Public Health Commons^™

Factors Associated With Suicidal Ideation In Oef/Oif Veterans, Chad M. Lemaire, David P. Graham

United States Public Health Resources

Background: The purpose of this projectwas to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.

Methods: A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.

Results: Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), …

Imagery Rescripting And Exposure Group Treatment Of Posttraumatic Nightmares In Veterans With Ptsd, Mary E. Long, Mary E. Hammons, Joanne L. Davis, B. Christopher Frueh, Myrna M. Khan, Jon D. Elhai, Ellen J. Teng

United States Public Health Resources

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. Thirtyseven 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, …

The Impact Of Endorsing Spitzer’S Proposed Criteria For Ptsd In The Forthcoming Dsm-V On Male And Female Veterans, Lyndsey N. Miller, Kathleen M. Chard, Jeremiah A. Schumm, Carol O’Brien

United States Public Health Resources

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 …

Two Sessions Of Sleep-Focused Mind–Body Bridging Improve Self-Reported Symptoms Of Sleep And Ptsd In Veterans: A Pilot Randomized Controlled Trial, Yoshio Nakamura, David L. Lipschitz, Richard Landward, Renee Kuhn, Gavin West

United States Public Health Resources

Objective: Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind–body interventions may be beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind–body intervention, mind–body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans.

Methods: This pilot study was a randomized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control. Both interventions …

Cerebrocerebellar Hypometabolism Associated With Repetitive Blast Exposure Mild Traumatic Brain Injury In 12 Iraq War Veterans With Persistent Post-Concussive Symptoms, Elaine R. Peskind, Eric C. Petrie, Donna J. Cross, Kathleen Pagulayan, Kathleen Mccraw, David Hoff, Kim Hart, Chang-En Yu, Murray A. Raskind, David G. Cook, Satoshi Minoshima

United States Public Health Resources

Disagreement exists regarding the extent to which persistent post-concussive symptoms (PCS) reported by Iraq combat Veterans with repeated episodes of mild traumatic brain injury (mTBI) from explosive blasts represent structural or functional brain damage or an epiphenomenon of comorbid depression or posttraumatic stress disorder (PTSD). Objective assessment of brain function in this population may clarify the issue. To this end, twelve Iraq war Veterans (32.0±8.5 [mean±standard deviation (SD)] years of age) reporting one or more blast exposures meeting American Congress of Rehabilitation Medicine criteria for mTBI and persistent PCS and 12 cognitively normal community volunteers (53.0±4.6 years of age) without …

Electroconvulsive Therapy For Major Depression Within The Veterans Health Administration, Paul N. Pfeiffer, Marcia Valenstein, Katherine J. Hoggatt, Dara Ganoczy, Dan Maixner, Erin M. Miller, Kara Zivin

United States Public Health Resources

Objectives: Electroconvulsive therapy (ECT) is the most effective treatment for severe or treatment resistant depression; however, the lack of widely accepted methods for determining when ECT is indicated may contribute to disparities and variation in use. We examined receipt of ECT among depressed patients in the largest coordinated health system in the US, the Veterans Health Administration.

Methods: Using administrative data, we conducted a multivariable logistic regression to identify individual clinical and sociodemographic predictors of receiving ECT, including variables of geographic accessibility to ECT, among patients diagnosed with major depressive disorder between 1999 and 2004.

Results: 307 (0.16%) …

Veterans Affairs General Surgery Service: The Last Bastion Of Integrated Specialty Care, Stephen Poteet, Margaret Tarpley, John L. Tarpley, A. Scott Pearson

United States Public Health Resources

BACKGROUND: In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients.

METHODS: Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to …

Substance Use Disorders In Iraq And Afghanistan Veterans In Va Healthcare, 2001–2010: Implications For Screening, Diagnosis And Treatment, Karen H. Seal, Greg Cohen, Angela Waldrop, Beth E. Cohen, Shira Maguen, Li Ren

United States Public Health Resources

Background: The prevalence and correlates of alcohol use disorder (AUD) and drug use disorder (DUD) diagnoses in Iraq and Afghanistan veterans who are new users of Department of Veterans Affairs (VA) healthcare nationwide has not been evaluated.

