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Briefings is published bi-monthly by the Mid-Atlantic (VISN 6) MIRECC’s Education Core
BriefingsVol 11 Issue 6 December 2015
In This Issue:Focus on the VISN
National Service .................................Project Updates
Abstinence Reinforcement Therapy ............PTSD Recovery Program ...............................Sleep ............................................................Mental Health Innovations ...........................Smoking Cessation Learning Collaborative ....
DisseminationInvited Lectures ..........................................
VHA Promising Practices Consortium ...........Conferences .................................................Publications .................................................
EvolutionsLeadership Activities ...................................
Honors & Awards .........................................Transitions ...................................................
Education & Other ResourcesFor Veterans ...............................................For Providers ...............................................
Contact InformationLeadership ...................................................
Fellowships ..................................................Research ......................................................
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https://www.blogs.va.gov/VAntage/24544/dr-robin-hurley-on-va-wake-forest-affiliation/
Posted on Tuesday, December 15, 2015 2:09 pm December 15, 2015 in Health by Ken McKinnon
You can watch the video at:
Focus on the VISNNationalService
An interview with Dr. Robin Hurley (MIRECCAssociate Director, Education) has just beenposted on VAntage Point, the official blogof the US Department of Veteran Affairs!
Dr. Hurley shares some of her thoughts on thetremendous impact that VA partnerships with USmedical schools have had on health care for Veteransand medicine in general.
Dr. Hurley coordinates and oversees training andeducation programs of VA residents and students atthe Salisbury VA Medical Center. She has beenstrengthening the VA’s affiliation with the Wake ForestSchool of Medicine in nearby Winston-Salem for sometime, commenting “I knew the relationship could bespecial.”
Consumer, Family, and Expert Panel Advisory Board
Recently, Dr. Beckham (MIRECC Co-Associate Director, Research) and her studyteam hosted a Consumer, Family and Expert Provider Advisory Board meeting.The purpose was to support her VA RR&D Merit Review funded studyevaluating the efficacy of an innovative smoking cessation treatment programfor Veterans experiencing unstable housing. The advisory board members metto review study progress in the first year, brainstorm about study recruitment,and provide feedback to the study team about study procedures.
Dr. Jonathan Wynn
The advisory board was led by Dr. Kimberly Green. The board includeshomeless Veterans who had participated in similar research projects, a familymember of a homeless Veteran, and a social worker from the Durham VA’sHealthcare for Homeless Veterans program. Drs. Michael Green and JonathanWynn, both clinician-researchers from the Greater Los Angeles VA MedicalCenter’sResearch Enhancement Award Program (REAP) for EnhancingCommunity Integration for Homeless Veterans, also serve on the advisoryboard. The board will continue to meet annually over the course of Dr.Beckham’s Merit Review.
ResearchProject Update
Dr. Michael Green
Abstinence Reinforcement Therapy (ART)for Homeless Veteran Smokers
Blueprint for Excellece Strategies 1, 2, 7, 8
Invited LecturesDr. Timothy Brearly (MIRECC Fellow,Salisbury site) and Dr. Robert Shura(MIRECC Faculty, Salisbury site) co-presented Malingering andResponse Bias as part of theSalisbury VAMC Mental HealthService Line Predoctoral InternshipTraining Program.
Dr. Jason Nieuwsma (AssociateDirector, Engaging Chaplains inMental Health Care) presentedMental Health - ChaplaincyIntegration, a full-day workshop , atthe invitation of the U.S. ArmyAtlantic Region Medical Command,Fort Belvoir Community Hospital,Fort Belvoir, VA.
Dr. Robin A. Hurley (MIRECCAssociate Director, Education)presented Neuropsychiatry of TBIand its Co-morbidities to theRichmond Polytrauma Fellowshipon November 18, 2015, via V-tel.Blueprint for Excellence Strategies 1, 2, 7, 8
Blueprint for Excellence Strategies 2, 7, 8
Blueprint for Excellence Strategies 1, 2, 8
Dr. Robert Shura (MIRECC Faculty,Salisbury site) presented TraumaticBrain Injury and MMPI-2-RFInterpretation as part of theSalisbury VAMC Mental HealthService Line Predoctoral InternshipTraining Program. Dr. Shura alsopresented Assessment ofMalingering and Response Bias aspart of the Salisbury VAMCPsychology Brown Bag series.Blueprint for Excellence Strategies 2, 7, 8
Dr. Courtney Slough (MIRECC Fellow,Salisbury site) made twopresentations during the EmergeFrom the Crowd: How to Become aStandout Residency Candidateworkshop held in conjunction withthe ACCP conference in October. Dr.Slough was the RoundtableDiscussion Leader for ResidentRoundtables and a Reviewer forCurriculum Vitae Writing.
