Medicine and Health Sciences Commons^™

Effectiveness Of Escoop® Lenses On A Select Group Of Veterans, Connie Chronister Od, Denise T. Wilcox Od, Stanley Hatch Od, Mph

Optometric Clinical Practice

Purpose: The purpose of this study was to perform a retrospective chart review to see if the use of EScoop® lenses improved the referred veterans' contrast acuity and subjective visual discomfort of glare, photophobia, or difficulty with night driving. Methods: We retrospectively reviewed examinations of 23 veterans aged 36 to 91 who chose EScoop ® for their spectacle prescription. The EScoop ® set available in our clinic included two shades, yellow or orange, two center lens thicknesses (LT), 6 or 9 mm, and with or without 4 prism diopters yoked base up (BU) prism. Results: The largest diagnostic group tested …

The U.S. Military Does Not Adequately Prepare Members For Transition From Service, Emily Graham

Population Health Research Brief Series

Nearly 250,000 U.S. military members transition out of service each year. The Transition Assistance Program (TAP) provides information, tools, and training to prepare service members for their transition to civilian life. However, nearly half of veterans say the military did not adequately prepare them for their transition from service. This issue brief highlights the shortcomings of veteran transition programs, like TAP, and provides recommendations for improving transition outcomes through more holistic programs.

A Manualized Occupational Therapy Communication Skills Intervention For Veterans With Posttraumatic Stress Disorder, Kiara Ainsworth, Steven M. Gerardi

Spring 2024 Virtual OTD Capstone Symposium

Post-traumatic stress disorder (PTSD) affects many individual's participation in daily activities. There is a lack of research in the area of occupational therapy (OT) treatment for veterans with PTSD. However, there has been an expressed need in the literature for a developed intervention for veterans with PTSD that includes communication skills as a component. To date, a manualized communication skills OT intervention for veterans with PTSD has not been created. The purpose of this paper was to develop a resource tool for occupational therapists to utilize as an intervention when treating veterans with PTSD using the framework of the Model …

Prevalence, Morbidity, And Mortality Of Men With Sex Chromosome Aneuploidy In The Million Veteran Program Cohort, Shanlee Davis, Craig Teerlink, Julie Lynch, Bryan Gorman, Meghana Pagadala, Aoxing Liu, Matthew Panizzon, Victoria Merritt, Giulio Genovese, Judith Ross, Richard Hauger

Department of Pediatrics Faculty Papers

IMPORTANCE: The reported phenotypes of men with 47,XXY and 47,XYY syndromes include tall stature, multisystem comorbidities, and poor health-related quality of life (HRQOL). However, knowledge about these sex chromosome aneuploidy (SCA) conditions has been derived from studies in the less than 15% of patients who are clinically diagnosed and also lack diversity in age and genetic ancestry.

OBJECTIVES: To determine the prevalence of clinically diagnosed and undiagnosed X or Y chromosome aneuploidy among men enrolled in the Million Veteran Program (MVP); to describe military service metrics of men with SCAs; and to compare morbidity and mortality outcomes between men with …

Learning From Women Veterans Who Navigate Invisible Injuries, Caregiving, And Reintegration Challenges, Nicholas A. Rattray, Diana Natividad, Katrina Spontak, Marina Kukla, Ai Nghia L. Do, Leah Danson, Richard M. Frankel, Gala True

School of Medicine Faculty Publications

Background: As women comprise a greater proportion of military service members, there is growing recognition of how their experiences in the early phase of military to civilian transitions have an important influence on their health and reintegration outcomes. Qualitative accounts of women veterans can inform programs that support transitioning service members. Objectives: We examined narratives of civilian reintegration among women veterans to understand their experiences of adjusting to community life while coping with mental health challenges. Methods/Participants: We interviewed 16 post-911 era women who were within 5 years of separating from military service and developed a case study based on …

Implementing Low-Dose Ct Scans To Screen For Lung Cancer In The Primary Care Setting, Monifa Ri'ana Beal

Doctoral Projects

Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in …

Integrating Stakeholder Feedback Into The Design Of A Peer-Delivered Primary Care Wellness Program: A Rapid Qualitative Study, Emily M. Johnson, Kyle Possemato, Matthew Chinman, Gala True, Jacob Hedges, Brittany N. Hampton, E. Jennifer Edelman, Stephen A. Maisto

