veterans Tag

21 Oct

Posted at 18:39h in PTSD

Mental Health Notice: This article is for general educational purposes and is not medical advice. TMS is FDA-cleared for certain conditions, including major depressive disorder, but its use for PTSD is considered off-label. Talk with a qualified provider about whether TMS is appropriate for you. If you are in crisis or having thoughts of suicide, call or text 988 (Suicide & Crisis Lifeline), text HOME to 741741, or call 911 in an emergency. Veterans can press 1 after dialing 988 to reach the Veterans Crisis Line. Providers named in this post are not warranted or endorsed by MedicalResearch.com or Eminent Domains Inc.

Many people with post-traumatic stress disorder do everything they are told. They attend therapy. They try medications. They practice coping skills. And still, the nightmares continue, the startle response stays on high alert, and the memories keep intruding. It can feel exhausting and discouraging.

If that sounds familiar, it does not mean you are beyond help.

30 Apr

Posted at 14:35h in PTSD
  [caption id="attachment_73553" align="aligncenter" width="500"] Freepix image[/caption]

If you or someone you know is struggling or in crisis, help is available.

Call or text 988 or chat at 988lifeline.org. To learn how to get support for mental health, drug or alcohol conditions, visit FindSupport.gov. If you are ready to locate a treatment facility or provider, visit FindTreatment.gov or call 800-662-HELP (4357).

U.S. veterans or service members in crisis can call 988 then press "1" for the Veterans Crisis Line, text 838255, or chat online.

The Suicide & Crisis Lifeline has a Spanish language line at 1-888-628-9454 (toll-free).

Two veterans walk into the same clinic. Both have nightmares. Both startle at fireworks. Both have been told they have PTSD. One responds well to a standard twelve-week trauma protocol. The other gets worse. The difference is rarely about effort, willingness, or "how bad" the trauma was. It's often about which kind of post-traumatic injury they're actually carrying — and whether the treatment plan was built for it.

25 Jun

Posted at 19:28h in Addiction, addiction-treatment, Veterans
[caption id="attachment_69223" align="aligncenter" width="500"]veterans-addiction-military-recovery Photo by Specna Arms[/caption] For many service members, the most difficult fight isn’t on the battlefield—it’s the one that starts after returning home. Reintegrating into civilian life can be filled with unseen challenges, especially when it comes to mental health and substance use. That’s why specialized military addiction treatment is more than a service—it’s a lifeline. At Sequoia Recovery Centers, we understand the unique struggles faced by veterans and active-duty personnel. And we believe they deserve care that honors their experience, meets them with dignity, and helps them reclaim their strength.

The Reality: Substance Use in the Military Community

Military personnel often face intense stress, trauma, and pressure to remain strong at all costs. This culture can make it difficult to acknowledge pain—let alone ask for help. According to the U.S. Department of Veterans Affairs:
  • 1 in 10 veterans has a substance use disorder (SUD)
  • Veterans with PTSD are 2 to 4 times more likely to struggle with addiction
  • Alcohol is the most commonly misused substance, though opioid and prescription drug misuse are on the rise
Unfortunately, stigma, fear of discharge, and limited access to tailored treatment often delay recovery.

06 Oct

Posted at 06:00h in PTSD
Even when you have had the best military training available it is almost impossible to prepare your mind and body for the violence and traumatic experiences you might endure during active service. The threat of PTSD and other health issues is very real, such as veterans experiencing shell shock and still trying to process that experience many years later. Here is a look at some of the main health issues that a veteran might experience. Mental health challenges ptsd-veterans-warWearing the physical scars of war is just one side of the story. Many veterans can suffer significant mental health challenges long after they retire from active duty. The very real threat of Post Traumatic Stress Disorder (PTSD) has been well publicized in recent years. It is estimated that PTSD affects as many as 15% of veterans who fought in the Iraq war, for instance. Depression and alcohol abuse are other mental health issues faced by a percentage of veterans.

09 Mar

Posted at 17:39h in Author Interviews, Chocolate, Heart Disease
MedicalResearch.com Interview with: Anne Yuk-Lam Ho, MPH Million Veteran Program (MVP) Data Core MVP Coordinating Center VA Boston Healthcare SystemAnne Yuk-Lam Ho, MPH Million Veteran Program (MVP) Data Core MVP Coordinating Center VA Boston Healthcare System MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) has been the leading cause of morbidity and mortality globally. Prevalence of CVD among US population is approximately 7% which places huge burden on our healthcare systems. And prevalence of CVD is as high as 28% among veterans at the VA healthcare system as veteran users are primarily older male with more histories of comorbidities.  Most CVD risk factors including lipids and blood pressure can be controlled by lifestyle modifications, such as diet. Chocolate is among dietary factors that play a role in modulating CVD risk factors is widely consumed in the US (~2.8 billion pounds annually. Although previous studies have reported beneficial effects of chocolate and/or cacao products (rich in flavonoids) on lipids, glucose metabolism and risk of diabetes, and lipids, little is known about the association of chocolate intake with coronary artery disease (CAD) among US veterans. Thus, sought to test the hypothesis that chocolate consumption is associated with a lower risk of CAD among xxx US veterans enrolled in the Million Veteran Program. 

