Encampment Medicine: Innovating Care Delivery in a Community of Tiny Shelters on Veterans Affairs Grounds.

Veterans experiencing homelessness face barriers to traditional U.S. Department of Veterans Affairs (VA) care, even when temporarily housed on VA grounds.

Advances, challenges, and future directions in trauma-related Findable, Accessible, Interoperable, Reusable (FAIR) data efforts.

Findable, Accessible, Interoperable, and Reusable (FAIR) data advances are becoming more common and more important across research fields given the large amount of research data in need of synthesis and application. Many novel methods improve the efficiency and accuracy of data reuse, combination, and synthesis, which is necessary given that there are over 500 published randomized controlled trials of posttraumatic stress disorder treatments in adults; however, these methods are still relatively new to the field of traumatic stress research. We provide a brief overview of relevant FAIR data efforts from other fields and within trauma health care and research; share examples of trauma-related FAIR data efforts to demonstrate recent advances and challenges; and suggest potential next steps to continue making trauma data more FAIR.

Caregiving Network Characteristics and Mental Health Care Utilization by Older Adults.

Background: Rates of mental health service use are low among older adults. This study examined associations between mental health care utilization and caregiving network characteristics, including caregiving network size, caregiving intensity, the presence of formal helpers, and primary caregiver characteristics.

Methods: Using a sample of 692 respondents in the health and retirement study (HRS) with linkage to veterans affairs healthcare records (mean age = 78.

Inequities in weathering California wildfires.

Two separate wildfires in different Los Angeles communities illustrate the disparate effects of and recovery from wildfires. Our comparison of patient and community characteristics of Veterans living in the affected areas related to social vulnerability identified specific vulnerabilities, and can inform policy levers to support more equitable disaster response and recovery efforts.

Peer Coaching to Support Weight Management in Primary Care: A Cluster Randomized Clinical Trial.

Importance: Employing peer coaches to provide weight management counseling in primary care could address patient- and clinician-level barriers to obesity care, improve outcomes, and boost engagement in weight management programs.

Objective: To evaluate the efficacy of peer coaching to deliver a low- to moderate-intensity intervention for weight management compared with enhanced usual care (EUC).

Design, Setting, And Participants: This 2-arm, cluster randomized clinical trial was conducted from November 2017 to August 2021 at a single US Department of Veteran Affairs (VA) site.

Factors associated with mortality following hospitalization among veterans with opioid use disorder.

Introduction: Hospitalizations are common among people with opioid use disorder (OUD). While hospitalizations represent opportunities to engage patients and offer treatment, they are also destabilizing events associated with an increased risk of death in the post-hospitalization period.

Methods: We conducted a retrospective cohort study within the Veterans Health Administration including all Veterans with OUD who experienced at least one medical hospitalization between January 2011 and December 2021.

Association between Trust of Researchers and Willingness to Participate in Alzheimer's Disease Biomarker Research.

Introduction: The study examined the relationship between trust of researchers in research naïve participants, including those at higher risk, and interest in Alzheimer's disease and related dementia (ADRD) biomarker research participation.

Methods: A cohort of 399 community-dwelling older adults completed a survey about their trust of researchers and interest in participating in ADRD biomarker research.

Results: After controlling for sociodemographics and knowledge of ADRD, higher trust of researchers was associated with lower levels of hesitancy to participate in ADRD biomarker and neuroimaging studies ( < 0.

Changes in Reproductive and Sexual Health Diagnoses of Women Veterans Using Department of Veterans Affairs Health Care Between FY2010 and FY2018.

Background: Women veterans are the fastest growing group of new Veterans Health Administration (VA) users with more than half a million using VA care in 2018. VA has implemented policies and programs to meet the reproductive and sexual health (RSH) needs of women veterans who increasingly rely on VA to provide comprehensive care.

Objective: We aimed to describe changes in the prevalence of RSH diagnosis categories among women veterans using VA care in fiscal year (FY) 2010 and FY2018.

Comparison of Number and Overlap of Diagnostic Information for Risk Adjustment for Dually Enrolled Veterans in Medicaid.

Objective: To measure discrepancies in risk adjustment scores using only Medicaid or Veterans Health Administration (VA) diagnoses for Veterans dually enrolled in VA and Medicaid.

Study Setting And Design: Veterans aged 18-64 enrolled in the VA and Medicaid for at least one full calendar year during 2017-2020. We compared the number and overlap of annual diagnoses derived from VA and Medicaid data.

Qualitative Investigation of Primary Care Provider Perspectives on the Assessment and Treatment of Insomnia.

Although common, insomnia is often undertreated and underrecognized in primary care settings. Few studies have examined primary care provider (PCP) perspectives to better understand the context of insomnia assessment and treatment. The purpose of the current study was to examine Veterans Affairs (VA) provider knowledge and practice regarding the assessment and treatment of insomnia by utilizing qualitative inquiry.

Visual outcomes, incidence and risk factors for RPE atrophy in myopic patients with dome-shaped macula and serous retinal detachment.

Objective: To evaluate the visual outcomes, incidence, and risk factors for retinal pigment epithelium (RPE) atrophy in highly myopic patients with dome-shaped macula (DSM) and serous retinal detachment (SRD).

Methods: Baseline and follow-up data were analyzed for visual acuity (VA), myopic classification, spherical equivalent (SE), and SRD presence. Incomplete RPE atrophy is characterized by discontinuous hypertransmission (<250 μm) with an irregular or interrupted RPE band.

Chronic Condition Burden by Veteran Status, Veterans Health Administration Enrollment, and Age Using Nationally Representative Survey Data.

