Pathways into homelessness among post 9/11 era veterans

This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.Despite the scale of veteran homelessness and government–community initiatives to end homelessness among veterans, few studies have featured individual veteran accounts of experiencing homelessness. Here we track veterans’ trajectories from military service to homelessness through qualitative, semistructured interviews with 17 post-9/11-era veterans. Our objective was to examine how veterans become homeless—including the role of military and postmilitary experiences—and how they negotiate and attempt to resolve episodes of homelessness. We identify and report results in 5 key thematic areas: transitioning from military service to civilian life, relationships and employment, mental and behavioral health, lifetime poverty and adverse events, and use of veteran-specific services. We found that veterans predominantly see their homelessness as rooted in nonmilitary, situational factors such as unemployment and the breakup of relationships, despite very tangible ties between homelessness and combat sequelae that manifest themselves in clinical diagnoses such as posttraumatic stress disorder. Furthermore, although assistance provided by the U.S. Department of Veterans Affairs (VA) and community-based organizations offer a powerful means for getting veterans rehoused, veterans also recount numerous difficulties in accessing and obtaining VA services and assistance. Based on this, we offer specific recommendations for more systematic and efficient measures to help engage veterans with VA services that can prevent or attenuate their homelessness

Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival

Military veterans may have higher rates of amyotrophic lateral sclerosis (ALS) mortality than non-veterans. Few studies, with sparse exposure information and mixed results, have studied relationships between military-related factors and ALS survival. We evaluated associations between military-related factors and ALS survival among U.S. military veteran cases

Lymphohaematopoietic malignancies in Scottish military veterans: Retrospective cohort study of 57,000 veterans and 173,000 non-veterans

Background: Lymphohaematopoietic malignancies are common in the general population. There have been concerns that military service may be associated with increased risk as a result of occupational exposures. To date, few studies have demonstrated an increased risk, although a disability pension is payable to veterans who were present at nuclear tests and who develop leukaemia (other than chronic lymphocytic leukaemia). The aim of the study was to utilise data from the Scottish Veterans Health Study to examine the risk of lymphohaematopoietic malignancy following military service in a large national cohort of veterans. Methods: Retrospective cohort study of 57,000 veterans and 173,000 non-veterans born between 1945 and 1985 matched for age, sex and area of residence, adjusted for areal deprivation and followed up for up to 30 years, using Cox proportional hazard models to compare the risk of lymphohaematopoietic malignancy overall, by diagnosis and by sex and birth cohort. Results: We found no statistically significant difference in risk between veterans and non-veterans either for all leukaemias (Cox proportional hazard ratio 1.03, 95% confidence intervals 0.84–1.27, p = 0.773), Hodgkin lymphoma (hazard ratio 1.19, 95% confidence intervals 0.87–1.61, p = 0.272) or for non-Hodgkin lymphoma (hazard ratio 0.86, 95% confidence intervals 0.71–1.04, p = 0.110). Conclusion: Our findings provide reassurance that service in the UK Armed Forces is not associated with increased risk of lymphohaematopoietic malignancy

A Case Study of Military Transition to Civilian Life

Service members experience significant challenges reintegrating into the civilian sector following military service. To research causes of the challenges new veterans face, a qualitative case study was conducted in which military veterans were interviewed and participated in a focus group to obtain information about their perceptions of military leadership and the transferability of their skills to the civilian setting. A review of artifacts, such as military basic training and leadership manuals, was conducted to check the consistency with which military veterans perceived their leadership and transition experience to match the military’s stated expectations and training. The conceptual framework for this case study included principles of transformational leadership. In this study, veterans from Post-9/11/2001 appeared to experience military leadership training as stated in military basic training and leadership manuals. There was a discrepancy between the leadership training and transition out of the military experience between the Pre- and Post-9/11/2001 veterans, which provided insight into potential future studies as well as an understanding of how military training changed over several decades. The primary goal of the study was to obtain insight into how the experience of transitioning out of the military could be further eased for newly exiting service members. The implications included the need for further study in how recruits are trained and readied for service as well as other studies that not only identify roots causes for difficult transitions but also the best way to assist exiting service members

Systematic Review of Veterans\u27 Coping Strategies: How Can Rural Veterans Improve Their Quality of Life?

