Federal practitioner : for the health care professionals of the VA, DoD, and PHS最新文献

{"title":"Evaluation of Health Professions Trainee Experiences Transitioning to New VHA Electronic Health Record.","authors":"Ellen A Ahlness, George Sayre, Erin Matteau, Edward Walton, Seppo Rinne","doi":"10.12788/fp.0682","DOIUrl":"10.12788/fp.0682","url":null,"abstract":"<p><strong>Background: </strong>Electronic health record (EHR) transitions are disruptive events that negatively impact staff. Health professions trainees (HPTs) play a critical role in providing patient care, but the impact of EHR transitions on clinical training and care is unknown. This study sought to examine HPT experiences during a Veterans Health Administration (VHA) EHR transition.</p><p><strong>Methods: </strong>The evaluation team at the Captain James A. Lovell Federal Health Care Center, which was transitioning to the new Cerner/Oracle Health EHR, conducted a mixed-methods analysis. Qualitative data included semistructured interviews with 19 HPTs, supervisors, and site leaders about their experiences. Quantitative data included 103 responses to 3 surveys.</p><p><strong>Results: </strong>The evaluation team identified 6 findings among the HPT responses: (1) transition management was viewed as poor; (2) EHR training was not relevant; (3) they were hopeful about the new EHR; (4) in-house support was considered essential; (5) learning Cerner/Oracle Health was rapid; and (6) the transition impacted clinical training, but not career plans.</p><p><strong>Conclusions: </strong>HPTs detailed transition experiences that were meaningfully better than those described by HPTs at earlier transition sites. The VHA should understand and mitigate the negative impact of transitions to ensure beneficial clinical training experiences and the delivery of quality patient care.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 5","pages":"186-192"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis Use by Veterans and Potential Interactions With Antineoplastic Agents: Analysis and Literature Review.","authors":"Tsvetelina Todorova, Elizabeth John, Srishti Sareen, Vaishnavi Tandra, Jessica Davis, Lindsey Lands, Alva Weir","doi":"10.12788/fp.0619","DOIUrl":"10.12788/fp.0619","url":null,"abstract":"<p><strong>Background: </strong>Extensive research exists investigating medicinal uses of cannabis products in patients with malignancies, though it is largely unknown how cannabis use may affect the efficacy of antineoplastics. Like many antineoplastic agents, cannabis is metabolized by cytochrome P450, leading to potential interactions. This observational study sought to identify the prevalence of cannabis use in patients with a malignancy at the Veterans Affairs Memphis Healthcare System and analyze the potential for interactions between various products and the antineoplastic agents the patients received.</p><p><strong>Methods: </strong>A retrospective review of electronic health records was completed for patients who used cannabis products during treatment and accepted the invitation to complete a survey during January 2024. Prescribed antineoplastic medications for each patient were recorded, and data were compiled and analyzed for potential interactions.</p><p><strong>Results: </strong>A total of 132 patients agreed to participate in the survey, and 50 (38%) acknowledged use of cannabis products within the previous 90 days. Forty-five patients (90%) who used cannabis within 90 days were male, and 29 patients (58%) were aged 60 to 65 years. Thirty-five patients (70%) predominantly inhaled cannabis. Twenty-one patients (42%) had chemotherapy, the most common treatment, 19 patients (38%) had immunotherapy, 12 patients (24%) used targeted therapy, and 10 patients (20%) used endocrine therapy.</p><p><strong>Conclusions: </strong>This analysis found a notable prevalence of patients with cancer concurrently using cannabis while being prescribed an antineoplastic. The results of this study suggest a potential decrease in the efficacy of immunotherapy and endocrine therapy and an increase in toxicity with chemotherapy and targeted agents when used alongside cannabis products.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 suppl2","pages":"S68-S73"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Considerations for Orthopedic Surgery in a Geriatric Population.","authors":"Rini Desai, Olivia Triplett, Michael Stickels, Harold Gene Dossett","doi":"10.12788/fp.0661","DOIUrl":"10.12788/fp.0661","url":null,"abstract":"<p><strong>Background: </strong>With more than half of orthopedic surgeries performed on patients aged ≥ 65 years, optimizing perioperative care in this population is essential. Age-related physiologic changes, multimorbidity, and frailty significantly increase surgical risks, including infection, venous thromboembolism, impaired wound healing, delirium, and prolonged recovery. Effective perioperative management strategies are essential to reduce morbidity and improve functional outcomes.