJ, Mosino T, Drummond SP, Myers US, Angkaw AC, Norman SB. Obstructive sleep apnea and posttraumatic stress disorder among OEF/OIF/OND veterans. J Clin Sleep Med 2015;11(5):513–518. PMID:25665698

  17. What was different about exposures reported by male Australian Gulf War veterans for the 1991 Persian Gulf War, compared with exposures reported for other deployments?

    PubMed

    Glass, Deborah C; Sim, Malcolm R; Kelsall, Helen L; Ikin, Jill F; McKenzie, Dean; Forbes, Andrew; Ittak, Peter

    2006-07-01

    This study identified chemical and environmental exposures specifically associated with the 1991 Persian Gulf War. Exposures were self-reported in a postal questionnaire, in the period of 2000-2002, by 1,424 Australian male Persian Gulf War veterans in relation to their 1991 Persian Gulf War deployment and by 625 Persian Gulf War veterans and 514 members of a military comparison group in relation to other active deployments. Six of 28 investigated exposures were experienced more frequently during the Persian Gulf War than during other deployments; these were exposure to smoke (odds ratio [OR], 4.4; 95% confidence interval, 3.0-6.6), exposure to dust (OR, 3.7; 95% confidence interval, 2.6-5.3), exposure to chemical warfare agents (OR, 3.9; 95% confidence interval, 2.1-7.9), use of respiratory protective equipment (OR, 13.6; 95% confidence interval, 7.6-26.8), use of nuclear, chemical, and biological protective suits (OR, 8.9; 95% confidence interval, 5.4-15.4), and entering/inspecting enemy equipment (OR, 3.1; 95% confidence interval, 2.1-4.8). Other chemical and environmental exposures were not specific to the Persian Gulf War deployment but were also reported in relation to other deployments. The number of exposures reported was related to service type and number of deployments but not to age or rank.

  18. Using Department of Veterans Affairs Administrative databases to examine long-term care utilization for men and women veterans.

    PubMed

    Guihan, M; Weaver, F M; Cowper, D C; Nydam, T; Miskevics, S

    1999-06-01

    We examined long-term care (LTC) utilization by male and female veterans using administrative databases maintained by VA. Research questions included: (1) Which LTC services are utilized? (2) Do utilization patterns of older veterans differ from those of elderly persons in the general U.S. population? (3) Do LTC needs of veterans vary by gender? We were unable to track LTC utilization of individuals across administrative databases. Some databases could only provide information at the national level, or alternatively, were available only at local facilities, or only at the patient or program-level data--making it impossible to get a clear picture of all the services received by an individual. Those planning to use administrative databases to conduct research must: (1) take more time than expected; (2) be flexible/willing to compromise, (3) "ferret out" information, and (4) recognize that because of dynamism inherent in information systems, results may change over time.

  19. 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

  20. Low systolic blood pressure and mortality from all causes and vascular diseases among older middle-aged men: Korean Veterans Health Study.

    PubMed

    Yi, Sang-Wook; Ohrr, Heechoul

    2015-03-01

    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. 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. 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. Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.

  1. BMI trajectory groups in veterans of the Iraq and Afghanistan wars.

    PubMed

    Rosenberger, Patricia H; Ning, Yuming; Brandt, Cynthia; Allore, Heather; Haskell, Sally

    2011-09-01

    The study sought to determine BMI trajectories in Iraq/Afghanistan veterans over 6 years and to examine sociodemographic factors associated with BMI trajectory membership. Our study sample included 16,656 veterans post-deployment and entering the Veteran Healthcare Administration (VHA) healthcare system. We used national VHA administrative sociodemographic data, tracked veteran BMI for 6 years, and used trajectory modeling to identify BMI trajectories and sociodemographic characteristics associated with trajectory membership. Five trajectory groups determined in the full sample were primarily differentiated by their post-deployment initial BMI: "healthy" (14.1%), "overweight" (36.3%), "borderline obese" (27.9%), "obese" (15.7%), and "severely obese" (6.0). Being female, younger, and white were associated with lower initial BMI trajectory group membership (p's<.05). Greater observed BMI increase was associated with higher initial BMI across groups (0.6, 0.8, 1.5, 1.9, 2.7). Gender specific trajectory models found that male Veterans with higher education and white female Veterans were associated with the lowest initial BMI group (p's<.05). Higher post-deployment BMI was associated with greater BMI gain over time for both male and female veterans. Older age is associated with higher BMI regardless of gender. Education level and racial status are differentially related to BMI trajectory by gender. Published by Elsevier Inc.

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

    PubMed Central

    CIUBOTARU, IRINA; GREEN, STEFAN J.; KUKREJA, SUBHASH; BARENGOLTS, ELENA

    2016-01-01

    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

  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. Published by Elsevier Inc.

  5. 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

  6. 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

  7. Fibromyalgia syndrome care of Iraq- and Afghanistan-deployed Veterans in Veterans Health Administration.

    PubMed

    Mohanty, April F; Helmer, Drew A; Muthukutty, Anusha; McAndrew, Lisa M; Carter, Marjorie E; Judd, Joshua; Garvin, Jennifer H; Samore, Matthew H; Gundlapalli, Adi V

    2016-01-01

    Little is known regarding fibromyalgia syndrome (FMS) care among Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OIF/OEF/OND) Veterans. Current recommendations include interdisciplinary, team-based combined care approaches and limited opioid use. In this study of OIF/OEF/OND Veterans who accessed Veterans Health Administration services between 2002 and 2012, we hypothesized that combined care (defined as at least 4 primary care visits/yr with visits to mental health and/or rheumatology) versus <4 primary care visits/yr only would be associated with lower risk of at least 2 opioid prescriptions 12 mo following an FMS diagnosis. Using generalized linear models with a log-link, the Poisson family, and robust standard errors, we estimated risk ratios (RRs) and 95% confidence intervals (CIs). We found that 1% of Veterans had at least 2 FMS diagnoses (International Classification of Diseases-9th Revision-Clinical Modification code 729.1) or at least 1 FMS diagnosis by rheumatology. Veterans with (vs without) FMS were more likely to be female, older, Hispanic, and never/currently married. Combined primary, mental health, and rheumatology care was associated with at least 2 opioid prescriptions (RR [95% CI] for males 2.2 [1.1-4.4] and females 2.8 [0.4-18.6]). Also, combined care was associated with at least 2 nonopioid pain-related prescriptions, a practice supported by evidence-based clinical practice guidelines. In tandem, these results provide mixed evidence of benefit of combined care for FMS. Future studies of healthcare encounter characteristics, care coordination, and benefits for Veterans with FMS are needed.

  8. 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.

  9. Post-marketing surveillance of ischaemic optic neuropathy in male veterans co-prescribed phosphodiesterase-5 inhibitors with organic nitrates or alpha-blockers.

    PubMed

    French, Dustin D; Margo, Curtis E

    2008-01-01

    The cause of nonarteritic anterior ischaemic optic neuropathy (ION) is unknown, although assumed to be related to transient vascular insufficiency of the optic nerve head. Because the interaction of phosphodiesterase-5 (PDE-5) inhibitors with either an organic nitrate or alpha-blocker may theoretically increase the risk of ION, we conducted a screening study to determine if such a risk might exist. Retrospective cohort study of male veterans with ION and possible ION. The national Veterans Health Administration (VHA) clinical database was cross-referenced (linked) with the VHA pharmacy database looking for specific drug combinations. Compared with no use, the relative risk (RR) of ION and possible ION for men prescribed both PDE-5 inhibitor and organic nitrate was 1.41 (95% CI 0.85, 2.33). Similarly, the RR of ION and possible ION with concurrent prescription of PDE-5 inhibitor and alpha-blocker was 1.21 (95% CI 1.01, 1.44). When risk was measured against use of a PDE-5 inhibitor alone, the RR was 1.29 (95% CI 0.78, 2.16) for PDE-5 inhibitor and organic nitrate and 1.12 (95% CI 0.92, 1.35) for PDE-5 inhibitor and alpha-blocker. We linked two large national databases to screen for a potentially important drug-drug-disease interaction. There was no increase in risk of ION and possible ION in men dispensed a PDE-5 inhibitor with either organic nitrates or an alpha-blocker compared with men dispensed PDE-5 inhibitor alone. An incidental observation that a substantial number of men were prescribed both an organic nitrate and a PDE-5 inhibitor within a single dispensing period raises concerns over non-ocular safety issues. The wisdom of co-dispensing medications that are contraindicated may deserve a broader audience.

  10. A genetic analysis of the Epworth Sleepiness Scale in 1560 World War II male veteran twins in the NAS-NRC Twin Registry.

    PubMed

    Carmelli, D; Bliwise, D L; Swan, G E; Reed, T

    2001-03-01

    Responses to the eight-item Epworth Sleepiness Scale (ESS) obtained from 1560 World War II male veteran twin pairs [818 monozygotic (MZ), 742 dizygotic (DZ)] were analysed to determine the extent to which genetic influences are involved in self-reported daytime sleepiness in the elderly. Average ESS score (+/- SD) in this sample was 7.1 +/- 3.9, range 0--24. More than half of the twins (65%--67%) reported a moderate to high chance of falling asleep while lying down to rest; fewer than 3% admitted that this would occur while sitting and talking to someone or while stopped in traffic. Daytime sleepiness was not associated with age but was significantly and positively associated with obesity. The intraclass twin correlation on ESS scores was 0.39 in MZ pairs and 0.21 in DZ pairs (both P < 0.001). Structural equation modeling of the observed variance-covariance matrices for MZ and DZ twins estimated the heritability of ESS to be 38% (95% confidence interval 33%--44%). Environmental influences not shared by twin brothers accounted for the remaining variance in daytime sleepiness. A reasonable interpretation of the heritability of ESS in this healthy cohort of elderly male twins is a genetic susceptibility for disordered breathing during sleep.

  11. Suicide among veterans in 16 states, 2005 to 2008: comparisons between utilizers and nonutilizers of Veterans Health Administration (VHA) services based on data from the National Death Index, the National Violent Death Reporting System, and VHA administrative records.

    PubMed

    Katz, Ira R; McCarthy, John F; Ignacio, Rosalinda V; Kemp, Janet

    2012-03-01

    We sought to compare suicide rates among veterans utilizing Veterans Health Administration (VHA) services versus those who did not. Suicide rates from 2005 to 2008 were estimated for veterans in the 16 states that fully participated in the National Violent Death Reporting System (NVDRS), using data from the National Death Index, NVDRS, and VHA records. Between 2005 and 2008, veteran suicide rates differed by age and VHA utilization status. Among men aged 30 years and older, suicide rates were consistently higher among VHA utilizers. However, among men younger than 30 years, rates declined significantly among VHA utilizers while increasing among nonutilizers. Over these years, an increasing proportion of male veterans younger than 30 years received VHA services, and these individuals had a rising prevalence of diagnosed mental health conditions. The higher rates of suicide for utilizers of VHA among veteran men aged 30 and older were consistent with previous reports about which veterans utilize VHA services. The increasing rates of mental health conditions in utilizers younger than 30 years suggested that the decreasing relative rates in this group were related to the care provided, rather than to selective enrollment of those at lower risk for suicide.

  12. Suicide Among Veterans in 16 States, 2005 to 2008: Comparisons Between Utilizers and Nonutilizers of Veterans Health Administration (VHA) Services Based on Data From the National Death Index, the National Violent Death Reporting System, and VHA Administrative Records

    PubMed Central

    Katz, Ira R.; Ignacio, Rosalinda V.; Kemp, Janet

    2012-01-01

    Objectives. We sought to compare suicide rates among veterans utilizing Veterans Health Administration (VHA) services versus those who did not. Methods. Suicide rates from 2005 to 2008 were estimated for veterans in the 16 states that fully participated in the National Violent Death Reporting System (NVDRS), using data from the National Death Index, NVDRS, and VHA records. Results. Between 2005 and 2008, veteran suicide rates differed by age and VHA utilization status. Among men aged 30 years and older, suicide rates were consistently higher among VHA utilizers. However, among men younger than 30 years, rates declined significantly among VHA utilizers while increasing among nonutilizers. Over these years, an increasing proportion of male veterans younger than 30 years received VHA services, and these individuals had a rising prevalence of diagnosed mental health conditions. Conclusions.The higher rates of suicide for utilizers of VHA among veteran men aged 30 and older were consistent with previous reports about which veterans utilize VHA services. The increasing rates of mental health conditions in utilizers younger than 30 years suggested that the decreasing relative rates in this group were related to the care provided, rather than to selective enrollment of those at lower risk for suicide. PMID:22390582

  13. Circulatory responses to weight lifting, walking, and stair climbing in older males.

    PubMed

    Benn, S J; McCartney, N; McKelvie, R S

    1996-02-01

    To compare the heart rate and intra-arterial blood pressure responses during weight lifting, horizontal and uphill walking, and stair climbing in older male subjects. We used intra-brachial artery catheterization to compare the arterial blood pressure (ABP) and heart rate (HR) responses during 10 repetitions (approximately 40 s) of single-arm curl (SAC) and single-arm overhead military press (SAMP) (70% of the one repetition maximum-1RM); 12 repetitions (approximately 50 s) of single- (SLP) and double-leg press (DLP) weight-lifting exercises (80% of 1RM); 10 minutes of horizontal treadmill walking (T10) at 2.5 mph holding a 20-pound weight in minutes 4 to 6 (T10) and 30 pounds in minutes 8 to 10 (T10); 4 minutes of treadmill walking (T4) at 3.0 mph up an 8% incline; and 12 flights (192 steps) of stair climbing (STR) at 60 to 65 steps/minute on a Stiarmaster 6000 ergometer (approximately 3 minutes). McMaster University, Hamilton, Ontario, Canada. Seventeen healthy males aged (mean +/- SE) 64.4 +/- 0.6 years. Continuous intra-arterial measurements of systolic, diastolic, and mean arterial pressure and heart rate and rate-pressure product. The peak values of HR, ABP and rate-pressure product (HR.BPs/1000;(RPP,10(3))) were not systematically ordered among the various activities. The lowest peak values for all variables were recorded during the initial 4 minutes of horizontal treadmill walking. The STR and T4 walking exercises elicited higher HRs (151 +/- 3.2 and 121 +/- 3.4 bpm) than the weight lifting (range from 100 +/- 4.8 (SAC) to 113 +/- 3.8 bpm (SAMP)), but the converse was true for diastolic pressure (range from 128 +/- 6.3 (SAC) to 151 +/- 4.8 mm Hg (SAMP) versus 101 +/- 2.5 (T4) to 118 +/- 3.4 mm Hg (T10) and mean arterial pressure (range from 145 +/- 4.5 (SAC) to 158 +/- 4.8 mm Hg (SAMP) versus 129 +/- 3.4 in T4 to 148 +/- 3.8 (T10) and 157 +/- 4.1 mm Hg (STR)). The peak systolic pressure was greatest in STR (271 +/- 9.6 mm Hg) followed by SAMP (261 +/- 9

  14. 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

  15. Military veterans and Social Security.

    PubMed

    Olsen, Anya

    There are 9.4 million military veterans receiving Social Security benefits, which means that almost one out of every four adult Social Security beneficiaries has served in the United States military. In addition, veterans and their families make up almost 40 percent of the adult Social Security beneficiary population. Policymakers are particularly interested in military veterans and their families and have provided them with benefits through several government programs, including Social Security credits, home loan guarantees, and compensation and pension payments through the Department of Veterans Affairs. It is therefore important to understand the economic and demographic characteristics of this population. Information in this article is based on data from the March 2004 Current Population Survey, a large, nationally representative survey of U.S. households. Veterans are overwhelmingly male compared with all adult Social Security beneficiaries who are more evenly split between males and females. Military veterans receiving Social Security are more likely to be married and to have finished high school compared with all adult Social Security beneficiaries, and they are less likely to be poor or near poor than the overall beneficiary population. Fourteen percent of veterans receiving Social Security benefits have income below 150 percent of poverty, while 25 percent of all adult Social Security beneficiaries are below this level. The higher economic status among veterans is also reflected in the relatively high Social Security benefits they receive. The number of military veterans receiving Social Security benefits will remain high over the next few decades, while their make-up and characteristics will change. In particular, the number of Vietnam War veterans who receive Social Security will increase in the coming decades, while the number of veterans from World War II and the Korean War will decline.

  16. Gender, race & the veteran wage gap.

    PubMed

    Vick, Brandon; Fontanella, Gabrielle

    2017-01-01

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

  17. "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…

  18. Older males secrete luteinizing hormone and testosterone more irregularly, and jointly more asynchronously, than younger males

    PubMed Central

    Pincus, Steven M.; Mulligan, Thomas; Iranmanesh, Ali; Gheorghiu, Sylvia; Godschalk, Michael; Veldhuis, Johannes D.

    1996-01-01

    New statistical perspectives on the secretory patterns of both luteinizing hormone (LH) and testosterone (T) may prove useful in further understanding the aging process, and possibly ultimately in improving the diagnosis and treatment of spermatogenetic failure and loss of sexual interest. We examined serum concentration time-series for LH and T in 14 young (21–34 years of age) and 11 aged (62–74 years of age) healthy men. For each subject, blood samples were obtained at 2.5-min intervals during a sleep period, with an average sampling duration of 7 hr. For each of LH and T, we used the model-independent statistic approximate entropy (ApEn) to quantify the irregularity of the serum concentration time-series; to quantify joint LH–T secretory asynchrony, we employed the recently introduced cross-ApEn. Although mean (and SD) LH and T concentrations were indistinguishable in the two age groups (P > 0.25), for LH, aged subjects had greater ApEn values (1.525 ± 0.221) than younger individuals (1.207 ± 0.252), P < 0.003, indicating more irregular secretion in the older cohort. For T, aged subjects also had greater ApEn values (1.622 ± 0.120) than younger counterparts (1.384 ± 0.228), P < 0.004. In young, but not older men, ApEn(T) significantly exceeded ApEn(LH), P < 0.02. Aged subjects had greater cross-ApEn values (1.961 ± 0.121) than younger subjects (1.574 ± 0.249), P < 10−4, with nearly 100% sensitivity and specificity, indicating greater LH–T asynchrony in the older group. In conjunction with previous findings of greater irregularity of growth hormone release with increasing age, we propose that increased secretory irregularity with advancing age may be a widespread hormonal phenomenon. Finally, theoretically, we clarify the need for quantifications such as ApEn and cross-ApEn via a study of a “variable lag” pulsatile process, and empirically note the potential wide applicability of cross-ApEn to quantify asynchrony in interconnected (hormonal

  19. Effects of Posttraumatic Stress Disorder and Metabolic Syndrome on Cognitive Aging in Veterans.

    PubMed

    Green, Erin; Fairchild, J Kaci; Kinoshita, Lisa M; Noda, Art; Yesavage, Jerome

    2016-02-01

    With the influx of veterans entering older adulthood, it is increasingly important to understand risk factors for cognitive decline. Posttraumatic stress disorder (PTSD) and the metabolic syndrome (MetS) are highly prevalent in older veterans. Although both increase risk for cognitive decline and often co-occur, it is unclear how they may interact to negatively impact cognition. The aim of this cross-sectional study was to investigate associations among PTSD, MetS, and cognitive function in older veterans. We hypothesized that co-occurring PTSD and MetS would be associated with worse cognitive performance than seen in either illness alone. Participants completed cognitive testing to assess processing speed, verbal memory, and executive function. Data from 204 male veterans aged 55-89 were analyzed with the use of hierarchical multiple regression models. Veterans with MetS demonstrated poorer performance on tasks of executive function (response inhibition and cognitive set shifting) and immediate verbal memory regardless of PTSD status. There was an interaction between MetS and PTSD on delayed verbal memory, suggesting that the negative impact of MetS on verbal memory was only significant for veterans not classified as having PTSD. This is the first study to examine the impact of comorbid PTSD and MetS on cognition. The results suggest that MetS is associated with poorer verbal learning and executive functioning independent of PTSD. We discuss the necessity of monitoring cerebrovascular risk factors and providing early behavioral and/or pharmaceutical interventions to lessen the risk of cognitive decline in older age. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  20. Exposure to potentially harmful drug-disease interactions among older community-dwelling veterans based on the Healthcare Effectiveness Data and Information Set quality measure: Who is at risk?

    PubMed Central

    Pugh, Mary Jo V.; Starner, Catherine I.; Amuan, Megan E.; Berlowitz, Dan R.; Horton, Monica; Marcum, Zachary A.; Hanlon, Joseph T.

    2012-01-01

    Objectives Identify prevalence and risk factors for drug-disease interactions included in the Healthcare Effectiveness Data and Information Set Drug-Disease Interaction (HEDIS Rx-DIS) Measure. Design Cross-sectional retrospective database analysis. Setting Outpatient clinics within the Department of Veterans Affairs (VA). Participants Individuals 65 years and older who received VA outpatient care October 1, 2003 to September 30, 2006. Measurements We identified drug-disease interactions in 2006 defined by the HEDIS Rx-DIS criteria among VA patients with dementia, falls, and chronic renal failure using VA pharmacy and administrative databases. We examined factors associated with HEDIS Rx-DIS exposure including demographic, health status, and access to care factors including VA outpatient health services use and co-payment status. Results Of the 305,041 older veterans who met criteria for inclusion, the one-year prevalence of HEDIS Rx-DIS exposure was 15.2%; prevalence was 20.2% for dementia, 16.2% for falls and 8.5% for chronic renal failure. Patients with high disease burden (physical, psychiatric, number of medications) were significantly more likely to have HEDIS Rx-DIS exposure, regardless of condition. Hispanics and individuals with no copayments were more likely to have Rx-DIS exposure than whites or those with required copayments. There was variation on other predictors based on the type of Rx-DIS. Conclusion The prevalence of Rx-DIS was common in older VA outpatients. Future studies should examine the risk of Rx-DIS exposure on health outcomes using separate analyses for each type of Rx-DIS separately before combining all Rx-DIS into a single measure of exposure. Studies that examine the effectiveness of interventions to reduce Rx-DIS exposure will also be helpful in improving the quality of care for older patients. PMID:21831166

  1. 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.