Background: Historically, US Veterans have reported higher chronic disease burden than non-Veterans. However, whether Veteran and Veterans Affairs (VA) coverage status continue to be associated with chronic disease burden or how these associations vary by age, especially among younger Veterans, is unknown.

Objective: To examine the number of chronic conditions among male Veterans with and without VA coverage, and male non-Veterans, overall and by age group.

Longitudinal predictors of alcohol use and problems during the COVID-19 pandemic in an at-risk veteran sample.

Individuals with pre-existing heavy alcohol use, prior traumatic exposures, and psychiatric disorders were considered an at-risk group for increased alcohol use and problems in the context of the COVID-19 pandemic. This study recruited from a multi-centre longitudinal cohort study of US military service members/veterans with combat exposure to examine the trajectories of alcohol use and problems in the context of a prolonged stressor. Individuals who endorsed heavy drinking and completed a measure of PTSD symptoms prior to the pandemic were invited to participate in a longitudinal survey study at three time points, three months apart, during the second year of the pandemic.

Trajectories of Pain Impact and Pain Self-Efficacy in People with HIV and Chronic Pain: Extending Findings from the Skills TO Manage Pain (STOMP) Randomized Clinical Trial.

Background: People with HIV (PWH) frequently experience chronic pain, which negatively impacts their health and functioning. To improve health outcomes, we need effective interventions for HIV-related chronic pain. Skills TO Manage Pain (STOMP), a novel pain self-management intervention tailored for PWH and chronic pain, has demonstrated efficacy in reducing pain impact (measured by the Brief Pain Inventory) and improving pain self-efficacy immediately after a 12-week intervention and three months later.

Unique Contributions of Social Workers to Geriatric Assessments for Community-Dwelling Older Persons.

Interdisciplinary teams, which include social workers, improve care and outcomes for older persons; however, trends show some geriatric programs are replacing social workers with nurse case managers or community health workers to cut costs. This study aimed to identify the unique, discipline-specific contributions of social workers in comprehensive geriatric assessments. Semi-structured interviews and inductive qualitative analysis were conducted to examine the role social workers within an interdisciplinary team at one US Department of Veterans Affairs (VA) hospital.

Acceptance and Commitment Therapy for Co-occurring Mental and Chronic Health Conditions.

Chronic illnesses affect nearly half of US adults, and nearly 30% of these patients suffer from a co-occurring mental health problem. Despite the high prevalence of comorbidity, existing treatments and service delivery approaches largely reflect fragmented, disease-specific care. Acceptance and commitment therapy (ACT) is a transdiagnostic behavioral intervention that is effective at promoting health behavior change and reducing distress among patients.

Silica Hazards in Engineered Stone Countertop Production: Worker Experiences and Challenges in Los Angeles.

Background: Silicosis is a progressive occupational lung disease caused by inhalation of respirable crystalline silica. Stone countertop workers are at risk of developing silicosis associated with engineered stone (ES) due to its high silica content and widespread use. This qualitative study assessed countertop workers' knowledge, attitudes, and practices regarding silica hazards.

Adrenal Dysfunction in Outpatients with Decompensated Cirrhosis: Impairment in the Hypothalamic-Pituitary-Adrenal Axis.

Background And Aims: The pathogenesis of adrenal dysfunction (AD) in cirrhosis is incompletely understood. We aimed to evaluate potential effects of cirrhosis on hypothalamic-pituitary-adrenal axis (HPA) functionality in stable outpatients with decompensated disease.

Methods: Outpatients with decompensated cirrhosis were prospectively recruited at a transplant center.

Predicting Risk of Long-Term Institutionalization Among Community Dwelling Veterans Before the COVID-19 Pandemic.

Objective: To identify risk of long-term institutionalization (LTI) among Veterans receiving care in the Veterans Health Administration (VA).

Study Setting And Design: We developed the "Predicted Long-term Institutionalization" (PLI) risk model for Veterans alive in the community at the end of fiscal-year (FY) 2017 followed for LTI in nursing home (cumulative NH days allowing any acute care and up to 7 days in community > 90 days) during FY2018-FY2019.

Data Sources And Analytic Sample: PLI used demographics, diagnoses, prior hospital and nursing home (NH) use, and risk indices for death and frailty from VA and Medicare claims and Minimum Data Set data.

Veterans' Behavioral Health Hospitalizations and Outcomes in VA Versus Non-VA Hospitals.

Objective: To compare outcomes for Department of Veterans Affairs (VA) enrollees' behavioral health (BH) hospitalizations by source (VA-direct, VA-purchased community care (CC), Medicaid, Medicare, private insurance, and other payers).

Study Setting And Design: We conducted a retrospective, longitudinal study with VA enrollees from 2015 to 2017 to examine differences in BH hospitalization outcomes by source. We used generalized linear models with clustered standard errors to predict length of stay (LOS), cost, and 30-day readmission.

Institutional Variation in Specialty Palliative Care Consultation Among Patients With Persistent Critical Illness: A Cohort Study.

Background: Development of persistent critical illness (PerCI) necessitating prolonged ICU stays varies across hospitals. Specialty palliative care consultation may mitigate PerCI development by influencing the transition to comfort-directed care when appropriate.

Research Question: Do hospitals with the lowest rates of PerCI have higher use of specialty palliative care consultations during the first 3 days of admission to the ICU as compared with hospitals with the highest rates of PerCI?

Study Design And Methods: This was a retrospective cohort of veterans admitted to Veterans Affairs (VA) ICUs from October 2015 through December 2021.