Methods: VA administrative data were used in retrospective cross-sectional descriptive and multivariable analyses to determine the prevalence and independent correlates of AUD and DUD in 456,502 Iraq and Afghanistan veterans who were first-time users of VA healthcare between October 15, 2001 and September 30, 2009 and followed through January 1, 2010.

Results: Over 11% received substance use disorder diagnoses: AUD, …

Motivational Interview Improves Treatment Entry In Homeless Veterans, R. Morgan Wain, Paula L. Wilbourne, Keith W. Harris, Heather Pierson, Jasmine Teleki, Thomas A. Burling, Steven Lovett

United States Public Health Resources

Motivational Interviewing (MI) has successfully been used to facilitate entry and compliance in drug and alcohol treatment programs. Some questions have been raised as to the effectiveness of MI in severely distressed populations. This study aims to assess the effectiveness of MI in a population of homeless, unemployed, and substance dependent veterans who are being wait-listed for entry into a residential treatment program. Seventy-five veterans placed on a wait-list were randomized to receive a single MI or standard (Std) intake interview. Outcomes assessed were entry, and length of stay (LOS). Secondary outcomes assessed included program completion and rates of graduation. …

Insomnia Characteristics And Clinical Correlates In Operation Enduring Freedom/Operation Iraqi Freedom Veterans With Post-Traumatic Stress Disorder And Mild Traumatic Brain Injury: An Exploratory Study, D. M. Wallace, S. Shafazand, A.R. Ramos, D.Z. Carvalho, H. Gardener, D. Lorenzo, W.K. Wohlgemuth

United States Public Health Resources

Background: There is limited data on chronic insomnia in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, in whom post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) often co-exist. Our aim was to compare sleep characteristics of three groups of OEF/OIF veterans: (1) healthy sleepers (HS), (2) those with insomnia associated with PTSD and mTBI (PTSD–mTBI), and (3) those with insomnia associated with PTSD alone.

Methods: Consecutive veterans with insomnia complaints (>6 months) were recruited over 6 months from the Miami VA Post Deployment clinic. Participants completed a sleep disorders clinical interview, medical history, and questionnaires …

Factors Influencing Receipt Of Outpatient Rehabilitation Services Among Veterans Following Lower Extremity Amputation, Jianxun Zhou, Barbara E. Bates, Jibby E. Kurichi, Pui L. Kwong, Dawei Xie, Margaret G. Stineman

United States Public Health Resources

Objective: To determine patient-, treatment-, and facilitylevel characteristics associated with receiving outpatient rehabilitation services after lower extremity amputation within the Veterans Affairs (VA) system.

Design: Observational study.

Setting: All Veterans Affairs Medical Centers (VAMCs).

Participants: Veterans (N=4165) with lower extremity amputation discharged from VAMCs between October 1, 2002, and September 20, 2004. Interventions: Not applicable.

Main Outcome Measures: Receipt of outpatient rehabilitation services up to 1 year postdischarge. A Cox proportional hazards model was used to determine the adjusted hazard ratio and 95% confidence interval of veterans to receive outpatient services.

Results: …

Tanning Predicts Bone Mass But Not Structure In Adolescent Females Living In Hawaii, Daniel L. Osborne, Connie M. Weaver, Linda D. Mccabe, George P. Mccabe, Rachel Novotny, Carol Boushey, Dennis A. Savaiano

Department of Anthropology: Faculty Publications

Objectives: To evaluate the relationship between facultative skin pigmentation, which predicts circulating levels of plasma 25-hydroxymitamin D, and several measures of bone mass and structure in a cross sectional sample of adolescent females living in Hawaii.