School of Medicine Faculty Publications

Background: Individuals seen in Primary Care with behavioral health concerns who decline behavioral health treatment may benefit from the support of peers (consumers in recovery from behavioral health concerns employed to support other consumers). Whole Health STEPS is a new intervention for Veterans in Primary Care with behavioral health concerns which combines essential elements of peers’ role and the Whole Health model using a stepped-care design. We incorporated stakeholder feedback in the Whole Health STEPS design to improve fit with Veterans, peers, and primary care settings. Methods: We conducted semi-structured qualitative interviews with VA staff using questions derived from the …

Assessment Revision Of ‘Perceptions Of Disabled Veterans In The Civilian Workforce’, Rebecca L. Reed

Pacific Journal of Health

As there continues to be limited research related to perceptions of disability status in the workforce, specific to the veteran population, the importance of employer understanding as well as willingness to provide accommodations is necessary to help promote change. This study carefully reviewed the assessment tool used by Reed (2016) to measure perceptions towards hiring disabled veterans as they enter the civilian workforce. To help support validity and/or reliability of the tool previously used, two professional experts were interviewed to provide feedback on the data tool in support of revisions. The vignettes, job attainment questionnaire, and demographics questionnaire were revised …

Survival Of Veterans Treated With Enzalutamide And Abiraterone For Metastatic Castrate Resistant Prostate Cancer Based On Comorbid Diseases, Martin W Schoen, Kenneth R Carson, Seth A Eisen, Charles L Bennett, Suhong Luo, Melissa A Reimers, Eric M Knoche, Alison L Whitmer, Yan Yan, Bettina F Drake, Kristen M Sanfilippo

2020-Current year OA Pubs

BACKGROUND: Comorbid diseases influence patient outcomes, yet little is known about how comorbidities interact with treatments for metastatic castrate-resistant prostate cancer (mCRPC). No head-to-head trials have compared the efficacy of abiraterone and enzalutamide - oral androgen-receptor targeted agents (ARTAs) for mCRPC. In patients with comorbid disease, outcomes with ARTAs may differ due to disparate mechanisms of action, adverse events, and drug interactions.

METHODS: Retrospective observational study of US veterans initiating treatment for mCRPC with abiraterone or enzalutamide between September 2014 and June 2017. Treatment duration and overall survival (OS) was compared based on age and comorbid diseases. The association between …

Multi-Ancestry Genome-Wide Association Study Of Cannabis Use Disorder Yields Insight Into Disease Biology And Public Health Implications, Daniel F Levey, Emma C Johnson, Arpana Agrawal, Et Al.

2020-Current year OA Pubs

As recreational use of cannabis is being decriminalized in many places and medical use widely sanctioned, there are growing concerns about increases in cannabis use disorder (CanUD), which is associated with numerous medical comorbidities. Here we performed a genome-wide association study of CanUD in the Million Veteran Program (MVP), followed by meta-analysis in 1,054,365 individuals (n

Serving Those Who Served: Renegotiating Support And Benefits For U.S. Military Veterans With Less Than Honorable Discharges, Mariah Brennan, Emily Graham

Population Health Research Brief Series

Approximately 1 in 7 veterans are discharged from the military under less than “Honorable” conditions. Veterans with less than “Honorable” discharges experience bias and stigma related to their discharge, which can lead to elevated risk for behavioral and mental health challenges and homelessness. This brief summarizes the different military discharge types, explains how less than “Honorable” discharges can affect veteran health, identifies groups of veterans who are at risk of receiving a less than “Honorable” discharge, and makes policy recommendations for the Department of Defense (DoD), civilian employers, and community healthcare providers.

