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Dieterich-Hartwell R, Malhotra B, Arslanbek A, DeBeer B, Alverio T, Kaimal G. Living With Toxic Wounds: The Voices and Visual Self-Representations of Gulf War Veterans. Qual Health Res 2024; 34:411-423. [PMID: 38019750 DOI: 10.1177/10497323231213818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Operations Desert Shield and Storm occurred over 30 years ago, yet many of those who were deployed continue to experience chronic and debilitating symptoms, now recognized as Gulf War Illness (GWI). While efforts have been made to explore clinical treatments for GWI, misperceptions and skepticism about its complex nature and a lack of consensus on its etiology impede progress in this area. A critical necessity remains to better understand the experiences, needs, and concerns of veterans with GWI. In this qualitative research study, 40 Gulf War veterans were interviewed about their perceptions regarding symptoms of physical health, cognitive functioning, quality of life, and the quality of care received. In addition, they depicted their experiences through an artistic elicitation collage. Through a grounded theory method, key findings indicated that there are remaining hurdles, such as challenging symptoms, persisting unknowns about the illness, and variations in treatment quality. Veterans have mostly managed and coped with GWI, but they voice the need for acknowledgment and support. The main implication from this study is the significance of both clinical and institutional validation and recognition of the GWI experience as well as the need for specific support systems.
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Affiliation(s)
| | - Bani Malhotra
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA
| | - Aslı Arslanbek
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA
| | - Bryann DeBeer
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, CO, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Tabitha Alverio
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, CO, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Girija Kaimal
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA
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DeBeer B, Mignogna J, Borah E, Bryan C, Monteith LL, Russell P, Williams M, Bongiovanni K, Villarreal E, Hoffmire C, Peterson A, Heise J, Mohatt N, Baack S, Weinberg K, Polk M, Alverio T, Keene R, Mealer M, Benzer J. A pilot of a veteran suicide prevention learning collaborative among community organizations: Initial results and outcomes. Suicide Life Threat Behav 2023; 53:628-641. [PMID: 37477513 DOI: 10.1111/sltb.12969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/27/2023] [Accepted: 04/18/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Veteran suicide remains an ongoing public health concern in need of fresh, community-based initiatives. The Department of Veterans Affairs (VA) has built an enterprise-wide integrated behavioral health system that has pioneered numerous suicide prevention methods. However, most Veterans receive healthcare outside the VA, from organizations that may not be equipped to address Veteran suicide risk. One solution is implementing a VA/community suicide prevention learning collaborative to support organizations in implementing suicide prevention best practices for Veterans. Although learning collaboratives have a history of supporting improved patient safety in healthcare systems, to our knowledge, none have focused on Veteran suicide prevention. METHOD The current quality improvement project sought to pilot a VA/community suicide prevention learning collaborative in the broader Denver and Colorado Springs areas with 13 organizations that served, interacted with, or employed Veterans. RESULTS The collaborative had a large footprint in the region, with organizations interacting with over 24,000 community members and over 5000 Veterans. Organizations implemented 92 Veteran suicide prevention program components within a 16-month period. Overall, the learning collaborative made significant strides in Veteran suicide prevention. CONCLUSION Findings suggest that this method facilitates rapid implementation of Veteran suicide prevention practices and may be promising for accelerating uptake within communities.
