Changes in Pain Among Housed and Unhoused U.S. Veterans After Receiving Battlefield Acupuncture at One Medical Center.

This study reports on 54 homeless and 53 stably housed veterans who received battlefield acupuncture (BFA) between September 2018 and October 2022. Linear mixed-effects regressions were used to examine change in overall pain score and how pain impacted four areas: (1) activity, (2) sleep, (3) mood, and (4) stress over the course of 8 weeks from the baseline visit at one BFA clinic. Results indicated significant reductions in the impact of pain on activity, sleep, and stress among both homeless and housed veterans. Although overall pain levels were not significantly impacted, further research on the impact of BFA on homeless populations is warranted.

Estimation of Utility Values for Computing Quality-adjusted Life Years Associated With Homelessness.

BACKGROUND: There is a lack of data-driven evidence about the burden of homelessness, and lack of a holistic measure of effectiveness for evaluating interventions targeting homelessness. Quality-adjusted life years (QALYs) can help holistically capture the burden of homelessness, and facilitate the valuation and comparison of interventions designed to address homelessness. OBJECTIVE: This study estimated utility values required to compute the QALYs associated with homelessness, and also examined individual-level characteristics that affect these values. RESEARCH DESIGN: The study is cross-sectional and derived from a large national survey conducted during the coronavirus disease 2019 pandemic. SUBJECTS: A sample of 6607 middle- and low-income adults in the United States. MEASURES: A self-completion standard gamble survey was used to estimate utility values associated with homelessness. Linear regression was used to analyze the association between individual-level characteristics and these utility values. RESULTS: The study estimated the average utility value associated with homelessness as 43.4% among the study participants. This implies that 1 year of life as a homeless individual is perceived to be equivalent to less than half a year of life as a stably housed individual in good health. The study also found that individuals who have experienced homelessness and financial distress value life as a homeless person considerably less than those who have not had these experiences. CONCLUSIONS: The method developed in this study can be used to estimate QALYs in studies evaluating homelessness interventions, thereby establishing the societal value of these interventions and informing policy and budgetary decision-making. Future studies estimating the utility values associated with homelessness in the general population, as well as specific homeless groups, are required to provide more generalizable evidence.

Mindfulness as a mediator between trauma exposure and mental health outcomes: Results from the National Health and Resilience in Veterans Study.

OBJECTIVE: Exposure to traumatic life events is associated with increased risk of posttraumatic stress disorder (PTSD) and other mental health problems such as suicidal ideation (SI), alcohol use disorder (AUD), and decreased quality of life (QOL). Mindfulness, which involves attending to the present moment, may help individuals cope with traumatic events by increasing acceptance of trauma-related experiences and decreasing trauma-related negative affect and avoidance of trauma reminders. The current study evaluated whether mindful attention to the present moment mediated the association between number of lifetime traumas and mental health. METHOD: The sample consisted of 1,268 trauma-exposed U.S. veterans who participated in the National Health and Resilience in Veterans Study, a nationally representative study of U.S. veterans. On average, the sample was 60.6 years of age (SD = 15.2, range = 20-94), predominantly male (89.8%), Caucasian (75.0%), and noncombat veterans (59.2%). RESULTS: Path analyses revealed that mindfulness partially mediated the relation between number of lifetime traumas and PTSD symptoms (ß = -.55), AUD (ß = -.17), and QOL (ß = .38), and fully mediated the relation between number of lifetime traumas and SI (ß = -.36). CONCLUSIONS: The relationship between lifetime trauma burden and various mental health issues of relevance to U.S. veterans may be mediated by mindfulness, or the ability to pay attention to the present moment. Interventions that bolster mindfulness may help mitigate the negative impact of cumulative traumas in this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Structural differences in basal ganglia of elite running versus martial arts athletes: a diffusion tensor imaging study.

