Tag Archives: Research

Traumatic Brain Injury – TBI and Spinal Cord Injury SCI

The VA says this about TBI and SCI: 

Due to the ongoing conflicts in Afghanistan and Iraq, Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) accounts for almost 25% of combat casualties.

Improvised explosive devices, blast (high pressure waves), landmines, and explosive fragments account for the majority of combat injuries in Afghanistan and Iraq. Although Kevlar helmets and advances in body armor have saved the lives of many soldiers, they do not protect against blasts and impacts to the head, face and cervical spinal cord.

Blast injuries often result in multiple traumas, including injuries to internal organs, limb loss, sensory loss, and psychological disorders. The term “polytrauma” has been coined to describe the co-occurring injuries.

The information above and below come from here which are part of an introduction and overview prepared by Joel Kupersmith, MD, Chief Research and Development Officer, VA for the purposes of a proposal solicitation.  I thought the overview might be of interest to those with these injuries and their families.

Traumatic Brain Injury:

Kevlar helmets have done much to protect the head but leave the forehead unprotected. The left and right frontal lobes, located behind the forehead control intellectual abilities such as the ability to plan and organize. This area of the brain also controls personality, behavior, and emotional control.

Concussion or mild TBI is the most common form of combat-related injury. Mild TBI can occur even in those not directly hit by the blast, without obvious external injuries, without loss of consciousness and without visible findings from acute Magnetic Resonance Imaging. Problems with memory, lack of concentration, increased anxiety and irritability are common hallmarks of mild TBI. Although evidence suggests that the majority of OIF/OEF soldiers who suffer mild TBI will recover over time, early diagnoses and treatment are critical so that aberrant behaviors due to TBI are not misinterpreted and soldiers are spared the risk of second impact syndrome. Appropriate recognition of TBI will facilitate quick return to pre-injury activity levels, including return to duty status.

In addition to mild TBI, soldiers close to the blasts are experiencing severe diffuse and contrecoup injuries. Soldiers with a moderate to severe TBI often show the similar symptoms as mild TBI yet also report: worsening headaches; repeated vomiting or nausea; seizures; inability to awaken from sleep; slurred speech; weakness, numbness and loss of coordination. Unlike mild TBI, these problems and others can persist long-term or result in permanent difficulties with memory, reasoning, emotion and expression making it impossible to return to duty, hold steady employment or regain pre-injury quality of life.

Penetrating focal injuries from mortar rounds or other forms of heavy artillery resulting in severe brain injury are not as prevalent. However, focal destruction of brain tissue is the most life-threatening, intractable type of brain injury causing permanent damage to the affected area and the functions it controls.

Spinal Cord Injury:

Current designs in military protective gear and advanced evacuation procedures have resulted in both a decrease in the percentage of spinal cord injured soldiers and an increase in the number of those that ultimately survive. Blast force and shrapnel injuries are most common. For those that survive, the cervical spinal cord, the unprotected and most mobile portion of the spinal cord, is the most common site of injury.

Soldiers with cervical SCI face short- and long-term consequences of losing motor and sensory function below the level of injury, coupled with a loss of autonomic regulation. Every organ system may be affected by cervical spinal cord injury. Alterations in the gastrointestinal, renal, skin and musculoskeletal organs are common, and respiratory problems are the overwhelming cause of morbidity and mortality. In addition, patients may experience chronic pain at or below the level of injury and, less frequently, above it.

Alterations in respiratory mechanics, and the development of alveolar hypoventilation, pneumonia, aspiration of gastric contents, pulmonary embolism, pulmonary edema, and sleep apnea are a few of the common respiratory complications associated with cervical SCI. Ultimately, dysfunction depends on the level and extent of injury. Lesions above C3 paralyze all respiratory muscles. When SCI involves C3 to C5 lesions, profound respiratory muscle dysfunction occurs leaving the patient unable to generate a cough or clear secretions. Because of this, neuroprotective strategies that rescue even one or two segments may be of significant functional benefit to veterans with SCI.

Let’s pray that this proposal results in research that leads to significant help for our injured veterans.    