Methods: Our sample was composed of adolescent females (n = 94) living in Hawaii where seasonal sun exposure is minimal, and who self-identified as either white (n = 16) or Asian (n = 78). Bone mineral content (BMC) of the total body, the lumbar spine and the hip, and cross sectional area (CSA) and section modulus (Z) at the …

Social Meaning Of Alcohol-Related Flushing Among University Students In China, Ian M. Newman, Izumi Jinnai, Jie Zhao, Zhaoqing Huang, Jia Pu, Ling Qian

Department of Educational Psychology: Faculty Publications

This study explored drinking patterns, alcohol-related flushing, and ways students themselves and other people respond to flushing in drinking situations. Of 1080 Chinese undergraduate university students given the survey questionnaire, 725 (67.1%) returned the completed surveys. Eighty percent of the students were drinkers (93% of males and 69% of females); 68% of the drinkers were flushers. Most of the students (59.3%) said flushing had no special meaning, that is, would ignore flushing; 54% of the flushers said they could keep drinking “but less” when they flush; 27% of the students said that a flushing person should stop drinking; however, if …

Where Have All The Plant Foods Gone? The Search For Refined Dietary Reconstruction From Chinchorro Mummies, Karl J. Reinhard, Sara Le-Roy-Toren, Bernardo Arriaza

Karl Reinhard Publications

The Chinchorro cemeteries of northern Chile are the first graveyards of the Andes (Arriaza 1995, Schiappacasse & Niemeyer 1984). The excavation and analysis of Chinchorro mummies reveals the 'true character of the people'. The burials themselves are optimal for preservation of corpses, burial furniture, and aspects of ceremonies associated with the dead. The analysis of corporeal remains gradually clarifies the details of daily activities and status. Therefore, we feel that a holistic approach to mummy studies provides enormously fruitful paths to understanding the character of the ancient Chinchorro society.

Paleoepidemiology Of Intestinal Parasites And Lice In Pre-Columbian South America, Adauto Araujo, Karl Reinhard, Daniela Leles, Luciana Sianto, Alena M. Iñiguez, Martin Fugassa, Bernardo Arriaza, Nancy Orellana, Luis Fernando Ferreira

Karl Reinhard Publications

Some human parasites originated in prehominid ancestors in Africa. Nematode species, such as Enterobius vermicularis (pinworm), hookworms and Trichuris trichiura are shared by humans and other close phylogenetic primates (Pan and Gorilla), showing that they infected a common ancestor to this group. When humans migrated from Africa to other continents they carried these parasites wherever climate conditions allowed parasite transmission from host to host. Other parasites, however, were acquired throughout human biological and social evolutive history when new territories were occupied. Paleoparasitology data is a valuable source to recover emergence and disappearance of parasite infections through analysis of …

Mycotoxins In Grains – Causes, Prevention And Control, Hester F. Vismer

INTSORMIL Presentations

Discusses mycotoxins, their effect on grain, mitigation considerations, and resulting human toxicology.

Importance Of Wildlife Disease Surveillance, Jerrold L. Belant, Amanda R. Deese

Human–Wildlife Interactions

A commentary on the importance of wildlife disease surveillance.

The Relationship Between Breastfeeding And Child Care For Working Mothers In The United States, Patricia Wonch Hill

Department of Sociology: Dissertations, Theses, and Student Research

Whether or not child care provider characteristics and factors related to the care giving environment impact breastfeeding duration for working mothers has not been systematically studied. In this dissertation, I use Ecological Health Promotion Theory to explore the relationship between child care and breastfeeding through three different analyses. First, I interviewed nine child care providers to assess their knowledge, attitudes and beliefs about infant feeding and whether they vary on these factors across individuals and child care licensing types. Second, I conducted a small mail survey of 93 licensed child care providers in order to create a scale measuring attitudes …

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

A Current Examination Of Dietary Intakes Of Fiber, Calcium, Iron, And Zinc And Their Relationship To Blood Lead Levels In U.S. Children Aged 1–5 Years, Stephanie A. Melchert

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

A CURRENT EXAMINATION OF DIETARY INTAKES OF FIBER, CALCIUM, IRON, AND ZINC AND THEIR RELATIONSHIP TO BLOOD LEAD LEVELS IN U.S. CHILDREN AGED 1-5 YEARS Stephanie Ann Melchert, M.S. University of Nebraska, 2010 Adviser: Kaye Stanek Krogstrand The effect of lead on the health and well-being of those exposed has been well documented and many efforts have been made to reduce exposure of lead to the United States population. Despite these efforts, many studies have documented cognitive impairments and behavioral problems in children with even low levels of lead in their blood. Previous studies have suggested that a proper diet …