  2. Severe Pain in Veterans: The Effect of Age and Sex, and Comparisons With the General Population.

    PubMed

    Nahin, Richard L

    2017-03-01

    This study provides national prevalence estimates of US military veterans with severe pain, and compares veterans with nonveterans of similar age and sex. Data used are from the 2010 to 2014 National Health Interview Survey on 67,696 adults who completed the Adult Functioning and Disability Supplement. Participants with severe pain were identified using a validated pain severity coding system imbedded in the National Health Interview Survey Adult Functioning and Disability Supplement. It was estimated that 65.5% of US military veterans reported pain in the previous 3 months, with 9.1% classified as having severe pain. Compared with veterans, fewer nonveterans reported any pain (56.4%) or severe pain (6.4%). Whereas veterans aged 18 to 39 years had significantly higher prevalence rates for severe pain (7.8%) than did similar-aged nonveterans (3.2%), veterans age 70 years or older were less likely to report severe pain (7.1%) than nonveterans (9.6%). Male veterans (9.0%) were more likely to report severe pain than male nonveterans (4.7%); however, no statistically significant difference was seen between the 2 female groups. The prevalence of severe pain was significantly higher in veterans with back pain (21.6%), jaw pain (37.5%), severe headaches or migraine (26.4%), and neck pain (27.7%) than in nonveterans with these conditions (respectively: 16.7%, 22.9%, 15.9%, and 21.4%). Although veterans (43.6%) were more likely than nonveterans (31.5%) to have joint pain, no difference was seen in the prevalence of severe pain associated with this condition. Prevalence of severe pain, defined as that which occurs "most days" or "every day" and bothers the individual "a lot," is strikingly more common in veterans than in members of the general population, particularly in veterans who served during recent conflicts. Additional assistance may be necessary to help veterans cope with their pain. Published by Elsevier Inc.

  3. 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. © The Author(s) 2012.

  4. EXPLORING OLDER ADOLESCENTS’ AND YOUNG ADULTS’ ATTITUDES REGARDING MALE HORMONAL CONTRACEPTION: APPLICATIONS FOR CLINICAL PRACTICE

    PubMed Central

    Marcell, Arik V.; Plowden, Keith; Bowman, Shameeka M.

    2005-01-01

    BACKGROUND: Male hormonal contraceptive methods (HCM) are in Phase I clinical trials in the U.S. International studies report adults have positive attitudes regarding male HCM, but little is known about U.S. minority young peoples’ attitudes – a population that experiences high unintended pregnancy rates. METHODS: Thirty urban African American young persons (50% males; mean age=18.8 [SD=2.5]) participated in semi-structured interviews to explore attitudes regarding male HCM. Data was independently analyzed by two researchers according to qualitative research methodology, including transcript coding for content, categorization of codes, performance of content analysis for theme development, and corroboration of findings by a third researcher. RESULTS: The data revealed five major themes that can facilitate and/or hinder male HCM adoption: 1) impact of reversing roles in HCM use; 2) men’s lack of involvement in health care; 3) men’s reliability to use HCM effectively; 4) perceived responsibility of men who use HCM; and 5) men’s apprehension to use new medicines. Overall, participants had positive impressions about male HCM (67% M; 67% F) and female partner trust of males’ use was high (85%), as were males’ intentions (60%). CONCLUSIONS: Findings provide a foundation for clinical interventions including: 1) increasing males’ involvement in reproductive health, 2) helping males to overcome apprehensions about male HCM safety, and 3) standardizing male HCM education in the clinical setting. Future research efforts should examine whether study findings hold for other populations. PMID:16006471

  5. Posttraumatic Stress Disorder Symptom Severity and Socioeconomic Factors Associated with Veterans Health Administration Use among Women Veterans.

    PubMed

    Lehavot, Keren; O'Hara, Ruth; Washington, Donna L; Yano, Elizabeth M; Simpson, Tracy L

    2015-01-01

    The Veterans Health Administration (VA) has historically focused on treating men. Although women veterans' VA use is increasing, they remain more likely than male veterans to receive their care in non-VA settings. To date, there is limited research on factors associated with VA use among women. We examined the relationship between demographic, civilian, military, and health-related variables with past-year VA use among women veterans. Women veterans were recruited over the internet to participate in an anonymous national survey (n = 617) in 2013. An empirically derived decision tree was computed using signal detection software for iterative receiver operator characteristics (ROC) to identify variables with the best sensitivity/specificity balance associated with past-year VA use. ROC analysis indicated that 85% of participants with high posttraumatic stress disorder (PTSD) and depressive symptoms and who were younger than 54 years of age used VA in the past year. Of those who were 54 years of age or older and had very high PTSD symptoms, 94% used the VA in the last year. By contrast, only 40% of participants with relatively lower PTSD symptoms had VA past-year use, although among these individuals, VA past-year use increased to 65% for those with a relatively lower income. Findings suggest that greater PTSD symptoms, depressive symptoms, and low income correlate with VA use, with very high PTSD symptoms in older groups, high PTSD symptoms coupled with high depressive symptoms in younger groups, and low income in those with lower PTSD symptoms each associated with greater past-year VA use. Ensuring PTSD assessment and treatment, and addressing socioeconomic factors, may be key strategies for health care delivered directly or through contract with VA facilities. Published by Elsevier Inc.

  6. 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

  7. 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

  8. 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

  9. Veterans Health Administration

    MedlinePlus

    ... code here VA » Veterans Health Administration Veterans Health Administration Marine Continues to Serve by Serving Veterans David ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  10. Veterans and Homelessness

    DTIC Science & Technology

    2011-04-01

    Homeless Veterans programs), employment assistance ( Homeless Veterans Reintegration Program and Compensated Work Therapy program), transitional...needs of female veterans , whose numbers are increasing. Women veterans face challenges that could contribute to their risks of homelessness . They are... homeless programs for veterans have the facilities to provide separate accommodations for women and women with children. Veterans

  11. 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.

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

    PubMed

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

    2013-01-01

    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. 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. 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. 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.

  13. Andropause or male menopause? Rationale for testosterone replacement therapy in older men with low testosterone levels.

    PubMed

    Cunningham, Glenn R

    2013-01-01

    To provide rationale for testosterone replacement therapy (TRT) in older men with low testosterone levels and symptoms consistent with testosterone deficiency. The relevant literature was reviewed using PubMed. Cross-sectional and longitudinal population-based studies indicate that total and free testosterone levels fall with aging, and they may be accompanied by symptoms consistent with androgen deficiency. Testosterone treatment of younger men with very low testosterone levels and hypothalamic, pituitary, or testicular disease is associated with improvements in symptoms, body composition, bone density, and hematocrit/hemoglobin. Studies evaluating testosterone treatment of older men with low testosterone levels are limited, but they suggest some increase in fat free mass, some decrease in fat mass, and some increase in bone density of the lumbar spine and femoral neck. The Testosterone Trial should provide definitive information regarding the potential benefits of TRT in men ≥65 years of age. If efficacy is confirmed, we will still need more information regarding the risks of TRT in older men.

  14. Characteristics of males who father babies born to adolescents versus older adult women in Taiwan.

    PubMed

    Wang, C S; Chou, P

    2001-06-01

    To identify characteristics of males who father babies born to adolescent mothers in southern Taiwan. This was a population-based cross-sectional study of male partners of 1,145 primigravidas (555 adolescent primigravidas and 590 adults) in Kaohsiung County, Taiwan, which compared their reports of their male partners' characteristics. Data were collected by a questionnaire that included demographic characteristics, health behavior problems, and attitudes toward the pregnancy. In multiple logistic regression analyses, the males who father babies born to adolescent primigravidas achieved a lower level of education; a greater age discrepancy between themselves and the mothers; a greater unemployment rate; less financial independence; more smoking, drinking, and drug abuse; less supportive attitude toward pregnancy; poorer attendance at childbirth; less provision of postpartum care for mothers and infants; and greater domestic violence than adult primigravidas (p < .05). These negative findings persist even after stratification by age discrepancy. Male partners of the adolescent mothers with an age difference of 5 years or more were more likely to report drug abuse and domestic violence than those of adult primigravidas. Males who father babies born to adolescent primigravidas were found to have many negative characteristics that place their partners and offspring at risk. Questions asked of or about the father of the baby during prenatal visits may help identify pregnant adolescents who need support during pregnancy and after delivery.

  15. Moderate-intensity intermittent work in the heat results in similar low-level dehydration in young and older males.

    PubMed

    Wright, Heather E; Larose, Joanie; McLellan, Tom M; Hardcastle, Stephen G; Boulay, Pierre; Kenny, Glen P

    2014-01-01

    Older individuals may be more susceptible to the negative thermal and cardiovascular consequences of dehydration during intermittent work in the heat. This study examined the hydration, thermal, and cardiovascular responses to intermittent exercise in the heat in 14 Young (Y, Mean ± SE; 25.8 ± 0.8 years), Middle-age (MA, 43.6 ± 0.9 years), and Older (O, 57.2 ± 1.5 years) healthy, non-heat acclimated males matched for height, mass, body surface area, and percent body fat. Rectal temperature (Tre), heart rate (HR), local sweat rate (LSR), and hydration indices were measured during 4 × 15-min moderate to heavy cycling bouts at 400 W heat production, each followed by a 15-min rest period, in Warm/Dry (35°C, 20% relative humidity [RH]) and Warm/Humid (35°C, 60% RH) heat. No differences were observed between the age groups for Tre, Tre change, HR, LSR, mass change, urine specific gravity, and plasma protein concentration in either condition, irrespective of the greater level of thermal and cardiovascular strain experienced in the Warm/Humid environment. Plasma volume changes (Dry Y: -5.4 ± 0.7, MA: -6.2 ± 0.9, O: -5.7 ± 0.9%, Humid Y: -7.3 ± 1.0, MA: -7.9 ± 0.8, O: -8.4 ± 1.0%) were similar between groups, as were urine specific gravity and plasma protein concentrations. Thus, physically active Young, Middle-age, and Older males demonstrate similar hydration, thermal, and cardiovascular responses during moderate- to high-intensity intermittent exercise in the heat.

  16. Gender differences in veterans health administration mental health service use: effects of age and psychiatric diagnosis.

    PubMed

    Chatterjee, Sharmila; Rath, Maria E; Spiro, Avron; Eisen, Susan; Sloan, Kevin L; Rosen, Amy K

    2009-01-01

    The objective of this study was to compare gender differences in mental health disease burden and outpatient mental health utilization among veterans utilizing Veterans Health Administration (VHA) mental health services in fiscal year 1999 (FY99), after the first Gulf War and significant restructuring of VHA services. We used logistic regression to examine the relationships among gender, age, diagnostic groups, and utilization of mental health and specialty mental health services in a national sample of veterans. The sample included 782,789 veterans with at least 1 outpatient visit in the VHA in FY99 associated with a mental health or substance abuse (SA) diagnosis. Subgroup analyses were performed for 4 diagnostic categories: 1) posttraumatic stress disorder (PTSD), 2) SA disorders, 3) bipolar and psychotic disorders, and 4) mood and anxiety disorders. Younger women veterans (<35 years old) were significantly less likely and older women (> or =35) more likely to use any mental health services in comparison with their male counterparts. Similar findings were observed for younger women diagnosed with SA or mood and anxiety disorders, but not among veterans with PTSD or bipolar and psychotic disorders, among whom no there were no gender or age differences. In the case of specialized services for SA or PTSD, women younger than 55 with SA or PTSD were significantly less likely to use services than men. Women veterans underutilized specialty mental health services in relation to men but receipt of mental health care overall in FY99 varied by age and diagnosis. Examining gender differences alone, without taking other factors into account, may not provide an adequate picture of women veterans' current mental health service needs.

  17. Differences in body composition and risk of lifestyle-related diseases between young and older male rowers and sedentary controls.

    PubMed

    Sanada, Kiyoshi; Miyachi, Motohiko; Tabata, Izumi; Suzuki, Katsuhiko; Yamamoto, Kenta; Kawano, Hiroshi; Usui, Chiyoko; Higuchi, Mitsuru

    2009-08-01

    The aim of this cross-sectional study was to compare body composition and risk factors of lifestyle-related diseases between young and older male rowers and sedentary controls. Healthy males aged 19-73 years participated in the study, and were divided into four groups: 26 young rowers, 24 senior rowers, 23 young sedentary controls, and 22 senior sedentary controls. Total and regional lean soft tissue, fat mass, and bone mineral density were measured using dual-energy X-ray absorptiometry. The HDL-cholesterol of senior rowers (67.4 +/- 13.4 mg . dl(-1)) was significantly (P < 0.05) higher than that of senior sedentary controls (59.2 +/- 11.9 mg . dl(-1)), while HDL-cholesterol was similar in senior rowers and young rowers (66.1 +/- 10.8 mg . dl(-1)). Arm, leg, and trunk lean soft tissue mass were significantly higher in senior rowers (5.6 +/- 0.6 kg, 18.2 +/- 1.8 kg, and 27.3 +/- 3.2 kg respectively) than in senior sedentary controls (5.1 +/- 0.4 kg, 16.3 +/- 1.4 kg, and 24.6 +/- 1.7 kg respectively; P < 0.05). Bone mineral density was also significantly higher in senior rowers than in senior sedentary controls (ribs, lumbar spine, and pelvic segments; P < 0.05). We conclude that age-related increases in the risk of lifestyle-related diseases, such as osteoporosis and sarcopenia, are attenuated in male rowers. These results suggest that regular rowing exercise may have a positive influence in the prevention of lifestyle-related diseases in older Japanese people.

  18. 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…

  19. 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…

  20. Health Disparities Among Sexual Minority Women Veterans

    PubMed Central

    Foynes, Melissa Ming; Shipherd, Jillian C.

    2013-01-01

    Abstract Background Lesbian and bisexual (i.e., sexual minority) identity is more common among women veterans than among male veterans. Unique health issues have been identified among women veterans and among sexual minority women, but little is known about women who are both sexual minorities and veterans. This study aimed to compare demographic and health information from sexual minority women veterans with sexual minority women non-veterans and heterosexual women veterans. Methods Behavioral Risk Factor Surveillance Survey data were pooled from ten U.S. states that elected to ask sexual identity during 2010. The analytic sample was comprised of women who identified both their sexual identity and veteran status (n=1,908). Mental health indicators were frequent mental distress, sleep problems, low social/emotional support, and low satisfaction with life. Health risk indicators included current smoking, overweight, and obesity. Physical health status was defined by three components: disability requiring assistive equipment, >14 days of poor physical health in the past 30 days, and activity limitations. Results Compared with heterosexual women veterans, sexual minority women veterans had higher odds of mental distress (odds ratio [OR]=3.03, 95% confidence interval [CI]: 1.61–5.70) and smoking (OR=2.31, 95%CI: 1.19–4.48). After adjusting for demographic correlates, sexual minority women veterans had three times the odds of poor physical health (OR=3.01, 95%CI: 1.51–5.99) than their sexual minority non-veteran peers. Conclusions Results suggest sexual minority women veterans may experience unique health disparities relevant to provision of care in both Veterans Affairs (VA) and non-VA healthcare systems. Future research requires availability of data that include sexual minority status. PMID:23746281

  1. Appalachian Veterans.

    ERIC Educational Resources Information Center

    Arnow, Pat, Ed.

    1987-01-01

    This journal issue focuses on Appalachian veterans and on the premise that Appalachians and Americans in general are still fighting the battles and dealing with the psychic aftermath of the Civil War and all wars fought since then. One article notes that Appalachian soldiers were 20 to 25% more likely to be killed in Vietnam than other soldiers.…

  2. 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.

  3. Ionizing radiation-induced mutant frequencies increase transiently in male germ cells of older mice.

    PubMed

    Xu, Guogang; McMahan, C Alex; Hildreth, Kim; Garcia, Rebecca A; Herbert, Damon C; Walter, Christi A

    2012-05-15

    Spontaneous mutant frequency in the male germline increases with age, thereby increasing the risk of siring offspring with genetic disorders. In the present study we investigated the effect of age on ionizing radiation-induced male germline mutagenesis. lacI transgenic mice were treated with ionizing radiation at 4-, 15- and 26-month-old, and mutant frequencies were determined for pachytene spermatocytes and round spermatids at 15 days or 49 days after ionizing radiation treatment. Cells collected 15 days after treatment were derivatives of irradiated differentiating spermatogenic cells while cells collected 49 days later were derivatives of spermatogonial stem cells. The results showed that (1) spontaneous mutant frequency increased in spermatogenic cells recovered from nonirradiated old mice (26-months-old), particularly in the round spermatids; (2) mutant frequencies were significantly increased in round spermatids obtained from middle-aged mice (15-months-old) and old age mice (26-months-old) at 15 and 49 days after irradiation compared to the sham-treated old mice; and (3) pachytene spermatocytes obtained from 15- or 26-month-old mice displayed a significantly increased mutant frequency at 15 days post irradiation. This study indicates that age modulates the mutagenic response to ionizing radiation in the male germline.

  4. Inflammation marker, damage marker and anabolic hormone responses to resistance training with vascular restriction in older males.

    PubMed

    Karabulut, Murat; Sherk, Vanessa D; Bemben, Debra A; Bemben, Michael G

    2013-09-01

    The goal of this study was to examine anabolic hormone, muscle damage marker and inflammation marker responses to two types of resistance training protocols in older men. Thirty-six healthy older males (mean age = 56.6 ± 0.6 years) completed 6 weeks of high-intensity resistance training (HI-RT), low-intensity resistance training with vascular restriction (LI-BFR) or no exercise control group (CON) three times per week. Three upper body exercises were performed by both exercise groups at the same intensity (at 80% 1-RM), but lower body exercises were performed by the HI-RT group at 80% 1-RM and by the LI-BFR group at 20% 1-RM with vascular restriction. Resting serum creatine kinase (CK), interleukin 6 (IL-6), insulin-like growth factor-I (IGF-I), IGF binding protein 3 (IGFBP-3) and testosterone (T) were measured before and after training. No significant group differences in resting CK, IL-6, IGF-I, IGFBP-3 and T were detected following training (P>0.05). In addition, there were no significant changes in muscle cross-sectional area (CSA), but a trend for significant decreases in the percent changes in thigh subcutaneous fat (P = 0.051). Although training-induced anabolic hormone response did not reach statistical significance, our findings on CK and IL-6 indicated that the LI-BFR training protocol was safe and well tolerated for older men to perform to improve muscular strength. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

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

    PubMed

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

    2015-07-15

    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 performed 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 N(G) -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.

  6. Diminished nitric oxide-dependent sweating in older males during intermittent exercise in the heat.

    PubMed

    Stapleton, Jill M; Fujii, Naoto; Carter, Michael; Kenny, Glen P

    2014-06-01

    Nitric oxide (NO) is a signalling molecule that contributes to the control of many physiological pathways, including the heat-loss response of skin vasodilatation. Recently, NO has been implicated in the control of sweating during exercise in young adults. We tested the hypothesis that ageing reduces NO-dependent sweating during exercise in the heat. Ten young (23 ± 3 years old) and 10 older men (64 ± 5 years old), matched for body surface area, performed three successive 15 min bouts of exercise (Ex1, Ex2 and Ex3) at the same rate of metabolic heat production (300 W m(-2)) in the heat (35°C, 20% relative humidity). Exercise periods were interspersed with 15 min recovery periods. Local sweat rate (ventilated capsule) was measured on two forearm skin sites, which were continuously perfused via intradermal microdialysis with 0.9% saline as control (CON) or 10 mm N(G)-nitro-l-arginine methyl ester (L-NAME), a non-selective NO synthase inhibitor. Local sweat rate at the end of Ex1 was lower in the CON conditions in the older versus young men (0.69 ± 0.19 versus 0.90 ± 0.17 mg min(-1) cm(-2), P = 0.018). In the young men, local sweat rate was reduced in the L-NAME-treated conditions compared with the CON conditions at the end of Ex1 (0.67 ± 0.14 versus 0.90 ± 0.17 mg min(-1) cm(-2), P = 0.004), Ex2 (0.78 ± 0.20 versus 1.03 ± 0.20 mg min(-1) cm(-2), P = 0.013) and Ex3 (0.78 ± 0.20 versus 1.03 ± 0.21 mg min(-1) cm(-2), P = 0.014). In the older men, there was no main effect of treatment conditions on local sweat rate (P = 0.537) such that local sweat rates in the L-NAME-treated and CON conditions were similar (Ex1, 0.65 ± 0.20 versus 0.69 ± 0.19 mg min(-1) cm(-2); Ex2, 0.80 ± 0.27 versus 0.91 ± 0.29 mg min(-1) cm(-2); and Ex3, 0.84 ± 0.31 versus 0.94 ± 0.38 mg min(-1) cm(-2)). We conclude that ageing attenuates the influence of NO in the control of local forearm sweating observed in young adults during short 15 min bouts of exercise in the heat. This

  7. Effects of exercise intensity and duration on fat metabolism in trained and untrained older males.

    PubMed

    Bassami, Minoo; Ahmadizad, Sajad; Doran, Dominic; MacLaren, Donald P M

    2007-11-01

    Advancing age is associated with changes in fat and carbohydrate (CHO) metabolism, which is considered a risk factor for cardiovascular disease and diabetes. The effects of exercise intensity and duration on fat and CHO metabolism in elderly male subjects were investigated in the present study. Seven trained (63.7+/-4.7 years) and six untrained (63.5+/-4.5 years) healthy males performed three 30 min trials on a cycle ergometer at 50, 60 and 70% VO2max and two other trials at 60 and 70% VO2max in which the total energy expenditure was equal to that for 30 min at 50% VO2max Respiratory measures were undertaken throughout the exercise and blood samples taken before and immediately after each trial. Statistical analyses revealed a significant effect of exercise intensity on fat oxidation when the exercise durations were equated as well as when the energy expenditure was held constant for the three trials, though no training effect was noted. Total carbohydrate oxidation increased significantly with exercise intensity (P<0.05) and with training. Significantly higher levels of non-esterified free fatty acid (NEFA) and glycerol were observed for trained compared with untrained though not for B-hydroxybutyrate (3-OH) or insulin. No differences in NEFA, glycerol, 3-OH were evident for increases in exercise intensity. Carbohydrate and fat oxidation are significantly affected by exercise intensity in elderly males, although only CHO oxidation is influenced by training. Furthermore, training-induced increases in the availability of NEFA and glycerol are not associated with an increase in fat oxidation, rather an increase in CHO oxidation.

