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My thesis will begin to examine alcoholism and recovery through the lens of moral injury, especially in relationship to the use of spirituality language and the often-invoked correlation between spirituality and sobriety. Through a literature review and interviews with abstaining alcoholics, I will unpack some of the implications of considering alcoholism through the lens of moral injury and begin to frame and examine some of the questions inherent in that consideration. By so doing, I hope to offer a fresh look into those aspects of recovery that fall within the Religious Studies purview.

The aim of the current study is to understand the health trajectory of female veterans who participated in a VHA sponsored weight management program and explore possible barriers to sustained weight loss and improved metabolic functioning over time. Obesity is a major health concern for discharged service members and women veterans in particular are faced with an increasing prevalence of obesity at a younger age with obese ethnic minorities posing the greatest health risk over time. The current study measured body mass index (BMI), triglycerides, and total cholesterol in female participants enrolled in the MOVE! ® Weight Management Program for Veterans at the Miami VAHS from 2005-2008 (N = 170). The sample was derived from an archival data set and participants were predominantly non-Hispanic Black (NHB) (n = 93, 54.7%), with a mean age of 48.26 (SD = 11.77) and BMI of 34.97 (SD = 6.61) at program entry. Medical information was gathered as part of routine primary care and participants were not asked to provide additional information. Multilevel modeling was utilized to measure change in BMI, triglycerides, and total cholesterol across seven time points before and after MOVE! ® participation. For the piecewise model, results showed a positive linear growth pattern in BMI prior to program enrollment, SE = .12, p < .001, and a negative linear pattern post-intervention, SE = .08, p = .05. For the continuous models, significant differences in triglycerides were observed between ethnic groups at program entry, but overall triglycerides did not significantly change over time. A significant negative linear effect was found for total cholesterol, SE = 1.08, p < .001. Age was found to be a significant negative predictor of triglycerides, SE = .003, p = .008, and total cholesterol, SE = .27, p = .003. VA user status, small sample size, and other extraneous lifestyle factors not directly measured in the current study may explain the lack of significant differences in BMI found between ethnic groups relative to literature on weight loss outcomes. Additionally, BMI in women may underestimate their total fat, which for the present study may explain why larger improvements in metabolic functioning were not observed. Future designs may consider measuring waist circumference to understand the complex relationship between total fat distribution and markers for poor health and utilizing a tailored approach to weight management.

In this PhD thesis, the lives and experiences of a group of combat veterans who began surfing following their return from war are explored. Having encountered life changing traumatic events and experienced much suffering (with many becoming diagnosed with post-traumatic stress disorder), these veterans joined an ex-services charity called Surf Action where they were introduced to surfing alongside other veterans who shared their suffering. The purpose of this research is to explore the effects of surfing and, more broadly, of participation in the charity Surf Action in the veterans lives and on their well-being. It is the first in-depth qualitative investigation of surfing in the lives of combat veterans. Using a combination of life history interviews and participant observation, I collected and analysed stories from the veterans about their lived experiences. Through rigorously applying the innovative analytical approach of dialogical narrative analysis (Frank, 2010, 2012), also inspired by phenomenology, the effects of the veterans stories both on and for their lives and well-being are examined. The analysis first demonstrates that stories of surfing were focused on the veterans physical and sensory interactions with the ocean environment, and helped to cultivate the notion of embodied respite from suffering. It is then suggested that by telling and enacting a collective story, the veterans at Surf Action (the Combat Surfers ) created a therapeutic community through which they accessed mutual support, recreated positive military identities associated with camaraderie, and legitimised their struggles with PTSD. Next, the masculine performances which shaped the veterans actions and narratives around help-seeking and dealing with PTSD are highlighted. Furthermore, the analysis reveals the meanings associated with moving beyond the chaotic influence of trauma in the veterans lives and suggests ways of keeping well following trauma and PTSD. The thesis also incorporates an ethnographic creative non-fiction as a way of enhancing knowledge translation and facilitating wider impact and dissemination of the findings. Finally, the thesis concludes with empirical, theoretical, methodological, and practical implications of the research, with an emphasis throughout on what to the study adds to knowledge. The potential of surfing to contribute to veterans healthcare is discussed alongside recommendations for the charity Surf Action and future possibilities for expanding this research.

This research examines the manifold forms of support that shape and influence Post-9/11 Native American Student Veterans to enter, persist, and graduate from a mainstream institution of higher education. Moreover, it is a qualitative assessment that explores how Post-9/11 Native American Student Veterans navigate the collegiate environment and balance their military and indigenous identities within the context of higher education. Through the individual voices of five Post-9/11 Native American Student Veterans, the results of this study illustrate their decision-making processes, weighing of options, and reasons for sacrifice. Each individual had unique experiences, situations, and circumstances to consider before committing and transitioning into higher education. The confluences of situations and circumstances often determine the ability of Native American Student Veterans to engage, persist, and complete their academic endeavors; therefore, support systems are vital in helping them navigate and overcome obstacles. Respectfully, the experiences of Post-9/11 Native American Student Veterans have the power to influence future generations and to clarify their options when transitioning from a military environment to a university environment. Moreover, the findings from these experiences can inform mainstream universities and Student Veteran Centers to strategically respond and develop support systems specifically designed to recruit, retain, and graduate Post-9/11 Native American Student Veterans.