Blueprint for Excellence Strategy 8
Vol 11 Issue 6 December 2015Briefings page 2
Focus on the VISN
A Self-Guided Approach for Veterans with Insomnia
Vol 11 Issue 6 December 2015Briefings page 3
Focus on the VISN
Employment Assistance for Veterans:The Impact of Vocational Rehabilitation Services
www.mirecc.va.gov/newsletter/current.asp
Mental Health InnovationsUpdates from VA’s Specialized Mental
Health Centers
Education ProjectUpdate
Blueprint for Excellece Strategy 8
The December 2015 edition of this national newsletter is now available on theMIRECC website at:
Research: Early Intervention for Vocational Problems May Help PreventHomelessness
Education: Training Materials Being Developed to Support Self-EmploymentProgram for VeteransClinical: Implementation Efforts Assist in Getting Veterans with SchizophreniaBack to Work
VHA Promising PracticesConsortium
Dr. John Lynch (MIRECC Faculty, Richmond site) lead the team that wasawarded a MIRECC Clinical Education Grant in 2011 to support disseminationof a PTSD treatment model that emphasizes functional and adaptive copingskills. As a result of that proposal, the PTSD Recovery Program treatmentmanuals (patient and therapist editions) were developed and distributed,including posting on our website. This program has been very well received andhas been implemented in several VA facilities since then. Users report positiveresults, and Dr. Lynch has submitted the program to the new VHA PromisingPractices Consortium. An upcoming article in the Journal of Aggression,Maltreatment & Trauma (November 2015) will discuss outcome statisticsdemonstrating improvements on an adaptive behavior checklist developed byDr. Lynch, the PCL-M, the MAPS, and a self-efficacy scale. The 3rd editions ofboth manuals are now available on our website.
Education Project Update Impulse Control in PTSD Treatment
https://www.vapulse.net/community/under-secretary-for-
health/promising-practices-consortium
to complete all activities within the 1-year timeframe.
Education ProjectUpdate
Self-Management Materials for SleepDisturbance in Recently Deployed Veterans
Dr. Christy Ulmer (MIRECC Faculty,Durham site) lead the team thatwas awarded a MIRECC ClinicalEducation Grant in 2011 to supporttranslation of an evidence-basedcognitive-behavioral treatment forinsomnia (CBTI) into a self-management workbook format.The team is now in the final stageof refining the workbook andworking on developing a nationalpilot test prior to official release.
Blueprint for Excellece Strategies 1, 2, 7, 8
Dr. John Lynch (MIRECC Faculty,Richmond site) submittedMeasurement practices in grouptreatment for veterans with combatPTSD on November 30, 2015.
Dr. Mira Brancu (MIRECC DeputyDirector) submitted Home-BasedMental Health Evaluation (HOME)on November 23, 2015.
The consortium is a new platformestablished by Dr. David Shulkin,the Under Secretary for Health,where anyone in VHA can sharesuccessful operational, clinical, andprogrammatic practices, and learnfrom others’ experiences in keystrategic areas that align with hispriorities.
Dr. Treven Pickett (MIRECCFaculty & Richmond SiteFellowship Co-Director) has beenappointed to serve on theCommittee on Disability Issues inPsychology by the AmericanPsychological Association’s Boardfor the Advancement ofPsychology in the Public Interest.
New Leadership Activities
Blueprint for Excellence Strategies 1, 8
Blueprint for Excellece Strategies 2, 7, 8
Dr. Robert Shura (MIRECC Faculty,Salisbury site) has been appointedto serve on the Committee forResearch of the AmericanNeuropsychiatric Association.