  8. Predicting functional decline of older men living in veteran homes by minimum data set: implications for disability prevention programs in long term care settings.

    PubMed

    Chen, Liang-Yu; Liu, Li-Kuo; Liu, Chien-Liang; Peng, Li-Ning; Lin, Ming-Hsien; Chen, Liang-Kung; Lan, Chung-Fu; Chang, Po-Lun

    2013-04-01

    To evaluate the risk and protective factors for functional decline of veteran home residents in Taiwan to develop disability prevention programs in long term care settings. A prospective cohort study. Two veteran homes in Taiwan. A total of 1045 residents of veteran homes. None. Minimum data set (MDS), resident assessment protocols (RAP), MDS-COGS, Resource Utilization Group-III Activities of Daily Living scale, MDS Social engagement scale, MDS Pain scale. A total of 1045 (83.0 ± 5.1 years, all men) residents completed the study, and 11.3% of them developed significant functional decline during the study period. Participants with long-term institutionalization history (odds ratio [OR] 2.966, confidence interval [CI] 1.270-6.927), underlying cerebrovascular disease (OR 4.432, CI 1.994-9.852) and dementia (OR 2.150, CI 1.029-4.504), and higher sum of RAP triggers (OR 1.366, CI 1.230-1.517) were more likely to develop functional decline, whereas those who had better social engagement were significantly protective from functional decline (OR 0.528, CI 0.399-0.697). Cerebrovascular disease, dementia, higher sum of RAP triggers, and long-term institutionalization were independent risk factors for functional decline, whereas better social engagement had a protective effect on functional dependence. Further study is needed to develop an integrated disability prevention program based on the discoveries of this study. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

    2017-10-01

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

  10. 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

  11. Detection and prevalence of abuse of older males: perspectives from family practice.

    PubMed

    Yaffe, Mark J; Weiss, Deborah; Wolfson, Christina; Lithwick, Maxine

    2007-01-01

    Family doctors' frequent contact with seniors put them in reasonable positions to detect elder abuse and initiate referral to adult protective services. Since doctor reporting is low, however, this paper explores whether the gender of patient and/or doctor impacts on identification of elder mistreatment, or creates differential detection of one gender over the other. Use of the validated Elder Abuse Suspicion Index (EASI), and a structured social work evaluation, is described to provide some gender-based data from Canadian family practice. Specifically, while the prevalence of elder abuse is estimated to range from 12.0% to 13.3%, the specific prevalence was found for females to be 13.6% to 15.2% and for males 9.1% to 9.7%.

  12. Weekly versus monthly testosterone administration on fast and slow skeletal muscle fibers in older adult males.

    PubMed

    Fitts, Robert H; Peters, James R; Dillon, E Lichar; Durham, William J; Sheffield-Moore, Melinda; Urban, Randall J

    2015-02-01

    In older adults, loss of mobility due to sarcopenia is exacerbated in men with low serum T. T replacement therapy is known to increase muscle mass and strength, but the effect of weekly (WK) vs monthly (MO) administration on specific fiber types is unknown. To determine the efficacy of WK vs MO T replacement on the size and functional capacity of individual fast and slow skeletal muscle fiber types. Subjects were randomized into a 5-month, double-blind, placebo-controlled trial. All subjects (ages, 61-71 y) were community-dwelling men who had T levels < 500 ng/dL. Subjects were dosed weekly for 5 months, receiving continuous T (WK, n = 5; 100 mg T enanthate, im injection), monthly cycled T (MO, n = 7; alternating months of T and placebo), or placebo (n = 7). Muscle biopsies of the vastus lateralis were obtained before and after treatment. Main outcomes for individual slow and fast fibers included fiber diameter, peak force (P0), rate of tension development, maximal shortening velocity, peak power, and Ca(2+) sensitivity. Both treatments increased fiber diameter and peak power, with WK treatment 5-fold more effective than MO in increasing type I fiber P0. WK effects on fiber diameter and force were 1.5-fold higher in slow fibers compared to fast fibers. In fast type II fibers, diameter and P0 increased similarly between treatments. The increased power was entirely due to increased fiber size and force. In conclusion, T replacement effects were fiber-type dependent, restricted to increases in cell size, P0, and peak power, and dependent on the paradigm selected (WK vs MO).

  13. New achievement and novel therapeutic applications of PDE5 inhibithors in older males.

    PubMed

    Frajese, G V; Pozzi, F

    2005-01-01

    Erectile dysfunction (ED) increases in prevalence and severity because of aging processes and related organic, iatrogenic and social problems. Decline of testosterone (T) levels is observed with age and also in illnesses with a common basis of endothelial damage. The T deficiency may lead to decreased energy, mood depression, reduction of sexual desire, but no correlation has been reported between T level and severity of ED, which is mainly a neurovascular disease. In facts, inhibition of phosphodiesterase type 5 (PDE5) isoenzyme with sildenafil, tadalafil and vardenafil enhances vasodilatation in the corpus cavernosum and subsequent penile erection. Absolute pharmacological potency of PDE5 inhibitors is similar and non-selectivity defines the side-effects profile, while their elimination half-life explains not only the different duration of action, but also short and long-term tolerability. Efficacy of PDE5 inhibitors in younger patients is greater in respect to older subjects because of associated pathologies and the decline in hypothalamic-pituitary-gonadal function. T is essential in erectile function, controlling the expression and activity of PDE5 and therefore, androgen supplementation improves therapeutic response to PDE5 inhibitors in hypogonadal subjects. Since sexual behavior is a complex interplay of physical, psychological, and social factors, the possible effect of these drugs on androgen levels and brain function need to be deeply investigated. The ubiquitarious distribution of PDE5 and the availability of selective inhibitory molecules foster newer studies in the treatment of heart failure, pulmonary hypertension, inflammation, and depression. This new progress is certainly contributing to a better medical approach to sexuality and quality of life in aging people.

  14. Outcomes of long-term testosterone replacement in older hypogonadal males: a retrospective analysis.

    PubMed

    Hajjar, R R; Kaiser, F E; Morley, J E

    1997-11-01

    To determine the complications, toxicities, and compliance of long term testosterone replacement in hypogonadal males, we retrospectively assessed 45 elderly hypogonadal men receiving testosterone replacement therapy and 27 hypogonadal men taking testosterone. Hypogonadism was defined as a bioavailable testosterone serum concentration of 72 ng/dL or less. Both groups received baseline physical examinations and blood tests. The testosterone-treated group received 200 mg testosterone enanthate or cypionate im every 2 weeks, and follow-up examinations and blood samplings were performed every 3 months. The control group had a single follow-up blood test and physical examination. There was no significant difference in the initial blood tests in the two groups. At 2 yr follow-up, only the hematocrit showed a statistically significant increase in the testosterone-treated group compared to the control group (P < 0.001). A decrease in the urea nitrogen to creatinine ratio and an increase in the prostate-specific antigen concentration was not statistically significant. Eleven (24%) of the testosterone-treated subjects developed polycythemia sufficient to require phlebotomy or the temporary withholding of testosterone, one third of which occurred less than 1 yr after starting testosterone treatment. There was no significant difference in the incidence of new illness in the two groups during the 2-yr follow-up. Although self-assessment of libido was dramatically improved in the testosterone-treated group (P < 0.0001), approximately one third of the subjects discontinued therapy. In conclusion, testosterone replacement therapy appears to be well tolerated by over 84% of the subjects. Long term testosterone replacement to date appears to be a safe and effective means of treating hypogonadal elderly males, provided that frequent follow-up blood tests and examinations are performed.

  15. The Veterans' Plight

    ERIC Educational Resources Information Center

    Jett, George Robert, Jr.; And Others

    1973-01-01

    This issue is devoted to the practical problems which confront veterans reentering society. Articles included deal with such topics as college admission, readjustment to school or college, vocational rehabilitation, experiences of a woman veteran, and the counseling of veterans. (JC)

  16. 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

  17. Reconceptualizing Cancer Survivorship Through Veterans' Lived Experiences

    PubMed Central

    Martin, Lindsey Ann; Moye, Jennifer; Street, Richard L.; Naik, Aanand D.

    2015-01-01

    This study assessed the biopsychosocial impact of cancer on Veteran older adult survivors by garnering their accounts of their illness experiences. A narrative analysis of 73 cancer diagnosis and treatment stories reveals five “paths” Veterans are taking 18 months postdiagnosis. These paths indicate that cancer survivorship cannot be conceptualized as a one-size-fits-all experience but rather is a process of Veterans understanding and making sense of the effects of cancer on their lives. Our future goal is to develop a screening tool to help clinicians identify a patient's “path” to tailor survivorship care to meet specific needs. PMID:24611460

  18. Subjective age, PTSD and physical health among war veterans.

    PubMed

    Solomon, Zahava; Helvitz, Hedva; Zerach, Gadi

    2009-05-01

    To examine the contribution of posttraumatic stress disorder (PTSD) and physical health to subjective age among war veterans. The sample included 502 veterans of the first Lebanon War who were assessed 20 years after the war by a series of self-report questionnaires. Data analyses included descriptive statistics, hierarchical and logistic regressions. Veterans with PTSD reported older subjective age than veterans without PTSD. Furthermore, both PTSD and general physical health contributed to subjective age, above and beyond chronological age and negative life events. Among the physical health problems, memory problems and weight gain were found to contribute to older age identity. In addition, the relation between general physical health and subjective age was stronger among veterans without PTSD than among veterans with PTSD. Possible explanations, clinical implications for integrative therapy for elderly PTSD victims, and recommendations for future research are presented.

  19. Suicide among incarcerated veterans.

    PubMed

    Wortzel, Hal S; Binswanger, Ingrid A; Anderson, C Alan; Adler, Lawrence E

    2009-01-01

    Both veterans and jail/prison inmates face an increased risk of suicide. The incarcerated veteran sits at the intersection of these two groups, yet little is known about this subpopulation, particularly its risk of suicide. A Pubmed/Medline/PsycINFO search anchored to incarcerated veteran suicide, veteran suicide, suicide in jails/prisons, and veterans incarcerated from 2000 to the present was performed. The currently available literature does not reveal the suicide risk of incarcerated veterans, nor does it enable meaningful estimates. However, striking similarities and overlapping characteristics link the data on veteran suicide, inmate suicide, and incarcerated veterans, suggesting that the veteran in jail or prison faces a level of suicide risk beyond that conferred by either veteran status or incarceration alone. There is a clear need for a better characterization of the incarcerated veteran population and the suicide rate faced by this group. Implications for clinical practice and future research are offered.

  20. Construction of the Chinese Veteran Clinical Research (CVCR) platform for the assessment of non-communicable diseases.

    PubMed

    Tan, Jiping; Li, Nan; Gao, Jing; Guo, Yuhe; Hu, Wei; Yang, Jinsheng; Yu, Baocheng; Yu, Jianmin; Du, Wei; Zhang, Wenjun; Cui, Lianqi; Wang, Qingsong; Xia, Xiangnan; Li, Jianjun; Zhou, Peiyi; Zhang, Baohe; Liu, Zhiying; Zhang, Shaogang; Sun, Lanying; Liu, Nan; Deng, Ruixiang; Dai, Wenguang; Yi, Fang; Chen, Wenjun; Zhang, Yongqing; Xue, Shenwu; Cui, Bo; Zhao, Yiming; Wang, Luning

    2014-01-01

    Based on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs. The Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation. A total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%). We first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long

  1. Mortality in Postmenopausal Women by Sexual Orientation and Veteran Status.

    PubMed

    Lehavot, Keren; Rillamas-Sun, Eileen; Weitlauf, Julie; Kimerling, Rachel; Wallace, Robert B; Sadler, Anne G; Woods, Nancy Fugate; Shipherd, Jillian C; Mattocks, Kristin; Cirillo, Dominic J; Stefanick, Marcia L; Simpson, Tracy L

    2016-02-01

    To examine differences in all-cause and cause-specific mortality by sexual orientation and Veteran status among older women. Data were from the Women's Health Initiative, with demographic characteristics, psychosocial factors, and health behaviors assessed at baseline (1993-1998) and mortality status from all available data sources through 2014. Women with baseline information on lifetime sexual behavior and Veteran status were included in the analyses (N = 137,639; 1.4% sexual minority, 2.5% Veteran). The four comparison groups included sexual minority Veterans, sexual minority non-Veterans, heterosexual Veterans, and heterosexual non-Veterans. Cox proportional hazard models were used to estimate mortality risk adjusted for demographic, psychosocial, and health variables. Sexual minority women had greater all-cause mortality risk than heterosexual women regardless of Veteran status (hazard ratio [HR] = 1.20, 95% confidence interval [CI]: 1.07-1.36) and women Veterans had greater all-cause mortality risk than non-Veterans regardless of sexual orientation (HR = 1.14, 95% CI: 1.06-1.22), but the interaction between sexual orientation and Veteran status was not significant. Sexual minority women were also at greater risk than heterosexual women for cancer-specific mortality, with effects stronger among Veterans compared to non-Veterans (sexual minority × Veteran HR = 1.70, 95% CI: 1.01-2.85). Postmenopausal sexual minority women in the United States, regardless of Veteran status, may be at higher risk for earlier death compared to heterosexuals. Sexual minority women Veterans may have higher risk of cancer-specific mortality compared to their heterosexual counterparts. Examining social determinants of longevity may be an important step to understanding and reducing these disparities. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

  2. Honoring the Call to Duty: Veterans’ Disability Benefits in the 21st Century

    DTIC Science & Technology

    2007-10-01

    service and the approximate percentage of each population receiving disability benefits at the end of fiscal year (FY) 2006. There are also many veterans ...time (Table 3- 1). Note that the percentage of each group receiving benefits relates only to the number of living veterans , not to the percentage of... Veterans ’ Disability Benefits in the 21st Century National Survey of Veterans found female veterans to be younger than their male counterparts

  3. 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…

  4. 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…

  5. Effects of sulfur dioxide on pulmonary function in healthy nonsmoking male subjects aged 55 years and older

    SciTech Connect

    Rondinelli, R.C.A.; Koenig, J.Q.; Marshall, S.G.

    1987-04-01

    To determine whether normal nonsmoking individuals aged 55 years or greater have heightened bronchial reactivity to inhaled SO/sub 2/, ten male subjects, 55 to 73 year of age, were exposed for 20 min at rest and 10 min during moderate exercise on a treadmill to the following: 1) NaCl droplet aerosol, or 2) 1.0 ppm of SO/sub 2/ and NaCl droplet aerosol. Seven of the subjects also were exposed to 0.5 ppm SO/sub 2/ and NaCl droplet aerosol. Significant decreases in forced expiratory volume in one sec (FEV/sub 1/) were seen 2-3 min post-exercise following all three test modes. The reduction in FEV/sub 1/ seen after NaCl aerosol + 1.0 ppm SO/sub 2/ was significantly greater than that seen after NaCl aerosol alone. The results show that men aged 55 years or older are somewhat more sensitive to NaCl aerosol + 1.0 ppm SO/sub 2/ than similarly exposed normal adolescents, but not nearly as sensitive as asthmatic subjects. This study also demonstrates that investigations of air pollutants and exercise can be undertaken in subjects of this age.

  6. The health and functional status of US veterans aged 65+: implications for VA health programs serving an elderly, diverse veteran population.

    PubMed

    Villa, Valentine M; Harada, Nancy D; Washington, Donna; Damron-Rodriguez, JoAnn

    2003-01-01

    As the US population is aging, so too is the US veteran population. Chief among the challenges facing the Department of Veterans Affairs (VA) is developing health programs and services that mesh with the needs of an aging veteran population and therefore improve the health status of elderly veterans. Meeting this challenge requires an understanding of the health needs of the older veteran population, including health disparities that exist across racial ethnic populations. This study examines the self-rated health and functioning of a national sample of veterans aged 65+ participating in the National Survey of Veterans. The results show that over one half of elderly veterans report difficulty in functioning and rate their health status as fair or poor. Additionally, elderly African American and Hispanic veterans report worse health than non-Hispanic white veterans across the majority of health indicators. Given the health profile of older veterans found in this study, it would seem necessary that programs serving older veterans be adept at the ongoing medical management of chronic disease and the provision of long-term care services.

  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. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  8. An open-label pilot study of aripiprazole for male and female veterans with chronic post-traumatic stress disorder who respond suboptimally to antidepressants.

    PubMed

    Youssef, Nagy A; Marx, Christine E; Bradford, Daniel W; Zinn, Sandra; Hertzberg, Michael A; Kilts, Jason D; Naylor, Jennifer C; Butterfield, Marian I; Strauss, Jennifer L

    2012-07-01

    Emerging data suggest that second-generation antipsychotics such as aripiprazole may be effective in the treatment of post-traumatic stress disorder (PTSD). However, few clinical trials have used aripiprazole in PTSD, and data are limited on its use in Veterans with PTSD. The objective of this pilot trial was to investigate the safety and efficacy of aripiprazole in Veterans with PTSD. Ten individuals (five men and five women) meeting the Diagnostic and statistical manual of mental disorders, 4th ed., PTSD criteria participated in this 12-week, open-label, flexibly dosed monotherapy trial. The dose range of aripiprazole was 5-30 mg/day, titrated to tolerability and clinical response. The primary outcome measure was the Clinician-Administered PTSD Scale. Additional outcomes included the Short PTSD Rating Interview, the Treatment Outcome PTSD Scale (Top-8), the Davidson Trauma Scale, the Positive and Negative Syndrome Scale, the Beck Depression Inventory-Fast Screen, and Clinical Global Impressions-Improvement. Eight participants completed the study, and aripiprazole was generally well tolerated and associated with a significant improvement in PTSD symptoms, as measured by the Clinician-Administered PTSD Scale (primary outcome measure) and by the Short PTSD Rating Interview, the Treatment Outcome PTSD Scale, and the Davidson Trauma Scale. An improvement was also observed on all three Positive and Negative Syndrome Scale subscales and the Beck Depression Inventory-Fast Screen, and the average Clinical Global Impressions-Improvement ratings indicated that patients were 'much improved'. These promising initial results merit further investigation in a larger, randomized-controlled trial.

  9. 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.

  10. Behaviors of older men living in the community. Correlates producing active composure.

    PubMed

    Carter, Kimberly Ferren

    2003-10-01

    The correlates of active composure behaviors for older veteran men living in the community were investigated to identify this aspect of the complex domain of health behavior. Cox's (1982) Interaction Model of Client Health Behavior was used to frame this investigation. The independent variables were age, education, race, marital status, children, siblings, income, spiritual well-being, functional status, motivation, health conceptions, and loneliness. The dependent variable was Schwirian's (1992) active composure, conceptualized as activities producing rest, relaxation, and anxiety and stress reduction. The sample was male veterans (N = 184) older than 65 who were not living in an institution. A multiple regression model explained 49% of the variance in active composure. Race, income, religious aspect of spiritual well-being, instrumental activities of daily living, and loneliness were significant predictors. Results suggest that nurses may find these correlates helpful in facilitating the identification of risk status and developing active composure self-care strategies for older men living in the community.

  11. Knowledge and risks of human immunodeficiency virus transmission among veterans with severe mental illness.

    PubMed

    Strauss, Jennifer L; Bosworth, Hayden B; Stechuchak, Karen M; Meador, Keith M; Butterfield, Marian I

    2006-04-01

    This study is among the first to examine knowledge about human immunodeficiency virus (HIV) and behavioral risks for HIV transmission among veterans with severe mental illness (SMI), a group at high risk for HIV infection. This study examined associations between accuracy of HIV knowledge, risk behaviors, and clinical and demographic characteristics in a sample of male veteran psychiatric inpatients diagnosed with SMI (N = 353). Results showed high rates of inaccurate HIV knowledge, with > 40% of patients demonstrating some inaccuracies, particularly those related to the progression and symptoms of acquired immunodeficiency syndrome. Inaccurate HIV knowledge was associated with older age, minority status, education level, marital status, no homelessness within the previous 6 months, and no reported history of illicit intranasal drug use. There is a need for more effective HIV prevention interventions for persons with SMI.

  12. Co-occurrence of antisocial behavior and substance use: testing for sex differences in the impact of older male friends, low parental knowledge and friends' delinquency.

    PubMed

    McAdams, Tom A; Salekin, Randall T; Marti, C Nathan; Lester, Whiney S; Barker, Edward D

    2014-04-01

    Delinquency and substance use (SU) are commonly comorbid during adolescence. In the present study we investigate this co-morbidity with 3 main objectives: 1. Evaluate reciprocal relationships between delinquency/SU across early adolescence. 2. Assess the impact of older male friends, low parental knowledge and friends' delinquency on subsequent development and inter-relationships of delinquency and SU. 3. Evaluate sex differences in these relationships. We applied cross-lagged structural equation models to the analysis of a longitudinal sample (n=3699). Findings demonstrated: (1) At ages 13-14 delinquency predicted SU more so than vice versa but effects became equal between ages 14 and 15. (2) Low parental knowledge and friends' delinquency predicted delinquency and SU. Older male friends predicted ASB. (3) Sex differences were present. For example, in the absence of antisocial friends low parent knowledge at age 12 indirectly predicted increased age 15 SU for girls more than boys.

  13. A random effects multinomial logit analysis of using Medicare and VA healthcare among veterans with dementia

    PubMed Central

    Zhu, Carolyn W.; Livote, Elayne E.; Ross, Joseph S.; Penrod, Joan D.

