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Moderate alcohol consumption has been associated with a lower risk of coronary artery disease (CAD) in the general population but has not been well studied in US veterans. We obtained self-reported alcohol consumption from Million Veteran Program participants. Using electronic health records, CAD events were defined as 1 inpatient or 2 outpatient diagnosis codes for CAD, or 1 code for a coronary procedure. We excluded participants with prevalent CAD (n = 69,995) or incomplete alcohol information (n = 8,449). We used a Cox proportional hazards model to estimate hazard ratios and 95% confidence intervals for CAD, adjusting for age, gender, body mass index, race, smoking, education, and exercise. Among 156,728 participants, the mean age was 65.3 years (standard deviation = 12.1) and 91% were men. There were 6,153 CAD events during a mean follow-up of 2.9 years. Adjusted hazard ratios (95% confidence intervals) for CAD were 1.00 (reference), 1.02 (0.92 to 1.13), 0.83 (0.74 to 0.93), 0.77 (0.67 to 0.87), 0.71 (0.62 to 0.81), 0.62 (0.51 to 0.76), 0.58 (0.46 to 0.74), and 0.95 (0.85 to 1.06) for categories of never drinker; former drinker; current drinkers of ≤0.5 drink/day, >0.5 to 1 drink/day, >1 to 2 drinks/day, >2 to 3 drinks/day, and >3 to 4 drinks/day; and heavy drinkers (>4 drinks/day) or alcohol use disorder, respectively. For a fixed amount of ethanol, intake at ≥3 days/week was associated with lower CAD risk compared with ≤1 day/week. Beverage preference (beer, wine, or liquor) did not influence the alcohol-CAD relation. Our data show a lower risk of CAD with light-to-moderate alcohol consumption among US veterans, and drinking frequency may provide a further reduction in risk.

While adherence to healthful dietary patterns has been associated with a lower risk of coronary artery disease (CAD) in the general population, limited data are available among US veterans. We tested the hypothesis that adherence to Dietary Approach to Stop Hypertension (DASH) food pattern is associated with a lower risk of developing CAD among veterans. We analyzed data on 153 802 participants of the Million Veteran Program enrolled between 2011 and 2016. Information on dietary habits was obtained using a food frequency questionnaire at enrollment. We used electronic health records to assess the development of CAD during follow-up. Of the 153 802 veterans who provided information on diet and were free of CAD at baseline, the mean age was 64.0 (SD=11.8) years and 90.4% were men. During a mean follow-up of 2.8 years, 5451 CAD cases occurred. The crude incidence rate of CAD was 14.0, 13.1, 12.6, 12.3, and 11.1 cases per 1000 person-years across consecutive quintiles of Dietary Approach to Stop Hypertension score. Hazard ratios (95% confidence interval) for CAD were 1.0 (ref), 0.91 (0.84-0.99), 0.87 (0.80-0.95), 0.86 (0.79-0.94), and 0.80 (0.73-0.87) from the lowest to highest quintile of Dietary Approach to Stop Hypertension score controlling for age, sex, body mass index, race, smoking, exercise, alcohol intake, and statin use (P linear trend,

The prediction of posttraumatic stress disorder (PTSD) has gained a lot of interest in clinical studies. Identifying patients with a high risk of PTSD can guide mental healthcare workers when making treatment decisions. The main goal of this paper is to propose several Bayesian network (BN) models to assess the probability that a veteran has PTSD when first visiting a U.S. Department of Veteran Affairs (VA) facility seeking medical care. The current practice is to use a five-question test called PC-PTSD-5. We aim to use the PC-PTSD-5 test, which is currently administered to most incoming new patients, and demographic information, military service history, and medical history. We construct a Bayes information criterion score-based BN, a group L2-regularized BN (GL2-regularized BN), and a naïve Bayes BN to assess the probability that a patient has PTSD. The GL2-regularized BN is a new method for constructing a BN motivated by some of the challenges of analyzing this data set. A secondary goal is to identify which features are important in predicting PTSD. We discover that the following features help compute the probability of PTSD: PC-PTSD-5, service-connected flag, combat flag, agent orange flag, military sexual trauma flag, traumatic brain injury, and age. History: Accepted by Ram Ramesh, Area Editor for Data Science & Machine Learning. Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information (https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2021.0174) as well as from the IJOC GitHub software repository (https://github.com/INFORMSJoC/2021.0174). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/. [ABSTRACT FROM AUTHOR]