A Parasitological Paradox: Why Is Ascarid Infection So Rare In The Prehistoric Americas?, Daniela Leles, Karl Reinhard, Martín Horacio Fugassa, Luis Fernando Ferreira, Alena M. Iñiguez, Adauto Araujo

Karl Reinhard Publications

Ascaris lumbricoides (giant roundworm) and Trichuris trichiura (whipworm) are the most common intestinal parasites found in humans worldwide today and they almost always co-occur. However, we find two distinct patterns in archae­ological material. In historical North American and Old World contexts, the association of A. lumbricoides and T. trich­iura is similar to the modern epidemiological picture. In contrast, the co-occurrence of A. lumbricoides and T. trichiura eggs in prehistoric South America is rare. For prehistoric contexts, T. trichiura is the most common parasite found in ar­chaeological material. Recently molecular biology techniques pointed to a subdiagnosis of roundworm infection in pre- …

Evaluating Microfossil Content Of Dental Calculus From Brazilian Sambaquis, Verônica Wesolowski, Sheila Maria Ferraz Mendonça De Souza, Karl Reinhard, Gregório Ceccantini

Karl Reinhard Publications

To date, limited numbers of dental calculus samples have been analyzed by researchers in diverse parts of the world. The combined analyses of these have provided some general guidelines for the analysis of calculus that is non-destructive to archaeological teeth. There is still a need for a quantitative study of large numbers of calculus samples to establish protocols, assess the level of contamination, evaluate the quantity of microfossils in dental calculus, and to compare analysis results with the literature concerning the biology of calculus formation. We analyzed dental calculus from 53 teeth from four Brazilian sambaquis. Sambaquis are the shellmounds …

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

The Influence Of Cultural Orientation, Alcohol Expectancies, And Self-Efficacy On Adolescent Drinking Behavior In China, Duane F. Shell, Ian M. Newman, Xiaoyi Fang

Department of Educational Psychology: Faculty Publications

Objective: We hypothesized that the drinking behavior of adolescents in China is influenced by expectancies and self-efficacy and that adolescents’ cultural orientation towards western versus traditional Chinese values influences expectancies, self-efficacy and drinking behavior, with western values leading to more dysfunctional patterns of beliefs and drinking, and that these beliefs are influenced by students’ gender and school environment. Methods: A total of 1020 high school students from Beijing completed the Chinese Adolescent Alcohol Expectancy, the Chinese Cultural Orientation and the Chinese Self-regulation Self-efficacy questionnaires. Results: Results generally confirmed our hypotheses. Higher negative expectancies and higher self-efficacy reduced …

Annual Report To The Nation On The Status Of Cancer, 1975-2006, Featuring Colorectal Cancer Trends And Impact Of Interventions (Risk Factors, Screening, And Treatment) To Reduce Future Rates, Brenda K. Edwards, Elizabeth Ward, Betsy A. Kohler, Christie Eheman, Ann G. Zauber, Robert N. Anderson, Ahmedin Jemal, Maria J. Schymura, Iris Lansdorp-Vogelaar, Laura C. Seeff, Marjolein Van Ballegooijen, S. Luuk Goede, Lynn A. G. Ries

United States Public Health Resources

BACKGROUND. The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information regarding cancer occurrence and trends in the United States. This year’s report includes trends in colorectal cancer (CRC) incidence and death rates and highlights the use of microsimulation modeling as a tool for interpreting past trends and projecting future trends to assist in cancer control planning and policy decisions.