Oldtimer

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VA Research Factsheet on PTSD

The following is a factsheet from the VA’s Research Advances Series titled Posttraumatic Stress Disorder (PTSD),  published in September, 2007:

Soldier from VA BulletinSoldier from VA Bulletin VA’s Office of Research & Development supports a strong program of research directed to understanding, treating, and preventing Posttraumatic Stress Disorder (PTSD), which is an unrelenting biological reaction to the experience of a traumatic event. In the case of veterans, the trauma may occur from combat duty or other experiences where one’s safety or life is threatened. VA researchers have long been leaders in discovering new advances for treating and understanding PTSD.    The photo came with the article in 2007    I found a larger version here They title it “Prayer”.    I don’t know who the original photographer was.

Examples of VA research advances

Drug already used by millions may be effective in the treatment of PTSD – In an exciting new treatment development, VA researchers found that prazosin, an inexpensive generic drug already used by millions of Americans for high blood pressure and prostate problems, improved sleep and reduced trauma nightmares in a small number of veterans with PTSD.  Plans are under way for a large, multi-site trial to confirm the drug’s effectiveness.

Prolonged-exposure therapy effective in treatment of women veterans with PTSD– VA researchers found that prolonged-exposure therapy – in which therapists helped them recall their trauma memories under safe, controlled conditions-was effective in reducing PTSD symptoms in women veterans who have developed PTSD as the result of sexual trauma in the military, and that such reductions remained stable over time. Women who received prolonged-exposure therapy had greater reductions of PTSD symptoms than women who received only emotional support and counseling focused on current problems. This approach may be tested in, and applied to, other PTSD populations.

First ever clinical trial for the treatment of military service-related chronic PTSD– The largest study of its kind, involving 400 veterans from 20 VA medical centers nationwide, is being conducted to determine if risperidone, a medication already shown to be safe and effective in the treatment of PTSD, is also effective in veterans with chronic PTSD who continue to have symptoms despite receiving standard medications used for this disorder.

Facts About PTSD:

PTSD is a psychiatric disorder that can affect people who have experienced life-threatening events, such as combat, a terrorist attack, or a personal assault. Symptoms include flashbacks, nightmares, depression, and social withdrawal, as well as physical health changes. Treatment often includes anti-anxiety drugs or other medication, as well as exposure therapy, a form of cognitive-behavioral therapy in which patients recall their traumas in a safe setting and gradually learn to adjust their emotional response. VA Research has long been leaders in making new advances for treating and understanding PTSD.

http://www.research.va.gov
Research & Development
Veterans Affairs

Oldtimer’s Comment: There are 17 of these factsheets.  Below is a linked list of them.    You may find something of interest in one or more of them.   For example, PTSD is mentioned in several.

Factsheets

  • Alzheimer’s Disease (193 KB, PDF)
  • Depression (192 KB, PDF)
  • Diabetes (168 KB, PDF)
  • Hearing Loss (194 KB, PDF)
  • Heart Disease and Stroke (223 KB, PDF)
  • Hepatitis C (198 KB, PDF)
  • HIV / AIDS (205 KB, PDF)
  • Iraq / Afghanistan (232 KB, )
  • Low Vision (248 KB, PDF)
  • Mental Health (191 KB, PDF)
  • Obesity (214 KB, PDF)
  • Osteoarthritis (175 KB, PDF)
  • Parkinson’s Disease (179 KB, PDF)
  • Personalized Medicine (208 KB, PDF)
  • Post-Traumatic Stress Disorder (PTSD) (189 KB, PDF)
  • Prosthetics / Amputations (209 KB, PDF)
  • Spinal Cord Injury (205 KB, PDF)
  • Substance Abuse (175 KB, PDF)
  • Womens’ Health (201 KB, PDF)
  • Oldtimer

    Program for homeless N.H. vets could close

    Program for homeless N.H. vets not funded
     

    Something is wrong here.  

    Something is very wrong!  

    We seem to be backing up.   The article below is just one of many like it.   Federal funds in support of our homeless are drying up, and even worse, many homeless veterans that have found shelter are themselves cast out onto the streets.  At least Liberty House is determined to keep up the fight for our veterans.   Our government doesn’t seem to really care.   To paraphrase: “We cut the funds, but it is local yokels that decide where the remainder is used.”   

    I’ve seen some of the inside workings of these interagency counsels.  It is kind of like, “they cut our funds for band-aids.  Which wound needs the dressings the most?  Where are the screams coming from?    Do we save that arm or let that leg go?   It is a fact of life that there are no good choices when there isn’t even close to enough money to go around and people are in serious trouble everywhere you look.    So they prioritize, hoping that HUD will not cut funding for the vets.    When an application has 6 choices and HUD chooses to fund the first 5, they are in effect saying, “the homeless veterans on the list are not worth our money”.   Even the VA shortchanges our homeless vets – they allocate only a net of $1.37 a day per homeless veteran.  

    Find the rest of this story here

    Program for homeless N.H. vets could close 

    By PHILIP ELLIOTT, The Associated Press
    Published: Wednesday, Mar. 14, 2007

    CONCORD – A temporary home for homeless veterans in Manchester will lose its entire federal budget next year, officials said Tuesday. Liberty House received $150,000 over the past three years from the U.S. Department of Housing and Urban Development, founder Don Duhamel said. But the money wasn’t included in the proposed federal budget. “We’re fighting for our life,” Duhamel said. “We’re going to have to go out and beg and whatever and find other sources.”Liberty House was at the bottom of Manchester’s six-item, $881,000 HUD application. The agency funded the first five requests and awarded them $723,000. It also set aside $82,000 for emergency shelters. “We don’t pick and choose the projects to receive funding in any local community,” HUD spokesman Brian Sullivan said. Those are chosen by local interagency committees, he said. Liberty House didn’t make the cut. “There’s only so much money that HUD gives,” said Paul Crawford, chair of Manchester’s board that reviews potential federal homeless programs. “We’ve been waiting for six months to hear. It wasn’t until the federal budget for the last year was done that we could find out.” Mary Sliney helped coordinate the city’s applications. She said outside experts in homelessness reviewed the proposals and ranked them.Liberty House has 10 beds for homeless vets and recently started letting another two sleep on couches, Duhamel said.

    “I’ll be damned if we’re going to close our door,” he said. “We’re taking them off the street and sending them back out there as taxpayers. We want to get them a job, an apartment, have them walk out of here as taxpayers and living a clean life.”

    Duhamel pointed to the growing number of Iraq war vets as a reason to keep funding his program.

    “They are giving us a hard time and this is when they need us the most. With this kind of war and all these brain injuries, they’re going to be hurting for the next 20 years,” he said.

    Sliney agreed that veterans from Iraq and Afghanistan need attention. 

    “This is a critical time as we’re looking at the folks who are the new veterans from our current wars,” Sliney said. “This is something we need to pay attention to.”

    Oldtimer’s comment:

    Wave more than just flags ’cause…

     Heros are out there too.

    For all homeless Veteran Posts

    FACT: 43% of Homeless Males Over 25 are Veterans!

    Fact:  If military service were not a causal factor in veteran homelessness, only 27% of homeless would be veterans! 

    In a previous post I’ve documented sources for several statistics relevant to homeless veterans.  The data in that post has been carefully researched and represent a significant improvement from my earlier attempts.  These new statistics include the percent of the total male homeless over 25 that are veterans (43%).    Let me present a couple of relevant charts for those of us who are more visually oriented.

    US vs Veteran Population

    The chart at the left shows that veterans make up 11.7% of the total US population 18 or older. 

     The figures are documented in the document linked above.

    Our total population is 301.9 million and 74.6 percent of us are 18 or older, old enough to enlist.  That works out to be just over 225 million, male and female.

    The veteran count, also documented in the link above, includes both wartime and peace time living veterans.

                                                                                                                                                  

    Male US Population vs VeteransThe chart at the left is the same except only the male populations are charted.  

    I’ve chosen to use this chart as it more reasonably represents the age and demographics of homeless veterans. 

    We also get to compare similar demographics between charts.   Less than 1% of veterans under 25 are homeless.  Less than 0.3% of homeless vets are women.