</p><p><strong>Observations: </strong>Using tools such as the Fracture Risk Assessment Tool and the Comprehensive Geriatric Assessment, frailty screening aids in identifying high-risk patients and guiding perioperative care. Preoperative strategies focus on controlling comorbidities, such as optimizing glycemic control for patients with diabetes to reduce the risk of postoperative complications. Assessing the mechanism of injury can provide valuable information about underlying conditions. Comprehensive nutritional evaluation is essential for geriatric patients undergoing orthopedic surgery, since malnutrition is common in this population and may impair recovery and increase morbidity. Postoperative management emphasizes early mobilization, delirium prevention, infection control, and anticoagulation management to reduce complications and improve recovery.</p><p><strong>Conclusions: </strong>Perioperative management of geriatric orthopedic patients requires a proactive, multidisciplinary approach that integrates preoperative risk assessment, intraoperative vigilance, and targeted postoperative care. Identifying and addressing frailty, optimizing nutrition, and implementing structured plans for screening and rehabilitation are essential to reduce complications and enhancing recovery.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 4","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Birt-Hogg-Dubé Syndrome: A Rare but Essential Diagnosis to Consider.","authors":"Andrew Hong, Kevin Eng, Jaime Betancourt","doi":"10.12788/fp.0705","DOIUrl":"10.12788/fp.0705","url":null,"abstract":"<p><strong>Background: </strong>Birt-Hogg-Dubé syndrome (BHD) is an autosomal dominant disorder characterized by multiple pulmonary cysts, predisposing individuals to spontaneous pneumothorax, cutaneous lesions-specifically fibrofolliculomas-and an increased risk of renal malignancies. Although diagnosing BHD is difficult due to the variable presentation of the disease, identification is crucial for proper management, which includes lifelong screening for renal malignancies and management of recurrent pneumothoraces. Despite its rarity, maintaining awareness of BHD in the differential diagnosis of pulmonary cysts is essential.</p><p><strong>Case presentation: </strong>We present the case of a nonsmoking male veteran in his 60s whose BHD diagnosis surfaced many years after a history of recurrent pneumothoraces, leading to 1 pleurodesis in each lung. Genetic testing of the <i>FLCN</i> gene confirmed the BHD diagnosis. A shave biopsy of a skin lesion confirmed a histologic pattern of fibrofolliculoma/trichodiscoma. Annual magnetic resonance imaging surveillance was initiated to monitor for potential renal malignancies.</p><p><strong>Conclusions: </strong>BHD is a rare and complex disease. Early recognition and diagnosis play a pivotal role in preventing potentially severe complications such as renal malignancies. Suspicion for a genetic disorder such as BHD, lymphangioleiomyomatosis, or pulmonary Langerhans cell histiocytosis should arise in patients who experience spontaneous pneumothorax, especially in the presence of multiple cystic lesions or a family history of pneumothoraces. Early consideration of pleurodesis after the first spontaneous pneumothorax is recommended. The complex presentation of BHD may delay recognition, which can be exacerbated by variable continuity of care.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 4","pages":"155-159"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Unplanned Postoperative Visits in a Veterans Affairs Hand Surgery Practice.","authors":"Loretta Coady-Fariborzian, Francisca Perdomo, Christy Anstead","doi":"10.12788/fp.0686","DOIUrl":"10.12788/fp.0686","url":null,"abstract":"<p><strong>Background: </strong>After elective soft tissue hand surgery, patients may make unplanned appointments when experiencing pain or anxiety. These appointments can contribute to late arrivals and delays in other clinics. Identifying predictive factors of unplanned postoperative visits may improve perioperative risk management or education and reduce unplanned appointments.</p><p><strong>Methods: </strong>Elective soft tissue hand surgeries performed from July 1, 2018, to June 30, 2022 (excluding 2020, the COVID-19 pandemic year) in Veterans Affairs North Florida/South Georgia Veterans Health System operating rooms by the plastic surgery service were identified in the electronic health record. Data collected included age, sex, current smoking status, and residential zip code, as well as diagnoses of diabetes, depression, anxiety, or posttraumatic stress disorder (PTSD). Postoperative clinic notes were examined for 3 months for each patient. A χ² analysis with <i>P</i> < .05 was used to determine whether age > 60 years, sex, proximity to the Malcom Randall Veterans Affairs Medical Center (MRVAMC), clinic, diabetes, smoking, depression, anxiety, or PTSD were statistically significant independent risk factors for unplanned appointments.