Credit Newswise - An innovative Veteran's Affair's home health care model provides patients and their caregivers with higher health-related quality of life and satisfaction with care than does private-sector home care, according to a study jointly conducted by researchers from the UIC, the VA and Northwestern University. The Journal of the American Medical Association will report the findings as the lead story. Susan Hughes, UIC School of Public Health professor and codirector of the Center for Research on Health and Aging in UIC's Health Research and Policy Centers, is the lead author. An early single-site study of the VA primary-care home care model, conducted by Hughes and colleagues at the Hines VA Hospital, found significant benefits and led the VA to fund this 16-site randomized trial of nearly 2,000 patients and 2,000 caregivers, most of whom were patients' spouses. The VA home-based primary care model is unique in that it enables physicians to designate a portion of their time as salaried staff to the home care program. In this model, there is close cooperation among nurses, social workers and other team members, and the physician is free to work with the patient directly or with the team on behalf of the patient. Medicare home care physicians, in contrast, are constrained by significant paperwork requirements and limited reimbursement for the management of home care patients, Hughes said. The study targeted hospitalized patients with severe disabilities or terminal illnesses and patients who were homebound with a primary diagnosis of congestive heart failure or chronic obstructive pulmonary disease. It examined the impact of the VA home care model on functional status, patient and caregiver health-related quality of life and satisfaction with care, caregiver burden, hospital readmissions and health care costs. Testing was conducted at the first, sixth and 12th months. The control group received customary VA and private sector care, with about half opting for Medicare home care services. As expected, the researchers found no difference in patient functional status. Terminally ill treatment patients scored significantly higher than control group patients on six of eight health-related quality of life measures, including emotional role function, social function, bodily pain, mental health, vitality and general health. The researchers found no health-related quality of life differences among non-terminally ill patients other than a significant decrease in bodily pain in the control group. There was no difference in satisfaction with care among terminal patients over 12 months, but nonterminal patients reported significant increases in satisfaction while the control group's satisfaction scores remained the same or declined slightly. "When the physician and home care team jointly manage patient care, you can get much better, consistent quality-of-life and satisfaction. I think it would be great if the VA model were replicated in a managed-care setting," Hughes said. Treatment group caregivers of both terminally ill and non-terminally ill patients also scored significantly higher than the control group in all but two of eight quality of life measures and showed consistent and significant gains in satisfaction with patient care. Treatment group caregivers of nonterminal patients reported a significant decline in burden compared to the control group. This finding is particularly relevant in light of a recent JAMA article showing that spousal caregivers who experience stress are at 60 percent higher risk of mortality over a four-year period than caregivers who do not experience stress, Hughes said. The VA home care study is among the first of its kind to consider the burden on family members and their emotional well-being. Researchers found decreases in hospital readmissions among the treatment group at six months, but not at 12 months. The cost of care was 12.1 percent higher in the treatment group at 12 months. Though half of the sites experienced higher costs, the remaining half either saved money or broke even, Hughes said. "We still need to do more to examine the impact on costs. A secondary analysis of the use and cost data is needed to determine how and why some sites improved outcomes at lower costs."