Introduction: High-stress situations, such as military deployments, may be a risk factor for hypertension. The relationship between the stress triggered by combat deployment and hypertension is unknown. Acute stress from combat conditions can cause a temporary rise in blood pressure, which decreases within hours or days. Cross-sectional studies have shown no association between hypertension and deployment to the 1991 Gulf War or to Vietnam. Self-reported hypertension often is used as an outcome in large population studies. Fair to substantial agreement has been observed between self-reported hypertension and various sources of administrative data, medical records, and blood pressure measurements. The goal of this dissertation was to determine whether recent deployment to Iraq and Afghanistan was associated with new-onset hypertension.Methods: Baseline Millennium Cohort Study questionnaires (July 2001 to June 2003) were completed by 77,047 individuals. Follow-up questionnaires (June 2004 to February 2006) were completed by 55,021 responders. The relationship between new-onset hypertension and history of a recent military deployment was assessed through multivariable logistic regression (N=37,075). Baseline data were analyzed cross-sectionally to assess factors associated with prevalent hypertension (N=70,100). Kappa statistics were used to compare self-reported hypertension with provider diagnosed hypertension and prescription antihypertensive medication dispensed (N=41,129).Results: The 3-year incidence of hypertension was 6.9%. After adjusting for demographic and lifestyle characteristics, deployers without combat exposure were less likely to develop new-onset hypertension compared to nondeployers (odds ratio [OR]=0.74; 95% confidence interval [CI]: 0.64, 0.85). There was no association between deployment with combat exposure and hypertension compared to nondeployers (OR=0.94; 95% CI: 0.82, 1.07). Among deployers reporting combat exposures, the risk for incident hypertension was 1.31 (95% CI: 1.07, 1.61) compared to deployers not reporting combat exposures. The prevalence of self-reported hypertension at baseline among Cohort members was 10.4%. There was moderate agreement between self-reported hypertension and provider-diagnosed hypertension, as well as antihypertensive medications dispensed.Conclusion: Military service members are adversely affected by hypertension. Although deployers had lower incidence of hypertension compared to nondeployers, individuals reporting combat exposures were more likely to report new-onset hypertension. Self-reported hypertension had moderate reliability compared with provider-diagnosed hypertension and dispensed antihypertensive medication.

"A field work placement in the social service department of the Veterans Administration Hospital, Augusta, Georgia, provided motivation and a source of data for this study. In reviewing the literature and conferring with social service administrators, it was pointed out that a basic criterion was needed in order to determine the positive effects of social service activities with neuropsychiatric tubercular patients. As the complexity of multiple interacting factors made a study of direct effect impossible, it was decided to compare social service activities and other factors to rapid and non-rapid movement of patients from Ward 14. This determined the association of other factors, in addition to social service activities, associated with movement and provided some basis on which further study of the effects of social service could be undertaken. An attempt was also made to show the association of specific characteristics of social service contacts with movement"--Introduction. / Typescript. / "June, 1959." / "Submitted to the Graduate Council of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Howard Borsuk, Professor Directing Study. / Includes bibliographical references.

"The purpose of the study was to ascertain whether there were any marked differences when the study sample of fifty-seven patients (dichotomized by level of education attained) were distributed by each of the possible recommendations made by the Committee. The data for the study were collected from the hospital records of fifty-seven male patients to determine if there were marked differences on eleven social and medical descriptive items between twenty-four patients who had no high school education, and thirty-three patients who completed high school. Knowledge of marked differences not due to chance in the various social and medical descriptive items studied might be of help to the Committee in arriving at recommendations for patient care. The frequency distribution on sixteen possible Committee recommendations for patient care between the two sub-samples are given; to what extent the recommendations were followed also is indicated. If the data revealed differentiating items between the patients who completed high school and those who did not complete high school the Committee might show whether it would be feasible to make more recommendations for the patient population"--Introduction. / Typescript. / "June, 1960." / "Submitted to the Graduate School of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: John T. Greene, Professor Directing Study. / Includes bibliographical references.

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Background: The inclusion of women in the armed Forces is becoming increasingly commonplace, with figures currently standing at 10.2% of the regular Forces in the United Kingdom (UK). This is set to rise with the introduction of the new Ground Close Combat (GCC) ruling which came in earlier this year (2017), allowing women to serve on the frontline with their male colleagues. However, alongside these changes, women already face stressors and exposure to combat in the Forces that potentially contribute to difficult transitions back into everyday life when leaving the military environment. The aim of this study was therefore to engage with and explore the experiences of female veterans psychological health and wellbeing as they transition from the Forces into civilian life, understanding the different processes they encounter as they transition. Methodology: Six female veterans who fit the inclusion criteria were recruited for the study. In this qualitative study, semi-structured, one-to-one, in-depth interviews were conducted and analysed in accordance with Charmaz's (2006) Constructivist Grounded Theory (CGT) guidelines. This iterative and inductive analytical process was utilised to construct an understanding of the participant's experiences and understandings of their transition. Findings: Concurrent with the CGT approach, nine theoretical categories developed from the analysis of the interviews, including role reversal, sexism and loss. These contributed to the development of a transition model, representing an interaction between the military environment, no mans land and the civilian environment. Findings indicate that experiences of transitioning faced by female veterans are complex, and involve gender-related issues. The findings also suggest that problems with mental health such as Post-Traumatic Stress Disorder are common, and are heightened by additional stressors specific to women's experience in the military and civilian environments. Discussion and Conclusion: These findings suggest that female veterans health and psychological wellbeing experiences in the military are parallel to those they experience in civilian life. Consistent with previous literature, the female veterans interviewed appear to have experienced their transitions differently to male counterparts, with additional stressors present throughout their transitions. These stressors contribute to the uncertainty of identity, stigma and a loss of military ways when transitioning back into a civilian society. Consequently, more services that are tailored to female military veterans, are proposed, in order to support the increasing number of female veterans that will present in the future. This has implications for therapeutic practice in counselling psychology, whereby a deeper understanding of the difficulties and challenges experienced by female veterans during transition into civilian life can inform therapeutic interventions and signposting to specific services tailored their needs.