Cognitive Decrements In 1991 Gulf War Veterans: Associations With Gulf War Illness And Neurotoxicant Exposures In The Boston Biorepository, Recruitment, And Integrative Network (Bbrain) Cohorts., D Keating, M Krengel, J Dugas, R Toomey, L Chao, L Steele, Lloyd P Janulewicz, T Heeren, E Quinn, N Klimas, K Sullivan

HPD Articles

BACKGROUND: During deployment, veterans of the 1991 Gulf War (GW) were exposed to multiple war-related toxicants. Roughly a third of these veterans continue to exhibit neurotoxicant induced symptoms of Gulf War Illness (GWI), a multi-faceted condition that includes fatigue, pain and cognitive decrements. When studied empirically, both deployed veterans with exposures and those who meet the criteria for GWI are more likely to show deficits in the area of neuropsychological functioning. Although studies have shown cognitive impairments in small sample sizes, it is necessary to revisit these findings with larger samples and newer cohorts to see if other areas of …

Gross Hematuria And Lower Urinary Tract Symptoms Associated With Military Burn Pits Exposures In Us Veterans Deployed To Iraq And Afghanistan, Mosammat M. Perveen, Henry E. Mayo-Malasky, Mary F. Lee-Wong, Julie M. Tomaska, Edward Forsyth, Amy Gravely, Mark A. Klein, Janeen H. Trembley, Tammy A. Butterick, Robert A. Promisloff, Pamela K. Ginex, Paul Barach, Anthony M. Szema

College of Population Health Faculty Papers

OBJECTIVE: The aim of the study is to describe rates of hematuria and other lower urinary tract symptoms, including self-reported cancer rates, among veterans postburn pits emissions exposure during deployment to Iraq and Afghanistan.

METHODS: US post-9/11 veterans with burn pits emissions exposure confirmed via DD214 forms in the Burn Pits360.org Registry were sent a modified survey. Data were deidentified and anonymously coded.

RESULTS: Twenty-nine percent of the 155 respondents exposed to burn pits self-reported seeing blood in their urine. The average index score of our modified American Urological Association Symptom Index Survey was 12.25 (SD, 7.48). High rates of …

Complementary And Integrative Therapies Available For Treating Veterans With Ptsd: An Integrative Review, Kelly Ann Greene

Doctoral Dissertations and Projects

PTSD is described as the resulting from exposure to threatened or real injury, death, or sexual violence. Its symptoms have four different clusters: avoidance, re-experiencing, hyperarousal, and negative alterations in mood. PTSD is a widespread diagnosis among U.S. military veterans. This is a way of daily life for many veterans, and not all therapy is successful. The Veterans Health Administration (VA) recognizes that conventional therapy is not always appropriate for each veteran with PTSD. The VA has developed the Whole Health approach, which represents a move toward more person-driven health care, which the VA characterizes as proactive, patient driven, and …

Expanding The Occupational Therapy Oncology Rehabilitation Program At James A. Haley Veterans' Hospital, Annalisa M. Rodriguez

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Understanding Veteran Perceptions About Mental Health And Its Treatment, Quinn Turner Stoddard

Dissertations and Theses

Mental health illnesses are a growing issue for a large part of the country, and veterans in particular are vulnerable to the numerous negative effects they pose. Despite the high number of people that may benefit from treatment, a variety of issues with trust, stigma, and attitudes may act as barriers to care utilization. In response, this study investigated the perceptions that veterans within the Pacific Northwest hold in regards to mental health treatment as well as their intentions to seek it out should they require it. Using the integrated model of behavioral prediction (IMBP), data was gathered about veterans’ …

Unmet Needs And Coping Strategies Of Older Underserved Veterans During The Covid-19 Pandemic, Trenton M. Haltom, Joyce Tiong, Tracy L. Evans, Nipa Kamdar, Gala True, Mark E. Kunik

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic has had profound impacts on people with diabetes, a group with high morbidity and mortality. Factors like race, age, income, Veteran-status, and limited or interrupted resources early in the COVID-19 pandemic compounded risks for negative health outcomes. Our objective was to characterize the experiences and needs of under-resourced Veterans with type 2 diabetes during the COVID-19 pandemic. Methods: We conducted semi-structured qualitative interviews (March through September 2021) with U.S. military Veterans with diabetes. Transcripts were analyzed using a team-based, iterative process of summarizing and coding to identify key themes. Participants included Veterans (n = 25) who …

Use Of Advance Directives In Us Veterans And Non-Veterans: Findings From The Decedents Of The Health And Retirement Study 1992–2014, Ho-Jui Tung, Ming-Chin Yeh