WASHINGTON — Flanked by veterans and their obedient dogs, two Republican lawmakers made the case that for those who have served their country, “a man’s best friend can also be a man’s best counselor.” Rep. Ron DeSantis (R-Fla.) on Wednesday introduced the Puppies Assisting Wounded Servicemembers (PAWS) Act — a new veteran legislation that creates a five-year pilot program which pairs veterans with the most severe levels of post-traumatic stress disorder or a traumatic brain injury with a service dog. According to the bill’s text, veterans would have to complete an evidence-based treatment and “remain significantly symptomatic by clinical standards” in order to qualify for the program. Rep. Ron DeSantis (R-Fla.) introduced on Wednesday the PAWS Act, legislation which creates a pilot program to give veterans with PTSD service dogs. (Image via Twitter @RepDeSantis) “I think we have a chance to save lives,” DeSantis, a Naval Reserve Officer, told TheBlaze Wednesday. “When you look at some of these veterans who are suffering from post-traumatic stress, the counseling, the drugs, it doesn’t work for everybody.” “We must make sure that all of our returning servicemembers are honored and taken care of, no matter the wounds they bear,” he said. The lawmaker pointed to a group of veterans who still lingered after a morning press conference in front of the U.S. Capitol Building, service dogs by their side, and said the service dogs have helped them lead productive lives and alleviate their PTSD symptoms. “A lot of them question if they would even be here if it weren’t for their service dogs,” he said, adding that the way PTSD is handled for post-9/11 veterans is different than how “these invisible wounds” were treated with combat veterans in past wars. DeSantis’ explanation of the gravity of just what the legislation calls for echoed what Rep. Keith Rothfus (R-Pa.) told reporters during a press conference just moments before. “Sometimes man’s best friend can be man’s best counselor,” Rothfus said. And for Cole Lyle, that sentiment is true. The PAWS Act is the project that Lyle, who served overseas in the Marine Corps for six years, has dedicated much of his life to over the past several months as the Texas resident has traveled to Washington, D.C. numerous times and met with countless elected officials. With Kaya, his own service dog, by his side, Lyle applauded the legislation and told reporters that without her, who he obtained with the help of his family through a third-party source, he would not have been standing there Wednesday — just mere steps from the U.S. Capitol. “I do believe that this [program] will help reduce the number of veteran suicides which is still a horrible, horrible thing that veterans deal with every day — the loss of their own brothers,” Lyle said. “It’s something I continue to struggle with, but with Kaya, she really helps me in transitional periods of my life, difficult moments in my life, and without her I don’t think I would be where I am today, so I have a personal interest in this policy solution and making it happen.” Image via Instagram @kayalyle In an interview with TheBlaze in November, before the legislation had even been created, Lyle had said, “One thing that a dog does that a pill doesn’t do is give you a sense of purpose again.” And it’s no question that Lyle’s purpose, his dedication to the creation of the PAWS Act, is prodigious, especially for veterans like himself. “You’ve got a guy like Cole Lyle; he’s out here beating the streets here and the halls of Congress lobbying people,” DeSantis said. “When he goes in there and tells people his story, it’s very difficult for members to say they don’t support it because it is a common sense reform.” That reform was also praised by Rory Diamond Wednesday, the executive director of the veterans organization K9s For Warriors which is the largest provider of service dogs to veterans with PTSD. “We work with veterans every single day,” Diamond said. “Almost all veterans that we serve on our campus have an incredibly high chance of committing suicide.” “This is absolutely critical to stopping [suicide],” Diamond said of the PAWS Act. The legislation also calls for the Government Accountability Office to track the program as well as render a study on its effectiveness. DeSantis noted that studies have already been commissioned that track the effectiveness of service dogs with veterans with PTSD, and he said that he believes the results will be “relatively positive.” In order to fund the program and all that accompanies it, the legislation calls for $10 million to be appropriated from 2017 to 2022, an amount that would be otherwise be appropriated for the Department of Veterans Affairs Office of Human Resources and Administration. “It makes sense; we’re not spending any more money; we’re just redirecting money out of the bureaucracy to the veterans,” DeSantis explained, adding that he hopes to see the bill pushed through Congress “quickly.” And as DeSantis said Wednesday, just before he was to file the legislation, “the concept is simple” — it will save lives. Credit Kaitlyn Schallhorn at the Blaze
GWEN IFILL: Now: offering higher education to those who have served. Many Americans join the military right out of high school. And once they return, some colleges are now giving them a chance to learn at the country’s top-tier schools. Special correspondent Jackie Judd reports for our weekly education series, Making the Grade. JACKIE JUDD: This was the classroom that taught Nicole Leadenham the lessons of war during deployments in Iraq and Afghanistan. NICOLE LEADENHAM, Army Veteran: I left for basic training 10 hours after I graduated high school. So that was going to be what I was going to do. JACKIE JUDD: Today, this is the 34-year old’s classroom, Vassar College in New York’s Hudson Valley. NICOLE LEADENHAM: I think that this is the time that I was meant to be here, at this stage in my life. I can really take advantage of the academics and, you know, learning. JACKIE JUDD: Leadenham, a junior and one of 30 post-9/11 vets at Vassar, is here because president Catharine Hill wanted to somehow close the education gap between young people who go off to elite campuses like this one and those who enlist and go off to fight the wars. CATHARINE BOND HILL, President, Vassar College: More of the young men and women who are enlisting are coming from lower socioeconomic backgrounds. And it just seems to me that part of the reward or the return for doing that is that they get access to education when they come back. JACKIE JUDD: Did you feel that this grateful nation notion, was it words and not action? CATHARINE BOND HILL: I think the evidence absolutely suggested that it was words and not action. JACKIE JUDD: The Veterans Administration says more than one million vets are using G.I. benefits. Most attend public or for-profit schools. The number at top-tier colleges and universities is so small, it is not even known. A few years back, Vassar invested in a campaign to attract veterans to apply. None did, even though their education would have been fully paid for. So, the college turned to the Posse Foundation, which is expert at reaching nontraditional students. For 25 years, it’s been sending groups, or posses, of students to elite colleges, students with academic and leadership potential who don’t fit the mold. Founder Debbie Bial thought the same model would work for veterans. DEBBIE BIAL, The Posse Foundation: Posse is about helping the top colleges and universities think about how to build a diverse student body, how to get as rich a dialogue going on campus as they possibly can, how to create community and build bridges across the various communities on campus. It made sense to us to include a piece of our population that served the country. MICHAEL SMITH, Posse Student, Wesleyan University: I think it’s going to allow for the trajectory of my life to be more vertical, by virtue of being here. JACKIE JUDD: Posse veteran Michael Smith, who grew up on Chicago’s South Side, is a sophomore at Wesleyan University in Middletown, Connecticut. That school joined the program two years ago. MICHAEL SMITH: By virtue of the educational experience I’m getting, by virtue of the skills I’m developing, and by virtue of the resources that are — that I just wouldn’t have had access to. JACKIE JUDD: Before arriving on campus, the veterans go through a kind of boot camp in New York City. It is four weeks of preparing for rigorous academics, learning how to craft a college term paper, and team-building, so the veterans know that, once they get here, they have a circle of support if they need it. But there are still hurdles. Leadenham needed to brush up on some old, forgotten skills. NICOLE LEADENHAM: I had problems with knowing how to study. It’s a very tangible skill that I didn’t have anymore, and I couldn’t even remember how I had done it before. So, I had gone to my professors’ office hours, stuff like that, being like, how can I better absorb the material? JACKIE JUDD: Another Vassar vet, Eduardo De La Torre, lives off campus with his young family. As the leader of a first-responder medical unit in Iraq, he frequently faced life-and-death situations. With that past experience and his current family obligations, he admits that mixing with other younger students can be awkward. EDUARDO DE LA TORRE, Posse Student, Vassar College: They’re like, yes, we’re going to do a study group today. I will text you later. And the next thing you know, you’re getting a text at midnight: “Hey, we’re going to go meet up at the retreat to go study for like an hour over this.” So, it’s been difficult building relationships with the students. JACKIE JUDD: Wesleyan sophomore Bryan Stascavage found himself in the middle of a full-throated culture clash on the very liberal campus. Stascavage, an Iraq War veteran and a conservative, was vilified after writing a column for the college newspaper critical of Black Lives Matter. BRYAN STASCAVAGE, Posse Student, Wesleyan University: The veterans that live here at the house with me looked at me wide-eyed like, what did you do, what did you write? And I knew that the articles that I were writing were not the prevailing opinion on campus. And I knew that it was only a matter of time when, I like to say that I connect with a beehive. MICHAEL ROTH, President, Wesleyan University: Unlike a fighting unit, where you really need cohesion and you all have to point in the same direction, at a university, you can afford dissent and controversy, as long as you learn to listen while that’s going on. JACKIE JUDD: Though difficult in the moment, Wesleyan president Michael Roth says the episode ultimately was good for the community. MICHAEL ROTH: That’s what you want, because, if you’re learning to listen, you’re learning to learn. JACKIE JUDD: It became a teachable moment. MICHAEL ROTH: It became a very teachable moment. BRYAN STASCAVAGE: I don’t want to be in an environment where everybody thinks the same as me, because you just don’t learn that way. EDUARDO DE LA TORRE: I think the military is stereotypically seen as something very conservative, and being in a very liberal campus, you can feel shut off, and you can feel like my voice isn’t going to be accepted here, and it’s not going to be heard. JACKIE JUDD: Still, many of the younger, more traditional students clearly appreciate being exposed to the experience and world view of their ex-military classmates. MAGGIE KENNEDY, Studen, Vassar College: I think it’s great because it gives a lot of different perspectives, especially at a liberal school, where a lot of people maybe not pro-military, per se. YANIV YAFFE, Student, Vassar College: It’s easy to in a class criticize American foreign policy, for example. You know, we’re so distant from things like Iraq and Afghanistan, but when you have a soldier who has been there, it really changes the conversation. EDUARDO DE LA TORRE: A student came up to me and they said, “I really appreciate you talking about that, because your service reminded me of my grandfather, and he was a World War II vet, and it was really hard for him to talk about anything. And it just made me really appreciate your service and what you did for me.” That’s a meaningful gesture. JACKIE JUDD: A thousand veterans applied to Posse for the 30 slots in the next freshman class, which, along with Wesleyan and Vassar, will include Dartmouth College in New Hampshire. Posse’s Debbie Bial expects that, in five years, about a dozen private liberal arts colleges will be a part of the program, giving other vets opportunities they never would have imagined, while also bringing their hard-won perspective to campuses previously shut off to military culture. The veterans also say the program has something to teach the entire country. NICOLE LEADENHAM: We’re capable of more than what we have been pigeonholed into. So, I think it’s important to know that we’re not just these broken people coming back, incapable of succeeding within society. JACKIE JUDD: A Vassar education has given Leadenham the confidence to plan for a future that includes helping other veterans find their own way back from the war. Credit > For the “PBS NewsHour,” this is Jackie Judd in Poughkeepsie, New York.
Credit Newswise A new study by a Brigham Young University professor has found that combat veterans' first marriages are 62 percent more likely to end in separation or divorce than other men's, a fact he hopes will be considered by defense policy-makers. "We found that combat experience is an important risk factor for divorce or separation," said Sven Wilson, an assistant professor of political science, whose study is reported in the new issue of the academic journal "Armed Forces & Society." "Traumatic experiences like combat seem to have a persistent impact on the ability of people to form and maintain successful relationships." Wilson and his fellow researchers compared divorce and separation rates between veterans who had seen combat and those who had not. The study analyzed the results of men's marriages throughout most of the past century, including before, during and after World War II, the Korean War and the Vietnam War. Wilson called for more research and for government officials to take a closer look at the total effect war has on the families of veterans. "The impact of war and military service on families of veterans is relatively understudied. A portion of these costs fall not just upon the men and women who serve, but upon those who stay home," Wilson said. "Do members of the military and their spouses need special counseling? Does the military need to more closely monitor what's going on in families? What kinds of support do veterans and their spouses need after their service ends? These are some issues that need to be added to the equation. We just don't know that much about them." Wilson used information from the National Survey of Families and Households, a nationwide study of more than 13,000 individuals conducted in the early 1990s. Using a statistical method called duration analysis, Wilson and his team examined the relationship between military service and men's first marriages, controlling for year and age at marriage, religion, socioeconomic status, education and other social variables. Surprisingly, marital dissolution rates are highest for Korean War veterans, not for Vietnam veterans as is commonly thought. The findings indicate that Vietnam veterans were 28 percent more likely to divorce than non-veterans from the same time period, but Korean War vets were 45 percent more likely to divorce over the subsequent 10 years than were non-veterans in their era. "There is a notion that Korea was much like World War II, but that Vietnam really messed people up," Wilson said. "We find quite the opposite. It's true that Vietnam vets were getting divorced at high rates, but so was everyone else at the time. We suspect that people often ignore general social trends when thinking about the effects of the Vietnam War." Veterans who married following the Korean and Vietnam Wars had significantly higher rates of marital dissolution when compared to non-veterans and World War II veterans. "After controlling for things like combat, age and religion, the effect of serving in Korea was more than twice as high as it was in World War II. There was a real sea change between World War II and Korea," Wilson said. Wilson says the results need to be interpreted in light of overall trends in marriage stability. "Starting in the '60s and continuing through the early '80s there was an unraveling of marriage and the social fabric in general," Wilson said. "For veterans it looks like this started much earlier than we would have anticipated."
Credit Newswise — Military veterans who report having common financial problems, such as bouncing a check or going over their credit limit, are four times more likely to become homeless in the next year than veterans without such problems. Furthermore, money mismanagement by itself made a significant contribution to predicting higher odds of subsequent homelessness in veteran populations above and beyond other variables, according the study by the American Journal of Public Health. “On the one hand, it's data showing what seems intuitive — that if you don't manage your money well, you can become homeless. On the other hand, this link has not been demonstrated before in research to our knowledge — for veterans or non-veterans,” said Eric Elbogen, PhD, corresponding author of the study and associate professor of psychiatry in the University of North Carolina School of Medicine and psychologist at the Durham Veterans Affairs Medical Center. Elbogen and researchers from UNC, the Durham Veterans Affairs (VA) Medical Center and Duke University came to those conclusions after analyzing data from a random sample of more than 1,000 Iraq and Afghanistan War era veterans who responded to two waves of the National Post-Deployment Adjustment Survey between 2009-2011. Thirty percent of veterans in the survey reported that in the past year, they had gone over their credit limit, bounced or forged a check, had been reported to a collection agency, or had fallen victim to a money scam. A statistical analysis of the survey data showed that money mismanagement, along with arrest history, mental health diagnosis, and income, were associated with homelessness in the next year. Such findings have implications for reducing homelessness. “Case managers in VA homelessness programs often provide money management assistance to clients,” Elbogen said, “This study suggests that veterans in these programs can benefit not only from obtaining housing, but also from learning financial literacy skills to maintain housing and avoid future homelessness.”
Credit Newswise — According to preliminary research results from the Department of Veterans Affairs, approximately 15 percent of recently returned female veterans utilizing the VA health care system report experiencing sexual trauma during military service. The cross-sectional study, presented at the American Public Health Association's 136th Annual Meeting & Exposition in San Diego, examined health care screening data of over 100,000 veterans of Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) who utilized medical care at any Veterans Health Administration facility during a six-year period. Along with the more than one in seven women, 0.7 percent of males also reported having experienced military sexual trauma (MST). Both males and females reporting MST were more likely to be diagnosed with a mental health condition than patients who did not report MST. "These data highlight the importance of the VA's universal screening policy," said Joanne Pavao, MPH, a Department of Veterans Affairs researcher on the study, "as well as early intervention among veterans who have experienced sexual trauma, to prevent long-term consequences." VHA policy requires that all male and female veterans are screened for experiences of military sexual trauma and that free treatment for MST-related conditions is provided at all VA health care facilities. Session 4365.0 - Burden of mental illness associated with military sexual trauma among veterans deployed to Iraq and Afghanistan
Credit Newswise — Veterans of all ages are involved in the troupe. Nate Stevenson Veterans work with theater professionals to produce Shakespeare's plays, giving them a chance to work through their own concerns as they rehearse and put on the production. Carissa DiPietro puts Shakespeare’s thoughts into her own words, but the meaning is similar: “I felt like I was surrounded by people who understood me and some of the things I’ve been through.” DiPietro is one of a group of military veterans who are using Shakespeare to work through their own challenges, under the guidance of two University of Wisconsin (UWM) theater professors. Their troupe, Feast of Crispian will be performing “Julius Caesar,” the weekend of Oct. 30-Nov. 1 in Milwaukee. Bill Watson, associate professor of theater, Nancy Smith-Watson, an actor and somatic body therapist, and Jim Tasse, senior lecturer in theater, founded the group as a way of helping veterans deal with depression, post-traumatic stress, addiction and reintegration into society. The name comes from the speech in Shakespeare’s “Henry V,” in which the king reminds his soldiers of their lasting bonds. Watson and Tasse, a veteran himself, volunteered their services to the Clement J. Zablocki Veterans Affairs Medical Center (VA), using rehearsal techniques developed and tested three decades ago by Shakespeare and Company in Massachusetts. The Watsons and Tasse, though, added their own unique approach to the use of Shakespeare’s texts -- a therapeutic intervention. They held their first workshop nearly three years ago, and have worked with more than 250 veterans since then, doing weekend theater boot camps and small presentations for family and friends. The current production of “Julius Ceasar” is the group’s first performance for the general public. “We wanted to try out the idea…to see if performing Shakespeare had any benefits, and we found that indeed it was having great benefit,” Tasse said. The statistics on challenges veterans face are eye opening: Each day, 22 veterans commit suicide and one-quarter of veterans end up homeless, said Watson. The Shakespeare approach works on a number of different levels. The veterans, who come from all branches of the service and range in age from early 20s to seniors, build a community of trust. “In acting, as in the military, everybody is important to the production,” Tasse