Current discussion regarding securing internships often focuses on their availability. Thus, quantity is especially emphasized. However, quality is also an issue of importance. The number of intern applicants receiving slots at quality internship sites, as defined by the internship having been accredited by the American Psychological Association or having successfully been reviewed by the Association of Psychology and Postdoctoral Internship Centers, was assessed. Information regarding the number of unfunded internships also was gathered. Recommendations for increasing the availability of quality internships are provided. Keywords: training; internship; intern selection

Psychology graduate students have been worried for several years as questions have circulated about the internship imbalance between the number of students seeking internships and the number of available internships. This project examined the issue of supply of and demand for internship slots at sites accredited by the American Psychological Association (APA). Data were provided by 99% (437 of 442) of the internship sites and 85% (245 of 289) of the APA-accredited professional psychology doctoral programs. Results confirmed speculations about the internship imbalance, or the bottleneck effect. Cumulative effects of the deficits are expected.

This study assessed the accuracy of the 'screen' versus 'metric' portions of eight subtests of the Neurobehavioral Cognitive Status Examination (NCSE). As part of a routine hospital assessment, 95 male patients were administered both portions of the instrument regardless of outcome on the screen. Results indicate that the screen items of some of the NCSE subtests produced a relatively high false negative rate, where the screen was passed. but the metric was failed. It is recommended that all items of the subtests be administered to more fully assess each domain and, therefore, reduce the probability of overlooking significant deficits.

The Controlled Oral Word Association Test (COWAT) is a measure of a person's ability to make verbal associations to specified letters (i.e., C, F. and L). This measure is a useful component of a neuropsychological battery as it is able to detect changes in word association fluency often found with various disorders. In order to generate current norms for the elderly and aid in interpreting their performance, the COWAT was administered to a group of community-dwelling elderly persons. Information regarding total numbers of words produced as well as frequency of perseverations, breaking set, using the same word stem, and using a proper noun is provided.

As the internship marketplace becomes more competitive, doctoral students and faculty of professional psychology programs must become more knowledgeable of the selection criteria used by APA-accredited internship sites. Clinical experience was identified as one of the most important criteria used for selection by all respondents. However, criteria used by medical schools, university counseling centers, and Veterans Affairs Medical Centers, the three largest suppliers of internships, and by sites reporting low, medium, or high competitiveness appeared to vary as a function of the unique characteristics of the sites.

This study examines the convergent validity of the substantive scales of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in the Veteran Affairs (VA) population. The sample includes test protocols drawn from all administrations of the MMPI-2-RF or MMPI-2 entered into the electronic medical record system between January 1, 2008 and May 31, 2015 at any VA across the United States. After excluding invalid protocols, substantive scale scores were correlated with external measures of depression, anxiety, and posttraumatic stress disorder if they were administered within |14| days of the MMPI-2/-RF. Results supported the convergent validity of the MMPI-2-RF emotional dysfunction domain scores. Discriminant validity for the remaining MMPI-2-RF substantive scale scores was also adequate. Limitations and implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) diagnosed at age < 55 as predictors, and sex and race as potential moderators, of dementia and other forms of cognitive impairment. Method: Veterans (N = 4,800) aged ⩾ 56 years were grouped by psychiatric history, sex, and race. Hierarchical and stepwise regression were employed to determine significant predictors. Results: MDD and PTSD were associated with almost double the risk for developing dementia or cognitive impairment at age ⩾ 56. Sex, as a moderator, had small effects whereas race increased the risk almost twofold for Black veterans, given the presence of MDD history. Discussion: MDD and PTSD act as significant risk factors for dementia and other forms of cognitive impairment, and Black veterans, given a history of MDD, may be at an increased risk. An important endeavor for future research is to examine how this risk may vary across dementia subtypes and related conditions. [ABSTRACT FROM AUTHOR]