Department of Health Policy and Community Health Faculty Publications

Evidence shows that older patients with advance directives such as a living will, or durable power of attorney for healthcare, are more likely to receive care consistent with their preferences at the end of life. Less is known about the use of advance directives between veteran and non-veteran older Americans. Using data from the decedents of a longitudinal survey, we explore whether there is a difference in having an established advance directive between the veteran and non-veteran decedents. Data were taken from the Harmonized End of Life data sets, a linked collection of variables derived from the Health and Retirement …

Study Protocol: Type Iii Hybrid Effectiveness-Implementation Study Implementing Age-Friendly Evidence-Based Practices In The Va To Improve Outcomes In Older Adults, Kirstin Manges Piazza, Laura Ellen Ashcraft, Liam Rose, Daniel E. Hall, Rebecca T. Brown, Mary Elizabeth (Libby) Bowen, Shahrzad Mavandadi, Alison C. Brecher, Shimrit Keddem, Bruce Kiosian, Judith A. Long, Rachel M. Werner, Robert E. Burke

College of Population Health Faculty Papers

Background

Unmet care needs among older adults accelerate cognitive and functional decline and increase medical harms, leading to poorer quality of life, more frequent hospitalizations, and premature nursing home admission. The Department of Veterans Affairs (VA) is invested in becoming an “Age-Friendly Health System” to better address four tenets associated with reduced harm and improved outcomes among the 4 million Veterans aged 65 and over receiving VA care. These four tenets focus on “4Ms” that are fundamental to the care of older adults, including (1) what Matters (ensuring that care is consistent with each person’s goals and preferences); (2) …

A Mindfulness Intervention For Veterans With Post-Traumatic Stress Disorder, Ashley N. Ries, Steven M. Gerardi Phd, Otd, Mss, Otr, Mary Horne Lcsw

Spring 2023 Virtual OTD Capstone Symposium

Every day, many United States veterans are suffering from the effects of post-traumatic stress disorder (PTSD). Responses to trauma may vary from person to person; however, a diagnosis of PTSD includes the individual experiencing clinically significant distress in their social and occupational areas of functioning. The impact of PTSD on a veteran’s life could impact their ability to carry out activities of daily living, decrease the amount of social participation they have, and limit their ability to perform instrumental daily activities, such as grocery shopping. Mindfulness is the practice of paying full attention to the present moment, without judgment, and …

Serving American Veterans: A Review And Analysis Of Gaps In Service In The Needs Of Veterans, Mary Elisabeth Germann

Baker Scholar Projects

The United States Department of Veterans Affairs is the agency of the federal government that is responsible for providing benefits, health care, and cemetery services to US military Veterans and their families. About a quarter of the nation’s population, approximately 70 million people, are potentially eligible for VA benefits and services because they are veterans, family members, or survivors of veterans. Due to this expansive demand, the United States has developed the most comprehensive system of Veterans assistance programs in the World. But many argue that the US VA still falls short of expectations and fails to fulfill the needs …

Experiences Of Transitioning Medics And Hospital Corpsman, David Renfro

Doctoral Projects

Approximately 2,000 medics transition from military service to civilian jobs annually, and the civilian workforce currently does not have a mechanism to utilize the skills of these transitioning veterans. Medics and Hospital Corpsmen are not licensed or certified, making transferring into employment in the community difficult. The Veterans Affairs (VA) has an intermediate care technician (ICT) program that provides employment for previous active-duty medics and hospital corpsmen. Understanding the transition of medics and hospital corpsmen better positions the Department of Defense and the VA leadership to support the transitioning veteran.
This DNP project used a quality improvement framework, and a …

Cognitive Behavioral Therapy For Chronic Pain In Veterans, Mari Bones

Honors Projects

This paper is an exploration of the use of Cognitive Behavioral Therapy (CBT) as treatment for chronic pain amongst veterans. CBT has been used as a treatment options for veterans since 2012 in order to decrease the use and misuse of opioids. It focuses on giving the patient tools to control the impact that chronic pain has on their body and mind. The paper explore this treatment, the aspects of it, complementary treatments, and results.