said. “Everybody has to do their job. They are a brotherhood and sisterhood.” On another level, acting gives the veterans a chance to explore their own feelings through another character. “It’s an opportunity to tell our stories, safeguarded by the script,” said Johny Sherwood, a senior UWM theater major and veteran of Afghanistan. He volunteered to take part in the program after hearing about it while he was at the VA for non-combat related surgery. “You can go to the dark places within, but your own secrets are secure.” The very words of Shakespeare give the veterans a chance to contemplate their own issues. Many of the plays and scenes used in workshops look at conflict and violence. Jan Masalewicz, a Vietnam veteran who found Shakespeare boring in high school, has developed a new appreciation of the plays. “Things he wrote about in his plays are still true today… war and betrayal and love … all that stuff.”The veterans and the professionals who work with them spend time exploring the themes of the plays, talking about how they relate to their lives, sharing their own emotions when they feel comfortable doing that, and learning to express some of their feelings through acting. The professionals work with the veterans, explaining the Shakespearean language and going on stage with them to give them the lines so they can focus on conveying the characters’ emotions. While not everyone in the group suffers from trauma and stress, all find a level of comfort in working together with a group of fellow veterans on a challenging project. Chris Nickrant, who served in the Air Force from 1970-74, has been with the group through almost every workshop. “It’s definitely expanding my horizons. I’m learning to reach out to other people.” The current play has also inspired him to read more about Shakespeare, Julius Caesar, Brutus and the assassination, he added. “You can go through counseling for years and years and not really reach into the emotional aspect until you do something like this,” said DiPietro. “I’m not really a crier, but I’ve cried in this group. That’s how safe I feel. It’s absolutely incredible.” “With this play, I have a purpose. Something I look forward to. Something to be excited about… I haven’t felt that way in a long time.”
Credit Newswise — One in four Gulf War veterans suffers from Gulf War Illness (GWI). The condition is characterized by unexplainable chronic fatigue, muscle pain and cognitive dysfunction and may be associated with exposure to chemicals, many identified as genotoxins, during deployment. Previous studies suggest that the symptoms of GWI are due to dysfunction of the mitochondria, the site in cells where molecules that power the body’s processes are produced. Not producing enough energy slows down the body and leaves the individual feeling tired. New preliminary research to be presented at Physiological Bionergetics: From Bench to Bedside shows for the first time direct evidence of greater mitochondrial damage in Gulf War veterans. The mitochondrion has its own DNA, separate from the cell’s, that encodes the proteins needed to produce the molecules that power the body’s processes. Damage to the mitochondrial DNA (mtDNA) directly affects the mitochondria’s ability to function and produce energy. Increases in the amount of mtDNA have been associated with disease. In this study, researchers measured the mtDNA amount and degree of mtDNA damage in blood cells from blood samples from veterans with GWI. Compared with healthy non-deployed controls, Gulf War veterans had more mtDNA content and greater mtDNA damage. According to the researchers, these findings further support that mitochondrial dysfunction may be involved in GWI. “Future studies are necessary to confirm these findings and determine their association with mitochondrial function. Work in this area may guide new diagnostic testing and treatments for veterans suffering from GWI,” the researchers wrote.
* Despite having access to health care, male veterans report poorer health than men in active duty, men in the National Guard and Reserves, and civilian men.* Men in the National Guard and Reserves were less likely to have health insurance than civilians, veterans or active duty servicemen.* Veterans and active duty servicemen report higher rates of smoking, tobacco use and drinking to excess than civilian men. Credit Newswise — Even with access to health care, male military veterans are in poorer health than men in active military duty, men in the National Guard and Reserves, and civilian men, finds a new study in the American Journal of Preventive Medicine. The study concluded that organizations that serve veterans should increase efforts at preventing poor health behaviors and linking them to health care services. The findings are from a 2010 survey of 53,000 veterans, 3,700 Guard and Reserve members, 2,000 active duty servicemen and 110,000 civilians. The survey included questions about their health and health behaviors, and their access to health care. A similar study of women veterans, National Guard/Reserve members, active servicewomen and civilians was published earlier this year by the same research team. "We think our research substantiates claims that veterans bear a disproportionate disease burden," said Katherine D. Hoerster, Ph.D., MPH, a research psychologist at the VA Puget Sound Health Care System in Seattle. Survey results found that veterans were more likely than active duty men to report diabetes. Veterans were more likely to report current smoking and heavy alcohol consumption than men in the National Guard and Reserves and civilian men and a lack of exercise compared to active duty and National Guard and Reserve. National Guard and Reserve men had higher obesity, diabetes and cardiovascular disease (versus active duty and veteran men, active duty men, and civilian men, respectively). Active duty men were more