This systematic review examines the empirical literature on an emerging body of coping strategies (CS), both civilian readjustment and health-risk related, experienced by United States military veterans exposed to combat stress and other military lifestyle stressors. Studies that met inclusion criteria were selected among quantitative, qualitative, and mixed-methods studies published in peer-reviewed journals. Population, Intervention, Comparison, and Outcome (PICO) criteria and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) were applied to all studies. Seventeen reports meeting a priori inclusion criteria were extracted from 107 studies accessed through 9 electronic databases. Data were synthesized to investigate two research questions informing evidence-based practice. What coping strategies do veterans use to deal with past military experience(s)? What are the health-risk coping strategies that veterans employ to adjust to past military life? There were five types of coping strategies (CS) that occurred most frequently including cognitive, religious/spiritual methods, drug and alcohol sedation, avoidance, and behavioral approaches. Veterans learn multiple coping strategies and techniques for overcoming and adapting to the demands of war during their military service. However, some behavioral coping strategies are associated with negative health-risks and some may not be as effective in the civilian world as they once were during active duty. Thus, these findings may assist social workers in collaborating with rurally located veterans in selecting optimal strategies to protect their health and advance their post-military service life goals

A Case Study of Military Transition to Civilian Life

Service members experience significant challenges reintegrating into the civilian sector following military service. To research causes of the challenges new veterans face, a qualitative case study was conducted in which military veterans were interviewed and participated in a focus group to obtain information about their perceptions of military leadership and the transferability of their skills to the civilian setting. A review of artifacts, such as military basic training and leadership manuals, was conducted to check the consistency with which military veterans perceived their leadership and transition experience to match the military’s stated expectations and training. The conceptual framework for this case study included principles of transformational leadership. In this study, veterans from Post-9/11/2001 appeared to experience military leadership training as stated in military basic training and leadership manuals. There was a discrepancy between the leadership training and transition out of the military experience between the Pre- and Post-9/11/2001 veterans, which provided insight into potential future studies as well as an understanding of how military training changed over several decades. The primary goal of the study was to obtain insight into how the experience of transitioning out of the military could be further eased for newly exiting service members. The implications included the need for further study in how recruits are trained and readied for service as well as other studies that not only identify roots causes for difficult transitions but also the best way to assist exiting service members

Pain in veterans of the Gulf War of 1991: a systematic review

BACKGROUND: Veterans of the Persian Gulf War of 1991 have reported a range of adverse health symptoms. This systematic review aims to identify all studies that have compared the prevalence of symptoms of pain in veterans of the Gulf War to that in a non-Gulf military comparison group, and to determine whether Gulf War veterans are at increased risk of reporting pain. METHODS: Studies published between January 1990 and May 2004 were identified by searching a large number of electronic databases. Reference lists and websites were also searched and key researchers were contacted. Studies were included if they reported the prevalence of any symptom or condition that included the word "pain" in Gulf War veterans and in a comparison group of non-Gulf veterans. 2401 abstracts were independently reviewed by two authors. RESULTS: Twenty studies fulfilled the inclusion criteria. Five main sites of pain were identified (muscle, joint, chest/heart, back and abdominal pain) and separate meta-analyses were performed to summarise the results related to each site. A greater proportion of Gulf veterans reported symptoms at each site of pain when compared to a non-Gulf military group. Gulf deployment was most strongly associated with abdominal pain, with Gulf veterans being more than three times more likely to report such pain than a comparison group (OR 3.23; 95%CI 2.31–4.51). Statistical heterogeneity between study estimates was significant, probably due to variation in measured periods of prevalence and symptom measurement methods. CONCLUSION: A higher proportion of veterans of the Persian Gulf War of 1991 reported symptoms of pain than military comparison groups. This is consistent with previously demonstrated increased reporting of more general symptoms (fatigue, multiple chemical sensitivity, post traumatic stress disorder) in these veterans compared with non-Gulf military groups. However, the primary studies were heterogeneous and varied greatly in quality

Military veterans in the federal civil service: a qualitative descriptive study using Schlossberg\u27s transition theory and appreciative inquiry to improve reintegration and retention