Potential Chemical Risks From Tattoos And Their Relevance To Military Health Policy In The United States, James D. Blando, Blas A. Guigni

Community & Environmental Health Faculty Publications

We summarize and consolidate disparate sources of information about the practice of tattooing and its potential implications for military population health and policy. Each branch of the United States military has policies about tattoos for service members, but these have varied over time and do not cover health protection. The number of veterans receiving disability payments and the cost of those payments has been rising over time; the broad category of skin conditions accounts for 11% of disability claims. Any additional factor, such as tattoos that may increase the occurrence of adverse skin reactions, can substantially impact veteran benefit expenses …

Opioid Prescriptions In A Veteran Population Undergoing Lumbar Spine Surgery: What Are The Current Knowledge Gaps?, Mark J. Lambrechts, Hernan Roca, Brian A. Karamian

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

Researching Medical Treatment Assessments From United States Military Veterans Diagnosed With Substance Use Disorder, And Determining Interest In The Matrix Model Of Treatment For Potential Application In Their Treatment Programs, Christopher R. Strunk

Dissertations and Theses

The purpose of this research study is to learn the beliefs and thoughts on the current state of medical treatment provided to United States (US) military Veterans diagnosed with substance use disorder (SUD), and gauge Veterans’ levels of interest and support in the potential application of the Matrix Model of Treatment (MMT) in their healthcare programs. This proposal focused on verifying the Veterans’ interest in the MMT model since the US Department of Veterans Affairs (DVA) does not currently implement this full-spectrum, 16-week treatment system. It is believed interest will be strong enough to merit supporting its consideration with approving …

Intimate Partner Violence Screening In The Veteran Affairs' Ambulatory Care Clinics: A Quality Improvement Project, Stephanie Ralston

Doctor of Nursing Practice Projects

Intimate Partner Violence is a type of Domestic Violence (DV), referring to physical, verbal, emotional, or sexual violence, or stalking between current or former intimate partners. Veterans may be at higher risk than those identified in the civilian population. The rate of IPV across military populations ranges from 13.5% to 58% with rates among female Veterans ranging from 29% to 74% (Veterans Affairs, 2023). This project's purpose was to evaluate the effectiveness of an awareness campaign on IPV screening and referral rates in a federal healthcare facility. Results from this DNP project indicate that ongoing training and education are vital …

Veteran Access To Mental Health Services And How It Contributes To The Rates Of Suicide, Kameron R. Grigsby

Kentucky Journal of Undergraduate Scholarship

This essay is an exploration of the access Veterans have to mental health services and how such access or lack thereof contributes to the rates of suicide among the Veteran population. The purpose of this essay is to examine various factors that influence Veteran access to mental health care and how these factors can be improved or eliminated. By analyzing such factors, healthcare professionals may begin to further implement provisions and practices to decrease the rising rate of suicides among Veterans.

Examining The Relationship Of Social Inclusion On Job Satisfaction And Turnover Intentions Of Us Post-9/11 Veterans, Sheree' L. Peters

Walden Dissertations and Doctoral Studies

Many American veterans return to the civilian workforce and report having problems reintegrating into society, as well as finding their role in the new corporate social realms. Over 80% leave their civilian jobs within the first two years of employment, and over 70% report experiencing feelings of loneliness. Recently, the World Health Organization reported that the lack of perceived social inclusion also has a significant economic impact on both individuals and societies. A quantitative, nonexperimental methodology was used to examine the moderating relationship of social inclusion on the relationship between job employee turnover intentions of post-9/11 enlisted veterans. This study …

Ambiguous Loss Feelings Amongst Caregivers Of Operation Enduring Freedom Veterans, Stephanie T. Spann

Walden Dissertations and Doctoral Studies

This quantitative study compares the possible relationship between ambiguous loss and the stress level of caregivers of Operation Enduring Freedom (OEF) veterans who served in combat. Injured servicemembers need caregivers to assist them in caring for their physical and mental health needs. This study examined whether there is a relationship between the perceived ambiguous loss among caregivers of OEF injured veterans and the stress level experienced by caregivers. The theoretical framework for this study is the ambiguous loss theory. The methodology used to test the hypothesis is a quantitative correlational design to compare ambiguous loss variables amongst caregivers of injured …