Blueprint for Excellence Strategies 7, 8
www.mirecc.va.gov/visn6
Recently, the VA’s Public Health Strategic Health Care Group partnered with ourMIRECC to sponsor a new Learning Collaborative. The focus is on IntegratedCare Smoking Cessation for Homeless Veterans. Led by Dr. Beckham (MIRECCCo-Associate Director, Research), the partners contracted with the DukeUniversity Medical Center’s Evidence-Based Practice Implementation Center(Duke EPIC) to help direct this Learning Collaborative. This project aimed toimprove the availability of smoking cessation services and outcomes forVeterans who are experiencing unstable housing. Veterans who are homelesssmoke at very high rates (up to 80%). They may also experience more negativehealth sequelae related to smoking. Specialty clinic-based tobacco cessationprograms have been shown to be effective in reducing smoking but areinfrequently attended, particularly by homeless Veterans. This limits theirimpact on prevalence, disease, and economic costs of smoking.
Clinical ProjectUpdate
Learning Collaborative on Integrated CareSmoking Cessation for Homeless Veterans
Vol 11 Issue 6 December 2015Briefings page 4
Focus on the VISN
Transitions
Blueprint for Excellence Strategies 2, 8
Blueprint for Excellece Strategies 1, 2, 7, 8
Clinical teams from Healthcare for Homeless Veterans Programs (34 providersfrom 7 VISN 6 VAMCs) were trained and coached on the implementation of a5-session smoking cessation intervention. The intervention is based on theIntegrated Care Smoking Cessation model. It combines evidence-basedsmoking cessation treatment with existing mental health treatment programsand/or other services. Clinical teams participated in several activities designedto promote implementation. These included launch calls, in-person learningsessions, educational seminars, site visits by the training team, and telephoneconsultation. Six of the 7 participating teams reported that a workplaceculture shift had taken place whereby tobacco cessation is now seen as apriority embraced by program staff. Most teams developed mechanisms forproviding smoking cessation, including access to smoking cessationmedications, directly to the Veterans enrolled in their program. At one monthafter the final learning session, 19 providers indicated they were providing theintervention to Veterans enrolled in their program. There were severalrecommendations for enhancing implementation. These included providingclinicians more training in Motivational Interviewing techniques, supportinguse of ongoing standard assessment procedures, and providing incentives toVeterans for successful smoking cessation.
Dr. Rich Weiner, previously MIRECCAssociate Director for Evaluations,now serves as the Interim Chair ofthe Department of Psychiatry andBehavioral Science Department inthe Duke University School ofMedicine. Dr Weiner is alsomaintaining a WOC position withDurham VA.
Drs. Robert Shura and Holly Miskey(MIRECC Faculty, Salisbury site)received faculty appointment at ViaCollege of Osteopathic Medicine(VCOM).
Honors & Awards
Dr. Courtney Slough (MIRECC Fellow,Salisbury site) received BoardCertification in Psychiatric Pharmacy(BCPP), November 2015.
Blueprint for Excellence Strategy 8
Dr. Eric Crawford, previously theMIRECC Assistant Director forClinical, has moved to SheridanWyoming VA where he is serving asthe Local Recovery Coordinator.
Katie Aiello, previously theLaboratory Manager of the PDMHStudy, has moved on to a clinicalposition outside of the VA. CaitlynCampbell has assumed the positionof PDMH Study and RepositoryProject Manager.
Dr. Jennifer Runnals, previouslyPost Deployment Mental Health(PDMH) IRB and Repositorycoordinator, has transitioned to aclinic position at the Durham VA.She will continue to serve as theResearch Privacy Officier for theDurham VA.
We wish everyone the best of luckin their new positions.
held in conjunction with the American College of Clinical Pharmacy (ACCP)2015 Global Conference on Clinical Pharmacy
November 12-15, 2015ChicagoABCT
Kelley ML, Harding HG, Lam N, Miller M. ModelingRisk for Partner Violence among OEF/OIF/OND Veteran-Partner Dyads. Poster
O’Farrell TJ, Schumm J, Kar H, Gnys M, Glynn S,Klostermann K. Dissemination of behavioral couplestherapy for substance use disorders. In W. Kim Halford(Chair), Dissemination of couple therapy and education:International perspectives.
Brown E, Lind MJ, Brown R, Berenz E, Hawn S, PickettT, McDonald S, Danielson C, Thomas S, Amstadter A.Protective factors against PTSD in OEF/OIF Veteransexposed to combat trauma. Poster
ConferencesSymposium
DeMarce JM, Gnys M, Kar H, Raffa SD, Karlin BE.National dissemination of cognitive behavioral therapyfor substance use disorders in the Department ofVeterans Affairs heath care system: Veteran outcomes.