    2011-01-01

    Aims To examine longitudinal patterns of VA-only use, dual VA and Medicare use, or Medicare-only use among veterans with dementia. Methods Data on VA and Medicare use (1998–2001) were obtained from and VA administrative datasets and Medicare claims for 2,137 male veterans with a formal diagnosis of Alzheimer’s disease or vascular dementia enrolled in the National Longitudinal Caregiver Study. A random effects multinomial logit model accounting for unobserved individual heterogeneity was used to estimate the effects of patient and caregiver characteristics on use group over time. Results Compared to VA-only use, dual VA and Medicare use was associated with being white, married, higher education, having private insurance, Medicaid, low VA priority level, more functional limitations, and having lived in a nursing home or died in that year. Medicare-only use was associated with older age, being married, higher education, having private insurance, low VA priority level, living further from a VA Medical Center, having more comorbidities, functional limitations, and having lived in a nursing home or died. Veterans whose caregivers reported better health were more likely to be dual users, but those whose caregivers reported more comorbidities were more likely to use Medicare only. Discussion Different aspects of veterans’ needs and caregiver characteristics have differential effect on where veterans seek care. Efforts to coordinate care between VA and Medicare providers are necessary to ensure patients receive high quality care. PMID:20635273

  14. Veterans Aging Cohort Study (VACS)

    PubMed Central

    Justice, Amy C.; Dombrowski, Elizabeth; Conigliaro, Joseph; Fultz, Shawn L.; Gibson, Deborah; Madenwald, Tamra; Goulet, Joseph; Simberkoff, Michael; Butt, Adeel A.; Rimland, David; Rodriguez-Barradas, Maria C.; Gibert, Cynthia L.; Oursler, Kris Ann K.; Brown, Sheldon; Leaf, David A.; Goetz, Matthew B.; Bryant, Kendall

    2010-01-01

    Background The Veterans Aging Cohort Study (VACS) is a study of human immunodeficiency virus (HIV) infected and uninfected patients seen in infectious disease and general medical clinics. VACS includes the earlier 3 and 5 site studies (VACS 3 and VACS 5) as well as the ongoing 8 site study. Objectives We sought to provide background and context for analyses based upon VACS data, including study design and rationale as well as its basic protocol and the baseline characteristics of the enrolled sample. Research Design We undertook a prospectively consented multisite observational study of veterans in care with and without HIV infection. Measures Data were derived from patient and provider self report, telephone interviews, blood and DNA samples, focus groups, and full access to the national VA “paperless” electronic medical record system. Results More than 7200 veterans have been enrolled in at least one of the studies. The 8 site study (VACS) has enrolled 2979 HIV-infected and 3019 HIV-uninfected age–race–site matched comparators and has achieved stratified enrollment targets for race/ethnicity and age and 99% of its total target enrollment as of October 30, 2005. Participants in VACS are similar to other veterans receiving care within the VA. VACS participants are older and more predominantly black than those reported by the Centers for Disease Control. Conclusions VACS has assembled a rich, in-depth, and representative sample of veterans in care with and without HIV infection to conduct longitudinal analyses of questions concerning the association between alcohol use and related comorbid and AIDS-defining conditions. PMID:16849964

  15. Activity-Limiting Musculoskeletal Conditions in US Veterans Compared to Non-Veterans: Results from the 2013 National Health Interview Survey

    PubMed Central

    Hinojosa, Ramon

    2016-01-01

    Past military service is associated with health outcomes, both positive and negative. In this study we use the 2013 National Health Interview Survey to examine the constellation of conditions referred to as musculoskeletal disorders (MSDs) for Veterans and non-veterans with health conditions that limit their daily activities. Multivariate logistic regression analysis reveal that Veterans are more likely to report MSDs like neck and back problems, fracture bone and joint problems as an activity limiting problem compared to non-veterans. The relationship between age and reports of activity limiting MSDs is moderated by Veteran status. Veterans in this sample report more activity limiting MSDs at younger ages compared to non-veterans and fewer MSDs at older ages. This research contributes to our understanding of potentially limiting health conditions at earlier ages for Veterans. PMID:28005905

  16. Activity-Limiting Musculoskeletal Conditions in US Veterans Compared to Non-Veterans: Results from the 2013 National Health Interview Survey.

    PubMed

    Hinojosa, Ramon; Hinojosa, Melanie Sberna

    2016-01-01

    Past military service is associated with health outcomes, both positive and negative. In this study we use the 2013 National Health Interview Survey to examine the constellation of conditions referred to as musculoskeletal disorders (MSDs) for Veterans and non-veterans with health conditions that limit their daily activities. Multivariate logistic regression analysis reveal that Veterans are more likely to report MSDs like neck and back problems, fracture bone and joint problems as an activity limiting problem compared to non-veterans. The relationship between age and reports of activity limiting MSDs is moderated by Veteran status. Veterans in this sample report more activity limiting MSDs at younger ages compared to non-veterans and fewer MSDs at older ages. This research contributes to our understanding of potentially limiting health conditions at earlier ages for Veterans.

  17. Spousal Labor Market Effects from Government Health Insurance: Evidence from a Veterans Affairs Expansion

    PubMed Central

    Boyle, Melissa A.; Lahey, Joanna N.

    2015-01-01

    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. JEL codes: H4, I1, J2 PMID:26734757

  18. 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.

  19. Center for Women Veterans

    MedlinePlus

    ... In the Spotlight... October is Lesbian, Gay, Bisexual & Transgender (LGBT) History Month Mammograms 2017 National Women Veterans ... We hope your visit was informative. U.S. Federal/Military Sites — You will leave the Department of Veterans ...

  20. For Homeless Veterans

    MedlinePlus

    ... homelessness by helping justice-involved Veterans who have mental health or substance use issues access needed VA clinical services. HCRV specialists work with Veterans to ease their transition from prison back into the community. How the Programs Work ...

  1. Introducing Veteran Critical Theory

    ERIC Educational Resources Information Center

    Phillips, Glenn A.; Lincoln, Yvonna S.

    2017-01-01

    Research on student veterans is in an infant state. As veterans continue to enroll in institutions of higher education, researchers must explore new ways of "knowing" student veterans. It is not enough to only describe and model this growing demographic, researchers must also have a tool for criticism and question. The next in an…

  2. 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

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

    2013-12-30

    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.

  3. Veterans transitioning from isolation to integration: a look at veteran/service dog partnerships.

    PubMed

    Crowe, Terry K; Sánchez, Victoria; Howard, Alyse; Western, Brenna; Barger, Stephanie

    2017-08-13

    This study explored the dynamics of veteran/service dog partnerships by gathering the perspectives of veterans with a history of post-traumatic stress disorder and/or traumatic brain injury. Exploratory qualitative methods (focus groups and individual interviews) were used to investigate veteran/service dog relationships related to community involvement, family and friend relationships, self-care, work, and leisure. Nine male veterans, Paws, and Stripes program graduates participated. Data were audio recorded and transcribed by two research team members who used qualitative analytic software to manage and code the data. The full research team discussed themes and reached consensus on the themes that emerged from analysis. Five themes emerged about the perceived benefit of veteran/service dog relationship: Secluded but Seeking Society (moving from isolation to reconnection); Opening Opportunities (navigating daily life); Bridging the Gap (facilitating social opportunities); and Reclaiming Life (transforming sense of worth and purpose). An overarching theme, Calming Catalyst, connected the other four themes. Veterans in this study reported that their goal was to reclaim and develop key aspects of their lives and they perceived service dogs as a support in their transition from isolation to reintegration. This study found that service dogs supported the veterans to meet their goal. Implications for rehabilitation There are a significant number of veterans with post-traumatic stress disorder and/or traumatic brain injury who are facing life challenges including self-care, securing work, participating in leisure activities, and integrating into the community. Service dogs are an emerging intervention used to assist veterans with reintegration into civilian life. There is a need for professionals to be aware of potential benefits of service dog/veteran partnerships. Based on our findings, veterans could benefit from being paired with a service dog to facilitate their

  4. Systematic review of women veterans' mental health.

    PubMed

    Runnals, Jennifer J; Garovoy, Natara; McCutcheon, Susan J; Robbins, Allison T; Mann-Wrobel, Monica C; Elliott, Alyssa

    2014-01-01

    Given recent, rapid growth in the field of women veterans' mental health, the goal of this review was to update the status of women veterans' mental health research and to identify current themes in this literature. The scope of this review included women veterans' unique mental health needs, as well as gender differences in veterans' mental health needs. Database searches were conducted for relevant articles published between January 2008 and July 2011. Searches were supplemented with bibliographic reviews and consultation with subject matter experts. The database search yielded 375 titles; 32 met inclusion/exclusion criteria. The women veterans' mental health literature crosses over several domains, including prevalence, risk factors, health care utilization, treatment preferences, and access barriers. Studies were generally cross-sectional, descriptive, mixed-gender, and examined Department of Veterans Affairs (VA) health care users from all service eras. Results indicate higher rates of specific disorders (e.g., depression) and comorbidities, with differing risk factors and associated medical and functional impairment for female compared with male veterans. Although satisfaction with VA health care is generally high, unique barriers to care and indices of treatment satisfaction exist for women. There is a breadth of descriptive knowledge in many content areas of women veterans' mental health; however, the research base examining interventional and longitudinal designs is less developed. Understudied content areas and targets for future research and development include certain psychiatric disorders (e.g., schizophrenia), the effects of deployment on woman veterans' families, and strategies to address treatment access, attrition, and provision of gender-sensitive care. Published by Elsevier Inc.

  5. Patient characteristics associated with the level of patient-reported care coordination among male patients with colorectal cancer in the Veterans Affairs health care system.

    PubMed

    Jackson, George L; Zullig, Leah L; Phelan, Sean M; Provenzale, Dawn; Griffin, Joan M; Clauser, Steven B; Haggstrom, David A; Jindal, Rahul M; van Ryn, Michelle

    2015-07-01

    The current study was performed to determine whether patient characteristics, including race/ethnicity, were associated with patient-reported care coordination for patients with colorectal cancer (CRC) who were treated in the Veterans Affairs (VA) health care system, with the goal of better understanding potential goals of quality improvement efforts aimed at improving coordination. The nationwide Cancer Care Assessment and Responsive Evaluation Studies survey involved VA patients with CRC who were diagnosed in 2008 (response rate, 67%). The survey included a 4-item scale of patient-reported frequency ("never," "sometimes," "usually," and "always") of care coordination activities (scale score range, 1-4). Among 913 patients with CRC who provided information regarding care coordination, demographics, and symptoms, multivariable logistic regression was used to examine odds of patients reporting optimal care coordination. VA patients with CRC were found to report high levels of care coordination (mean scale score, 3.50 [standard deviation, 0.61]). Approximately 85% of patients reported a high level of coordination, including the 43% reporting optimal/highest-level coordination. There was no difference observed in the odds of reporting optimal coordination by race/ethnicity. Patients with early-stage disease (odds ratio [OR], 0.60; 95% confidence interval [95% CI], 0.45-0.81), greater pain (OR, 0.97 for a 1-point increase in pain scale; 95% CI, 0.96-0.99), and greater levels of depression (OR, 0.97 for a 1-point increase in depression scale; 95% CI, 0.96-0.99) were less likely to report optimal coordination. Patients with CRC in the VA reported high levels of care coordination. Unlike what has been reported in settings outside the VA, there appears to be no racial/ethnic disparity in reported coordination. However, challenges remain in ensuring coordination of care for patients with less advanced disease and a high symptom burden. Cancer 2015;121:2207-2213. © 2015

  6. The relationship between employment and veteran status, disability and gender from 2004-2011 Behavioral Risk Factor Surveillance System (BRFSS).

    PubMed

    Smith, Diane L

    2014-01-01

    In 2011, about 1.8 million or 8 percent of the 22.2 million veterans were women in the US. The unemployment rate for female veterans of the wars in Iraq and Afghanistan rose to 13.5%, above the 8.4% for non-veteran adult women. To examine data from the Behavioral Risk Factor Surveillance System (BRFSS), from 2004-2011 to determine the relationship between employment and veteran status, disability and gender. Chi square analysis was used to determine if significant differences existed between the employment rate of female veterans with disabilities and female veterans without disabilities, female non-veterans with disabilities and male veterans with disabilities. Binomial logistic regression analysis was used to determine how veteran status, disability and gender affected the likelihood of not being employed. Significant differences were found in employment rate between female veterans with disabilities and female veterans without disabilities, but not when compared to female non-veterans with disabilities or male veterans with disabilities. Disability was the strongest factor increasing the likelihood of not being employed, though veteran status and female gender were also predictive. Female veterans with disabilities experience low levels of employment. Policies and programs are needed to address the unique needs of these veterans.

  7. Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

    PubMed Central

    Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M.; Weinick, Robin M.; Woods, Dulani; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade. PMID:28083423

  8. Developing the PTSD Checklist-I/F for the DSM-IV (PCL-I/F): Assessing PTSD Symptom Frequency and Intensity in a Pilot Study of Male Veterans with Combat-Related PTSD

    PubMed Central

    Holliday, Ryan; Smith, Julia; North, Carol; Surís, Alina

    2015-01-01

    The widely used posttraumatic stress disorder (PTSD) Checklist (PCL) has established reliability and validity, but it does not differentiate posttraumatic symptom frequency from intensity as elements of posttraumatic symptom severity. Thus, the PCL in its existing form may not provide a comprehensive appraisal of posttraumatic symptomatology. Because of this, we modified the PCL to create the PCL-I/F that measures both frequency and intensity of PTSD symptoms via brief self-report. To establish validity and internal consistency of the PCL-I/F, we conducted a pilot study comparing PCL-I/F scores to structured diagnostic interview for PTSD (the Clinician Administered PTSD Scale [CAPS]) in a male combat veteran sample of 92 participants. Statistically significant correlations between the PCL-I/F and the CAPS were found, suggesting initial validation of the PCL-I/F to screen and assess frequency and intensity of combat-related PTSD symptoms. Implications are discussed for screening and assessment of PTSD related to combat and non-combat trauma. PMID:25654696

  9. Suicide in Scottish military veterans: a 30-year retrospective cohort study.

    PubMed

    Bergman, B P; Mackay, D F; Smith, D J; Pell, J P

    2017-07-01

    Although reassuring data on suicide risk in UK veterans of the 1982 Falklands conflict and 1991 Gulf conflict have been published, there have been few studies on long-term overall suicide risk in UK veterans. To examine the risk of suicide in a broad population-based cohort of veterans in Scotland, irrespect ive of length of service or exposure to conflict, in comparison with people having no record of military service. A retrospective 30-year cohort study of 56205 veterans born 1945-85 and 172741 matched non-veterans, using Cox proportional hazard models to compare the risk of suicide and fatal self-harm overall, by sex, birth cohort, length of service and year of recruitment. There were 267 (0.48%) suicides in the veterans compared with 918 (0.53%) in non-veterans. The difference was not statistically significant overall [adjusted hazard ratio (HR) 0.99; 95% confidence interval (CI) 0.86-1.13]. The incidence was lower in younger veterans and higher in veterans aged over 40. Early service leavers were at non-significantly increased risk (adjusted HR 1.13; 95% CI 0.91-1.40) but only in the older age groups. Women veterans had a significantly higher risk of suicide than non-veteran women (adjusted HR 2.44; 95% CI 1.32-4.51, P < 0.01) and comparable risk to veteran men. Methods of suicide did not differ significantly between veterans and non-veterans, for either sex. The Scottish Veterans Health Study adds to the emerging body of evidence that there is no overall difference in long-term risk of suicide between veterans and non-veterans in the UK. However, female veterans merit further study.

  10. 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.

  11. 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

  12. Caring for Vietnam Veterans.

    PubMed

    Elliott, Brenda

    2015-01-01

    Veterans of the Vietnam era are now the largest group of United States Veterans, and are at or approaching Social Security and Medicare eligibility. As a result, it is likely that home care clinicians will be caring for many patients who are Vietnam Veterans. The purpose of this article is to increase awareness of the unique healthcare needs of Vietnam Veterans. Having an understanding of military and Veteran culture can help inform home healthcare clinicians in ways to manage the unique healthcare needs of Veterans and engage previously learned behaviors and attitudes from military service. In addition, knowing the types of exposures and health risks specific to this era could be beneficial in identifying potential problems that may have not yet been addressed.

  13. Women Veterans and Mental Health

    MedlinePlus

    ... Health > Women veterans and mental health Mental Health Women veterans and mental health Post-traumatic stress disorder ( ... hurt you. Post-traumatic stress disorder (PTSD) and women veterans PTSD can occur after you have been ...

  14. Disparities in HIV and syphilis prevalence and risk factors between older male clients with and without steady sex partners in southwestern rural China.

    PubMed

    Chen, Li; His, Jenny H; Wu, Xinghua; Shen, Zhiyong; Lu, Huaxiang; Chen, Huanhuan; Huang, Hui; Zhang, Heng; Ruan, Yuhua; Shao, Yiming; Tang, Zhenzhu

    2017-04-12

    Heterosexual intercourse accounted for 93% of reported HIV cases in Guangxi, and Guangxi had 10% of China's total number of reported HIV cases. Older men are particularly vulnerable to STIs, for example, 46% of Guangxi's HIV cases were men over 50 years of age. As this is an under-studied population in China, effective prevention and control policies have yet to be developed. Thus, the aim of this study was to use a large-scale cross-sectional survey to understand the demographic and behavior factors associated with HIV and syphilis infections among older male clients of female sex workers (FSWs) in a high epidemic area of rural Guangxi, China. A large-scale cross-sectional survey was conducted in 2012 among older male clients of FSWs in low-cost commercial sex venues. Questionnaire interviews were administered to collect sociodemographic and sexual behavior information. Blood samples were collected for HIV and syphilis infection tests. Of the 3485 participants, 2509 (72.0%) clients had a steady sex partner and 976 (28.0%) clients had no steady sex partner. The overall prevalence of HIV and syphilis infection were 3.0% and 3.2%, respectively. Compared to those with a steady sex partner, clients with no steady partner had higher odds of HIV infection (AOR: 1.90, 95% CI: 1.27-2.86), syphilis infection (AOR: 1.53, 95% CI: 1.02-2.30), and having factors associated with HIV or syphilis infection, including non-commercial casual sex encounters in last month (AOR: 3.29, 95% CI: 2.42-4.46), >10 years of commercial sex history (AOR: 1.31, 95% CI: 1.12-1.53), >2 incidents of commercial sex in last month (AOR: 1.53, 95% CI: 1.19-1.96), and aphrodisiac use in last month (AOR: 1.40, 95% CI: 1.16-1.70). Clients with no steady partner had lower odds of having heterosexual intercourse (AOR: 0.66, 95% CI: 0.56-0.79), awareness and knowledge of HIV/AIDS (AOR: 0.75, 95% CI: 0.64-0.88), and having had HIV tests (AOR: 0.65, 95% CI: 0.44-0.98). Older male clients of low

  15. 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.

  16. Veterans Health Administration

    MedlinePlus

    ... Act Resources Business Congressional Affairs Jobs Benefits Booklet Data & Statistics National Resource Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & Protections Media ...

  17. Changes in Suicide Mortality for Veterans and Nonveterans by Gender and History of VHA Service Use, 2000-2010.

    PubMed

    Hoffmire, Claire A; Kemp, Janet E; Bossarte, Robert M

    2015-09-01

    Veterans are believed to be at high risk of suicide. However, research comparing suicide rates between veterans and nonveterans is limited, and even less is known regarding differences by history of Veterans Health Administration (VHA) service use. This study directly compared veteran and nonveteran suicide risk while for the first time differentiating veterans by VHA service use. The cross-sectional study analyzed data from 173,969 adult suicide decedents from 23 states (2000-2010) included in the U.S. Department of Veterans Affairs suicide data archive. Annual standardized mortality ratios (SMRs) were computed for veterans compared with nonveterans and for veterans who used VHA services compared with veterans who did not, overall and separately for males and females. After the analysis controlled for age and gender differences, the number of observed veteran suicides was approximately 20% higher than expected in 2000 (SMR=1.19, 95% confidence interval [CI]=1.10-1.28), and this increased to 60% higher by 2010 (SMR=1.63, CI=1.58-1.68). The elevated risk for female veterans (2010 SMR=5.89) was higher than that observed for male veterans (2010 SMR=1.54). Trends for non-VHA-utilizing veterans mirrored those of the veteran population as a whole, and the SMR for VHA-utilizing veterans declined. Since 2003, the number of suicides among VHA-utilizing veterans was less than expected when compared directly with the suicide rate among non-VHA-utilizing veterans. Veterans are members of the community and, as such, are an important part of observed increases in U.S. suicide rates. Not all veterans are at equal or increasing risk of suicide, however. VHA-utilizing veterans appear to have declining absolute and relative suicide rates.

  18. Suicide Mortality Among Patients Treated by the Veterans Health Administration From 2000 to 2007

    PubMed Central

    Bohnert, Amy S. B.; Ilgen, Mark A.; Ignacio, Rosalinda; McCarthy, John F.; Valenstein, Marcia M.; Knox, Kerry L.

