Objective: To examine whether neurobehavioral symptoms mediate the relationship between comorbid mental health conditions (major depressive disorder [MDD] and/or posttraumatic stress [PTSD]) and participation restriction among Veterans with mild traumatic brain injury (mTBI). Setting: Health Administration (VHA). Participants: National sample of mTBI who received VHA outpatient care 2012 2020. Design: Secondary data analysis clinical data. We specified a latent variable path model to...

Objective: To examine the relationship between neighborhood disadvantage and severity of vestibular, sensory, mood-behavioral, cognitive neurobehavioral symptoms among Veterans with a mild traumatic brain injury (mTBI); whether in underrepresented racial/ethnic groups high experience most severe symptoms. Setting: Outpatient Health Administration (VHA). Participants: following data available electronic health record (2014-2020): (1) clinician-confirmed mTBI complete symptom inventory (NSI)...

Objectives: To assess the prevalence of traumatic brain injury (TBI) among Veterans seeking mental health services using a 4-item tool, Traumatic Brain Injury–4 (TBI-4), and to establish classification accuracy TBI-4 Ohio State University TBI-Identification Method as criterion standard. Study Design: Archival observational data collected from individuals care at Mountain VA Medical Center. Participants: The sample for archival study was 1810. Three hundred sixteen completed measures. Main...

Background: US military Veterans returned from Operation Enduring Freedom/Operation Iraqi New Dawn (OEF/OIF/OND) with symptoms associated mild traumatic brain injury [mTBI; i.e., persistent post-concussive (PPC) symptoms] and posttraumatic stress disorder (PTSD). Interventions aimed at addressing both physical psychological stressors (e.g., PPC PTSD symptoms) are needed. This study was conducted to assess the feasibility, acceptability, safety of a probiotic intervention, as well begin...

Rising US suicide rates are particularly notable among military veterans, especially women. It is unknown whether these differences extend to suicidal ideation (SI) and attempts (SA), which major predictors of suicide. Literature comparing SI SA prevalence timing onset between veterans nonveterans limited.The objective this study was estimate compare relative age service nonveterans, by gender.Gender-stratified analysis cross-sectional data from the Comparative Health Assessment Interview...

Importance Research to identify the direct and indirect associations of military-related traumatic brain injury (TBI) with suicide has been complicated by a range data-related challenges. Objective To differences in rates new-onset mental health conditions (ie, anxiety, mood, posttraumatic stress, adjustment, alcohol use, substance use disorders) among soldiers without history TBI explore (through suicide. Design, Setting, Participants This retrospective cohort study used data from Substance...

Abstract Epitope-based vaccines designed to induce CTL responses specific for HIV-1 are being developed as a means addressing vaccine potency and viral heterogeneity. We identified set of 21 HLA-A2, HLA-A3, HLA-B7 restricted supertype epitopes from conserved regions develop such vaccine. Based on peptide-binding studies phenotypic frequencies allelic variants, these predicted be immunogenic in greater than 85% individuals. Immunological recognition all but one the candidate was demonstrated...

Reliance on self-report limits clinicians' ability to accurately predict suicidal behavior. In this study the predictive validity of an objective measure, death/suicide Implicit Association Test (d/sIAT), was tested among psychiatrically hospitalized veterans. Following acute stabilization, 176 participants completed d/sIAT and traditional suicide risk assessments. Participants had similar scores regardless whether they recently attempted suicide. However, significantly predicted attempts...

To determine whether a multifaceted vestibular-related rehabilitation program (Balance and Eye-Movement Exercises for Persons with Multiple Sclerosis; BEEMS) improves balance in persons MS there are differences outcomes based on brainstem/cerebellar lesion involvement.A 2-arm, examiner-blinded, stratified (involvement vs no involvement of structures), randomized controlled trial was implemented. Eighty-eight participants were allocated to BEEMS or treatment control. Computerized Dynamic...

Objective: Examine associations between traumatic brain injury (TBI) and (1) suicide (2) method among individuals receiving Veterans Health Administration (VHA) care. Setting: VHA, Fiscal Years 2006-2015. Participants: with a TBI diagnosis during/prior to the study window ( n = 215 610), compared 20% random sample of those without 1 187 639). Design: Retrospective, cohort study. Cox proportional hazards models were fit accounting for time-dependent measures, chronic conditions, demographics...

Medical leaders have warned of the potential public health burden a “parallel pandemic” faced by healthcare workers during COVID-19 pandemic. These individuals may experienced scenarios in which their moral code was violated resulting potentially morally injurious events (PMIEs). In present study, hierarchical linear modeling utilized to examine role PMIEs on pandemic-related difficulties psychosocial functioning among 211 providers (83% female, 89% White, and an average 11.30 years...

Women veterans experience disproportionately high rates of military sexual trauma (MST). Nonetheless, many MST survivors delay or forgo health care, particularly within Veterans Health Administration (VHA) settings. Institutional betrayal (IB) has been posited as a potential explanation for this.The current study examined if IB was associated with women veterans' willingness to seek VHA and non-VHA mental medical prior use past year MST-related care.Participants were 242 who screened...

Abstract Background Older veterans with multimorbidity experience physical and social vulnerabilities that complicate receipt of adherence to rehabilitation services. Thus, traditional programs are insufficient address this population's heterogenous clinical presentation. Objective To evaluate the feasibility acceptability a MultiComponent TeleRehabilitation (MCTR) program for older multimorbidity. Design Randomized controlled cross‐over study. Setting Telehealth from Veterans Affairs...

Objective: To investigate the incidence of early/unplanned (E/U) separations following mild traumatic brain injury (mTBI) and assess whether sex impacts hazard separation. Setting: Military Health System (MHS). Participants: Active duty service members (N = 75,730) with an initial mTBI diagnosis in military records between January 2011 2018. Design: Retrospective cohort study electronic health MHS. Cause-specific Cox proportional hazards models were used at birth as primary predictor. Main...

After hospitalizations, many older adults experience a rapid functional decline and rely on home health (HH) care services to regain physical function. Understanding rehabilitation treatment elements that improve function is important for optimizing care. Two randomized controlled trials demonstrated similar improvement in (≥65 years, ≥3 comorbidities) receiving either high intensity (n=133) or standardized usual (n=140) HH approaches the 60 days following hospitalization. This secondary...

Abstract The transmission of the prion disease bovine spongiform encephalopathy (BSE) to humans raises concern about chronic wasting (CWD), a deer and elk. In 7 Colorado counties with high CWD prevalence, 75% state hunting licenses are issued locally, which suggests that residents consume most regionally harvested game. We used death certificate data from 1979 through 2001 evaluate rates human Creutzfeldt-Jakob (CJD). relative risk (RR) CJD for CWD-endemic county was not significantly...

Physical activity outcomes are poor following total knee arthroplasty (TKA). The purpose was to evaluate feasibility of a physical feedback intervention for patients after TKA. Participants completing conventional TKA rehabilitation were randomized (PAF; n = 22) or control (CTL; 23) group. PAF included real-time feedback, weekly action planning, and monthly group support meetings (12 weeks). CTL received attention education. Feasibility assessed using retention, adherence, dose goal...

Background: Home-health-care utilization after total knee arthroplasty (TKA) is increasing. Recent publications have suggested that supervised rehabilitation not needed to optimize functional recovery TKA; however, few studies evaluated patients in home-health-care settings. The objectives of this study were (1) determine whether physical therapy (PT) associated with improvements for settings TKA and (2) which factors are related PT. Methods: This was an analysis Medicare claims data treated...