Drapkin ML, Manual JL, Wilbourne PL, Kar H, Gnys M.National dissemination of motivational enhancementtherapy in the Veterans Healthcare Administration:Training program design, initial outcomes, and lessonslearned.
November 5 -7, 2015
Back to Basics:Integrating Clinical and Scientific Knowledgeto Advance the Field of Trauma
New Orleans, Louisiana, USA
International Societyfor Traumatic Stress Studies
ISTSS31st Annual Meeting
Brown RC, Mortensen J, Hawn S, McDonald S, PickettT, Danielson CK, Thomas S, Amstadter AB. TheNomological Network of a Behavioral Distress ToleranceTask in Trauma-Exposed Combat Veterans. Paper
Hawn SE, Chowdhury N, Kevorkian S, Sheth D, BrownRC, McDonald S, Pickett T, Danielson CK, Thomas S,Amstadter AB. Examination into the moderating effectsof impulsivity and risk taking propensity on therelationship between PTSD and Alcohol in OEF/OIF/ONDVeterans. Poster
Chowdhury N, Lind M, Hawn S, Brown R, McDonald S,Pickett T, Danielson CK, Thomas S, Amstadter AB,Berenz EC. Negative trauma cognitions and PTSDsymptom severity in OIF/OEF combat veterans. Poster
Lind MJ, Brown E, Farrell-Carnahan L, Brown R, Hawn S,McDonald S, Pickett T, Danielson CK, Thomas S,Amstadter AB. Sleep disturbances in combat-exposedveterans: Associations with PTSD, personality, and coping.PosterMiskey HM, McDonald SD, Shura RD, Pickett TC, Yoash-Gantz RE, Rowland JA. Performance Validity, but notPTSD, is Associated with Cognitive Performance in Iraqand Afghanistan War Era Veterans. Poster
Nieuwsma JA, Buck PJ, King HA, Jackson GL, CantrellWC, Meador KG. On the front line addressing moralinjury: A survey of VA/DoD chaplains and implicationsfor mental health collaboration.
Vol 11 Issue 6 December 2015Briefings page 5
Nieuwsma JA, King HA, Jackson GL, Cantrell WC,Rhodes JE, Bates MJ, Meador, KG. Training Militaryand VA Chaplains in the Use of Evidence-BasedPsychotherapeutic Principles and Practices.
Sheth D, Hawn SE, Hummel K, Brown RC, McDonald S,Pickett T, Danielson C K, Thomas S, Amstadter AB.Relationship between resilience, posttraumatic stressdisorder, and alcohol consumption in OEF/OIF Veterans.Poster
SymposiumJ Currier (Chair) & JA Nieuwsma (Discussant) - Moralinjury, spirituality, and military trauma: Probing into theclinical implications of treating morally injured patients.
Nieuwsma JA, Buck PJ, Jackson GL, Lane ME, MeadorKG. Utilization of cognitive behavioral therapeuticprinciples by chaplains in health care and militarysettings. Poster
How to Become a Standout Residency Candidate
C Slough (Roundtable discussion leader) Resident roundtables
JA Nieuwsma (Chair) & W Tenhula (Discussant) -Disseminating evidence-based psychotherapies andprinciples to diverse provider groups across theDepartments of Veterans Affairs and Defense.
C Slough (Reviewer) - Curriculum vitae writingEmerge from the Crowd:
San Francisco, CaliforniaOctober 17, 2015
Military Health in
NORTH CAROLINA MEDICAL JOURNAL
North Carolina
a journal of health policy analysis and debate
November/December 2015Volume 76, Number 5
Publications
Stevens FL, Pickett TC, Wilder Schaaf KP, Taylor BC, Gravely A, Van Houtven CH, Friedemann-Sánchez G, Griffin JM.The Relationship between Training and Mental Health among Caregivers of Individuals with Polytrauma. BehaviouralNeurology, 2015; Article ID 18941. http://dx.doi.org/10.1155/2015/185941
Policy Forum - Invited SidebarNieuwsma JA. Moral Injury: An Intersection for Psychological and SpiritualCare. North Carolina Medical Journal. 2015, 76(5), 300-301.