    2012-01-01

    Objectives. We sought to examine rates of suicide among individuals receiving health care services in Veterans Health Administration (VHA) facilities over an 8-year period. Methods. We included annual cohorts of all individuals who received VHA health care services from fiscal year (FY) 2000 through FY 2007 (October 1, 1999–September 30, 2007; N = 8 855 655). Vital status and cause of death were obtained from the National Death Index. Results. Suicide was more common among VHA patients than members of the general US population. The overall rates of suicide among VHA patients decreased slightly but significantly from 2000 to 2007 (P < .001). Male veterans between the ages of 30 and 64 years were at the highest risk of suicide. Conclusions. VHA health care system patients are at elevated risk for suicide and are appropriate for suicide reduction services, although the rate of suicide has decreased in recent years for this group. Comprehensive approaches to suicide prevention in the VHA focus not only on recent returnees from Iraq and Afghanistan but also on middle-aged and older Veterans. PMID:22390612

  19. Serum uric acid is associated with lumbar spine bone mineral density in healthy Chinese males older than 50 years

    PubMed Central

    Xiao, Jing; Chen, Weijun; Feng, Xinhui; Liu, Wenyi; Zhang, Zhenxing; He, Li; Ye, Zhibin

    2017-01-01

    Objectives We aimed to investigate the association of serum uric acid (UA) levels with bone mineral density (BMD) at all skeletal sites in healthy Chinese males >50 years of age. Methods A cross-sectional study of 385 Chinese males >50 years of age who underwent health checkup in Huadong Hospital Affiliated to Fudan University in Shanghai, China, was conducted. Clinical and bone characteristics were compared in different UA tertiles (UA1: UA <4.7 mg/dL, UA2: 4.7 mg/dL ≤ UA <6 mg/dL and UA3: UA ≥6 mg/dL). Pearson correlation and multiple regression analysis were used to study the correlation of UA with BMD at various skeletal sites. Results Serum UA levels were positively associated with higher BMD and T-values at the lumbar spine, but not at other skeletal sites, after adjusting for multiple confounding factors. Lumbar spine BMD; the T- and Z-values at the lumbar spine, total hip and femoral neck; as well as intact parathyroid hormone (iPTH) levels are higher in the highest tertile of UA than in the second tertile of UA. Conclusion Our results provide epidemiological evidence in Chinese Han males aged >50 years that serum UA levels are positively correlated with lumbar spine BMD and T-values, suggesting that UA may exert protective effect on bone density at the lumbar spine in Chinese males >50 years of age. PMID:28280317

  20. 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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Paralyzed Veterans of America

    MedlinePlus

    ... the Military Join Team REVolution today & run the Marine Corps Marathon! #YouRaceTheyWin LOOKING FOR SUPPORT? VETERANS CAREGIVERS ... our lives…" - Noah Currier: “Oscar Mike”, Cpl, U.S. Marine Corps Veteran READ HIS STORY OUR BLOG The ...

  2. 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…

  3. 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…

  4. Black Veterans Return

    ERIC Educational Resources Information Center

    Fendrich, James; Pearson, Michael

    1970-01-01

    This is a survey study of black veterans' attitudes toward white authorities, the "law and order controversy, racial separatism, violence, and black identification. Results of the survey are held to suggest that alienation will move a substantial proportion of these veterans into the black radical movement. (KG)

  5. A Combined Training Program for Veterans with Amnestic Mild Cognitive Impairment

    DTIC Science & Technology

    2015-10-01

    AWARD NUMBER: W81XWH-12-1-0584 TITLE: A Combined Training Program for Veterans with Amnestic Mild Cognitive Impairment PRINCIPAL INVESTIGATOR...Sept 2014 – 26 Sept 2015 4. TITLE AND SUBTITLE A Combined Training Program for Veterans with Amnestic Mild Cognitive Impairment 5a. CONTRACT NUMBER...augmentation for cognitive training intervention to improve memory performance in older Veterans with a diagnosis of amnestic Mild Cognitive Impairment

  6. Evidence of poorer life-course mental health outcomes among veterans of the Korean War cohort.

    PubMed

    Brooks, Matthew Stephen; Fulton, Lawrence

    2010-03-01

    Comparing the outcomes of veterans who served in Korea and those who served elsewhere, we examined the treatment of post-traumatic stress disorder (PTSD), other mental health conditions, psychiatric treatment locations, and six mental health well-being measures. The analytic sample consisted of nationally representative data from the 2001 National Survey of Veterans (NSV). Analyses included multiple logistic regressions that controlled for sociodemographic characteristics. Korean era veterans in the NSV (n = 4030): 1498 served in Korea; 2532 elsewhere during the era. Veterans who served in Korea have notably poorer mental health than those who served elsewhere. These results suggest higher resource needs among aging Korean era veterans. Clinicians, policy makers and the Department of Veterans Affairs should focus on mental health services to older veterans.

  7. Mental health treatment preferences and challenges of living with multimorbidity from the veteran perspective.

    PubMed

    DiNapoli, Elizabeth A; Cinna, Christopher; Whiteman, Karen L; Fox, Lauren; Appelt, Cathleen J; Kasckow, John

    2016-10-01

    To explore middle-aged and older veterans' current disease-management practices, mental health treatment preferences, and challenges of living with multiple chronic health conditions (i.e., multimorbidity). Semi-structured qualitative interviews and self-report measures were collected from 28 middle-aged and older (50 years of age or older) veterans with multimorbidity. Our sample of veterans with multimorbidity was, on average, mildly depressed and anxious with elevated stress and disability. Veterans acknowledged the interaction of physical and emotional symptoms, which caused greater difficulty with health care management and daily functioning. Veterans had many concerns regarding their physical and emotional health conditions, such as continued disease progression and the addition of other emotional and physical health complications. Veterans also identified specific self-care approaches for disease management (e.g., medication, healthy lifestyle practices, and psychological stress management techniques), as well as barriers to engaging in care (e.g., money, transportation, and stigma). Participants preferred a combination of medication, psychotherapy, and healthy lifestyle practices for mental health treatment. The majority of participants (88.5%) agreed that these mental health treatments would be beneficial to integrate into disease management for older veterans with multimorbidity. Lastly, veterans provided an array of recommendations for improving Veteran's Administration services and reducing mental health stigma. These findings provide support for patient-centered approaches and integrated mental and physical health self-management in the Veteran's Administration for middle-aged and older veterans with multiple chronic conditions. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  8. 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.

  9. Differential effects of heart rate modification training on college students, older males, and patients with ischemic heart disease.

    PubMed

    Lang, P J; Troyer, W G; Twentyman, C T; Gatchel, R J

    1975-01-01

    Seventy male subjects participated in a six session study of feedback-mediated heart rate modification. Three groups of subjects were compared: (1) college students, (2) patients with ischemic heart disease, and (3) healthy males, age-matched to the patients. The groups did not differ in heart rate during rest or in response to a perceptual-motor tracking task. However, the college students produced significantly larger changes in cardiac rate than the other two groups when instructed to modify heart rate (speed or slow) and provided with exteroceptive feedback. The patients showed the poorest overall feedback performance. These differences between groups were greater for speeding than for the slowing task. Relationships were explored between feedback performance and resting heart and respiration rate, drug regime, and personality questionnaires. The results were consistent with the hypothesis that interdependence between psychological stimuli and cardiovascular events is reduced in heart disease.

  10. 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.

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

    PubMed Central

    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

  12. 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.

  13. Sexual revictimization among Iraq and Afghanistan war era veterans.

    PubMed

    Schry, Amie R; Beckham, Jean C; The Va Mid-Atlantic Mirecc Workgroup; Calhoun, Patrick S

    2016-06-30

    Research in both civilian and military populations has demonstrated that females who experience childhood sexual abuse (CSA) are more likely to experience sexual assault in adulthood than females who did not experience CSA. Among veteran samples, however, little research has examined previous sexual assault as a risk factor of military sexual assault and post-military sexual assault, and very little research has examined revictimization in male veterans. The purpose of this study was to examine risk of sexual revictimization in a sample of veterans who served during the wars in Iraq and Afghanistan. A sample of 3106 veterans (80.4% male) completed a measure of lifetime exposure to traumatic events, including sexual abuse and sexual assault. Logistic regression analyses were used to examine previous sexual abuse/assault as predictors of later sexual assault; analyses were conducted separately for males and females. In general, previous sexual abuse/assault was associated with later sexual assault in both male and female veterans. These findings have important assessment and treatment implications for clinicians working with veterans. Published by Elsevier Ireland Ltd.

  14. Sexual Revictimization among Iraq and Afghanistan War era Veterans

    PubMed Central

    Schry, Amie R.; Beckham, Jean C.; Calhoun, Patrick S.

    2016-01-01

    Research in both civilian and military populations has demonstrated that females who experience childhood sexual abuse (CSA) are more likely to experience sexual assault in adulthood than females who did not experience CSA. Among veteran samples, however, little research has examined previous sexual assault as a risk factor of military sexual assault and post-military sexual assault, and very little research has examined revictimization in male veterans. The purpose of this study was to examine risk of sexual revictimization in a sample of veterans who served during the wars in Iraq and Afghanistan. A sample of 3,106 veterans (80.4% male) completed a measure of lifetime exposure to traumatic events, including sexual abuse and sexual assault. Logistic regression analyses were used to examine previous sexual abuse/assault as predictors of later sexual assault; analyses were conducted separately for males and females. In general, previous sexual abuse/assault was associated with later sexual assault in both male and female veterans. These findings have important assessment and treatment implications for clinicians working with veterans. PMID:27149409

  15. The Association Between Primary Source of Healthcare Coverage and Colorectal Cancer Screening Among US Veterans.

    PubMed

    May, Folasade P; Yano, Elizabeth M; Provenzale, Dawn; Neil Steers, W; Washington, Donna L

    2017-08-01

    Colorectal cancer (CRC) is a deadly but largely preventable disease. Screening improves outcomes, but screening rates vary across healthcare coverage models. In the Veterans Health Administration (VA), screening rates are high; however, it is unknown how CRC screening rates compare for Veterans with other types of healthcare coverage. To determine whether Veterans with Veteran-status-related coverage (VA, military, TRICARE) have higher rates of CRC screening than Veterans with alternate sources of healthcare coverage. We conducted a cross-sectional analysis of Veterans 50-75 years from the 2014 Behavioral Risk Factor Surveillance System survey. We examined CRC screening rates and screening modalities. We performed multivariable logistic regression to identify the role of coverage type, demographics, and clinical factors on screening status. The cohort included 22,138 Veterans. Of these, 76.7% reported up-to-date screening. Colonoscopy was the most common screening modality (83.7%). Screening rates were highest among Veterans with Veteran-status-related coverage (82.3%), as was stool-based screening (10.8%). The adjusted odds of up-to-date screening among Veterans with Veteran-status-related coverage were 83% higher than among Veterans with private coverage (adjusted OR = 1.83, 95% CI = 1.52-2.22). Additional predictors of screening included older age, black race, high income, access to medical care, frequent medical visits, and employed or married status. CRC screening rates were highest among Veterans with Veteran-status-related coverage. High CRC screening rates among US Veterans may be related to system-level characteristics of VA and military care. Insight to these system-level characteristics may inform mechanisms to improve CRC screening in non-VA settings.

  16. The effects of misclassification biases on veteran suicide rate estimates.

    PubMed

    Huguet, Nathalie; Kaplan, Mark S; McFarland, Bentson H

    2014-01-01

    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. 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. 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. 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.

  17. 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

  18. 76 FR 72242 - Proposed Information Collection (Survey of Post-Deployment Adjustment Among OEF and OIF Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-22

    ... of automated collection techniques or the use of other forms of information technology. Title: Survey... (healthcare, relationship and parenting readjustment) differently affect male and female Veterans. Affected...

  19. Opioid dispensing and overlap in veterans with non-cancer pain eligible for Medicare Part D.

    PubMed

    Suda, Katie J; Smith, Bridget M; Bailey, Lauren; Gellad, Walid F; Huo, Zhiping; Burk, Muriel; Cunningham, Francesca; Stroupe, Kevin T

    Pain is the most prevalent problem among veterans, who receive pain diagnoses 5 times more frequently than the general population. Opioids are commonly prescribed for pain, but they have potential for misuse and serious adverse events. The study objective was to evaluate opioid dispensing patterns and predictors for overlap in veterans who are eligible for Medicare Part D benefits. A sample of male and all female veterans aged 66 years and older without cancer in 2005-2009 was included. Overlapping days' supply of opioids were evaluated within the U.S. Department of Veterans Affairs (VA), within Part D, and in cross-system users of VA and Part D-reimbursed pharmacies during 2007-2009. Dispensing patterns were analyzed with t tests and chi-square tests. Predictors of overlap were identified with general estimating equations. At least 1 opioid was dispensed to 88.5% of the sample. In 2006 after Part D implementation, 55.2% of opioids were dispensed by VA, decreasing to 44.3% in 2009 (P <0.0001). Opioids dispensed from Part D-reimbursed pharmacies had a higher frequency of overlap compared to those filled at a VA facility (P <0.0001). While overlapping days' supply for opioids filled at VA decreased, overlap increased for prescriptions filled at Part D-reimbursed pharmacies (P <0.0001). There was minimal overlap in opioids between systems, but cross-system use increased over the study period. Predictors for overlap include females, Part D enrollment, no VA medication copay, sleep disorders, psychiatric diagnoses, and substance or alcohol abuse (all P <0.01). Veterans who were Hispanic, older, and had higher incomes had lower overlap odds (all P <0.0001). Opioids dispensed from Part D-reimbursed pharmacies had a higher frequency of overlapping days' supply as compared to those filled by the VA, but there was minimal overlap between systems. While overlapping opioid prescriptions filled by the VA decreased from 2007 to 2009, overlap increased for prescriptions

  20. Filipino Veterans Promise Act

    THOMAS, 113th Congress

    Sen. Heller, Dean [R-NV

    2013-05-07

    Senate - 06/12/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-111. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. Veterans Pension Protection Act

    THOMAS, 113th Congress

    Sen. Wyden, Ron [D-OR

    2013-04-17

    Senate - 06/12/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-111. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  2. Health Programs for Veterans

    MedlinePlus

    ... and friends with qualified, caring VA responders Weight Management The MOVE! program: helping veterans lose weight, keep it off and improve ... Complete Directory EMAIL UPDATES Email Address Required Button ...

  3. Center for Women Veterans

    MedlinePlus

    ... Services Veterans Day 2016 “State of Women Veterans” Social Media Campaign VA has launched a “State of Women Veterans” (SOWV) social media campaign. For 10 weeks, beginning August 31 st , ...

  4. 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

  5. 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

  6. Longitudinal Cognitive Trajectories of Women Veterans from the Women's Health Initiative Memory Study.

    PubMed

    Padula, Claudia B; Weitlauf, Julie C; Rosen, Allyson C; Reiber, Gayle; Cochrane, Barbara B; Naughton, Michelle J; Li, Wenjun; Rissling, Michelle; Yaffe, Kristine; Hunt, Julie R; Stefanick, Marcia L; Goldstein, Mary K; Espeland, Mark A

    2016-02-01

    A comparison of longitudinal global cognitive functioning in women Veteran and non-Veteran participants in the Women's Health Initiative (WHI). We studied 7,330 women aged 65-79 at baseline who participated in the WHI Hormone Therapy Trial and its ancillary Memory Study (WHIMS). Global cognitive functioning (Modified Mini-Mental State Examination [3MSE]) in Veterans (n = 279) and non-Veterans (n = 7,051) was compared at baseline and annually for 8 years using generalized linear modeling methods. Compared with non-Veterans, Veteran women were older, more likely to be Caucasian, unmarried, and had higher rates of educational and occupational attainment. Results of unadjusted baseline analyses suggest 3MSE scores were similar between groups. Longitudinal analyses, adjusted for age, education, ethnicity, and WHI trial assignment revealed differences in the rate of cognitive decline between groups over time, such that scores decreased more in Veterans relative to non-Veterans. This relative difference was more pronounced among Veterans who were older, had higher educational/occupational attainment and greater baseline prevalence of cardiovascular risk factors (e.g., smoking) and cardiovascular disease (e.g., angina, stroke). Veteran status was associated with higher prevalence of protective factors that may have helped initially preserve cognitive functioning. However, findings ultimately revealed more pronounced cognitive decline among Veteran relative to non-Veteran participants, likely suggesting the presence of risks that may impact neuropathology and the effects of which were initially masked by Veterans' greater cognitive reserve. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Veterans Crisis Line Callers With and Without Prior VHA Service Use

    PubMed Central

    Britton, Peter C.; Kopacz, Marek S.; Stephens, Brady; Bossarte, Robert M.

    2016-01-01

    This study examines differences between Veterans with and without prior Veterans Health Administration service use who received a clinical referral from the Veterans' Crisis Line. Approximately 91% of Veterans had a history of service use and 9% did not. Callers with prior service use were older, had more mental health disorders, made in-person contact more quickly, and used more outpatient mental healthcare. Those without prior service use were younger, had more mental health problems, and presented for care later. Callers with suicide-related diagnoses had high rates of service contact. These groups represent different subpopulations with unique healthcare needs and practices. PMID:26649615

  8. Direct and indirect effects of religiosity on valuation of life through forgiveness and social provisions among older incarcerated males.

    PubMed

    Randall, G K; Bishop, Alex J

    2013-02-01

    Few studies have investigated the influence of religiosity (REL), forgiveness, and social resources on incarcerated individuals' attachment to their lives, or valuation of life (VOL). We tested a model linking REL to VOL through 3 subscales of the Heartland Forgiveness Scale (Self, Others, and Situations) and social provisions (SPS). Cross-sectional data were collected from 261 male prison inmates, aged 45-82, incarcerated in 8 state-managed correctional facilities. Participants were sampled from the prison census database (Oklahoma Department of Corrections or DOC). Exclusion criteria, per the Oklahoma DOC, were those housed in medical or psychiatric units, currently in solitary confinement, or sentenced to death row. To account for possible violations of multivariate normality, we used the Satorra-Bentler chi-square statistic. The final model fit the data well, explaining 57% of the variance in VOL: χ(2) (N = 261; df = 3) = 7.40; p = .06; Comparative Fit Index = .99; root mean squared error of approximation = .08; standardized root mean squared residual = .02. Significant indirect effects of REL on VOL were present through Forgiveness of Others and SPS, and of REL on SPS through Forgiveness of Others. Analyses controlled for age, race, education, perceived physical health, and depressive symptoms. Implications of the findings for those involved with prisoner care are discussed, particularly therapeutic interventions including process models of forgiveness.

  9. 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

  10. 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…

  11. 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…

  12. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes

    PubMed Central

    O'Hanlon, R.; Prasad, S.; Deighan, A.; MacMillan, P.; Oxborough, D.; Godfrey, R.; Smith, G.; Maceira, A.; Sharma, S.; George, K.; Whyte, G.

    2011-01-01

    This study examined the cardiac structure and function of a unique cohort of documented lifelong, competitive endurance veteran athletes (>50 yr). Twelve lifelong veteran male endurance athletes [mean ± SD (range) age: 56 ± 6 yr (50–67)], 20 age-matched veteran controls [60 ± 5 yr; (52–69)], and 17 younger male endurance athletes [31 ± 5 yr (26–40)] without significant comorbidities underwent cardiac magnetic resonance (CMR) imaging to assess cardiac morphology and function, as well as CMR imaging with late gadolinium enhancement (LGE) to assess myocardial fibrosis. Lifelong veteran athletes had smaller left (LV) and right ventricular (RV) end-diastolic and end-systolic volumes (P < 0.05), but maintained LV and RV systolic function compared with young athletes. However, veteran athletes had a significantly larger absolute and indexed LV and RV end-diastolic and systolic volumes, intraventricular septum thickness during diastole, posterior wall thickness during diastole, and LV and RV stroke volumes (P < 0.05), together with significantly reduced LV and RV ejection fractions (P < 0.05), compared with veteran controls. In six (50%) of the veteran athletes, LGE of CMR indicated the presence of myocardial fibrosis (4 veteran athletes with LGE of nonspecific cause, 1 probable previous myocarditis, and 1 probable previous silent myocardial infarction). There was no LGE in the age-matched veteran controls or young athletes. The prevalence of LGE in veteran athletes was not associated with age, height, weight, or body surface area (P > 0.05), but was significantly associated with the number of years spent training (P < 0.001), number of competitive marathons (P < 0.001), and ultraendurance (>50 miles) marathons (P < 0.007) completed. An unexpectedly high prevalence of myocardial fibrosis (50%) was observed in healthy, asymptomatic, lifelong veteran male athletes, compared with zero cases in age-matched veteran controls and young athletes. These data suggest a

  13. 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.

  14. 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).

  15. Longitudinal Cognitive Trajectories of Women Veterans from the Women’s Health Initiative Memory Study

    PubMed Central

    Padula, Claudia B.; Weitlauf, Julie C.; Rosen, Allyson C.; Reiber, Gayle; Cochrane, Barbara B.; Naughton, Michelle J.; Li, Wenjun; Rissling, Michelle; Yaffe, Kristine; Hunt, Julie R.; Stefanick, Marcia L.; Goldstein, Mary K.; Espeland, Mark A.

    2016-01-01

    Purpose of the Study: A comparison of longitudinal global cognitive functioning in women Veteran and non-Veteran participants in the Women’s Health Initiative (WHI). Design and Methods: We studied 7,330 women aged 65–79 at baseline who participated in the WHI Hormone Therapy Trial and its ancillary Memory Study (WHIMS). Global cognitive functioning (Modified Mini-Mental State Examination [3MSE]) in Veterans (n = 279) and non-Veterans (n = 7,051) was compared at baseline and annually for 8 years using generalized linear modeling methods. Results: Compared with non-Veterans, Veteran women were older, more likely to be Caucasian, unmarried, and had higher rates of educational and occupational attainment. Results of unadjusted baseline analyses suggest 3MSE scores were similar between groups. Longitudinal analyses, adjusted for age, education, ethnicity, and WHI trial assignment revealed differences in the rate of cognitive decline between groups over time, such that scores decreased more in Veterans relative to non-Veterans. This relative difference was more pronounced among Veterans who were older, had higher educational/occupational attainment and greater baseline prevalence of cardiovascular risk factors (e.g., smoking) and cardiovascular disease (e.g., angina, stroke). Implications: Veteran status was associated with higher prevalence of protective factors that may have helped initially preserve cognitive functioning. However, findings ultimately revealed more pronounced cognitive decline among Veteran relative to non-Veteran participants, likely suggesting the presence of risks that may impact neuropathology and the effects of which were initially masked by Veterans’ greater cognitive reserve. PMID:26615021

  16. 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.

  17. 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.

