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Complementary and integrative health (CIH) approaches have gained empirical support and are increasingly being utilized among veterans to treat a myriad of conditions. A cluster of medically unexplained chronic symptoms including fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems, often referred to as Gulf War Illness (GWI) prominently affect US Gulf War era (GWE) veterans, yet little is known about CIH use within this population. Using data collected as part of a larger study (n = 1153), we examined the influence of demographic characteristics, military experiences, and symptom severity on CIH utilization, and utilization differences between GWE veterans with and without GWI. Over half of the sample (58.5%) used at least one CIH modality in the past six months. Women veterans, white veterans, and veterans with higher levels of education were more likely to use CIH. GWE veterans with a GWI diagnosis and higher GWI symptom severity were more likely to use at least one CIH treatment in the past six months. Over three quarters (82.7%) of veterans who endorsed using CIH to treat GWI symptoms reported that it was helpful for their symptoms. Almost three quarters (71.5%) of veterans indicated that they would use at least one CIH approach if it was available at VA. Results provide a deeper understanding of the likelihood and characteristics of veterans utilizing CIH to treat health and GWI symptoms and may inform expansion of CIH modalities for GWE veterans, particularly those with GWI.

Nonsuicidal self-injury (NSSI) is a robust predictor of suicidal thoughts and behaviors; however, while there are typically only small differences observed in the prevalence of NSSI between men and women, this condition has been largely overlooked and underestimated among men. Assessing NSSI methods more common in men may address misidentification as well as allow for more precise NSSI prevalence estimates. Survey data from a national sample of Gulf War I-Era veterans (N = 1063) was used to estimate the prevalence of NSSI and compare prevalence of NSSI methods between men and women veterans. Demographic and clinical correlates of NSSI engagement were also examined. The national lifetime prevalence rate of NSSI among Gulf War I-Era veterans was 22.40%, whereas the past year prevalence rate was 8.10%. In both men and women, wall/object punching was the most common NSSI method endorsed across the lifetime. Men had slightly higher overall NSSI prevalence rates compared with women. This study highlights the need to systematically assess NSSI, particularly among veterans, to better identify, and consequently treat, NSSI in men. This is the first available prevalence estimate of NSSI to include the assessment of wall/object punching in a national sample of adult veterans.

Geothermal Academy: A Pathway for Confirmation of Ground-Source Heat Pumps in the United States. In 2008, Oak Ridge National Laboratory issued a report on geothermal heats pumps (GHPs) focused on the market status, barriers to adoption, and actions to overcome these barriers (Hughes 2008). Of the barriers raised in this report, of the most pressing is the lack of performance and energy usage data for GHPs. Further, an associated barrier is a lack of a fair comparison of the energy usage of conventional heating and cooling systems for the same building. Because of these barriers, we are not able to say how much energy is used by well-designed GHP systems on a long-term basis, nor are we able to say how better their energy usage is compared to conventional systems. The need for a fair comparison with conventional systems is particularly relevant as modern versions of conventional air conditioners, gas furnaces, and boilers have also incorporated energy saving technologies. As a first step to address this barrier, the Geothermal Academy has developed a framework for data collection. This framework has already been applied to several geothermal installations in Colorado (Nakagawa etal. 2010). The framework classifies data into different categories basedmore » on the relevance of the dat to understanding the energy consumption of a GHP system. The categories are: direct energy consumption data, heat exchange performance data, and GHP design parameter data. The main recommendation of this project is to include a minimal data collection system on each heat pump installed in the U.S., capable of measuring the electrical energy consumed, the entering/exiting fluid temperatures, and circulation rates. This is a viable and cost effective solution which will provide performance data, as data collection systems are only a fraction of the cost of a GHP unit and modern GHP units already incorporate sensors to monitor energy usage and the entering and exiting fluid temperatures. Specifically, these sensors are used to control the GHP unit to provide the heat exchange required to provide a desired temperature within a building. Accordingly, it is straightforward for this operational data to be collected to start building a database of GHP performance such that can provide statistically relevant comparison with other heating and cooling systems. In addition to collecting the data, such a system could be easily implemented with a wireless transmitter so that data could be sent to a home PC where it could be transmitted to a central database. Display of the data on a user's PC would provide feedback on the performance of their system which could perhaps refine their use of the system to reach their personal energy goals. Although a system such as that described above has yet to be incorporated directly into commercial GHP systems, it is straightforward and inexpensive to outfit a GHP with a data acquisition system and supplemental sensors. A secondary recommendation is to consider funding a pilot effort that will collect the energy and performance time series data from a representative sample of installations. A preliminary pilot effort was undertaken by the Geothermal Academy at a middle school in Ft. Collins, Colorado, which demonstrated the feasibility and ease of such an effort. A full-scale pilot effort would be most suited to evaluate the performance of GHP installations in different climate settings, preferably focusing on residential, commercial, and public buildings. If a full-scale pilot effort were to be undertaken, it is recommended to also identify large buildings which may incorporate a back-up conventional heating and cooling system in order to provide statistically relevant comparison data to assess the improvement in GHP energy usage over other heating and cooling technologies. Such a data collection system would provide several benefits to the different sectors of society (consumers, installers, policy makers, researchers, utility companies, government regulators) which are concerned with GHP technology and implementation.« less