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Affiliation(s)
- Bryann DeBeer
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Joseph Mignogna
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Elisa Borah
- The University of Texas at Austin, Austin, Texas, USA
| | - Craig Bryan
- The Ohio State University, College of Medicine, Columbus, Ohio, USA
- VA VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
| | - Lindsey L Monteith
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, Colorado, USA
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Patricia Russell
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, Colorado, USA
| | | | - Kathryn Bongiovanni
- VA VISN 17 Clinical Resource Hub, Texas Valley Costal Bend VA, Harlingen, Texas, USA
| | - Edgar Villarreal
- VA Office of Mental Health and Suicide Prevention, Denver, Colorado, USA
| | - Claire Hoffmire
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alan Peterson
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas, USA
- Department of Psychology, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Jenna Heise
- Suicide Prevention Center of New York, Albany, New York, USA
- Zero Suicide Institute Faculty, Education Development Center, Waltham, Massachusetts, USA
| | - Nathaniel Mohatt
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, Connecticut, USA
- Booz Allen Hamilton, Arlington, Virginia, USA
| | - Sylvia Baack
- Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | | | - Marcy Polk
- Portland VA Medical Center, Portland, Oregon, USA
| | - Tabitha Alverio
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Robin Keene
- Central Texas Veterans Health Care System, Temple, Texas, USA
| | - Meredith Mealer
- Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VHA Medical Center, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Justin Benzer
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA
- Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
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Mahoney MA, Rings JA, Softas-Nall BC, Alverio T, Hall DM. Homecoming and College Transition Narratives of Student Military Veterans. Journal of College Student Psychotherapy 2021. [DOI: 10.1080/87568225.2021.1926034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Michael A. Mahoney
- Department of Veterans Affairs, VA Pacific Islands Health Care System, Honolulu, Hawaii, USA
| | - Jeffrey A. Rings
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, Colorado, USA
| | - Basilia C. Softas-Nall
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, Colorado, USA
| | - Tabitha Alverio
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, Colorado, USA
| | - Deon M. Hall
- Department of Applied Psychology and Counselor Education, University of Northern Colorado, Greeley, Colorado, USA
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Elnitsky CA, Blevins C, Findlow JW, Alverio T, Wiese D. Student Veterans Reintegrating From the Military to the University With Traumatic Injuries: How Does Service Use Relate to Health Status? Arch Phys Med Rehabil 2017; 99:S58-S64. [PMID: 29097180 DOI: 10.1016/j.apmr.2017.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/16/2017] [Accepted: 10/22/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine the effects of campus services on the health of veterans with traumatic injuries and comorbidities as they return from military service and enter college. DESIGN Cross-sectional Internet survey using a mixed-methods analysis approach. SETTING Four-year urban research university. PARTICIPANTS Veterans returning from active military duty (N=127). INTERVENTIONS None. MAIN OUTCOME MEASURES Surveys included standardized measures of health status, traumatic injuries, and functional impairment (PTSD Checklist, Civilian version; Veterans Health Administration traumatic brain injury [TBI] screen; and Veterans RAND-12 item Health Survey); use of campus services and perceived effectiveness of these services in supporting reintegration to the university; and recommendations for additional services. RESULTS Quantitative and qualitative data revealed that student veterans experience high rates of chronic pain that interfere with their daily functioning (92.7%), symptoms of posttraumatic stress disorder (PTSD) (77.9%), symptoms of TBI (26.0%), and comorbidities as the polytrauma clinical triad (14.2%). Despite the high prevalence of pain, PTSD, and TBI, few students used disability services (5.2%), counseling services (18.8%), or student health services (36.5%). Students experienced challenges accessing needed health services when reintegrating from the military to the university, including mutable university service factors. CONCLUSIONS Findings indicate the need for campus services to address the particular needs of student veterans and the need for determining what particular services should be offered to help this population cope with injuries and succeed in college.
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Affiliation(s)
- Christine A Elnitsky
- School of Nursing, The University of North Carolina at Charlotte, Charlotte, NC.
| | - Cara Blevins
- Health Psychology Program, The University of North Carolina at Charlotte, Charlotte, NC
| | - Jan Warren Findlow
- Department of Public Health Sciences, The University of North Carolina at Charlotte, Charlotte, NC
| | - Tabitha Alverio
- Department of Psychology, The University of North Carolina at Charlotte, Charlotte, NC
| | - Dennis Wiese
- Dean of Students, The University of North Carolina at Charlotte, Charlotte, NC
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Levens SM, Armstrong LM, Orejuela-Dávila AI, Alverio T. The two sides of adversity: the effect of distant versus recent adversity on updating emotional content in working memory. Cogn Emot 2016; 31:1243-1251. [PMID: 27400150 DOI: 10.1080/02699931.2016.1197099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Previous research suggests that adversity can have both adaptive and maladaptive effects, yet the emotional and working memory processes that contribute to more or less adaptive outcomes are unclear. The present study sought to investigate how updating emotional content differs in adolescents who have experienced past, recent, or no adversity. Participants who had experienced distant adversity (N = 53), no adversity (N = 58), or recent adversity only (N = 20) performed an emotion n-back task with emotional facial expressions. Results revealed that the distant adversity group exhibited significantly faster reaction times (RTs) than the no adversity and recent adversity only groups. In contrast, the recent adversity only group exhibited significantly slower RTs and more errors than the distant adversity and no adversity groups. These results suggest an emotion and executive control pathway by which both the benefits and negative effects of adversity may be conferred. Results also highlight the importance of time in assessing the impact of adversity.
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Affiliation(s)
- Sara M Levens
- a Department of Psychology , University of North Carolina , Charlotte , NC , USA
| | | | | | - Tabitha Alverio
- a Department of Psychology , University of North Carolina , Charlotte , NC , USA
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