  18. Rooted in the Community: Assessing the Reintegration Impacts of Agriculture on Rural Veterans.

    PubMed

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

    2017-08-23

    To assess the impact of a Veteran-oriented community agricultural initiative (CAI) on transitioning rural Veterans. Convergent mixed-method program evaluation. A Veteran-oriented farm-to-market CAI in rural Washington State. Veterans who were members of the CAI. Health, well-being, and reintegration were assessed by self-reported data from interview, demographic survey, validated health quality of life measure (Veterans RAND-12 -VR-12), validated reintegration measure (Military to Civilian Questionnaire -M2C-Q), and general satisfaction survey. Veteran participants were primarily Caucasian (88.4%, n=38) and male (74.4%, n=32) and most had a service-connected disability rating (58.2%, n=25). Qualitative and quantitative data revealed that the veterans participating in this CAI experienced health and reintegration benefits. Results on the M2C-Q, VR-12, and the satisfaction survey suggest that participating in this CAI contributed to improved mental, physical, and emotional health and vocational skills, community connectedness, and interpersonal communication. Qualitative interviews supported quantitative findings and revealed that participating in the CAI provided Veterans with a sense of satisfaction, belonging, and helped decrease the stigma surrounding their Veteran status. Veterans who participate in this CAI reported general improvements in physical and mental health, including improvements in sleep, nutrition, exercise, and decreases in anxiety, pain, depression and medication and substance use, all known factors which impact Veteran reintegration. Copyright © 2017. Published by Elsevier Inc.

  19. Development and Validation of an Older Occupant Finite Element Model of a Mid-Sized Male for Investigation of Age-related Injury Risk.

    PubMed

    Schoell, Samantha L; Weaver, Ashley A; Urban, Jillian E; Jones, Derek A; Stitzel, Joel D; Hwang, Eunjoo; Reed, Matthew P; Rupp, Jonathan D; Hu, Jingwen

    2015-11-01

    The aging population is a growing concern as the increased fragility and frailty of the elderly results in an elevated incidence of injury as well as an increased risk of mortality and morbidity. To assess elderly injury risk, age-specific computational models can be developed to directly calculate biomechanical metrics for injury. The first objective was to develop an older occupant Global Human Body Models Consortium (GHBMC) average male model (M50) representative of a 65 year old (YO) and to perform regional validation tests to investigate predicted fractures and injury severity with age. Development of the GHBMC M50 65 YO model involved implementing geometric, cortical thickness, and material property changes with age. Regional validation tests included a chest impact, a lateral impact, a shoulder impact, a thoracoabdominal impact, an abdominal bar impact, a pelvic impact, and a lateral sled test. The second objective was to investigate age-related injury risks by performing a frontal US NCAP simulation test with the GHBMC M50 65 YO and the GHBMC M50 v4.2 models. Simulation results were compared to the GHBMC M50 v4.2 to evaluate the effect of age on occupant response and risk for head injury, neck injury, thoracic injury, and lower extremity injury. Overall, the GHBMC M50 65 YO model predicted higher probabilities of AIS 3+ injury for the head and thorax.

  20. A Note on Disappearing Veterans

    PubMed Central

    Teachman, Jay

    2014-01-01

    In this research note, the rapid decline of the veteran population in the United States from 1980 to 2010 is outlined. The decline in the veteran population has been accompanied by an increasing concentration of veterans in smaller, more rural counties, often surrounding military bases. The result is that there has been a consistent increase in the residential segregation of veterans from the nonveteran population. PMID:25580041

  1. 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.

  2. Veterans' fall risk profile: a prevalence study.

    PubMed

    Quigley, Patricia A; Palacios, Polly; Spehar, Andrea M

    2006-01-01

    The Veterans Health Administration (VHA) serves the health care needs of an adult, predominantly male, and aging population. The aging profile of VHA patients is 25% greater than the civilian sector (DVA 2001). Aged patients are at higher risk for falls. In February 2002, 6 VHA medical centers profiled their inpatients' fall risk profile as one aspect of program initiatives targeted at reducing veterans' fall risk and fall-related injuries, participating in a one-day collection of fall risk measurement using the Morse Fall Scale (MFS) for all inpatients (n = 1819), acute and long-term care units. Data results are reported for age, MFS score, and the relationship between age and score, and by type of ward/unit, ie, predominately acute and critical care or long-term care. The results of this prevalence study documented that the veteran inpatient population are at high-risk for anticipated physiological falls. This Veteran Integrated Services Network-wide Deployment of an Evidence-based Program to Prevent Patient Falls study was completed as part of a nationally funded clinical initiative, National Program Initiative 20-006-1.

  3. Recruitment and retention of young adult veteran drinkers using Facebook

    PubMed Central

    Pedersen, Eric R.; Naranjo, Diana; Marshall, Grant N.

    2017-01-01

    The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook’s wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment. PMID:28249027

  4. Gene expression associated with suicide attempts in US veterans.

    PubMed

    Flory, J D; Donohue, D; Muhie, S; Yang, R; Miller, S A; Hammamieh, R; Ryberg, K; Yehuda, R

    2017-09-05

    According to a recent report from the Office of Suicide Prevention in the US Department of Veterans Affairs, veterans represent 8.5% of the US population, but account for 18% of all deaths from suicide. The aim of this study of psychiatric patients (n=39; 87% male) was to compare blood gene expression data from veterans with a history of one or more suicide attempts to veterans who had never attempted suicide. The attempter and non-attempter groups were matched for age and race/ethnicity, and both groups included veterans with a diverse psychiatric history that included posttraumatic stress disorder (PTSD) and substance-use disorders. Veterans were interviewed for lifetime psychiatric history, including a detailed assessment of prior suicide attempts and provided a blood sample. Results of Ingenuity Pathway Analysis (IPA) identified several pathways associated with suicide attempts, including the mammalian target of rapamycin (mTOR) and WNT signaling pathways. These pathways are of particular interest, given their role in explaining pharmacological treatments for suicidal behavior, including the use of ketamine and lithium. These results suggest that findings observed in civilians are also relevant for veterans and provide a context for interpreting results observed in post-mortem samples. In conclusion, an emerging body of work that shows consistency in findings across blood and brain samples suggests that it might be possible to identify molecular predictors of suicide attempts.

  5. Recruitment and retention of young adult veteran drinkers using Facebook.

    PubMed

    Pedersen, Eric R; Naranjo, Diana; Marshall, Grant N

    2017-01-01

    The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook's wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment.

  6. 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…

  7. 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…

  8. 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

  9. Sex differences in mental health and substance use disorders and treatment entry among justice-involved Veterans in the Veterans Health Administration.

    PubMed

    Finlay, Andrea K; Binswanger, Ingrid A; Smelson, David; Sawh, Leon; McGuire, Jim; Rosenthal, Joel; Blue-Howells, Jessica; Timko, Christine; Blodgett, Janet C; Harris, Alex H S; Asch, Steven M; Frayne, Susan

    2015-04-01

    Over half of veterans in the criminal justice system have mental health or substance use disorders. However, there is a critical lack of information about female veterans in the criminal justice system and how diagnosis prevalence and treatment entry differ by sex. To document prevalence of mental health and substance use disorder diagnoses and treatment entry rates among female veterans compared with male veterans in the justice system. Retrospective cohort study using national Veterans Health Administration clinical/administrative data from veterans seen by Veterans Justice Outreach Specialists in fiscal years 2010-2012. A total of 1535 females and 30,478 male veterans were included. Demographic characteristics (eg, sex, age, residence, homeless status), mental health disorders (eg, depression, post-traumatic stress disorder), substance use disorders (eg, alcohol and opioid use disorders), and treatment entry (eg, outpatient, residential, pharmacotherapy). Among female veterans, prevalence of mental health and substance use disorders was 88% and 58%, respectively, compared with 76% and 72% among male veterans. Women had higher odds of being diagnosed with a mental health disorder [adjusted odds ratio (AOR)=1.98; 95% confidence interval (CI), 1.68-2.34] and lower odds of being diagnosed with a substance use disorder (AOR=0.50; 95% CI, 0.45-0.56) compared with men. Women had lower odds of entering mental health residential treatment (AOR=0.69; 95% CI, 0.57-0.83). Female veterans involved in the justice system have a high burden of mental health disorders (88%) and more than half have substance use disorders (58%). Entry to mental health residential treatment for women is an important quality improvement target.

  10. 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…

  11. 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…

  12. Cigarette Smoking, Reduction and Quit Attempts: Prevalence Among Veterans With Coronary Heart Disease

    PubMed Central

    Phillips, Barbara R.; Backus, Lisa I.

    2016-01-01

    Introduction Cigarette smoking increases the risk of illness and early death for people with coronary heart disease. In 2010, Brown estimated prevalence rates for smoking among veterans and nonveterans with or without coronary heart disease in the United States, based on the 2003 through 2007 data from the Behavioral Risk Factor Surveillance System (BRFSS). Recent changes in BRFSS methods promise more accurate estimates for veterans. To inform assessment of efforts to reduce smoking, we sought to provide prevalence rates for smoking behaviors among US veterans with coronary heart disease and to compare rates for veterans with those for civilians. Methods We conducted a cross-sectional analysis of participants who responded to BRFSS from 2009 to 2012. Accounting for complex BRFSS sampling, we estimated national prevalence rates by sex for smoking status, frequency, and quit attempts; for those with and those without coronary heart disease; for civilians; for veterans and active duty personnel combined; and, after adjusting for BRFSS mingling of active duty personnel and veterans, for veterans only. We examined differences between veterans and civilians by using age-standardized national estimates. Results Among men with coronary heart disease, more veterans than civilians smoked and more were daily smokers, but veterans were no more likely to attempt to quit. Among women with coronary heart disease, we found no differences between civilians and veterans. Conclusion Cigarette smoking is more prevalent among male veterans with coronary heart disease than among their civilian counterparts. Not distinguishing active duty personnel from veterans can materially affect prevalence estimates intended to apply solely to veterans. PMID:27010844

  13. Paralyzed Veterans of America

    MedlinePlus

    ... NW Washington, DC 20006-3517 Use of this website is Subject to PVA's Policy Statement, Disclaimers, and Privacy Policy. Paralyzed Veterans of America is a 501(c)(3) tax-exempt, non-profit organization. DC Web Design by Reef Light Interactive About Us Contact Us ...

  14. The Veteran's View

    ERIC Educational Resources Information Center

    Pellegrin, Jeanette

    2013-01-01

    In one important way, student-veterans are like all other students. They need supportive relationships to achieve their academic goals. Serving these students well means learning their stories and helping them succeed. In the process, some of these people may change one's life. In this article, the author shares the touching stories of some of the…

  15. 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…

  16. 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

    ... AFFAIRS Board of Veterans Appeals, Veterans Information Office, Voice of the Veteran Call Center Survey..., Voice of the Veterans Call Center Survey''. We have corrected the office telephone number of the contact... Office, Voice of the Veterans Call Center Survey''. At the AGENCY heading, second column, remove...

  17. Correlates of institutionalized senior veterans' quality of life in Taiwan

    PubMed Central

    2010-01-01

    Background Senior veterans living in government sponsored, long-term care (LTC) facilities, known as veterans' homes (VHs), are a special minority group in Taiwan. These seniors came from different provinces of mainland China during their teenage years at the end of civil wars in 1945. The situation of institutionalized senior veterans shares many characteristics with the concept of "total institution". Very little quality of life (QOL) research has involved senior veterans. This study aimed to explore the QOL and related factors of VH-dwelling senior veterans in Taiwan. Methods Chronic conditions and socio-demographic characteristics of 260 male VH residents were recorded. The Brief Form of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF, Taiwanese version); Short-Form 36; Inventory of Socially Supportive Behavior questionnaire; Geriatric Depression Scale-short form; Barthel Index; and instrumental activities of daily living were used. Data analyses including descriptive and inferred statistics were performed using SPSS, version 17. Results WHOQOL-BREF showed acceptable reliability in this study. Compared to Taiwanese male norms, WHOQOL-BREF physical, psychological, and social relationship domain scores were around the 25th percentile, and the environment domain was about the 75th percentile. Our participants scored low in all concepts of SF-36. Although these residents rated the social support of their children, relatives, friends, social and medical staff as low, they gave high satisfaction ratings to their social supports. On multiple stepwise linear regression analysis, depressive symptoms, number of chronic conditions, retired military rank, and relatives' support correlated with QOL in both the physical and psychological domains. Friends' support and depressive symptoms correlated with the social relationships domain. Friends' support and instrumental activities of daily living correlated with the environment domain. Conclusions In

  18. Comparison of an intensive pharmacist-managed telephone clinic with standard of care for tobacco cessation in a veteran population.

    PubMed

    Chen, Timothy; Kazerooni, Rashid; Vannort, Erin M; Nguyen, Khanh; Nguyen, Stacey; Harris, Jessica; Bounthavong, Mark

    2014-07-01

    To evaluate the effectiveness of the Pharmacist-Managed Telephone Tobacco Cessation Clinic (PMTTCC) compared to the standard of care (SOC) at the Veterans Affairs San Diego Healthcare System. A retrospective cohort study was performed investigating the proportion of veterans who quit smoking at 6 months while enrolled in the PMTTCC. Chart review was performed using the Veterans Affairs Computerized Patient Record System. The PMTTCC group included patients who had received medication and counseling from the tobacco cessation pharmacists. The cohort was compared to a matched SOC group who did not receive counseling, only tobacco cessation medication therapy through a primary care provider. The primary outcome for this study was patient-reported tobacco cessation at 6 months. Secondary outcomes were abstinence at 1 and 3 months. A total of 1,006 patients were included in the analysis, 503 patients from the PMTTCC and 503 patients from SOC. The overall study population was 54 years old on average, 92.5% male, 70.0% Caucasian, 45.5% with history of psychiatric conditions, and had an average smoking history of 33-pack years. Patients in the PMTTCC group had statistically significant improvements in abstinence at 6 months versus the SOC group (81/503, 16.1% vs. 48/503, 9.5%; p < .0001). Quitters were older on average versus non-quitters (56.03 vs. 53.65 years; p = .01). Patients enrolled in the PMTTCC had improved tobacco abstinence rates at 6 months compared to SOC. Although the study was not designed to test for causality, the results lend support for using intensive tobacco cessation management in veteran population. © 2013 Society for Public Health Education.

  19. 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.

  20. 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.

  1. Self-reported changes in subjective health and anthrax vaccination as reported by over 900 Persian Gulf War era veterans.

    PubMed

    Schumm, Walter R; Reppert, Earl J; Jurich, Anthony P; Bollman, Stephan R; Webb, Farrell J; Castelo, Carlos S; Stever, James C; Sanders, Diane; Bonjour, Gabriele N; Crow, Janet R; Fink, Carol J; Lash, Jeanne F; Brown, Beverlyn F Cay; Hall, Carolyn A; Owens, Barbara L; Krehbiel, Michelle; Deng, Liang-Yu; Kaufman, Mark

    2002-04-01

    A 1999 study of United Kingdom servicemembers by Unwin, et al. recently found significant relationships between anthrax and other vaccinations, reactions to those vaccines, and later health problems for male current or former active military Gulf War veterans. Likewise, in 2000 Steele and in 1998 Gilroy found possible adverse effects of vaccinations on Gulf War veterans. However, the role of such vaccinations remains controversial; more recent government reports continue to dispute the existence of any data that might reflect adversely on the role of vaccinations on the health of Gulf War veterans. To address this controversy, the current study assessed similar relationships for over 900 Reserve Component Gulf War Era veterans from Ohio and nearby states. Gulf War veterans were more likely to report poorer health than non-Gulf veterans. Female veterans were more likely to report mild or severe reactions to vaccines than male veterans. Those veterans who received anthrax vaccine reported more reactions to vaccines than those who did not receive anthrax vaccine. Declines in long-term subjective health were associated with receipt of anthrax vaccine by Gulf War veterans but not for those who did not deploy to the Gulf, although few of the latter received anthrax vaccine. Regardless of deployment status, veterans who reported more severe reactions to vaccines were more likely to report declines in subjective health. Female veterans reported poorer health during the Gulf War than did male veterans, but sex was not related to veterans' reports of subjective health at subsequent times. It is recommended that servicemembers who experience severe reactions to anthrax vaccine be medically reevaluated before receiving further anthrax vaccine and that careful follow-ups be conducted of those receiving the vaccine currently, in accordance with Nass's 1999 recommendations. We also recommend that safer alternatives to thimerosal (a mercury sodium salt, 50% mercury) be used to

  2. Creating a sampling frame for population-based veteran research: representativeness and overlap of VA and Department of Defense databases.

    PubMed

    Washington, Donna L; Sun, Su; Canning, Mark

    2010-01-01

    Most veteran research is conducted in Department of Veterans Affairs (VA) healthcare settings, although most veterans obtain healthcare outside the VA. Our objective was to determine the adequacy and relative contributions of Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), and Department of Defense (DOD) administrative databases for representing the U.S. veteran population, using as an example the creation of a sampling frame for the National Survey of Women Veterans. In 2008, we merged the VHA, VBA, and DOD databases. We identified the number of unique records both overall and from each database. The combined databases yielded 925,946 unique records, representing 51% of the 1,802,000 U.S. women veteran population. The DOD database included 30% of the population (with 8% overlap with other databases). The VHA enrollment database contributed an additional 20% unique women veterans (with 6% overlap with VBA databases). VBA databases contributed an additional 2% unique women veterans (beyond 10% overlap with other databases). Use of VBA and DOD databases substantially expands access to the population of veterans beyond those in VHA databases, regardless of VA use. Adoption of these additional databases would enhance the value and generalizability of a wide range of studies of both male and female veterans.

  3. 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... . Please refer to ``OMB Control No. 2900-NEW Board of Veterans' Appeals, Voice of the Veteran Call Center... of Veterans' Appeals, Voice of the Veteran Call Center Survey. OMB Control Number: 2900-NEW, Board...

  4. Characteristics of adult male and female firearm suicide decedents: findings from the National Violent Death Reporting System.

    PubMed

    Kaplan, M S; McFarland, B H; Huguet, N

    2009-10-01

    To examine the risk factors and precipitating circumstances associated with firearm suicide. Data from the restricted National Violent Death Reporting System (2003-6) for 25 491 male and female suicide decedents aged 18 and older were analysed by multiple logistic regression to estimate the relative odds of firearm use with 95% CIs. Firearms were often used in male (58.1%) and female (31.2%) suicides. Among male decedents, older age, veteran status, residing in areas with higher rates of firearm availability, raised blood alcohol concentration, acute crisis and relationship problems were all associated with firearm use. Conversely, men with a diagnosis of a mental health problem, a history of suicide attempts or alcohol problems had lower odds of firearm use. Among female decedents, factors with a significant effect on firearm use included: being older, married, white and a veteran; residing in areas with higher rates of firearm availability; having an acute crisis; having experienced the death of a relative or friend; being depressed; and having relationship problems. Of note, women who had a treated DSM-IV-diagnosed problem, previous suicide attempts and physical health problems were less likely to use firearms. These findings challenge the conventional view that those who are severely depressed and suicidal are prone to highly lethal methods, such as firearms. Rather, firearms users may be reacting to acute situations.

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

    PubMed

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

    2016-11-01

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

  6. An examination of family adjustment among Operation Desert Storm veterans.

    PubMed

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

    2008-08-01

    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 turn were associated with poorer family adjustment, although these indirect effects did not reach statistical significance. The model for female veterans evidenced a significant direct negative association between combat exposure and family adjustment when it statistically accounted for PTSD symptoms. When the relative impacts of separate PTSD symptom groupings were examined, those reflecting withdrawal/numbing symptoms and arousal/lack of control symptoms significantly and indirectly accounted for the negative effects of combat exposure on family adjustment. Study findings indicate a number of possible pathways through which war-zone deployments negatively impact military families and suggest several avenues for future research. Copyright 2008 APA, all rights reserved.

  7. Firearm suicide among veterans in the general population: findings from the national violent death reporting system.

    PubMed

    Kaplan, Mark S; McFarland, Bentson H; Huguet, Nathalie

    2009-09-01

    Military veterans are particularly vulnerable to suicide compared with their civilian peers. Scant attention has been devoted to the problem of firearm suicide among veterans, particularly women. The purpose of this study was to examine the rate, prevalence, and relative odds of firearm use among veteran suicide decedents in the general population. The analyses are based on data derived from 28,534 suicide decedents from the 2003 to 2006 National Violent Death Reporting System. Across the age groups, male and female veterans had higher firearm suicide rates than nonveterans. Among males and females, younger veterans (18-34 years) had the highest firearm and total suicide rates. The male and female veteran suicide decedents were, respectively, 1.3 and 1.6 times more likely to use firearms relative to nonveterans after adjusting for age, marital status, race, and region of residence. Although violent death and the use of firearms are generally associated with men, the results reported here suggest that firearms among female veterans deserve particular attention among health professionals within and outside the veterans affairs system. In addition, the focus should not be exclusively on the Operation Enduring Freedom/Operation Iraqi Freedom military cohort but also on men and women who served in earlier combat theaters, including the Gulf war, Vietnam Era, Korean Conflict, and World War II.

  8. Veterans use of non-VHA services: implications for policy and planning.

    PubMed

    Miller, Edward Alan; Intrator, Orna

    2012-01-01

    Most Veterans elect not to use the Veterans Health Administration (VHA), even if eligible, or access the VHA system but rely on non-VHA providers as well. Given considerable cross-system use, failure to account for non-VHA care can bias conclusions about prevalence and incidence in utilization, diagnoses, and other characteristics. Furthermore, though dual VHA and non-VHA use provides Veterans with additional service options, it makes it difficult for VHA to ensure continuity of care. To better coordinate services, the VHA needs to construct the necessary health information bridges while widening the purview of case management programs. These changes are especially important in light of increased demand for care among younger Veterans returning from Iraq and Afghanstain and older Veterans who served in previous wars.