</p><p><strong>Results: </strong>Of 1009 hand surgeries, 81 (8.0%) patients returned for unplanned visits. Age (<i>P</i> = .82), proximity to MRVAMC (<i>P</i> = .34), diabetes (<i>P</i> = .60), current smoking (<i>P</i> = .55), anxiety (<i>P</i> = .33), and PTSD (<i>P</i> = .37) were not statistically significant predictors of unplanned visits. Depression (<i>P</i> = .04) and female sex (<i>P</i> = .03) were found to be independent risk factors for unplanned appointments. The most common indication for the appointment was pain.</p><p><strong>Conclusions: </strong>Female sex and a depression diagnosis were statistically significant predictors for unplanned appointments in the early postoperative period after elective soft tissue hand surgery.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 4","pages":"137-141"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Ken Kizer's Legacy at Risk? The Future of the Veterans Health Administration.","authors":"Cynthia M A Geppert","doi":"10.12788/fp.0713","DOIUrl":"10.12788/fp.0713","url":null,"abstract":"","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 4","pages":"125-126"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Review of Dual CGRP-Targeted Regimens for Acute and Preventive Treatment of Migraines in a Veteran Population.","authors":"Amanda Forrest, Dallin Billow, Alison Martin","doi":"10.12788/fp.0688","DOIUrl":"10.12788/fp.0688","url":null,"abstract":"<p><strong>Background: </strong>Medications targeting calcitonin gene-related peptide (CGRP) have been approved for both acute treatment and prevention of migraines. Controversy surrounds the concomitant use of these agents for these 2 purposes, given their similar mechanisms of action and the limited data available to support concurrent use.</p><p><strong>Methods: </strong>A medication use evaluation was performed using electronic health record prescription records. The primary objective was to assess the safety of dual CGRP-targeting therapies when used for both the prevention and acute treatment of migraines. A secondary exploratory objective was to assess the efficacy of combination treatment regimens. Patients were included if they had a documented diagnosis of migraine and were concomitantly using a preventive CGRP-targeting regimen and a gepant for acute migraine treatment between April 1, 2023, and January 31, 2025.</p><p><strong>Results: </strong>The analysis included 89 patients. Most were female (60.7%), with a mean age of 46.8 years and a diagnosis of chronic migraines (76.4%). There were 149 unique dual CGRP-targeting regimens identified and included in the safety analysis, 59 of which were eligible for the exploratory efficacy analysis. No new or concerning adverse effects were identified. Only 7 adverse drug reactions were reported by patients and documented. The efficacy analysis revealed no median change in migraine intensity (0.0, <i>P</i> = .18) or duration (0.0, <i>P</i> = .92). Ten patients receiving dual CGRP therapy reported that the addition of a gepant for acute treatment was effective, and 20 reported that it was ineffective. There was a lack of documentation for the remaining 29 patients.</p><p><strong>Conclusions: </strong>The use of concomitant dual CGRP-targeting agents for migraine treatment and prevention appears to be safe and well tolerated. Efficacy data were limited in this study; randomized controlled trials are needed to fully assess this endpoint.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 4","pages":"142-148"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involving Concerned Significant Others in Firearm Suicide Prevention: Development of the Family FireArms Secure Storage Training Intervention.","authors":"Bryann B DeBeer, Alexis Blessing, Monica Matthieu, Joseph Simonetti, Elisa Borah, Elizabeth Karras-Pilato, Meredith Mealer, Joseph Mignogna, Sandra B Morissette","doi":"10.12788/fp.0695","DOIUrl":"10.12788/fp.0695","url":null,"abstract":"<p><strong>Background: </strong>Firearms account for 71% of veteran deaths by suicide and unsecure firearm storage practices are directly associated with increased suicide risk. Most firearm suicide prevention interventions deployed by the US Department of Veterans Affairs (VA) are directed at high-risk populations; however, a significant proportion of suicide attempts and deaths by suicide occur in individuals with undetected risk. Veterans may be open to discussions with a trusted, concerned significant other (CSO) such as a family member, friend, or spouse, including discussions about secure firearm storage. However, no interventions exist within the VA that address mental health crisis preparedness for CSOs and veterans.</p><p><strong>Observations: </strong>The Family FireArms Secure Storage Training (FFAST) intervention was developed for veterans who do not securely store firearms. The intervention consists of 4 main components delivered during a virtual meeting between an interventionist, veteran, and CSO. Participants discuss current firearm storage practices and develop a plan to adopt more secure storage behaviors and respond to potential crisis situations. This article provides detailed descriptions of the intervention and the intended benefits of each component.