Publications
Policy Forum - Invited CommentaryPickett T, Rothman D, Crawford EF, Brancu E, Fairbank JA, Kudler HS.Mental health among military personnel and veterans. North CarolinaMedical Journal. 2015, 76(5), 299-306.
Schry A, Hibberd R, Wagner HR, Turchik J A, Kimbrel NA, Wong M, Elbogen EE, Strauss JL, VA Mid-Atlantic MIRECCWorkgroup, Brancu M. Functional correlates of military sexual assault in male veterans. Psychological Services. 2015,12(4): 384 - 393.
Nieuwsma JA, King HA, Cantrell WC, Jackson GL, Bates MJ, Rhodes JE, Wright L, Bidassie B, White B, Davis RC,Ethridge K, Roddenberry V, O’Mara S, Gatewood S, Irvine RJ, Meador KG. Improving patient-centered care viaintegration of chaplains with mental health care: Department of Veterans Affairs (VA) / Department of Defense (DoD)Joint Incentive Fund project final report (2015). Durham, NC: Department of Veterans Affairs Mental Health andChaplaincy Program.
Nieuwsma JA, Walser RD, Farnsworth JK, Drescher KD, Meador KG, Nash W. Possibilities within acceptance andcommitment therapy for approaching moral injury. Current Psychiatry Reviews. 2015, 11: 193-206.
Marx CE, Naylor JC, Kilts JD, Dunn CE, Tupler L, Szabo ST, Capehart BP, Morey RA, Shampine LJ, Acheson SK. (2016).Neurosteroids and Traumatic Brain Injury: Translating Biomarkers to Therapeutics; Overview and Pilot Investigations inIraq and Afghanistan Era Veterans. In Laskowitz D, Grant G (Eds.), Translational Research in Traumatic Brain Injury.Boca Raton (FL): CRC Press/Taylor and Francis Group, 2016. Chapter 7: 145-162. Frontiers in Neuroscience
Book Chapters
http://www.ncbi.nlm.nih.gov/books/NBK326734/?report=classic
Reports
Journal Articles
http://www.mirecc.va.gov/mentalhealthandchaplaincy/Docs_and_Images/Chaplains_MH_JIF_Final_Report.pdf
Invited Articles
Spoont MR, Williams JW Jr, Kehle-Forbes S, Nieuwsma JA, Mann-Wrobel MC, Gross R. The rational clinicalexamination: Does this patient have posttraumatic stress disorder? JAMA. 2015, 314: 510-510.
Schry AR, Rissling MB, Gentes EL, Beckham JC, Kudler HS, Straits-Troster K, Calhoun PS. The Relationship betweenPost-Traumatic Stress Symptoms and Physical Health in A Survey of U.S. Iraq and Afghanistan Era Veterans.Psychosomatics. 2015, 56(6): 674-684.
This commentary describes the prevalence of mental health problemsaffecting military service members and veterans in North Carolina andthe rest of the nation, with a special emphasis on those who served inthe recent wars in Iraq and Afghanistan. Approximately 1.9 million ofthese veterans have become eligible for Veterans Affairs health caresince 2002, and an estimated 1.16 million veterans have registered forthis care.
Vol 11 Issue 6 December 2015Briefings page 6
PTSD Coach Online is for anyone who needs help withupsetting feelings. Trauma survivors, their families, oranyone coping with stress can benefit.
PTSD Coach OnlineThis course provides parents with tools thatstrengthen parenting skills and helps themreconnect with their children.
Parenting: Positive Communication
AIMS: Anger & Irritability Management SkillsThis course offers a wide range of practical skills andtools to manage your anger and develop self-controlover your thoughts and actions.
Moving Forward: Stress vs PerformanceAn educational and life coaching programthat teaches Problem Solving skills to helpyou better handle life’s challenges
http://www.veterantraining.va.gov/
There are several free and anonymous on-line education and life coaching programs thatuse interactive exercises and video demonstrations to teach skills for overcoming lifechallenges.