14 Jun

Posted at 11:22h in Author Interviews, Heart Disease, Lipids, Statins
MedicalResearch.com Interview with: [caption id="attachment_42382" align="alignleft" width="200"]Fatima Rodriguez, MD, MPH Division of Cardiovascular Medicine Stanford University Stanford, CA 94305-5406, Dr. Rodriguez[/caption] Fatima Rodriguez, MD, MPH Division of Cardiovascular Medicine Stanford University Stanford, CA 94305-5406, MedicalResearch.com: What is the background for this study? What are the main findings? Response: Individuals with LDL-cholesterol levels above 190mg/dL are often underdiagnosed and undertreated, yet remain at high-risk of cardiovascular disease. In a national sample of veterans, we identified over 60,000 patients who met criteria for uncontrolled, severe hypercholesterolemia based on an index LDL-C value ≥190mg/dL. We found that only half of these high-risk patients are being treated with statins, and less than 10% are on high-intensity statin therapy as recommended by the 2013 ACC/AHA guidelines. We also found that both older and younger patients were less likely to be treated with statins. Women were less likely to be treated with statins, whereas minority groups and those with a diagnosis of hypertension were more likely to be treated. Disparities in use of statins were also noted by geographic region and hospital teaching status.

08 May

Posted at 10:54h in Alzheimer's - Dementia, Author Interviews, Brain Injury, JAMA
MedicalResearch.com Interview with: Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist, San Francisco VA Medical Center Senior Investigator, Tideswell at UCSF: http://www.tideswellucsf.org/ Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?
  • Previous studies have found a link between moderate to severe head injuries and increased dementia risk.
  • The association between mild head injuries and dementia – especially mild head injury that doesn’t result in loss of consciousness – is less well established
  • We examined the association between mild head injuries with and without loss of consciousness and dementia diagnoses in nearly 360,000 Veterans receiving care in the VA health care system.
  • We found that Veterans with a head injury diagnoses were two to four times more likely to be diagnosed with dementia than those without head injury diagnoses.
  • The risk of dementia diagnosis was doubled in Veterans who experienced head injury without loss of consciousness compared to those with no head injury. 

02 Mar

Posted at 17:10h in Author Interviews, JAMA, Occupational Health, PTSD
MedicalResearch.com Interview with: [caption id="attachment_40322" align="alignleft" width="133"]Dr. Lori Davis, MD Research and Development Service, Tuscaloosa Veterans Affairs (VA) Medical Center, Department of Psychiatry, School of Medicine, University of Alabama, Tuscaloosa Tuscaloosa, Alabama Dr. Davis[/caption] Dr. Lori Davis, MD Research and Development Service, Tuscaloosa Veterans Affairs (VA) Medical Center, Department of Psychiatry, School of Medicine, University of Alabama, Tuscaloosa Tuscaloosa, Alabama MedicalResearch.com: What is the background for this study? What are the main findings? Response: Symptoms of posttraumatic stress disorder (PTSD) interfere with a person’s ability to function at work, making it harder to stay employed and establish oneself in a career.  Veterans with PTSD are uniquely challenged given their motivation to serve others, be leaders and not be generally receptive to reaching out for help. Conventional wisdom about PTSD and employment has traditionally been to first commit to treatment, learn coping skills, manage one’s symptoms and then reintegrate into mainstream employment. However, this view is being transformed by our research that suggests a more assertive recovery-oriented approach to the treatment of PTSD that involves returning to meaningful competitive employment as soon as possible. This study compared Evidence-based Supported Employment (also known as Individual Placement and Support or IPS) integrated within PTSD treatment teams to the treatment as usual Transitional Work model offered within the VA. This multisite trial demonstrated significantly greater effectiveness of the IPS-supported employment over stepwise, transitional work vocational rehabilitation for Veterans living with chronic PTSD.