  9. Outreach to Veterans With Serious Mental Illness Who Are Lost to Care: Predictors of Outreach Contact.

    PubMed

    Burton, Cynthia Z; Abraham, Kristen M; Grindle, Chelsea M; Visnic, Stephanie; Hack, Samantha M; McCarthy, John F; Bowersox, Nicholas W

    2017-03-13

    This evaluation identified factors associated with outreach contact to veterans with serious mental illness (SMI) who were lost to Veterans Health Administration (VHA) care. From March 2012 through September 2013, the VHA SMI Re-Engage initiative identified 4,241 veterans for reengagement outreach; 31% of whom were successfully contacted. Higher odds of contact was associated with older age, married status, no history of homelessness, bipolar disorder diagnosis, having no recent inpatient stay, living closer to a VHA medical center, fewer years since last visit, and having a service-connected disability. Several factors are associated with recontact with veterans with SMI who are lost to VHA care. These may promote treatment engagement and retention. Study findings may inform outreach interventions to enhance access for these veterans. (PsycINFO Database Record

  10. Sexual dysfunction in veterans with post-traumatic stress disorder.

    PubMed

    Tran, Jana K; Dunckel, Gina; Teng, Ellen J

    2015-04-01

    Veterans with post-traumatic stress disorder (PTSD) experience high rates of sexual dysfunction. However, the topic of sexual dysfunction is often overlooked clinically and underexamined in the PTSD research literature. Clinician assessment and treatment of sexual dysfunction are particularly important for Veterans, who are at increased risk of exposure to trauma. Review the literature regarding sexual dysfunction among Veterans with PTSD. Review of the literature. Sexual dysfunction, including erectile difficulties in males and vaginal pain in females, is common among Veterans with PTSD. Several underlying mechanisms may account for the overlap between PTSD and sexual dysfunction. Certain barriers may contribute to the reluctance of providers in addressing problems of sexual dysfunction in Veterans with PTSD. With the high likelihood of sexual dysfunction among Veterans with PTSD, it is important to consider the integration of treatment strategies. Efforts to further the research on this important topic are needed. Published 2015. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  11. Age-related modifiers of clinical presentation and health service use among veterans with bipolar disorder.

    PubMed

    Sajatovic, Martha; Blow, Frederic C; Ignacio, Rosalinda V; Kales, Helen C

    2004-09-01

    This retrospective analysis of a large Department of Veterans Affairs (VA) database evaluated differences in clinical presentation, health service use, and use of psychotropic medications between older and younger adults with bipolar disorder. The results presented in this article focus on veterans with bipolar disorder who were active in the VA's National Psychosis Registry in federal fiscal year 2001 (FY01). The registry listed 65,556 individuals as having bipolar disorder in FY01. In FY01, nearly 25 percent of veterans with bipolar disorder (more than 16,000 individuals) were aged 60 years or older, and more than 10 percent were aged 70 years or older. Elderly persons were hospitalized at similar or slightly lower rates than middle-aged persons but tended to have longer hospital stays. Use of outpatient services was also higher in older populations. Patterns of use of psychotropic medications indicated that valproate is the most commonly used mood-stabilizing agent in the VA, in use by 72.9 percent of patients who receive a mood stabilizer. Use of lithium is substantial as well, with more than 40 percent of patients taking this agent. In addition, just over 40 percent of all veterans with bipolar disorder receive antipsychotic medication. Bipolar disorder affects large numbers of veterans across the entire life span, and use of VA resources by this population becomes greater with advancing age. Data from this study provide new information about the unique treatment requirements and clinical presentations of older patients with bipolar disorder.

  12. Putting Veterans to Work

    DTIC Science & Technology

    2012-02-13

    commercials and briefly cheered at sporting events.”3 However, veteran unemployment negatively impacts our entire country, and existing Federal programs...the Real Dope ,” which provided servicemen advice on matters such as getting a job, employment bureaus, and general demobilization information.45...Sparrow, History of Personnel Demobilization in the United State Army, 300. 16 William Brown Meloney, Where Do We Go from Here? This is the Real Dope

  13. Veterans' Record Reconstruction Act

    THOMAS, 111th Congress

    Rep. Carbajal, Salud O. [D-CA-24

    2017-09-14

    09/14/2017 Referred to the Committee on Armed Services, and in addition to the Committee on Veterans' Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Veterans' Record Reconstruction Act

    THOMAS, 112th Congress

    Rep. Carbajal, Salud O. [D-CA-24

    2017-09-14

    House - 09/14/2017 Referred to the Committee on Armed Services, and in addition to the Committee on Veterans' Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Women Veterans Health Care: Frequently Asked Questions

    MedlinePlus

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

  16. Alcohol consumption and health status in very old veterans.

    PubMed

    Denneson, Lauren M; Lasarev, Michael R; Dickinson, Kathryn C; Dobscha, Steven K

    2011-03-01

    Previous research has linked drinking with health, but has yet to address alcohol consumption and the relationship between drinking and health among very old veterans. To help fill this gap, the authors present a cross-sectional self-report study on 1105 veterans age 90 and older who completed the national Veteran's Affairs (VA) Survey of the Health Experiences of Patients (SHEP) for fiscal year (FY) 2005. Alcohol consumption was measured using Alcohol Use Disorders Identification Test scores (AUDIT-C). Health status was measured using the Veterans Rand Health Survey: VR-12. Among men (n = 1063), 60% were abstainers. No significant differences in mental health component (MCS; F(3,1040) = 1.80, P = .15) or physical health component (PCS; F(3,1040) = 1.48, P = .22) scores were detected across consumption categories. Among women (n = 42), 47% were abstainers. These results suggest many very old veterans abstain from alcohol and, among men, the associations between health status and drinking observed in younger groups may not be present in very old age.

  17. Eating disorders and associated mental health comorbidities in female veterans

    PubMed Central

    Mitchell, Karen S.; Rasmusson, Ann; Bartlett, Brooke; Gerber, Megan R.

    2014-01-01

    Eating disorders (EDs) remain understudied among veterans, possibly due to perceptions that this primarily male population does not suffer from EDs. However, previous research suggests that male and female veterans do experience EDs. The high rates of posttraumatic stress disorder (PTSD), depression, and obesity observed among veterans may make this group vulnerable to disordered eating. Retrospective chart review was used to obtain data from 492 female veterans who presented to a women’s primary care center at a large, urban VA medical center between 2007 and 2009. A total of 2.8% of this sample had been diagnosed with an ED. In bivariate analyses, presence of PTSD and depression were significantly associated with having an ED diagnosis. However, when these two disorders were included in a multivariate model controlling for age, only depression diagnosis and lower age were significantly related to ED status. In sum, the rate of EDs in this sample is comparable to prevalence estimates of EDs in the general population. Current findings underscore the importance of assessing for EDs among VA patients and the need for further research among veterans. PMID:25015710

  18. 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.

  19. 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.

  20. 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'.

  1. Continued Use of Warfarin in Veterans with Atrial Fibrillation After Dementia Diagnosis.

    PubMed

    Orkaby, Ariela R; Ozonoff, Al; Reisman, Joel I; Miller, Donald R; Zhao, Shibei; Rose, Adam J

    2017-02-01

    To determine the effectiveness of warfarin in older adults with dementia. Retrospective cohort study. Department of Veterans Affairs national healthcare system. Veterans aged 65 and older (73% aged ≥75, 99% male, 91% white) who had been receiving warfarin for nonvalvular atrial fibrillation for at least 6 months, were newly diagnosed with dementia in fiscal year 2007 or 2008, and were not enrolled in Medicare Advantage (n = 2,572). The onset of dementia was defined according to International Classification of Diseases, Ninth Revision, code. Participants were followed for up to 4 years for persistence of warfarin therapy, anticoagulation control, major hemorrhage, ischemic stroke, and all-cause mortality. The average CHADS2 score was 3.3 ± 1.3. After a diagnosis of dementia, 405 individuals (16%) persisted on warfarin therapy. Unadjusted Cox proportional hazards analysis demonstrated a protective effect of warfarin in prevention of ischemic stroke (hazard ratio (HR) = 0.64, 95% confidence interval (CI) = 0.46-0.89, P = .008), major bleeding (HR = 0.72, 95% CI = 0.55-0.94, P = .02), and all-cause mortality (HR = 0.66, 95% CI = 0.55-0.79, P < .001). Using propensity score matching, the protective effect of continuing warfarin persisted in prevention of stroke (HR = 0.74, 95% CI = 0.54-0.996, P = .047) and mortality (HR = 0.72, 95% CI = 0.60-0.87, P < .001), with no statistically significant decrease in risk of major bleeding (HR = 0.78, 95% CI = 0.61-1.01, P = .06). Discontinuing warfarin after a diagnosis of dementia is associated with a significant increase in stroke and mortality. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  2. Five-year trends in women veterans' use of VA maternity benefits, 2008-2012.

    PubMed

    Mattocks, Kristin M; Frayne, Susan; Phibbs, Ciaran S; Yano, Elizabeth M; Zephyrin, Laurie; Shryock, Holly; Haskell, Sally; Katon, Jodie; Sullivan, J Cherry; Weinreb, Linda; Ulbricht, Christine; Bastian, Lori A

    2014-01-01

    An increasing number of young women veterans are returning from war and military service and are seeking reproductive health care from the Veterans Health Administration (VHA). Many of these women seek maternity benefits from the VHA, and yet little is known regarding the number of women veterans utilizing VHA maternity benefits nor the characteristics of pregnant veterans using these benefits. In May 2010, VHA maternity benefits were expanded to include 7 days of infant care, which may serve to entice more women to use VHA maternity benefits. Understanding the changing trends in women veterans seeking maternity benefits will help the VHA to improve the quality of reproductive care over time. The goal of this study was to examine the trends in delivery claims among women veterans receiving VHA maternity benefits over a 5-year period and the characteristics of pregnant veterans utilizing VHA benefits. We undertook a retrospective, national cohort study of pregnant veterans enrolled in VHA care with inpatient deliveries between fiscal years (FY) 2008 and 2012. We included pregnant veterans using VHA maternity benefits for delivery. Measures included annualized numbers and rates of inpatient deliveries and delivery-related costs, as well as cesarean section rates as a quality indicator. During the 5-year study period, there was a significant increase in the number of deliveries to women veterans using VHA maternity benefits. The overall delivery rate increased by 44% over the study period from 12.4 to 17.8 deliveries per 1,000 women veterans. A majority of women using VHA maternity benefits were age 30 or older and had a service-connected disability. From FY 2008 to 2012, the VHA paid more than $46 million in delivery claims to community providers for deliveries to women veterans ($4,993/veteran). Over a 5-year period, the volume of women veterans using VHA maternity benefits increased by 44%. Given this sizeable increase, the VHA must increase its capacity to care

  3. 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

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

    PubMed

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

    2015-10-01

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

  5. Relationship between substance use and attitudes towards seeking professional psychological help among veterans filing PTSD claims.

    PubMed

    Meshberg-Cohen, Sarah; Kachadourian, Lorig; Black, Anne C; Rosen, Marc I

    2017-11-01

    Veterans in distress often do not seek mental health treatment, even when such services are available. Substance use may further undermine treatment-seeking, given its association with negative treatment views. This study examined attitudes towards seeking psychological help in a sample of veterans diagnosed with posttraumatic stress disorder (PTSD), with and without co-occurring substance use disorders (SUD). Altogether, 143 male OEF/OIF veterans filing service-connected benefits claims for PTSD completed the Attitudes Towards Seeking Professional Psychological Help-Short Form (ATSPPH-SF) and other baseline assessments. Treatment attitudes were compared among veterans with (n=34) and without (n=109) SUD using ANCOVA, controlling for demographic covariates. Post-hoc ANCOVA compared means on the two ATSPPH-SF subscales: Openness to Seeking Treatment, and Value/Need in Seeking Treatment. Overall, ATSPPH-SF scores were similar to those reported in other samples of young men. Controlling for demographic covariates, veterans with co-occurring SUD held significantly less favorable attitudes towards seeking help than veterans without comorbid SUD. In subscale analyses, valuation of treatment was significantly lower among veterans with SUDs, but openness towards treatment was not. Substance-using veterans' lower valuation of treatment may reflect opinions that problems resolve on their own, psychotherapy is ineffective, or concerns that SUDs complicate treatment. Thus an approach towards engaging these veterans in treatment that addresses a general skepticism towards the value of psychological help is warranted. Published by Elsevier Ltd.

  6. Platelet 5-HT concentration and comorbid depression in war veterans with and without posttraumatic stress disorder.

    PubMed

    Mück-Seler, Dorotea; Pivac, Nela; Jakovljević, Miro; Sagud, Marina; Mihaljević-Peles, Alma

    2003-07-01

    The serotonergic system is implicated in the pathophysiology of posttraumatic stress disorder (PTSD) and depression. The present study focused on platelet serotonin (5-HT) concentration and symptoms of comorbid depression in war veterans with or without PTSD. PTSD and depression were evaluated using Clinician Administered PTSD Scale, Davidson Trauma Scale, Montgomery-Asberg Depression Rating Scale and Hamilton Anxiety Scale. Sixty-five male drug-free war veterans (48 with PTSD and 17 without PTSD) and 65 age- and sex-matched healthy controls were studied. Comorbid depression occurred in 54 and 31% of war veterans with PTSD and without PTSD, respectively. Platelet 5-HT concentration was similar in the groups of depressed and nondepressed war veterans with or without PTSD and healthy controls. Platelet 5-HT concentration was found to differ between war veterans with various degrees of appetite loss. A positive correlation was observed between platelet 5-HT concentration and severity of appetite loss in veterans with PTSD. There was no relationship between platelet 5-HT concentration and severity of other symptoms of PTSD or depression. War veterans included in the study were outpatients. War veterans with PTSD had a high incidence of comorbid depression, that was not related to platelet 5-HT concentration. The marked relationship between platelet 5-HT concentration and severity of appetite loss, suggested that 5-HT system is involved in the regulation of appetite, at least in depressed war veterans with PTSD.

  7. Understanding Student Veterans in Transition

    ERIC Educational Resources Information Center

    Jones, Kevin C.

    2013-01-01

    In this research report the author details a phenomenological study documenting identity development in student veterans making the transition from active military service to higher education. This study took place at a doctoral granting proprietary university with a significant veteran population and consisted of in-depth interviews. This…

  8. 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…

  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. Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002-2008.

    PubMed

    Seal, Karen H; Metzler, Thomas J; Gima, Kristian S; Bertenthal, Daniel; Maguen, Shira; Marmar, Charles R

    2009-09-01

    We sought to investigate longitudinal trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans. We determined the prevalence and predictors of mental health diagnoses among 289,328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from 2002 to 2008 using national VA data. Of 289,328 Iraq and Afghanistan veterans, 106,726 (36.9%) received mental health diagnoses; 62,929 (21.8%) were diagnosed with posttraumatic stress disorder (PTSD) and 50 432 (17.4%) with depression. Adjusted 2-year prevalence rates of PTSD increased 4 to 7 times after the invasion of Iraq. Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years (adjusted relative risk = 2.0 and 4.9, respectively). Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders. Greater combat exposure was associated with higher risk for PTSD. Mental health diagnoses increased substantially after the start of the Iraq War among specific subgroups of returned veterans entering VA health care. Early targeted interventions may prevent chronic mental illness.

  11. Prescription headache medication in OEF/OIF veterans: results from the Women Veterans Cohort Study.

    PubMed

    Seng, Elizabeth K; Driscoll, Mary A; Brandt, Cynthia A; Bathulapalli, Harini; Goulet, Joseph; Silliker, Norman; Kerns, Robert D; Haskell, Sally G

    2013-09-01

    To examine differences in male and female veterans of Operations Enduring Freedom/Iraqi Freedom (OEF/OIF) period of service in taking prescription headache medication, and associations between taking prescription headache medication and mental health status, psychiatric symptoms, and rates of traumatic events. Headaches are common among active service members and are associated with impairment in quality of life. Little is known about headaches in OEF/OIF veterans. Veterans participating in the Women Veterans Cohort Study responded to a cross-sectional survey to assess taking prescription headache medication, mental health status (Post Deployment Health Assessment), psychiatric symptoms (portions of the Brief Patient Health Questionnaire and the Posttraumatic Stress Disorder Checklist), and traumatic events (the Traumatic Life Events Questionnaire and queries regarding military trauma). Gender differences among taking prescription headache medication, health status, psychiatric symptoms, and traumatic events were examined. Regression analyses were used to examine the influence of gender on the associations between taking prescription headache medication and health status, psychiatric symptoms, and traumatic events. 139/551 (25.2%) participants reported taking prescription headache medication in the past year. A higher proportion of women veterans (29.1%) reported taking prescription medication for headache in the last year compared with men (19.7%). Taking prescription headache medication was associated with poorer perceived mental health status, higher anxiety and posttraumatic stress disorder symptoms, and higher rates of traumatic events. The association between prescription headache medication use and perceived mental health status, and with the association between prescription headache medication use and posttraumatic stress disorder symptoms, was stronger for men than for women. Among OEF/OIF veterans, the prevalence of clinically relevant headache is high

  12. The mental health of veterans.

    PubMed

    Murphy, D; Iversen, A; Greenberg, N

    2008-06-01

    For the majority service in the Armed Forces is beneficial and, in the main, military veterans have successful lives. However, a minority have a bleaker outlook as a result of on-going ill health and social exclusion. Whilst the media focuses on Post Traumatic Stress Disorder, in reality the most frequent mental health problems for veterans are alcohol problems, depression and anxiety disorders. These difficulties are difficult to manage as veterans, particularly those who are unwell, demonstrate a reticence to seek help for mental health problems. Another issue is that many veterans are now reserve personnel who have been found to be at greater risk of developing mental health problems than their regular counterparts. Steps to improve the knowledge and expertise of primary care services about veteran's mental health issues and increasing the availability of treatment options are important and are underway.

  13. Characterizing binge drinking among U.S. military Veterans receiving a brief alcohol intervention.

    PubMed

    Cucciare, Michael A; Darrow, Maura; Weingardt, Kenneth R

    2011-04-01

    Brief web-based alcohol interventions (BAIs) are effective for reducing binge drinking in college students and civilian adults, and are increasingly being applied to U.S. military populations. However, little is known about factors associated with binge drinking in Veteran populations and therefore some concern remains on the generalizability of studies supporting BAIs for addressing binge drinking in this population. This study sought to better understand the characteristics (e.g., demographic, coping related mental health factors, prior exposure to traumatic events, and factors assessing motivation to change alcohol use) of a predominantly male sample of binge drinking Veterans receiving a BAI from a VA provider. A primarily male (93.5%) sample (N=554) of Veterans completed a BAI consisting of brief assessment and personalized feedback. We found that Veterans who were younger, used drugs/alcohol to cope with symptoms of PTSD and depression (e.g., nightmares and flashbacks and sleep difficulties), and had experienced sexual assault, had higher self-reported peak blood alcohol concentration and a higher likelihood for a binge drinking episode in the last 90days. BAIs may be a promising approach for addressing binge drinking in Veterans. However, binge drinking among a sample of mostly male Veterans receiving a BAI may be associated with a complex set of factors that are less prevalent in the college student population and thus studies demonstrating the efficacy of BAIs with Veterans are needed. Published by Elsevier Ltd.

  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. Health Status Among 28,000 Women Veterans

    PubMed Central

    Frayne, Susan M; Parker, Victoria A; Christiansen, Cindy L; Loveland, Susan; Seaver, Margaret R; Kazis, Lewis E; Skinner, Katherine M

    2006-01-01

    BACKGROUND Male veterans receiving Veterans Health Administration (VA) care have worse health than men in the general population. Less is known about health status in women veteran VA patients, a rapidly growing population. OBJECTIVE To characterize health status of women (vs men) veteran VA patients across age cohorts, and assess gender differences in the effect of social support upon health status. DESIGN AND PATIENTS Data came from the national 1999 Large Health Survey of Veteran Enrollees (response rate 63%) and included 28,048 women and 651,811 men who used VA in the prior 3 years. MEASUREMENTS Dimensions of health status from validated Veterans Short Form-36 instrument; social support (married, living arrangement, have someone to take patient to the doctor). RESULTS In each age stratum (18 to 44, 45 to 64, and ≥65 years), Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were clinically comparable by gender, except that for those aged ≥65, mean MCS was better for women than men (49.3 vs 45.9, P<.001). Patient gender had a clinically insignificant effect upon PCS and MCS after adjusting for age, race/ethnicity, and education. Women had lower levels of social support than men; in patients aged <65, being married or living with someone benefited MCS more in men than in women. CONCLUSIONS Women veteran VA patients have as heavy a burden of physical and mental illness as do men in VA, and are expected to require comparable intensity of health care services. Their ill health occurs in the context of poor social support, and varies by age. PMID:16637944

  16. 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

  17. Suicide among war veterans.

    PubMed

    Rozanov, Vsevolod; Carli, Vladimir

    2012-07-01

    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.

  18. Learning and memory in combat veterans with posttraumatic stress disorder.

    PubMed

    Yehuda, R; Keefe, R S; Harvey, P D; Levengood, R A; Gerber, D K; Geni, J; Siever, L J

    1995-01-01

    The authors investigated a broad range of memory functions for stimuli unrelated to trauma to determine whether symptoms such as intrusive memories might reflect an underlying cognitive deficit unrelated to the psychological content of the traumatic memory in patients with posttraumatic stress disorder (PTSD). The authors measured the intellectual functioning of 20 male combat veterans with PTSD and 12 normal comparison subjects using the WAIS and evaluated them for performance on memory using the California Verbal Learning Test. Veterans with PTSD showed normal abilities in the functions of initial attention, immediate memory, cumulative learning, and active interference from previous learning. However, these veterans showed a circumscribed cognitive deficit, manifested by the presence of substantial retroactive interference and revealed by a significant decrement in retention following exposure to an intervening word list. The data suggest that patients with PTSD may have fairly specific deficits in the monitoring and regulation of memory information.

  19. Examination of Chronic Smoking Behavior and Eligibility for Low-Dose Computed Tomography for Lung Cancer Screening Among Older Chinese Male Smokers.