Online Life Skills Training for Veterans
Resources for Veterans & Families
Vol 11 Issue 6 December 2015Briefings page 7
NC4VETS Resource GuideThe purpose of this comprehensive resource guide is to assist and educate Veterans in learningabout state and federal Veteran benefits. Topic areas include services, employment, healthcare,education, housing and personal services.
http://www.nc4vets.com/blog/resource-guideThis resource guide was produced by the North Carolina Division of Veterans Affairs in partnership with theGovernor’s Working Group on Veterans, Service Members, and Their Families. http://www.veteransfocus.org
Self-help materials can provide valuable education and support forVeterans who may be facing mental health challenges, their friends,and family members. There are a wide variety of self-help materialsavailable and it can sometimes be difficult to select the most useful.VA has assembled a list of reviewer-recommended materials thatmay be helpful in finding the right option for you. For help in findingthese materials, please click the “How to Use” tab.
Resources to Empower VeteransMental Health
The VA’s Specialized Mental Health Centers have launched a new website:
http://www.mentalhealth.va.gov/self_help.asp
Online Military Culture Training for Community Providers
It’s important that all who care for Veterans have a basic understanding of military culture. In the interest of thehighest quality, most compassionate health care for our Nation’s Veterans, the Departments of Veterans Affairsand Defense launched an online course available at no cost to all Veteran care providers.
Military Culture: Core Competencies for Healthcare Professionals
http://deploymentpsych.org/military-culture
This course stems from research, surveys and hundreds of hours of interviews with Service members andVeterans. It is designed as a comprehensive training in military culture for seasoned practitioners as well as forthose less familiar with military populations. The interactive course includes a self-assessment to help providersbetter understand the biases they may unknowingly have that may be impacting the care they are providing toVeterans and their families. It also includes a variety of vignettes and candid video testimonials to highlight themeaning of military cultural competence.
Click on New Users to register. You will then see the available courses listed:
http://www.ahecconnect.com/citizensoldier
This workshop series was developed by MIRECC faculty in collaboration with Citizen Soldier Support Program(CSSP) and North Carolina Area Health Education Center (NC AHEC). The web-based versions of the coursesare all free at:
Treating the Invisible Wounds of War
1 - Treating the Invisible Wounds of War (TTIWW)english & spanish editions
2 - TTIWW - A Primary Care Approach3 - TTIWW - Employee Assistance in the CivilianWorkforce4 - TTIWW - Issues of Women Returning from Combat
5 - TTIWW - Recognizing the Signs of mTBI duringRoutine Eye Examinations
6 - TTIWW - Understanding Military Family Issues7 - TTIWW - Taking a Military History: Four
Critical Questions
Provider Education
Vol 11 Issue 6 December 2015Briefings page 8
CBOC Mental Health RoundsSouthMIRECC
Central
Each CBOC MH Rounds presentation is now offered twice a month:
Wednesday January 13 from 9-10 am ET & Thursday January 14 from 12-1 pm ETDriving and Dementia
Remember to register in TMS in advance to attend and receive credit. If you require assistance contact EESProgram Manager - [email protected] or Education Tech - [email protected]
www.mirecc.va.gov/visn6
VISN 6 DirectorDaniel F. Hoffmann, FACHE
Director - Mental Health Service LineMiguel Lapuz, MBA, MD
Associate Director - EducationRobin A. Hurley, [email protected]
Associate Director - ClinicalR. Keith Shaw, [email protected]
Assistant Director - EducationKatherine H. Taber, [email protected]
Co-Associate Directors - Research
MIRECC Leadership MIRECC Fellowships
DirectorJohn Fairbank, PhD
Deputy DirectorMira Brancu, PhD
Christine Marx, [email protected]
Jean C. Beckham, [email protected]
Health ServicesPatrick Calhoun, PhD
NeurocognitionLarry A. Tupler, [email protected]
NeuroscienceScott D. Moore, MD, PhD
NeuroimagingRajendra A. Morey, [email protected]
Durham VAMC siteChristine Marx, MD
Special Fellowship forPsychology/Allied Health
Salisbury VAMC siteRobin Hurley, MD
Richmond VAMC siteTreven Pickett, PsyD
[email protected] McDonald, PhD
Salisbury VAMC siteKristin Humphrey, PhD
GeneticsJean C. Beckham, [email protected]
Interventions & MetabolomicsChristine Marx, MD
VISN Leadership
Durham VAMCStudy Coordinator
Richmond VAMCRobin Lumpkin
[email protected] ext 4251
Salisbury VAMCMary Peoples
[email protected] ext 2956
Research Sites & Contacts
Special Fellowship forPhysicians
Durham VAMC sitePatrick Calhoun, PhD
Vol 11 Issue 6 December 2015Briefings page 9