04 Mar

Posted at 21:47h in Author Interviews, Electronic Records, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_32640" align="alignleft" width="79"]Steven K. Dobscha, M.D. Professor, Department of Psychiatry, OHSU Director, VAPORHCS Center to Improve Veteran Involvement in Care Oregon Health & Science University Dr. Dobscha[/caption] Steven K. Dobscha, M.D. Professor, Department of Psychiatry, OHSU Director, VAPORHCS Center to Improve Veteran Involvement in Care Oregon Health & Science University MedicalResearch.com: What is the background for this study?  Response: Several health care systems across the United States now offer patients online access to all of their clinical notes (sometimes referred to as progress notes) through electronic health record portals; this type of access has been referred to as OpenNotes (see www.opennotes.org for more information on the national OpenNotes initiative). Veterans have been able to use OpenNotes in the Veterans Health Care (VHA) system since 2013. However, some individuals have expressed concern that online access to clinical notes related to mental health could cause some patient harms. We are conducting a VA-funded research project with several objectives: 1) to examine benefits and unintended negative consequences of OpenNotes use as perceived by veterans receiving VHA mental health care and by VHA mental health clinicians, and 2) to develop and evaluate brief web-based courses designed to help veterans and clinicians use OpenNotes in ways that optimize Veteran-clinician collaboration and minimize unintended consequences.

09 Sep

Posted at 00:39h in Author Interviews, Health Care Systems, JAMA
MedicalResearch.com Interview with: [caption id="attachment_27754" align="alignleft" width="146"]Andrew C. Eppstein, MD, FACS Assistant Professor of Clinical Surgery Indiana University School of Medicine Department of Surgery, Division of General Surgery Richard L. Roudebush VA Medical Center Indianapolis, Indiana Dr. Andrew Eppstein[/caption] Andrew C. Eppstein, MD, FACS Assistant Professor of Clinical Surgery Indiana University School of Medicine Department of Surgery, Division of General Surgery Richard L. Roudebush VA Medical Center Indianapolis, Indiana MedicalResearch.com: What is the background for this study? What are the main findings? Response: A few years ago we encountered long wait times for patients undergoing elective general surgery in our tertiary care VA medical center. Demand had grown and our existing systems were not able to accommodate surgical patients in a timely fashion. By fiscal year (FY) 2012, our wait times averaged 33 days, though patients with malignancies would be moved to the head of the line, pushing more elective cases further back. To address rising demand and worsening wait times, our Surgery Service convened an analysis of our processes using Lean methodology in collaboration with the Systems Redesign Service. Multidisciplinary meetings were held in 2013 to analyze inefficiencies in the current system and ways to address them to create a streamlined, ideal system. The collaborations included surgeons, nurses, ancillary staff, operating room and sterile processing staff, and hospital administration. Projects were rolled out stepwise in mid-2013 under General Surgery, the busiest surgical service at our institution. We noted a sharp decline in patient wait times after initiation of reforms such as improved OR flexibility, scheduling process changes, standardization of work within the department, and improved communication practices. These wait times dropped to 26 days in FY 2013 and further to 12 days in FY 2014, while operating volume and overall outpatient evaluations increased, with decreased no-shows to clinic. Our decreased wait times were sustained through the remainder of the observed period.

19 Jul

Posted at 00:53h in Author Interviews, PTSD, Sleep Disorders
MedicalResearch.com Interview with: [caption id="attachment_26240" align="alignleft" width="170"]Jim Burch, MS, PhD Associate Professor Dept. of Epidemiology & Biostatistics Cancer Prevention & Control Program Arnold School of Public Health University of South Carolina, Columbia, SC and Health Science Specialist WJB Dorn Department of Veterans Affairs Medical Center Columbia, SC Dr. Jim Burch[/caption] Jim Burch, MS, PhD Associate Professor Dept. of Epidemiology & Biostatistics Cancer Prevention & Control Program Arnold School of Public Health University of South Carolina, Columbia, SC and Health Science Specialist WJB Dorn Department of Veterans Affairs Medical Center Columbia, SC MedicalResearch.com: What is the background for this study? Response: Over 21 million Veterans live in the U.S., and nearly 9 million of them receive healthcare through the Veterans Health Administration, which is the largest integrated healthcare system in the U.S. The military population is particularly vulnerable to sleep disturbances due to their work schedules, living conditions, and other physical and psychological factors that accompany their jobs. However, previous studies have not comprehensively described the scope and characteristics of sleep disorders among Veterans. Sleep is considered a physiological necessity. Inadequate sleep has been associated with a wide range of adverse health outcomes, including an increased risk of chronic diseases such as heart disease and cancer, psychiatric disorders, reduced quality of life, and increased mortality.