    PubMed

    Li, Chien-Ching; Matthews, Alicia K; Dong, XinQi

    2017-07-01

    Low-dose computed tomography lung cancer (LDCT) screening is an effective way to decrease lung cancer mortality. Both Medicare and private insurers offer coverage of LDCT screening to beneficiaries who are at high risk of developing lung cancer. In this study, we examined rates and predictors of chronic smoking behavior and eligibility for coverage of LDCT screening among older Chinese men living in the greater Chicago area. Data were obtained from the Population Study of Chinese Elderly in Chicago, a population-based survey of community-dwelling, older Chinese adults in the Chicago metropolitan area. Eligibility criteria according to Centers of Medicare and Medicaid Services (CMS) and U.S. Preventive Services Task Force (USPSTF) for LDCT screening were used. Multivariate logistic regression was conducted to determine predictors of chronic smoking behavior which was operationalized as meeting criteria for LDCT screening. A quarter of the sample were current smokers and 42.5% reported a prior history of smoking. Eighteen percent and 22% of older Chinese men met the eligibility criteria for appropriateness for CMS and USPSTF LDCT screening, respectively. Furthermore, education, marital status, and number of children were significantly associated with chronic smoking behavior. Older Chinese men with chronic smoking behavior are at high risk of developing lung cancer and nearly one in five meet eligibility for LDCT screening. Increased outreach and education regarding early detection of lung cancer and smoking cessation are needed for this vulnerable and high-risk population.

  20. 76 FR 28925 - Tribal Veterans Cemetery Grants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-19

    ... AFFAIRS 38 CFR Part 39 RIN 2900-AN90 Tribal Veterans Cemetery Grants AGENCY: Department of Veterans... regulations governing Federal grants for the establishment, expansion, and improvement of veterans cemeteries... establishment, expansion, and improvement of Tribal Organization veterans cemeteries, as authorized by...

  1. 38 CFR 52.50 - Eligible veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Eligible veterans. 52.50 Section 52.50 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM... disorder associated with service in the Southwest Asia theater of operations during the Gulf War,...

  2. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Eligible veterans. 51.50 Section 51.50 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM... associated with service in the Southwest Asia theater of operations during the Persian Gulf War, as...

  3. 38 CFR 21.276 - Incarcerated veterans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the veteran's living expenses are paid by a non-VA Federal, State, or local government program...)) (b) Definition. The term incarcerated veteran means any veteran incarcerated in a Federal, State, or local prison, jail, or other penal institution for a felony. It does not include any veteran who...

  4. 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, as...

  5. 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 provided...

  6. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  7. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  8. 38 CFR 51.50 - Eligible veterans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  9. Association of Pain With Physical Function, Depressive Symptoms, Fatigue, and Sleep Quality Among Veteran and non-Veteran Postmenopausal Women.

    PubMed

    Patel, Kushang V; Cochrane, Barbara B; Turk, Dennis C; Bastian, Lori A; Haskell, Sally G; Woods, Nancy F; Zaslavsky, Oleg; Wallace, Robert B; Kerns, Robert D

    2016-02-01

    To characterize the prevalence and longitudinal effects of pain in older Veteran and non-Veteran women. Data on 144,956 participants in the Women's Health Initiative were analyzed. At baseline, Veteran status, pain severity, and pain interference with activity were assessed. Outcomes of physical function, depressive symptoms, fatigue, and sleep quality were reported at baseline by all study participants and longitudinally on two follow-up occasions (3 years and 13-18 years after baseline) in the observational study participants (n = 87,336). At baseline, a total of 3,687 (2.5%) had a history of military service and 22,813 (15.8%) reported that pain limited their activity level moderately to extremely during the past 4 weeks. Prevalence of pain interference did not differ in Veterans and non-Veterans (16.8% and 15.7%, respectively; p= .09). At baseline, women with moderate-to-extreme pain interference had substantially worse physical function and greater symptoms of depression, fatigue, and insomnia than those with less pain (p < .001 for all comparisons), adjusting for several social, behavioral, and health related factors. There were no significant military service by pain interference interactions for any of the outcomes (p > .2), indicating that the effect of pain interference on outcomes at baseline did not vary between Veterans and non-Veterans. Moderate-to-extreme pain interference was associated with a greater rate of decline in physical function over time (p < .001) and higher incidence of limited physical functioning (p < .001), but these effects did not vary by Veteran status. Similar results were observed with pain severity as the exposure variable. As the Veteran population ages and the number of women exposed to combat operations grows, there will be an increased need for health care services that address not only pain severity and interference but also other disabling comorbid symptoms. © The Author 2016. Published by Oxford University Press on

  10. Imagery rescripting and exposure group treatment of posttraumatic nightmares in Veterans with PTSD.

    PubMed

    Long, Mary E; Hammons, Mary E; Davis, Joanne L; Frueh, B Christopher; Khan, Myrna M; Elhai, Jon D; Teng, Ellen J

    2011-05-01

    This study details results of an open trial of a group psychological treatment for Veterans with posttraumatic stress disorder (PTSD) and chronic posttraumatic nightmares called "Imagery Rescripting and Exposure Therapy" (IRET). IRET is a variant of a successful imagery rescripting treatment for civilian trauma-related nightmares that was modified to address the needs of the Veteran population. Thirty-seven male U.S. Veterans with PTSD and nightmares attended 6 multicomponent group sessions. Findings indicated that the intervention significantly reduced frequency of nightmares and PTSD severity, as well as increased hours of sleep. Unlike the few open trials examining treatment of nightmares in Veterans, effect sizes in this study were similar to those that have been found in the civilian randomized controlled trial. These preliminary findings suggest that a nightmares treatment can be adapted to successfully reduce distress associated with combat Veterans' chronic nightmares. Clinical and research implications are discussed.

  11. Many Shades of Green: Assessing Awareness of Differences in Mental Health Care Needs Among Subpopulations of Military Veterans.

    PubMed

    Ahlin, Eileen M; Douds, Anne S

    2017-08-01

    The current study sought to examine access to services by various veteran subgroups: racial/ethnic minorities, females, rural populations, and LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Queer). Generally, the Veteran Service Officers (VSOs) interviewed for this study did not feel that these subgroups were well served by the program and treatment options presently available, and that other groups such as males and urban veterans received better access to necessary psychosocial and medical care. This research extends studies that explore overall connection to services by further demonstrating barriers to receipt of services by specific subgroups of veterans, particularly those at risk for involvement in the criminal justice system.

  12. 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

  13. 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.

  14. Antipsychotic prescriptions in Iraq and Afghanistan veterans with posttraumatic stress disorder in Department of Veterans Affairs healthcare, 2007-2012.

    PubMed

    Cohen, Beth E; Shi, Ying; Neylan, Thomas C; Maguen, Shira; Seal, Karen H

    2015-04-01

    Antipsychotic medications have been increasingly prescribed for off-label uses, including treatment of posttraumatic stress disorder (PTSD). Given limited knowledge about their use in returning Iraq and Afghanistan veterans with PTSD, we explored rates of antipsychotic use in this population and correlations with sociodemographic, military service, and psychiatric factors. Iraq and Afghanistan veterans with a PTSD diagnosis based on ICD-9-CM codes enrolled in Veterans Administration care between January 1, 2007, and September 30, 2011, were followed through September 30, 2012. Patients with a comorbid diagnosis of schizophrenia or bipolar disorder were excluded. Poisson regression models evaluated factors associated with prescriptions for antipsychotic versus other psychiatric medications (primary outcome). The mean age of our study population was 29.3 years, and 9.4% were women. Of 186,460 veterans with PTSD diagnoses examined, 19.9% received no psychiatric medications, and the remainder received psychiatric medications that excluded (61.2%) or included (18.9%) antipsychotics. In adjusted models, several factors were independently associated with antipsychotic use, including male sex (adjusted relative risk = 1.25; 95% CI, 1.20-1.30) and enlisted rank (1.44; 95% CI, 1.35-1.53). Increased likelihood of antipsychotic prescribing was associated with suicidal ideation (4.77; 95% CI, 4.59-4.95) and comorbid psychiatric diagnoses including personality disorder (4.27; 95% CI, 4.09-4.46), drug use disorder (3.56; 95% CI, 3.43-3.69), and alcohol use disorder (2.75; 95% CI, 2.65-2.84). A substantial minority of Iraq and Afghanistan veterans diagnosed with PTSD received antipsychotics. Male veterans, those of enlisted rank, and those with suicidal ideation and psychiatric comorbidities were more likely to receive antipsychotics than other types of psychiatric medications. Providers should be cautious about antipsychotic use, given their known metabolic risks and questionable

  15. Effect of clinician-veteran racial pairing in the treatment of posttraumatic stress disorder.

    PubMed

    Rosenheck, R; Fontana, A; Cottrol, C

    1995-04-01

    This study explored the effect of veterans' race and of the pairing of veterans' and clinicians' race on the process and outcome of treatment for war-related posttraumatic stress disorder (PTSD). As part of the national evaluation of the PTSD Clinical Teams program of the Department of Veterans Affairs, data on assessment of 4,726 white and black male veterans at admission to the program and on the race and other characteristics of their 315 primary clinicians were obtained. Measures of service delivery and treatment emphasis were obtained 2, 4, 8, and 12 months after program entry, along with clinicians' ratings of improvement. After control for sociodemographic characteristics, clinical status, and clinicians' characteristics, multivariate analysis showed that black veterans had significantly lower program participation ratings than white veterans on 10 of 24 measures, but no differences in clinicians' improvement ratings were noted. Additional analyses showed that pairing of white clinicians with black veterans was associated with lower program participation on four of the 24 measures and with lower improvement ratings on one of 15 measures. When treated by either black or white clinicians, black veterans had poorer attendance than white veterans, seemed less committed to treatment, received more treatment for substance abuse, were less likely to be prescribed antidepressant medications, and showed less improvement in control of violent behavior. Although no differences were noted on most measures, the pairing of black veterans with white clinicians was associated with receiving fewer services. According to some other measures, black veterans received less intensive services regardless of the clinician's race.

  16. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Code 8320-01 Proposed Information Collection (Board of Veterans' Appeals Voice of the Veteran.... BILLING CODE 8320-01-P ...

  17. Determinants of utilization and cost of VHA care by OEF/OIF Veterans screened for mild traumatic brain injury.

    PubMed

    Amara, Jomana; Pogoda, Terri K; Krengel, Maxine; Iverson, Katherine M; Baker, Errol; Hendricks, Ann

    2014-09-01

    To determine the demographic and service characteristics that differentially impact utilization and cost of Veterans Health Administration (VHA) services for Operation Enduring Freedom and Operation Iraq Freedom (OEF/OIF) Veterans screened or evaluated for traumatic brain injury (TBI). We examined Department of Defense (DoD) and VHA administrative records of OEF/OIF Veterans who were screened or evaluated for TBI. Our study population was OEF/OIF Veterans who separated from DoD in Fiscal Years 2003-2009 and who were screened or evaluated in VHA for TBI between October 2008 and July 2009. We describe the demographics and service characteristics of separated Veterans and those who accessed the VHA. We report the cost of VHA utilization and estimate a probit regression model to assess determinants of VHA utilization and costs by OEF/OIF Veterans screened and evaluated for TBI by VHA. Females and Veterans older than 37 years utilize VHA services more intensely. Across all services, the Reserve Components utilize health services more than the Active Components placing more demand on VHA for services. VHA utilization and costs is impacted by the demographic and service characteristics of Veterans. The variation in Veteran groups incurring higher costs and utilization indicates different usage patterns of VHA services by each group with implications for patient load as the DoD deploys higher numbers of females and the Reserve Components. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  18. An estimate of the veteran population in England: based on data from the 2007 Adult Psychiatric Morbidity Survey.

    PubMed

    Woodhead, Charlotte; Sloggett, Andy; Bray, Issy; Bradbury, Jason; McManus, Sally; Meltzer, Howard; Brugha, Terry; Jenkins, Rachel; Greenberg, Neil; Wessely, Simon; Fear, Nicola

    2009-01-01

    The health and well-being of military veterans has recently generated much media and political interest. Estimating the current and future size of the veteran population is important to the planning and allocation of veteran support services. Data from a 2007 nationally representative residential survey of England (the Adult Psychiatric Morbidity Survey) were extrapolated to the whole population to estimate the number of veterans currently residing in private households in England. This population was projected forward in two ten-year blocks up to 2027 using a current life table. It was estimated that in 2007, 3,771,534 (95% CI: 2,986,315-4,910,205) veterans were living in residential households in England. By 2027, this figure was predicted to decline by 50.4 per cent, mainly due to large reductions in the number of veterans in the older age groups (65-74 and 75+ years). Approximately three to five million veterans are currently estimated to be living in the community in England. As the proportion of National Service veterans reduces with time, the veteran population is expected to halve over the next 20 years.

  19. Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions.

    PubMed

    Darkins, Adam; Ryan, Patricia; Kobb, Rita; Foster, Linda; Edmonson, Ellen; Wakefield, Bonnie; Lancaster, Anne E

    2008-12-01

    Between July 2003 and December 2007, the Veterans Health Administration (VHA) introduced a national home telehealth program, Care Coordination/Home Telehealth (CCHT). Its purpose was to coordinate the care of veteran patients with chronic conditions and avoid their unnecessary admission to long-term institutional care. Demographic changes in the veteran population necessitate VHA increase its noninstitutional care (NIC) services 100% above its 2007 level to provide care for 110,000 NIC patients by 2011. By 2011, CCHT will meet 50% of VHA's anticipated NIC provision. CCHT involves the systematic implementation of health informatics, home telehealth, and disease management technologies. It helps patients live independently at home. Between 2003 and 2007, the census figure (point prevalence) for VHA CCHT patients increased from 2,000 to 31,570 (1,500% growth). CCHT is now a routine NIC service provided by VHA to support veteran patients with chronic conditions as they age. CCHT patients are predominantly male (95%) and aged 65 years or older. Strict criteria determine patient eligibility for enrollment into the program and VHA internally assesses how well its CCHT programs meet standardized clinical, technology, and managerial requirements. VHA has trained 5,000 staff to provide CCHT. Routine analysis of data obtained for quality and performance purposes from a cohort of 17,025 CCHT patients shows the benefits of a 25% reduction in numbers of bed days of care, 19% reduction in numbers of hospital admissions, and mean satisfaction score rating of 86% after enrolment into the program. The cost of CCHT is $1,600 per patient per annum, substantially less than other NIC programs and nursing home care. VHA's experience is that an enterprise-wide home telehealth implementation is an appropriate and cost-effective way of managing chronic care patients in both urban and rural settings.

  20. Qualitative Inquiry Explores Health-Related Quality of Life of Female Veterans With Post-Traumatic Stress Disorder.

    PubMed

    Haun, Jolie N; Duffy, Allyson; Lind, Jason D; Kisala, Pamela; Luther, Stephen L

    2016-11-01

    As the number of female veterans increases, health care systems must be prepared to meet the individualized needs of this population. To date, published data on health-related quality of life (HRQOL) of veterans with post-traumatic stress disorder (PTSD) focus on quantitative data and primarily represent the male population. The purpose of this study was to qualitatively explore the impact of PTSD on female veterans' HRQOL. A descriptive qualitative study used focus groups and demographic surveys to achieve data collection in a sample of veterans with PTSD. This report focuses on the analysis of a sample of 12 females to explore PTSD HRQOL experiences unique to female veterans. Female veterans reported several areas in which their HRQOL was impacted adversely in social participation, physical, cognitive, and emotional aspects of their lives. Issues with self-medication and substance abuse were also reported by participants. Female participants' perceptions about Veterans Health Administration were also discussed, highlighting unmet needs when receiving care for PTSD. These data provide unique insights from the perspective of female veterans with PTSD about their HRQOL and receiving care within the Veterans Health Administration health care system. These data can inform future research to better address the needs of female veterans living with PTSD. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  1. Simulated driving performance of combat veterans with mild tramatic brain injury and posttraumatic stress disorder: a pilot study.

    PubMed

    Classen, Sherrilene; Levy, Charles; Meyer, Dustin L; Bewernitz, Megan; Lanford, Desiree N; Mann, William C

    2011-01-01

    We determined differences in driving errors between combat veterans with mild traumatic brain injury and posttraumatic stress disorder and healthy control participants. We compared 18 postdeployed combat veterans with 20 control participants on drivingerrors in a driving simulator. Combat veterans were more likely to be male; were younger; and had more racial diversity, less formal education, and lower cognitive scores than control participants. Control participants made more signaling errors (t [19] = -2.138, p = .046, SE = 0.395), but combat veterans made more overspeeding (t [17.3] = 4.095, p = .001, SE = 0.708) and adjustment-to-stimuli (t [17] = 2.380, p = .029, SE = 0.140) errors. Young age was related to overspeeding. Combat veterans made more critical driving errors than did control participants. Such errors made on the road may lead to crashes or injuries. Although limited in generalizability, these findings provide early support for developing safe driving interventions for combat veterans.

  2. Increased risk for substance use and health-related problems among homeless veterans.

    PubMed

    Dunne, Eugene M; Burrell, Larry E; Diggins, Allyson D; Whitehead, Nicole Ennis; Latimer, William W

    2015-10-01

    The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p < .001), mental health problems (OR = 4.12, 95% CI: 2.28-7.42, p < .001), and physical problems (OR = 1.83, 95% CI: 1.08-3.67, p < .01). Finally, over half of homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p < .05). Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services. © American Academy of Addiction Psychiatry.

  3. Criminal justice involvement, trauma, and negative affect in Iraq and Afghanistan war era veterans.

    PubMed

    Elbogen, Eric B; Johnson, Sally C; Newton, Virginia M; Straits-Troster, Kristy; Vasterling, Jennifer J; Wagner, H Ryan; Beckham, Jean C

    2012-12-01

    Although criminal behavior in veterans has been cited as a growing problem, little is known about why some veterans are at increased risk for arrest. Theories of criminal behavior postulate that people who have been exposed to stressful environments or traumatic events and who report negative affect such as anger and irritability are at increased risk of antisocial conduct. We hypothesized veterans with posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI) who report anger/irritability would show higher rates of criminal arrests. To test this, we examined data in a national survey of N = 1,388 Iraq and Afghanistan war era veterans. We found that 9% of respondents reported arrests since returning home from military service. Most arrests were associated with nonviolent criminal behavior resulting in incarceration for less than 2 weeks. Unadjusted bivariate analyses revealed that veterans with probable PTSD or TBI who reported anger/irritability were more likely to be arrested than were other veterans. In multivariate analyses, arrests were found to be significantly related to younger age, male gender, having witnessed family violence, prior history of arrest, alcohol/drug misuse, and PTSD with high anger/irritability but were not significantly related to combat exposure or TBI. Findings show that a subset of veterans with PTSD and negative affect may be at increased risk of criminal arrest. Because arrests were more strongly linked to substance abuse and criminal history, clinicians should also consider non-PTSD factors when evaluating and treating veterans with criminal justice involvement.

  4. 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

    Martinez, Carlos H; Moy, Marilyn L; Nguyen, Huong Q; Cohen, Miriam; Kadri, Reema; Roman, Pia; Holleman, Robert G; Kim, Hyungjin Myra; Goodrich, David E; Giardino, Nicholas D; Richardson, Caroline R

    2014-02-03

    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. 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. 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. Clinical Trials.gov NCT01102777.

  5. Veterans Crisis Line Callers With and Without Prior VHA Service Use.

    PubMed

    Britton, Peter C; Kopacz, Marek S; Stephens, Brady; Bossarte, Robert M

    2016-07-02

    This study examines differences between Veterans with and without prior Veterans Health Administration service use who received a clinical referral from the Veterans' Crisis Line. Differences between groups were identified using data taken from 13,444 calls and medical records. Approximately 91% of Veterans had a history of service use and 9% did not. Callers with prior service use were older, had more mental health disorders, made in-person contact more quickly, and used more outpatient mental healthcare. Those without prior service use were younger, had more mental health problems, and presented for care later. Callers with suicide-related diagnoses had high rates of service contact. These groups represent different subpopulations with unique healthcare needs and practices.

  6. HELP Veterans Act of 2010

    THOMAS, 111th Congress

    Rep. Herseth Sandlin, Stephanie [D-SD-At Large

    2010-05-20

    Senate - 09/29/2010 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:

  7. Veterans Accountability Act of 2013

    THOMAS, 113th Congress

    Rep. Huelskamp, Tim [R-KS-1

    2013-04-26

    House - 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:

  8. 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:

  9. Veterans' Outreach Act of 2013

    THOMAS, 113th Congress

    Sen. Sanders, Bernard [I-VT

    2013-05-09

    Senate - 06/12/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-111. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. Wounded Veteran Job Security Act

    THOMAS, 111th Congress

    Rep. Doggett, Lloyd [D-TX-25

    2009-01-13

    Senate - 06/09/2009 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' Employment and Training Service

    MedlinePlus

    ... Certification for Veterans State Strategies for Successfully Removing Barriers. VETS-4212 Federal Contractor Reporting Federal contractors and ... Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont ...

  12. Energy Jobs for Veterans Act

    THOMAS, 111th Congress

    Rep. Teague, Harry [D-NM-2

    2010-02-03

    03/24/2010 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. 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' Benefits Act of 2011

    THOMAS, 112th Congress

    Rep. Runyan, Jon [R-NJ-3

    2011-06-24

    Senate - 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:

  15. Energy Jobs for Veterans Act

    THOMAS, 111th Congress

    Rep. Teague, Harry [D-NM-2

    2010-02-03

    Senate - 03/24/2010 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:

  16. 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:

  17. Wounded Veteran Job Security Act

    THOMAS, 111th Congress

    Rep. Doggett, Lloyd [D-TX-25

    2009-01-13

    06/09/2009 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:

  18. Veterans Conservation Corps Authorization Act

    THOMAS, 112th Congress

    Sen. Nelson, Bill [D-FL

    2012-02-17

    Senate - 06/13/2012 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 112-567. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. Veterans Dog Training Therapy Act

    THOMAS, 111th Congress

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

    2009-10-21

    Senate - 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: