Partner Aggression Among Iraq and Afghanistan Veterans with PTSD May be an Important Treatment Consideration and Target for Prevention.

Intimate Partner Aggression Perpetrated and Sustained by Male Afghanistan, Iraq, and Vietnam Veterans With and Without Posttraumatic Stress Disorder. 12/23/09. Veterans with posttraumatic stress disorder (PTSD) consistently evidence higher rates of intimate partner aggression perpetration than veterans without PTSD, but most studies have examined rates of aggression among Vietnam veterans several years after their deployment. The primary aim of this study was to examine partner aggression among male Afghanistan or Iraq veterans who served during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) and compare this aggression to that reported by Vietnam veterans with PTSD. Three groups were recruited, OEF/OIF veterans with PTSD (n = 27), OEF/OIF veterans without PTSD (n = 31), and Vietnam veterans with PTSD (n = 28). Though only a few comparisons reached significance, odds ratios suggested that male OEF/OIF veterans with PTSD were approximately 1.9 to 3.1 times more likely to perpetrate aggression toward their female partners and 1.6 to 6 times more likely to report experiencing female perpetrated aggression than the other two groups. Significant correlations among reports of violence perpetrated and sustained suggested many men may have been in mutually violent relationships. Taken together, these results suggest that partner aggression among Iraq and Afghanistan veterans with PTSD may be an important treatment consideration and target for prevention. Journal of Interpersonal Violence via PubMed

DoD-VA Deployment Health Working Group Sponsors Workshop on the Challenges of Environmental Exposures

DoD and VA Discuss Environmental Exposure Challenges 12/23/09. Last November, an assembly of some of the top physicians, epidemiologists, and researchers from across the Department of Defense (DoD), the Department of Veterans Affairs (VA), and even the United Kingdom Ministry of Defense gathered in a day long workshop to discuss the challenges of environmental exposures within the Iraqi and Afghan theaters of operation, and what was being done to address them. Military Health System

VAOIG Inspection of Unexpected Death at North Chicago VA Medical Center

Healthcare Inspection Review of an Unexpected Death North Chicago VA Medical Center North Chicago, Illinois 12/22/09. The purpose of this inspection was to determine the validity of allegations regarding the care provided to a patient who died within 24 hours of admission to the North Chicago VA Medical Center (VAMC), North Chicago, Illinois. The complainant suggested that a medical trainee may have been inadequately supervised. We found the quality of care reviews conducted by the VAMC to be thorough. Although we found deficiencies in the quality of care provided for this patient, we did not demonstrate a connection with the patient’s death. We recommended that managers evaluate this case with Regional Counsel for possible disclosure to the patient’s family. We also recommended that staff comply with the VAMC’s policy for rapid intervention in patients with deteriorating clinical conditions. Management submitted appropriate implementation plans. VAOIG

Diagnosis and Management of Cardiovascular Disease in Women Veterans

Risk factor treatment in veteran women at risk for cardiovascular disease. 12/22/09. CONCLUSIONS: Our findings show a high prevalence of cardiovascular disease (CVD) risk factors and low knowledge levels among ambulatory veteran women. There is a need for improvement in recognition and aggressive management of CVD risk factors, including the use of noninvasive studies as surrogate markers for early diagnosis. Continued efforts to educate women and providers about CVD risk factors, heart-healthy behaviors, screening, and treatment are vital to improve the current state of women's health and decrease future adverse cardiac event rates. Journal of Surgical Research via PubMed

Virtual Reality Exposure Therapy for Portugesse War Veterans Suffering From PTSD

PTSD Elderly War Veterans: A Clinical Controlled Pilot Study. 12/22/09. Abstract: Around 25,000 war veterans in Portugal suffer posttraumatic stress disorder (PTSD). This clinically controlled study evaluates virtual reality exposure therapy (VRET) as an alternative procedure to reduce PTSD symptoms. Ten patients were assigned to three groups: VRET, exposure in imagination (EI), and waiting list (WL). The patients were Portuguese veterans from a series of wars fought in former African colonies more than 30 years ago. While the EI group participated in traditional imagination therapy, the VRET group was exposed to a virtual reality (VR) war scenario. Cues such as ambush, mortar blasting, and waiting for rescue were used in the VR. Patients enrolled in the VRET group showed statistical reduction of PTSD-associated disorders like depression and anxiety. Far from being conclusive, this pilot study nonetheless presents some promising data on the use of VRET on old war veteran populations. Cyberpsychology & Behavior via PubMed

Journal of Rehabilitation Research & Development (JRRD) Volume 46, 2009

Single-Topic Issue: Pain after Spinal Cord Injury 12/21/09. The present single-topic issue concerns several important research areas relevant for both the understanding of pain and the development of future effective treatments for pain associated with SCI. Because the pains that are experienced after an SCI are particularly complex, effective communication between the basic and clinical research communities and clinical care providers is critical for the progress in this area. JRRD

VA Adopts New Care Delivery System for Chronic Diseases

VA Adopts Patient-Centered Care Model Based on Treatment of Chronic Conditions 12/31/09. WASHINGTON, DC—Diabetes is, in many ways, the prototypical chronic disease. It is slow moving, progressive, complex, and it impacts patients’ lives in ways that cannot be quantified on a medical chart. Physicians at the Department of Veterans Affairs have learned a lot about treating diabetes over the last several decades, and during that time, certain concepts have emerged: shared decision-making processes, patient-guided treatment, and population management. Now, as VA undertakes a system-wide effort to evaluate and redesign its primary care delivery system, those concepts are helping to guide a process that will help move VA care, including diabetic care, into the 21st century. U.S. Medicine

DoD Launches Study of Female Vietnam Vets Health and Impact of War

DoD to Study the Impact of Wartime Deployment on Women's Health and Mental Outcomes 12/21/09. WASHINGTON, DC—As women Vietnam veterans approach their mid-60s, physicians are finding it more important to understand the impact of wartime deployment on their health and mental outcomes nearly 40 years after service on this under-researched demographic. To try to fill in those research gaps, the DoD is launching a comprehensive study of women veterans who served in the military during the Vietnam War, exploring the effects of their military service on their health. U.S. Medicine

NFL & DoD Collaborate on Managing TBIs

Collaboration Between Department of Defense and National Football League on Response to Traumatic Brain Injury 12/21/09 WASHINGTON, DC—Lately, traumatic brain injury (TBI) is receiving due attention on both the battlefield and the gridiron. An October 28, 2009 hearing before Congress has prompted NFL Commissioner Roger Goodell to implement a new policy for players with suspected head injuries. The NFL is also reportedly initiating collaboration with the Department of Defense to share information on the most successful strategies for managing head injuries U.S. Medicine

Congressional Research Service Report on TBI in Military

Traumatic Brain Injury: Care and Treatment of Operation Enduring Freedom and Operation Iraqi Freedom Veterans 12/20/09. Traumatic brain injury (TBI), defined in the medical literature as a disruption in brain function
that is caused by a head injury, has become known as one of the “signature wounds” of the wars in Iraq and Afghanistan due to its high occurrence in post-deployment servicemembers and veterans of these wars. As servicemembers return home, many need ongoing care for mild, moderate, or severe TBI. The growing number of TBI patients and the nature of their injuries creates the need for increased treatment capacity for veterans, and raises a number of policy issues that Congress may move to consider. CRS via FAS