Military veterans are facing difficulties when finding jobs after leaving active duty. In November 2009, President Barack Obama signed into effect Executive Order 13518 to establish a hiring initiative to recruit more veterans in the federal government. As a result, the employment opportunities of veterans improved as the number of veterans increased in the federal workforce. However, data from 2008 to 2012 revealed that the number of veterans leaving federal civil service was at the same level as the number of hires (Partnership of Public Service, 2014). According to Rein (2015), veterans who find employment in the federal civil service leave their job within two years of being hired. The reason is connected to a significant number of veterans who are struggling in their transition to their new workplace (Schafer, Swick, Kidder, & Carter, 2016). This study used Schlossberg’s transition theory to assess the transition of veterans from the military. The transition theory is a framework consisting of four factors: Self, Situation, Support, and Strategy. The literature studies about the transition of military veterans are focused mainly on the factors of Self (the identity of veterans), and Situation (the challenges of veterans when transitioning). There is a lack of studies in supporting veterans as well as creating strategies for their retention and integration after obtaining employment. The purpose of this descriptive qualitative study was to interview military veterans with leadership status in the federal civil service. The aim was to examine and learn from their experience to develop strategies for the retention of newly hired veterans. Ten military veterans with a leadership position and a minimum of five years of work experience in the federal government participated in the study. Interview questions were derived from the Appreciative Inquiry method. Results of the data collected revealed that veterans have a profound public service outlook, which is why they joined the federal civil service. Conversely, veterans wanted federal leaders to value and recognize their military experience as well as to support their professional career. Additionally, the participants in this study provided advice to veterans who want to work for the federal government

Acquired disability during foreign missions in male war veterans Case study report of wives’ voice

The article is a qualitative research report written from the theoretical perspective of disability studies. Qualitative research, case study, carried out for the purposes of this article, concerns learning about disabilities acquired in husbands a war veterans by their wives. The place of research is military culture, while the aim is to understand the essence of what wives learned about the disability of their husbands during the entire process of adaptation to life with a disability after returning from a mission, against the background of life in military culture. The theoretical part of the article contains a review of world literature with an emphasis on defining acquired disability. The very phenomenon of acquiring disability by veterans during military missions and its background, i.e. the anthropological phenomenon of culture shock, were analyzed. The empirical part of this article is a qualitative report of 3 case studies and 3 voices of war veterans’ wives. The research question in this report was formulated as follows: What did the wives learn about the acquired disability of their own veterans’ husbands after their return from military missions abroad? Research results generated after coding and categorization analyzes (Gibbs, 2011) indicate categories that answer the main research question and sub-questions in the following contexts: (a) acquired disability, (b) military support, (c) veterans’ privileges (d) auto-marginalization of veterans (e) wives’ infirmity, (f) alcohol and domestic violence, (g) before suicide, (h) wives suggesting changes in the support of veterans with acquired disabilities. The results of the analyzes indicate that the wives learned about the symptoms and characteristics of their husbands’ disabilities (mental and physical) and, additionally, they learned about the secondary disability (auto-marginalization, alcohol or drug addiction, domestic violence, escalation of suicidal thoughts) during adaptation after military missions.The article is a qualitative research report written from the theoretical perspective of disability studies. Qualitative research, case study, carried out for the purposes of this article, concerns learning about disabilities acquired in husbands a war veterans by their wives. The place of research is military culture, while the aim is to understand the essence of what wives learned about the disability of their husbands during the entire process of adaptation to life with a disability after returning from a mission, against the background of life in military culture. The theoretical part of the article contains a review of world literature with an emphasis on defining acquired disability. The very phenomenon of acquiring disability by veterans during military missions and its background, i.e. the anthropological phenomenon of culture shock, were analyzed. The empirical part of this article is a qualitative report of 3 case studies and 3 voices of war veterans’ wives. The research question in this report was formulated as follows: What did the wives learn about the acquired disability of their own veterans’ husbands after their return from military missions abroad? Research results generated after coding and categorization analyzes (Gibbs, 2011) indicate categories that answer the main research question and sub-questions in the following contexts: (a) acquired disability, (b) military support, (c) veterans’ privileges (d) auto-marginalization of veterans (e) wives’ infirmity, (f) alcohol and domestic violence, (g) before suicide, (h) wives suggesting changes in the support of veterans with acquired disabilities. The results of the analyzes indicate that the wives learned about the symptoms and characteristics of their husbands’ disabilities (mental and physical) and, additionally, they learned about the secondary disability (auto-marginalization, alcohol or drug addiction, domestic violence, escalation of suicidal thoughts) during adaptation after military missions

Risk factors associated with Mild Cognitive Impairment in ageing UK Military veterans

