Clinical Research Directory

Goal-oriented Telehealth Rehabilitation of Executive Functioning for Veterans With Chronic TBI

Provision of interventions that address cognitive and emotional problems faced by Veterans with history of TBI pursuing community reintegration is an important concern for VA. Using telerehabilitation, the current project will help determine whether goal-directed training of attentional control functions via personally relevant activities will improve community integration for Veterans with history of TBI and cognitive difficulties. Findings may guide rehabilitation training towards providing services to maximize success in attaining complex functional goals in which Veterans can engage in skill strengthening 'where they are' (any location).

OpRESTORE AI-Patient Navigator Study

OpRESTORE is a national NHS service that supports UK veterans with complex physical health problems linked to their military service. Veterans referred to OpRESTORE often need care from many different specialists, including surgeons, pain teams, rehabilitation, and mental health services. Currently, decisions about which service is most appropriate are made by a multidisciplinary team (MDT) of clinicians. While effective, this process can be slow, resource-intensive, and sometimes difficult for patients to navigate. This study will develop and test a new digital "navigator" tool that uses artificial intelligence (AI) to support these referral decisions. The aim is to see whether the tool can safely and accurately match veterans to the right care pathway, while reducing delays and improving patient experience. The project will be carried out in several stages: * Reviewing past OpRESTORE records to design the AI model. * Testing the tool alongside the MDT ("shadow testing") to check whether its recommendations match the clinical decisions. * Running a case-control study to compare outcomes between patients referred using AI support and those referred by the MDT alone. * Creating and testing a structured self-referral form to make it easier for veterans to access care directly. The main outcome will be whether the AI tool makes the same referral decisions as the MDT. Other outcomes include patient satisfaction, quality of life, time taken to reach the right service, and overall costs. The study will recruit veterans aged 18 or older who are referred to OpRESTORE with a physical health need. It will run for two years. If successful, this approach could free up clinician time, shorten waits for treatment, and improve veterans' health and wellbeing, while laying the foundations for wider use of AI-supported navigation across the NHS.

Using Integrated Care and Wearable Technology to Evaluate Outcomes of the Shields & Stripes Program for Veterans and First Responders

This study aims to evaluate outcomes from the Shields \& Stripes (S\&S) program - a 12-week, multidisciplinary wellness intervention designed for veterans and first responders. The S\&S program integrates occupational therapy (OT), mental health (MH), physical therapy (PT), and registered dietitian (RD) services to promote recovery, resilience, and performance in individuals who have experienced cumulative stress, trauma exposure, or occupational burnout. This research will use a retrospective mixed-methods observational design to analyze data collected from previous S\&S participants who consent to research use of their de-identified information. No intervention or treatment changes will occur as part of this study. Quantitative data will include biometric information (e.g., sleep, activity, and heart rate variability via Oura Ring), standardized self-report measures (GAD-7, PHQ-9, PCL-5, RAND-36, PSQI, ISI), satisfaction surveys, and laboratory nutrition panels. Qualitative data will include semi-structured interviews with consenting participants and S\&S providers following program completion. The purpose of the study is to identify patterns of improvement in physical, psychological, and occupational functioning and to explore how integrated, team-based care supports holistic recovery. Findings may inform the development of future evidence-based wellness programs for military and first-responder populations. Participation involves minimal risk, and all data will be de-identified before analysis.

The Relationship Between Training Dynamics and General Health Status in Veteran Football Players

The goal of this observational study is to learn how training habits and general health status are related to injury risk in veteran football players (men over 35 years old who play recreational football). The main questions it aims to answer are: Do specific training patterns (such as frequency, intensity, and duration) increase or lower the risk of injury? How does general health status (including factors like sleep, nutrition, and existing health conditions) affect injury risk? Participants will: Complete questionnaires about their training habits, lifestyle, and general health Report any injuries they experience during the football season Attend periodic health assessments

Psilocybin to Treat Depression in Spinal Cord Injury

The main goal of this study is to determine if psilocybin is safe for use in people with SCI. The study will measure how people with SCI respond to three psilocybin doses: low (5mg), medium (10mg), and high (25mg). The main question the study aims to answer is: does psilocybin increase the number and severity of adverse (bad) events reported by people with SCI? These may include pain, muscle spasms, symptoms of depression, and symptoms of low or high blood pressure. The investigators will also measure how well people with SCI tolerate the psychedelic experience, and compare responses between the low (5mg), medium (10mg), and high (25mg) doses. Participants will: * Agree to be enrolled in the study for up to 13 months. * Agree to complete the seven (7) visits that are included in the psilocybin-assisted therapy. * Agree to complete follow-up study visits, including in-person visits to the James J Peters VA Medical Center, located in the Bronx, New York and remote visits. * Agree to keep a log of how they are feeling and any change in the frequency or severity of adverse events.

K08 VR Fear Conditioning

The goal of this clinical trial is to learn how people respond to fear-related experiences in a virtual reality (VR) environment. The study will also look at how brain activity and body responses are connected to learning and memory of fear. To do so, we recruit individuals who are already implanted with a Responsive Neurostimulator (RNS) device for the treatment of epilepsy. This research may help improve our understanding of anxiety disorders and how to better treat them in the future. The main questions it aims to answer are: 1) How do people learn to associate certain cues in VR with feelings of fear or safety? 2) What brain and body responses happen during fear learning? Participants will: 1) Wear a virtual reality headset and experience different environments and sounds, 2) Have their brain activity, heart rate, and sweating measured, and 3) Receive safe, mild electrical pulses through the RNS device during the study to help study fear learning. Participants will attend one or more study sessions, each lasting about 3-4 hours.

NightWare and Cardiovascular Health in Veterans With PTSD

The purpose of this study is to learn more about the effectiveness of a prescription wrist-wearable device called NightWare (NW) on improving sleep in Veterans with nightmares related to posttraumatic stress disorder (PTSD). The investigators also want to learn whether it improves cardiovascular health among this population.