The aim of this study was to use diffusion tensor imaging (DTI) to characterize and compare microscopic differences in white matter integrity in the basal ganglia between elite professional athletes specializing in running and martial arts. Thirty-three young adults with sport-related skills as elite professional runners (n = 11) or elite professional martial artists (n = 11) were recruited and compared with non-athletic and healthy controls (n = 11). All participants underwent health- and skill-related physical fitness assessments. Fractional anisotropy (FA) and mean diffusivity (MD), the primary indices derived from DTI, were computed for five regions of interest in the bilateral basal ganglia, including the caudate nucleus, putamen, globus pallidus internal segment (GPi), globus pallidus external segment (GPe), and subthalamic nucleus. Results revealed that both athletic groups demonstrated better physical fitness indices compared with their control counterparts, with the running group exhibiting the highest cardiovascular fitness and the martial arts group exhibiting the highest muscular endurance and flexibility. With respect to the basal ganglia, both athletic groups showed significantly lower FA and marginally higher MD values in the GPi compared with the healthy control group. These findings suggest that professional sport or motor skill training is associated with changes in white matter integrity in specific regions of the basal ganglia, although these positive changes did not appear to depend on the type of sport-related motor skill being practiced.

When health insurance is not a factor: national comparison of homeless and nonhomeless US veterans who use Veterans Affairs Emergency Departments.

OBJECTIVES: We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. METHODS: We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64,091) and nonhomeless (n = 866,621) ED users on sociodemographics, medical and psychiatric diagnoses, and other clinical characteristics. RESULTS: Homeless veterans had 4 times the odds of using EDs than nonhomeless veterans. Multivariate analyses found few differences between homeless and nonhomeless ED users on the medical conditions examined, but homeless ED users were more likely to have been diagnosed with a drug use disorder (odds ratio [OR] = 4.12; 95% confidence interval [CI] = 3.97, 4.27), alcohol use disorder (OR = 3.67; 95% CI = 3.55, 3.79), or schizophrenia (OR = 3.44; 95% CI = 3.25, 3.64) in the past year. CONCLUSIONS: In a national integrated health care system with no specific requirements for health insurance, the major differences found between homeless and nonhomeless ED users were high rates of psychiatric and substance abuse diagnoses. EDs may be an important location for specialized homeless outreach (or "in" reach) services to address mental health and addictive disorders.

Religiosity among adults who are chronically homeless: association with clinical and psychosocial outcomes.

OBJECTIVE: This study examined changes in religious faith among homeless people enrolled in a supported housing program and their association with clinical and psychosocial outcomes. METHODS: A total of 582 clients at 11 sites were separated into three groups based on whether they reported a decrease, an increase, or no change in their religiosity scores at one-year follow-up. Groups were compared on outcomes controlled for baseline measures. RESULTS: At one-year follow-up, participants who gained faith reported doing more volunteer work, being more engaged in community activities, and having a higher quality of life than those who lost faith. Participants who reported a large gain in faith had better mental health ratings than those who reported a large loss in faith. CONCLUSIONS: Religious faith is a correlate of improvement among chronically homeless adults and may influence clinical and psychosocial outcomes.

Effect of alcohol consumption on estimated glomerular filtration rate and creatinine clearance rate.

BACKGROUND: Moderate alcohol consumption is widely recognized as beneficial in the prevention of cardiovascular disease, yet the renal effects of alcohol intake are still controversial. The present study is designed to investigate the influence of alcohol consumption on calculated creatinine clearance rate (CCr) and glomerular filtration rate (GFR) in a Southern Taiwan Pai-Wan aboriginal community with a high prevalence of alcohol consumption. METHODS: This is a cross-sectional community-based study. The 1466 aboriginal subjects, 40-95 years of age, are a stratified random subpopulation identified during an integrative health care programme. They were sampled for drinking patterns. The main outcome measurements were serum creatinine, estimated CCr and GFR. RESULTS: Subjects with alcohol consumption had significantly higher levels of serum triglycerides, high-density lipoprotein cholesterol, uric acid, estimated CCr and GFR values than non-drinkers. Their blood pressure was also significantly higher. They had lower total cholesterol and low-density lipoprotein cholesterol concentrations. Increasing alcohol consumption was independently and significantly associated with a higher level of estimated CCr and GFR when analysed as both a categorical and continuous variable. CONCLUSIONS: The present study shows that chronic alcohol consumption has a negative effect on blood pressure and lipid profile and stimulates the estimated GFR.