Publications by authors named "Laurel Copeland"
Article Synopsis
- Before the COVID-19 pandemic, the U.S. Department of Veterans Affairs (VA) had the largest telehealth program in the U.S., and the pandemic prompted an expansion of telehealth to help veterans, particularly those experiencing housing instability (HI), access diabetes care.
- The study used mixed methods, including data analysis and interviews, to assess how diabetes care delivery via VA Video Connect (VVC) changed and which sociodemographic factors influenced usage among veterans with HI from 2019 to 2022.
- Findings revealed that younger, non-rural, and certain demographic groups of veterans were more likely to utilize VVC, while barriers to its use included in-person care limitations and the need for enhanced education and technology
Regional disparities in heart transplant mortality in the United States.
Eur Heart J Qual Care Clin Outcomes
September 2024
Background: Mortality after heart transplantation can be influenced by multiple factors. This study analyzed its variation across 4 regions of the United States.
Objective: Analyze the differences in mortality among patients receiving a heart transplant across 4 regions of the United States.
Article Synopsis
- Gender-affirming hormone treatment (GAHT) is used by transgender individuals to alleviate gender dysphoria and enhance life quality, but more research is needed on its long-term effects.* -
- This study aimed to determine the relationship between sex hormones (estradiol for transfeminine individuals and testosterone for transmasculine individuals) and the development of metabolic syndrome in transgender veterans compared to cisgender veterans.* -
- The research involved a cohort of 1,290 participants and found that changes in metabolic syndrome risk scores over time varied significantly between transgender individuals and cisgender referents.*
Article Synopsis
- This study examined how donor heart characteristics, specifically left ventricular ejection fraction (EF) and wall thickness (LVWT), affect survival rates in heart transplant (HTx) recipients using data from the UNOS registry between 2006-2022.
- A total of 21,012 adult HTx recipients were analyzed, separated into four groups based on donor EF and LVWT, revealing no significant differences in mortality rates at 30 days, 1 year, or 5 years.
- The findings suggest that broadening donor selection criteria could help increase the donor pool and potentially lower waitlist mortality for those needing heart transplants.
Currently, the prevalence of autism spectrum disorder (henceforth "autism") is 1 in 36, an increasing trend from previous estimates. In 2015, the United States adopted a new version (International Classification of Diseases, 10th Revision) of the World Health Organization coding system, a standard for classifying medical conditions. Our goal was to examine how the transition to this new coding system impacted autism diagnoses in 10 healthcare systems.
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- The study aimed to evaluate the prevalence of maternal chronic hypertension (MCH) among Veterans and assess blood pressure control before pregnancy as well as medication management during pregnancy.
- About 8% of Veterans with documented pregnancies had MCH, with a significant portion showing uncontrolled blood pressure, particularly in those with chronic kidney disease and diabetes.
- The findings suggest a need for improved interventions to manage MCH and preconception blood pressure to ensure better health outcomes during pregnancy.*
Background: Infertility care is provided to Veterans through the Veterans Health Administration (VHA) medical benefits package and includes infertility evaluation and many infertility treatments.
Objective: Our objective was to examine the incidence and prevalence of infertility diagnoses and the receipt of infertility healthcare among Veterans using Veterans Health Administration (VHA) healthcare from 2018 to 2020.
Methods: Veterans using the VHA and diagnosed with infertility during October 2017-September 2020 (FY18-20) were identified in VHA administrative data and through VA-purchased care (i.
Article Synopsis
- Multiple myeloma (MM) is a rare cancer linked to Agent Orange (AO) exposure in Vietnam War veterans, potentially affecting the progression from monoclonal gammopathy of undetermined significance (MGUS) to MM.
- A study analyzed health records of Vietnam War veterans to understand how AO exposure and other factors (like age, race, and health conditions) impacted survival rates among those with MM or MGUS.
- Results showed no significant difference in MGUS to MM transformation based on AO exposure, but highlighted that factors like alcohol use and older age increased mortality risks, while hematopoietic cell transplantation offered a protective benefit.
Article Synopsis
- Sudden cardiac death (SCD) is a significant risk for heart transplant patients, affecting 8%-35% of them, but the reasons for this risk are not fully understood.
- This study looked at whether having an implantable cardioverter-defibrillator (ICD) before heart transplant had any effect on long-term survival after the surgery.
- The findings revealed that while patients with an ICD were generally older and had more risk factors for SCD, their ICD status did not correlate with improved long-term survival after heart transplantation.
Article Synopsis
- The study investigates how PTSD symptoms may worsen during the military-to-civilian transition and identifies risk and protective factors influencing PTSD onset for U.S. veterans.
- A large sample of nearly 49,000 veterans completed web surveys over three years, with findings showing high trauma exposure (59%) and a probable PTSD prevalence of 30%.
- Results indicate that factors like current stress, gender, and race/ethnicity are linked to PTSD risk, while psychological resilience and social support play protective roles, emphasizing the importance of ongoing support for veterans facing PTSD challenges.
Article Synopsis
- The study examines the challenges faced by clinicians in managing limb injuries among Post-9/11 Veterans, particularly concerning extremity arterial vascular injuries (EVI) and the current lack of best practices for their care.
- A cohort of 490 Veterans with confirmed arterial injuries was analyzed to determine the correlation between guideline-concordant care for peripheral vascular disease and other treatments, including mental health services and opioid use.