</p><p><strong>Conclusions: </strong>FFAST is a novel approach to firearm suicide prevention within the VA because it involves CSOs and emphasizes crisis preparedness and secure firearm storage among veterans who have not been identified as high suicide risk. Future applications include pilot studies to evaluate the intervention's feasibility, acceptability, and efficacy.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 suppl1","pages":"S1-S7"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting the Needs of Those Who Have Served: The Role of VHA Specialized Mental Health Centers of Excellence.","authors":"Jennifer K Fairchild, Jerome Yesavage, Clifford Smith","doi":"10.12788/fp.0680","DOIUrl":"10.12788/fp.0680","url":null,"abstract":"<p><strong>Background: </strong>Access to effective mental health services is a critical part of the Veterans Health Administration (VHA) mission. The demand for these services has increased significantly in recent years, with the number of veterans receiving direct VHA mental health care increasing 78% from 2009 to 2024.</p><p><strong>Observations: </strong>Legislative actions, such as the PACT Act of 2022, expanded eligibility for VHA services to new cohorts of veterans. Many of these newly enrolled veterans have complex physical and psychiatric comorbidities that necessitate specialized mental health care. The VHA's specialized mental health Centers of Excellence (CoEs) are well equipped to help meet the unique needs of veterans. These mental health CoEs are dedicated to advancing research, training VHA clinicians and personnel, and developing effective treatment programs in high priority areas of veteran mental health (eg, posttraumatic stress disorder, traumatic brain injury, substance abuse). Noteworthy initiatives, such as the national rollouts of effective therapeutic interventions and suicide prevention strategies, highlight the unique ability of mental health CoEs to rapidly translate research into practice.</p><p><strong>Conclusions: </strong>Specialized mental health CoEs have contributed to VHA by pioneering evidence-based approaches in veteran mental health care. Ongoing efforts with advanced methodologies and technologies, such as precision medicine and artificial intelligence, have the potential to further optimize health care resources while enhancing mental health care and ensuring better outcomes for veterans.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 suppl1","pages":"S1-S5"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated Unified Protocol for Transdiagnostic Treatment of Anxiety Disorders in a VHA System.","authors":"Allison C Aosved, Marissa Sia, Jodi C Bell, Theresa B Brown, Hsin-Tine Tina Liu-Tom","doi":"10.12788/fp.0687","DOIUrl":"10.12788/fp.0687","url":null,"abstract":"<p><strong>Background: </strong>Veterans often present with multiple co-occurring mental health disorders, such as anxiety and depression, posing significant treatment challenges. Veterans are at increased risk for suicide, and anxiety and mood disorders are associated with increased suicide attempts and death by suicide. The Unified Protocol (UP) is a transdiagnostic cognitive behavioral therapy (CBT) intervention that addresses underlying emotional experiences (ie, negative affect and emotional distress) present in anxiety, depressive, and emotional disorders. UP uses interventions that can also be found in other CBT protocols, including motivational enhancement, mindful awareness, cognitive reframing, and exposure strategies. As a transdiagnostic intervention, UP can address anxiety, mood, emotional disorders, and other co-occurring disorders within the same treatment. Few veterans who could benefit from high-quality CBT interventions, such as UP, can access them.</p><p><strong>Observations: </strong>The Veterans Affairs Pacific Islands Health Care System (VAPIHCS) created the Intensive Virtual Evidence-Based Psychotherapy Team for Anxiety With or Without Co- Occurring Depression program to deliver transdiagnostic UP with an accelerated model of service delivery (≥ 3 therapy sessions weekly). The program increased access to and completion of CBT for patients at VAPIHCS. By delivering UP in a massed or accelerated format (≥ 4 sessions weekly), the program provided an empirical solution that increased access to UP. It consists of 3 main components: (1) individual massed UP therapy (4 sessions weekly); (2) whole health and wellness classes (4 group sessions weekly); and (3) individual health coaching (1 session weekly). A total of 87.5% of participants completed all 16 UP therapy sessions the first year. Patients reported reduced anxiety, depression, suicidal ideation, and substance use risk with improvements in psychological flexibility and quality of life.</p><p><strong>Conclusions: </strong>Virtual massed UP was found to be feasible, acceptable, effective, and to have high retention rates and patient satisfaction in a diverse veteran population with anxiety and other emotional disorders.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"43 suppl1","pages":"S1-S7"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}