Objective This study evaluated the effectiveness of cognitive processing therapy and prolonged exposure in conditions reflective of current clinical practice within the Veterans Health Administration. Method This study involved a retrospective review of 2030 charts. A total of 750 veterans from 10 U.S. states who received cognitive processing therapy or prolonged exposure in individual psychotherapy were included in the study (participants in cognitive processing therapy, N = 376; participants in prolonged exposure, N = 374). The main dependent variable was self-reported posttraumatic stress disorder symptoms as measured by total scores on the Posttraumatic Stress Disorder Checklist. The study used multilevel modeling to evaluate the absolute and relative effectiveness of both treatments and determine the relationship between patient-level variables and total Posttraumatic Stress Disorder Checklist scores during treatment. Results Cognitive processing therapy and prolonged exposure were equally effective at reducing total Posttraumatic Stress Disorder Checklist scores. Veterans who completed therapy reported significantly larger reductions in the Posttraumatic Stress Disorder Checklist than patients who did not complete therapy. There were no significant differences in the improvement of posttraumatic stress disorder symptoms with respect to age and three racial/ethnic groups (Caucasian, African American, and Hispanic). Conclusions Cognitive processing therapy and prolonged exposure were shown to be effective in conditions highly reflective of clinical practice and with a highly diverse sample of veterans. Challenges related to dropout from trauma focused therapy should continue to be researched. [ABSTRACT FROM AUTHOR]

Compares the long and short forms of the geriatric depression scale in elderly veterans at a Midwestern Veterans Administration Medical Center Nursing Home Care Unit. Suitability of short form as a substitute for long form in screening geriatric nursing home population; Scatterplots of long and short forms.

The Adaptive Counseling and Therapy (ACT) model (Howard, Nance, & Myers, 1987a) was examined as it might apply to supervision in psychotherapy. Using four categories drawn from the ACT model (telling, teaching, supporting, delegating), graduate students of varied levels were surveyed about their perceptions of the supervision style they had experienced and their preferred style. Results suggest trainees, overall, prefer styles high in support. “Supporting” (high support, low direction) was also found to be the style most often used in supervision. [ABSTRACT FROM PUBLISHER]

Introduction: This study seeks to understand the demographic changes in the active-duty service member profile, both prior to and following September 11, 2001 (9/11). The study analyzed diagnosis of posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) and measures of severity of those diagnoses as recorded in service-connection ratings (percent disability)., Methods: A retrospective cohort-study of military veterans who received care at Veterans Health Administration medical centers between December 1998 and May 2014 was conducted based on clinical data recorded and stored within the Corporate Data Warehouse., Results: A cohort of 1,339,937 veterans received an inpatient or outpatient diagnosis of PTSD and/or TBI. The cohort was divided into 4 service period groups and 3 diagnosis categories. The service periods included pre-9/11 (n = 1,030,806; 77%), post-9/11 (n = 204,083; 15%), overlap-9/11 (n = 89,953; 7%), and reentered post-9/11 (n = 15,095; 1%). The diagnosis categories included PTSD alone (n = 1,132,356; 85%), TBI alone (n = 100,789; 7%) and PTSD+TBI (n = 106,792; 8%). Results of the post-9/11 group revealed significant changes, including (1) increase of veterans with PTSD+TBI; (2) increase of female veterans with PTSD+TBI; and (3) increase of severity level of diagnosed PTSD/TBI as evidenced by higher service-connected disability pensions at younger age in the post-9/11 group. Additionally, data revealed unequal distribution of veterans with PTSD+TBI across geographic areas., Conclusions: The veteran of the post-9/11 service period does not mirror the veteran of the pre-9/11 service period. Findings are valuable for policy making, allocation of resources, and for reconsidering the prevailing paradigm for treating veterans with PTSD and/or TBI., Competing Interests: Author affiliations The authors report no actual or potential conflicts of interest with regard to this article., (Copyright © 2020 Frontline Medical Communications Inc., Parsippany, NJ, USA.)