20 Sep

Posted at 13:54h in Author Interviews
Miklos Z Molnar, MD, PhD, FEBTM, FERA, FASN Associate Professor of Medicine Division of Nephrology, Department of Medicine University of Tennessee Health Science Center Memphis, TN, 38163 MedicalResearch.com Interview with: Miklos Z Molnar, MD, PhD, FEBTM, FERA, FASN Associate Professor of Medicine Division of Nephrology, Department of Medicine University of Tennessee Health Science Center Memphis, TN, 38163 Medical Research: What is the background for this study? What are the main findings? Response: Restless legs syndrome is a common sleep disorder, but there is a paucity of large cohort studies examining the association of restless legs syndrome with clinical outcomes, including all-cause mortality, incident coronary heart disease, stroke and chronic kidney disease. From a nationally representative prospective cohort of over 3 million US veterans [93% male, median follow-up time of 8.1 years (interquartile range: 7.0–8.5years)] with baseline estimated glomerular filtration rate ≥60 mL/min/1.73 m2, a propensity-matched cohort of 7392 patients was created, and the association between incident restless legs syndrome and the following was examined:
  • (1) all-cause mortality;
  • (2) incident coronary heart disease;
  • (3) incident strokes; and
  • (4) incident chronic kidney disease defined as estimated glomerular filtration rate <60 mL/min/1.73 m2.
Compared with restless legs syndrome-negative patients, incident restless legs syndrome was associated with 88% higher mortality risk [hazard ratio and 95% confidence interval: 1.88 (1.70–2.08)], and almost four times higher risk of coronary heart disease and stroke [hazard ratio: 3.97 (3.26–4.84) and 3.89 (3.07–4.94), respectively]. The risk of incident chronic kidney disease was also significantly higher in incident restless legs syndrome patients [hazard ratio: 3.17 (2.74–3.66)] compared with restless legs syndrome-negative counterparts. These associations was independent from other confounders such as demographic data, comorbidities and other sleep disorders (sleep apnea and periodic limb movements in sleep).

11 Mar

Posted at 23:54h in Author Interviews, JAMA, Pain Research
Matthew J. Bair, MD, MS Research Service, Veterans Affairs Health Services Research and Development, Center for Health Information and Communication Richard L. Roudebush Veterans Affairs Medical Center, Department of Medicine, Indiana University School of Medicine, Health Services Research, Regenstrief Institute, Inc, Indianapolis, IndianaMedicalResearch.com Interview with: Matthew J. Bair, MD, MS Research Service, Veterans Affairs Health Services Research and Development, Center for Health Information and Communication Richard L. Roudebush Veterans Affairs Medical Center, Department of Medicine, Indiana University School of Medicine, Health Services Research, Regenstrief Institute, Inc, Indianapolis, Indiana MedicalResearch.com: What is the background for this study? Dr. Bair: Despite the prevalence and functional, psychological, and economic impact of chronic pain, there have been few intervention studies to treat chronic pain in Veterans. MedicalResearch.com: What are the main findings? Dr. Bair: A stepped-care intervention that combined analgesics, self-management strategies, and brief cognitive behavioral therapy resulted in statistically significant reductions in pain-related disability, pain interference, and pain severity in Veterans with chronic musculoskeletal pain.

30 Sep

Posted at 23:04h in Alcohol, Author Interviews
Keren Lehavot, PhD Research Clinical Psychologist VA Puget Sound Health Care System Assistant Professor Department of Psychiatry & Behavioral Sciences University of WashingtonMedicalResearch.com Interview with: Keren Lehavot, PhD Research Clinical Psychologist VA Puget Sound Health Care System Assistant Professor Department of Psychiatry & Behavioral Sciences University of Washington Medical Research: What are the main findings of the study? Dr. Lehavot: Alcohol misuse is a significant public health concern among women living in the U.S. Women who have served in the military are a unique population who report relatively high rates of hazardous drinking, and those who identify as lesbian or bisexual (LB) may be at especially high risk for alcohol misuse. While previous research suggests that lesbian or bisexual veterans report higher rates of alcohol misuse than their heterosexual counterparts, mediators that might explain this disparity have not been identified. To that end, we examined the role of civilian and military traumas and mental health symptoms (i.e., depression, post-traumatic stress disorder) in explaining disparities in alcohol misuse between sexual minority and heterosexual women veterans across the U.S. Women veterans were recruited using the Internet to participate in an online, anonymous, national survey. Findings indicated that lesbian or bisexual veterans scored significantly higher on an alcohol misuse measure than heterosexual women veterans. LB veterans also reported higher rates of childhood trauma, physical victimization in adulthood both during the military and as a civilian, and mental health symptoms, partly accounting for their higher rates of alcohol misuse.

01 Jul

Posted at 14:00h in Addiction, Author Interviews, Opiods, Pharmacology

MedicalResearch.com Interview with:Dr. Robin L. Toblin LCDR Robin L. Toblin, PhD, MPH (USPHS) Clinical Research Psychologist Walter Reed Army Institute of Research MedicalResearch: What are the main findings of your study? Dr. Toblin: Our study focused on chronic pain and opioid use in an infantry brigade three months after returning from war. We surveyed...