likely to report current smoking and heavy alcohol consumption than civilians and National Guard and Reserves, and reported more smokeless tobacco use than civilians. While the Department of Veterans Affairs (VA) addresses these common health concerns, Hoerster noted that only 37 percent of eligible veterans receive care through the VA system of hospitals. In addition, National Guard and Reserve servicemen were found to be the least likely of the groups to have access to health care. The researchers advised that other health care providers need to be aware of the prevalence of these health issues facing Guard and Reserve servicemen and veterans. The finding that National Guard and Reserve members have poorer access to care should be addressed, Hoerster added. "This is an important military sub-population to target." One factor may be that members of the National Guard and Reserves are not linked up to services provided by the VA as effectively as active duty service members are when they leave the military, she noted. The greater prevalence of heart problems and diabetes reported by these servicemen makes poor access to care even more problematic, she said. Increased rates of tobacco and alcohol use reported by active duty servicemen can lead to greater health problems for this group in the future, Hoerster said. "Addressing tobacco and alcohol use should also be a top priority." Other research has suggested that veterans have a higher disease burden because of their military service, said Joy Ilem, deputy national legislative director for Disabled American Veterans, an organization that serves veterans and provides assistance in learning about and applying for benefits. However, it is surprising that this study found that veterans have poorer health outcomes and poorer health behavior than other groups given the emphasis that the VA puts on prevention of disease and promotion of a healthy lifestyle, Ilem observed. "Not all vets have a connection to the VA system, but they may need one in the future," she added. Veterans who have health issues directly related to their service are more likely to use VA facilities and are more likely to be sicker than the overall population of veterans, Ilem added.
Credit Newswise — An estimated 15-20 percent of U.S. troops returning from Iraq and Afghanistan suffer from some form of traumatic brain injury (TBI) sustained during their deployment, with most injuries caused by blast waves from exploded military ordnance. The obvious cognitive symptoms of minor TBI -- including learning and memory problems -- can dissipate within just a few days. But blast-exposed veterans may continue to have problems performing simple auditory tasks that require them to focus attention on one sound source and ignore others, an ability known as "selective auditory attention." According to a new study by a team of Boston University (BU) neuroscientists, such apparent "hearing" problems actually may be caused by diffuse injury to the brain's prefrontal lobe. "This kind of injury can make it impossible to converse in everyday social settings, and thus is a truly devastating problem that can contribute to social isolation and depression," explains computational neuroscientist Scott Bressler, a graduate student in BU's Auditory Neuroscience Laboratory, led by biomedical engineering professor Barbara Shinn-Cunningham. For the study, Bressler, Shinn-Cunningham and their colleagues -- in collaboration with traumatic brain injury and post-traumatic stress disorder expert Yelena Bogdanova of VA Healthcare Boston -- presented a selective auditory attention task to 10 vets with mild TBI and to 17 control subjects without brain injuries. Notably, on average, veterans had hearing within a normal range. In the task, three different melody streams, each comprised of two notes, were simultaneously presented to the subjects from three different perceived directions (this variation in directionality was achieved by differing the timing of the signals that reached the left and right ears). The subjects were then asked to identify the "shape" of the melodies (i.e., "going up," "going down," or "zig-zagging") while their brain activity was measured by electrodes on the scalp. "Whenever a new sound begins, the auditory cortex responds, encoding the sound onset," Bressler explains. "Attentional focus, however, changes the strength of this response: when a listener is attending to a particular sound source, the neural activity in response to that sound is greater." This change of the neural response occurs because the brain's "executive control" regions, located in the brain's prefrontal cortex, send signals to the auditory sensory regions of the brain, modulating their response. The researchers found that blast-exposed veterans with TBI performed worse on the task -- that is, they had difficulty controlling auditory attention -- "and in all of the TBI veterans who performed well enough for us to measure their neural activity, 6 out of our 10 initial subjects, the brain response showed weak or no attention-related modulation of auditory responses," Bressler says. "Our hope is that some of our findings can be used to develop methods to assess and quantify TBI, identifying specific factors that contribute to difficulties communicating in everyday settings," he says. "By identifying these factors on an individual basis, we may be able to define rehabilitation approaches and coping strategies tailored to the individual." Some TBI patients also go on to develop chronic traumatic encephalopathy (CTE) -- a debilitating progressive degenerative disease with symptoms that include dementia, memory loss and depression -- which can now only be definitively diagnosed after death. "With any luck," Bressler adds, "neurobehavioral research like ours may help identify patients at risk of developing CTE long before their symptoms manifest."