- Findings revealed that only 25% of the patients received appropriate vascular care despite 46% experiencing complications, highlighting significant gaps in treatment even among those with moderate to severe injuries.
Medications with Potential for Fetal Risk Prescribed to Veterans.
J Womens Health (Larchmt)
October 2022
Article Synopsis
- Women service members face mental health challenges and high medication use during pregnancy, with the study examining their experiences using data from 2015 to 2021.* -
- About 36% of the pregnant women veterans had a pain-related disorder, while significant percentages dealt with major depression and PTSD, with a notable decline in SSRI/SNRI use during pregnancy.* -
- Counseling on medication use should be prioritized for women veterans planning to get pregnant, and better communication between VHA providers and community obstetricians is essential for improving health outcomes.*
Article Synopsis
- Veterans transitioning to civilian life face multiple challenges, especially in financial aspects, which can affect their overall well-being and adjustment to non-military life.
- A study analyzed data from nearly 49,000 Veterans over three years to assess their perceived financial status, satisfaction, functioning, and adjustment difficulties.
- Results showed that while many Veterans had stable financial situations post-separation, a significant portion struggled, with troubled financial status linked to greater difficulty in adjusting to civilian life and specific demographic factors influencing financial satisfaction.
This study assessed the effectiveness of employment programs components, which resulted in the identification of content and process components that increase employability. Employment program use was studied among 1172 United States of America military veterans to determine which content (i.e.
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- The study investigates the health and well-being of U.S. military veterans in the three years following their discharge, questioning previous beliefs that veterans improve over time post-service.
- Researchers surveyed 3,733 newly separated veterans multiple times to track changes in health and community involvement, finding a general decline in well-being.
- Significant deteriorations were observed in mental health and community participation, especially among female veterans and specific at-risk groups, underscoring the need for targeted support and intervention efforts.
Introduction: Public Law 111-163 Section 206 of the Caregivers and Veteran Omnibus Health Services Act amended the Veterans Health Administration's (VHA) medical benefits package to include 7 days of medical care for newborns delivered by Veterans. We examined the newborn outcomes among a cohort of women Veterans receiving VHA maternity benefits and care coordination.
Materials And Methods: We conducted a secondary analysis of phone interview data from Veterans enrolled in the COMFORT (Center for Maternal and Infant Outcomes Research in Translation) study 2016-2020.
Article Synopsis
- The study examines how quality of life and psychosocial factors, like health literacy and social support, impact unplanned hospital readmissions following surgery for Veterans.
- It involved a cohort of 736 Veterans who underwent elective surgeries and found that 16.3% were readmitted within 30 days of discharge, often due to lower mental and physical health and inadequate social support.
- The researchers highlight the importance of addressing mental health, health literacy, and social support in post-surgery care plans to reduce readmissions and improve recovery outcomes.
Objectives: Maternal alcohol misuse during the postpartum period is associated with negative maternal and infant outcomes. This study examined whether greater stress exposure in the year before the baby's birth and maternal post-traumatic stress disorder (PTSD) were associated with postpartum alcohol misuse among a sample of women veterans. Maternal PTSD was also examined as a moderator of the association between stress exposure and postpartum alcohol misuse.
View Article and Find Full Text PDFIdentifying factors that contribute to military veterans' post-military well-being.
Appl Psychol Health Well Being
May 2021
Article Synopsis
- Prior research focused on individual factors affecting veterans' health, but this study explores how these factors interact and impact overall well-being during their transition to civilian life.
- Utilizing data from 7,150 veterans after military service, the study used machine learning to link initial assessments of mental health and social support to their well-being a year later.
- Key findings indicate that veterans with low depression, high social support, and strong resilience reported better well-being; however, factors like demographics or trauma history were less predictive, especially noting that depression had a greater impact on women's well-being.
Article Synopsis
- The study investigates how discrimination-related stress affects PTSD symptoms among diverse military veterans, focusing on racial and gender differences.
- Black and Hispanic/Latino/a/x veterans showed higher levels of PTSD severity and discrimination stress compared to White veterans, with notable gender disparities.
- The findings suggest that PTSD severity increases are influenced by the combined effects of race, gender, and discrimination, emphasizing the importance of an intersectional approach in future research and interventions.
Patency of arterial repairs from wartime extremity vascular injuries.
Trauma Surg Acute Care Open
December 2020
Background: Extremity vascular injury (EVI) causes significant disability in Veterans of the Afghanistan/Iraq conflicts. Advancements in acute trauma care improved survival and decreased amputations. The study of wartime EVI has relied on successful limb salvage as a surrogate for vascular repair.
View Article and Find Full Text PDFBackground: Although research has shown that exposure to potentially traumatic and morally injurious events is associated with psychological symptoms among veterans, knowledge regarding functioning impacts remains limited.
Methods: A population-based sample of post-9/11 veterans completed measures of intimate relationship, health, and work functioning at approximately 9, 15, 21, and 27 months after leaving service. Moral injury, posttraumatic stress, and depression were assessed at ~9 months post-separation.
Article Synopsis
- The study investigates the relationship between opioid use and the risk of developing new depression episodes (NDE), particularly focusing on the role of insomnia as a co-occurring condition.
- It finds that while both chronic opioid use and insomnia are individually linked to increased depression risk, the combination of chronic opioid use and insomnia may heighten this risk, although results were not statistically significant.
- The authors suggest that healthcare providers should pay attention to sleep issues in patients on long-term opioid therapy, as insomnia might contribute to a higher likelihood of developing depression.