     The total US Male population 25 and older is 93,800,000.   The total male veterans 25 and older is 24,910,000.

    Male Veterans Make Up 27% Of  Male Population Over 25.

                                                                                                                                                           

    43% of Homeless Men Over 25 are Veterans!

    25 and older male homeless vetsThe chart at the left shows that male homeless veterans make up 43% of the male homeless over 25.  The data is documented in the previous post link above.

    If the homeless veterans were representative of the US male population, you would expect that the last two charts would look very similar. 

    You would expect the male homeless veterans to represent about 27% of the homeless population

    Veterans are grossly overrepresented  in the homeless population.

                                                                                                                                                    

    The Department of Veterans Affairs says this about the homeless veterans:

    Although many homeless veterans served in combat in Vietnam and suffer from PTSD, at this time, epidemiological studies do not suggest that there is a causal connection between military service, service in Vietnam, or exposure to combat and homelessness among veterans.”

    The VA Claims “No Causal Connection To Service”

    OK, I think the charts above put the lie to that statement.  If there were no causal relationship, the homeless veterans would total less than 123,000 instead of the 200,000 that are homeless on any given night and the pie charts would look essentially the same.  It is my opinion that PTSD and substance abuse problems acquired while in service play a major role in the lives of homeless veterans.  

    The VA goes out of its way to try to acquit PTSD and combat service as causal effects.  Why do that do that?  Why even bring it up at all?  Could it be that they know that military service is a factor to homeless veterans (big time)  but do not want to pay for it?  Smoke screens that try to let us believe they have considered those things and found them not a factor?   Well….  something is a factor and it is time the VA took its head out of the sand!

    I call on our Congress to get to the bottom of this and fix it. 

    These are men and women that put on uniforms and took up arms in service to our country and so far our country has been too cheap to treat them as the Heroes that they are.

    Oldtimer:  Click for All Homeless Veteran Posts.  

    Homeless Youth – Some Random Facts That May Scare You

    Some random facts that may scare you:

    Estimates are that one in seven youths will leave home by the age of 18 (National Runaway Switchboard, 2001).

     “Every year, assault, illness, and suicide claim the lives of approximately 5,000 runaway and homeless youth” (The National Runaway Switchboard, 2001, p. 2). 

     Young people on the streets find it very difficult to meet their basic needs, so they may also resort to survival sex to provide for themselves. 

     According to the Office of Juvenile Justice and Delinquency Prevention, more than half of all runaways are girls (Hammer, et al., 2002). Makes you want to cry

    The National Network for Youth (2003) reports that most homeless youth living on the streets are boys. Boys are more likely to be kicked out and girls more likely to run away, possibly because boys are more likely to engage in deviant behaviors that cause parents to kick them out and girls are more likely to experience sexual abuse that prompts them to run away.

    The same abuse continues on the streets as girls are more likely to be raped and boys are more likely to be physically assaulted (Cauce, et al., 2000; MacLean, Embry,& Cauce, 1999).

    Ensign and Bell (2004) found the average length of homelessness differed significantly according to whether the youth lived in a shelter or on the streets. For those living in shelters, the average length of homelessness was four months (range one to nine months), but the average length for those on the streets was three years (range one month to eight years).

    One in eight youth under 18 will leave home and become a street person in need of services (Raleigh-DuRoff, 2004), and 40 percent do not return home

    Do you have children or grandchildren or neighbors with children at risk?   Do something about it before it is too late.  Get help now.

    I hope the picture above makes you want to cry.  

    Oldtimer’s comment:  Click for All the Homeless Youth articles

    Research – Unaccompanied and Homeless Youth Review of Literature (1995-2005)

    Research – Unaccompanied and Homeless Youth Review of Literature (1995-2005)

    National Center for Homeless EducationThis review is based on literature published between 1995 and 2005 on issues concerning unaccompanied youth experiencing homelessness. It provides an overview of the challenges these young people face and includes research about why they leave their homes, how they live after leaving, and what interventions are being used to assist them.   NCHE stands for National Center for Homeless Education.

    pdf icon This is a 30 page pdf that you can read or download here