BackgroundThe exploration of adverse health outcomes and chronic health conditions in military veterans is essential in occupational epidemiology to identify gaps in public health needs. Recent demographic reports in the UK showed a higher proportion of military veterans were in the 65 years and over category than non-veterans. Additionally given that military veterans are at risk of mental and physical ill-health and lifestyle-related factors (including depression, post-traumatic stress disorder, traumatic brain injury (TBI), diabetes, heart disease, high cholesterol, high blood pressure, stroke, obesity, cigarette smoking, frequent alcohol consumption, and being physically inactive), the risk of Mild Cognitive Impairment (MCI) is probable and warrants further exploration. Previous research has investigated the association between the aforementioned mental and physical health disorders, lifestyle-related factors, and dementia in the military and non-veteran populations in the UK. Although research is yet to compare the risk of MCI in UK military veterans and non-veterans using data from a single study which is essential for making direct comparisons.AimsThis thesis aimed to address this gap by using data from a single UK-based study to investigate the association between mental and physical ill-health status, lifestyle-related factors, and MCI. This was done in three main analysis: (a) comparing the risk of MCI in individuals with or without the aforementioned risk factors in the overall sample, (b) comparing the risk of MCI only in military veterans and non-veterans with the aforementioned risk factors, (c) comparing the risk of MCI in military veterans with or without the aforementioned risk factors.MethodsA series of epidemiological analyses was conducted to address the aim of this thesis. A systematic review and meta-analysis explored the association between the aforementioned health risk factors and MCI and dementia in military veterans. Based on the findings from the systematic review and meta-analysis, a deep dive analysis was conducted utilising data from the PROTECT study, a cohort study exploring healthy brain ageing, cognitive decline, and MCI in middle-aged and older adults (≥40 years) in the UK. This included analysis from two prospective cohort studies and a cross-sectional study investigating the association between MCI and (1) depression, (2) cardiovascular health (CVH) and lifestyle-related risk factors, and (3) lifetime TBI.ResultsFindings from the systematic review and meta-analysis, which included 25 peer-reviewed articles, showed over two-thirds of existing research were based on dementia in military veterans. Depression, TBI, and obesity were significantly associated with cognitive decline in military veterans. The meta-analysis showed depression (OR = 2.45, 95% CI 1.37-4.36), PTSD (OR=1.86, 95% CI 1.56-2.21) and TBI (OR=2.05, 95% CI 1.68-2.50) significantly increased the risk of dementia in military veterans.A prospective cohort analysis was conducted using data from the PROTECT study which comprised of military veterans and non-veterans. Depression significantly increased the risk of MCI (HR=2.45, 95% CI 2.03-3.01) in the overall sample. There was no significant difference in the risk of MCI between military veterans and non-veterans with depression (HR=0.56, 95% CI 0.24-1.30) and between military veterans with or without depression (HR=1.85, 95% CI 0.67-5.12).The next prospective cohort analysis explored the association between nine CVH and lifestyle-related risk factors and MCI in a sample of military veterans and non-veterans. The risk of MCI significantly reduced in military veterans who were obese (HR=0.21, 95% CI 0.07-0.65), frequent alcohol consumers (HR=0.53, 95% CI 0.38-0.74), or physically inactive (HR=0.46, 95% CI 0.25-0.85) compared to non-veterans. There was a significant difference in the risk of MCI between military veterans with diabetes (HR=2.22, 95% CI 1.04-4.75) or high cholesterol (HR=3.11, 95% CI 1.64-5.87) compared to military veterans without diabetes or high cholesterol.A cross-sectional analysis was conducted which comprised of military veterans and non-veterans. TBI significantly increased the risk of MCI (OR=1.21, 95% CI 1.11-1.31) in the overall sample. There was no significant difference in the risk of MCI between military veterans and non-veterans with TBI (OR=1.19, 95% CI 0.98-1.45) and between military veterans with or without TBI (OR=1.21, 95% CI 0.83-1.74).ConclusionIn summary, the risk of MCI was driven by mental and physical health and lifestyle-related risk factors and not by military veteran status except for obesity, alcohol consumption and physical inactivity. Within the military veteran sample, diabetes and high cholesterol increased the risk of MCI. This thesis highlighted the importance of understanding risk factors associated with MCI in UK military veterans. These findings have clinical, social, occupational and research implications. Future research is needed to explore other health risk factors, subtypes of MCI and the military job profile of military veterans.</div