METHODS. Information regarding invasive cancers was obtained from the NCI, CDC, and NAACCR; and information …

Cytotoxicity Of Bacterial-Derived Toxins To Immortal Lung Epithelial And Macrophage Cells, Dianne E. Peterson, Jayne M. Collier, Matthew E. Katterman, Rachel A. Turner, Mark R. Riley

Department of Agricultural and Biological Systems Engineering: Faculty Publications

Health risks associated with inhalation and deposition of biological materials have been a topic of great concern due to highly publicized cases of inhalation anthrax, of new regulations on the release of particulate matter, and to increased concerns on the hazards of indoor air pollution. Here, we present an evaluation of the sensitivity of two immortal cell lines (A549, human lung carcinoma epithelia) and NR8383 (rat alveolar macrophages) to a variety of bacterial-derived inhalation hazards and simulants including etoposide, gliotoxin, streptolysin O, and warfarin. The cell response is evaluated through quantification of changes in mitochondrial succinate dehydrogenase activity, release of …

Surgical Intervention For Infective Endocarditis In A Veteran Population, Lorraine D. Cornwell, Danny Chu, Scott A. Lemaire, Joseph Huh, Shubhada Sansgiry, Joseph S. Coselli, Faisal G. Bakaeen

United States Public Health Resources

Abstract

BACKGROUND: Surgical management of infective endocarditis can be challenging. Veteran patients are unique because they often have significant comorbidities, and surgical management of endocarditis in this population has not been well described.

METHODS: Using a prospective database, 46 consecutive patients who underwent valve surgery for acute infective endocarditis between 1987 and 2009 were identified. Survival was assessed using the Kaplan-Meier method.

RESULTS: All patients were men (mean age, 56±9 years). The most common indication for surgical intervention was congestive heart failure (60%). The aortic valve was the only valve infected in most patients (65%). Operative morbidity …

Mortality Patterns Of Army Chemical Corps Veterans Who Were Occupationally Exposed To Herbicides In Vietnam, Yasmin Cypel, Han Kang

United States Public Health Resources

PURPOSE: This research examined the risk of disease-related mortality of the Army Chemical Corps (ACC) veterans who handled/sprayed herbicides in Vietnam in comparison with their non-Vietnam veteran peers or U.S. men.

METHODS: Vital status was determined through December 31, 2005. All-cause mortality and cause-specific mortality were compared for individuals who served in Vietnam (n Z 2872) versus those who did not (n Z 2737). Similar analyses were completed on a subset of the original Vietnam cohort that consisted of individuals who either reported spraying herbicide (n Z 662) or not (n Z 811). The observed deaths for each …

Public Health Clinical Demonstration Project For Smoking Cessation In Veterans With Posttraumatic Stress Disorder, Eric A. Dedert, Sarah M. Wilson, Patrick S. Calhoun, Scott D. Moore, Kim W. Hamlett-Berry, Jean C. Beckham

United States Public Health Resources

Veterans with post traumatic stress disorder are at high risk for smoking and experience difficulty with smoking cessation. We designed this clinical demonstration project to provide a low-cost, feasibly implemented smoking cessation intervention that would maximize the number of smokers who accessed the intervention. Five hundred eighty-four veteran smokers were contacted by invitational letters. Interested veterans received follow-up telephone calls using standardized scripts offering three intervention resources: 1) a referral to the National Cancer Institute's Smoking Quitline, 2) web-based counseling, and 3) local Veteran Affairs pharmacologic treatment for smoking cessation. Twenty-three percent of survey recipients participated in the clinical program. …

An Examination Of The Construct Validity Of Posttraumatic Stress Disorder With Veterans Using A Revised Criterion Set, Anouk L. Grubaugh, Mary E. Long, Jon D. Elhai, B. Christopher Frueh, Kathryn M. Magruder

United States Public Health Resources

Ongoing concerns exist in the literature regarding the construct of posttraumatic stress disorder (PTSD) and how to best conceptualize and measure this disorder. We compared the traditional DSM-IV PTSD symptom criteria (i.e., symptoms from clusters B, C, and D) to a revised criterion set that omits overlapping mood and other anxiety symptoms on PTSD prevalence, PTSD diagnostic caseness, associated psychiatric comorbidity, functional status, and structural validity using a cross-sectional, multi-site primary care sample of 747 veterans. After removing items theorized to overlap with mood and other anxiety disorders, PTSD prevalence was identical using both criterion sets (i.e., 12%). Overall, there …