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The Challenges of Malaria Prevention for Women at War
Remington L. Nevin, MD, MPH, of the Johns Hopkins Bloomberg School of Public Health and author of “Issues in the Prevention of Malaria Among Women at War” in the new book Women at War discusses the challenges in preventing malaria in deployed women, the lack of clinical trial data on the impact of antimalarial drugs on women, and the recent success in avoiding malaria in Liberia.
[Scroll down to hear the full interview.]
Women currently make up about 15% of the military population, and more than 300,000 women have deployed since September 11, 2001. Women at War includes 19 chapters covering a host of topics, including deployment, issues at home, psychological challenges, and the veteran experience, reviewing epidemiology, changes in policy and demographics, factors affecting health, issues related to reproductive and urogenital health, and suggestions for health care providers treating women service members and veterans.
For a limited time, a discount is being offered to Federal Practitioner readers. Click here and use the promo code AMPROMD9 at checkout.
Remington L. Nevin, MD, MPH, of the Johns Hopkins Bloomberg School of Public Health and author of “Issues in the Prevention of Malaria Among Women at War” in the new book Women at War discusses the challenges in preventing malaria in deployed women, the lack of clinical trial data on the impact of antimalarial drugs on women, and the recent success in avoiding malaria in Liberia.
[Scroll down to hear the full interview.]
Women currently make up about 15% of the military population, and more than 300,000 women have deployed since September 11, 2001. Women at War includes 19 chapters covering a host of topics, including deployment, issues at home, psychological challenges, and the veteran experience, reviewing epidemiology, changes in policy and demographics, factors affecting health, issues related to reproductive and urogenital health, and suggestions for health care providers treating women service members and veterans.
For a limited time, a discount is being offered to Federal Practitioner readers. Click here and use the promo code AMPROMD9 at checkout.
Remington L. Nevin, MD, MPH, of the Johns Hopkins Bloomberg School of Public Health and author of “Issues in the Prevention of Malaria Among Women at War” in the new book Women at War discusses the challenges in preventing malaria in deployed women, the lack of clinical trial data on the impact of antimalarial drugs on women, and the recent success in avoiding malaria in Liberia.
[Scroll down to hear the full interview.]
Women currently make up about 15% of the military population, and more than 300,000 women have deployed since September 11, 2001. Women at War includes 19 chapters covering a host of topics, including deployment, issues at home, psychological challenges, and the veteran experience, reviewing epidemiology, changes in policy and demographics, factors affecting health, issues related to reproductive and urogenital health, and suggestions for health care providers treating women service members and veterans.
For a limited time, a discount is being offered to Federal Practitioner readers. Click here and use the promo code AMPROMD9 at checkout.
Women at War: A Growing Body of Evidence-Based Research
[Scroll down to hear the full interview.]
Women currently make up about 15% of the military population, and more than 300,000 women have deployed since September 11, 2001. Women at War includes 19 chapters covering a host of topics, including deployment, issues at home, psychological challenges, and the veteran experience, reviewing epidemiology, changes in policy and demographics, factors affecting health, issues related to reproductive and urogenital health, and suggestions for health care providers treating women service members and veterans.
For a limited time, a discount is being offered to Federal Practitioner readers. Click here and use the promo code AMPROMD9 at checkout.
[Scroll down to hear the full interview.]
Women currently make up about 15% of the military population, and more than 300,000 women have deployed since September 11, 2001. Women at War includes 19 chapters covering a host of topics, including deployment, issues at home, psychological challenges, and the veteran experience, reviewing epidemiology, changes in policy and demographics, factors affecting health, issues related to reproductive and urogenital health, and suggestions for health care providers treating women service members and veterans.
For a limited time, a discount is being offered to Federal Practitioner readers. Click here and use the promo code AMPROMD9 at checkout.
[Scroll down to hear the full interview.]
Women currently make up about 15% of the military population, and more than 300,000 women have deployed since September 11, 2001. Women at War includes 19 chapters covering a host of topics, including deployment, issues at home, psychological challenges, and the veteran experience, reviewing epidemiology, changes in policy and demographics, factors affecting health, issues related to reproductive and urogenital health, and suggestions for health care providers treating women service members and veterans.
For a limited time, a discount is being offered to Federal Practitioner readers. Click here and use the promo code AMPROMD9 at checkout.
AMSUS Federal Health in Transition Wrap-Up
Dr. Clancy Outlines VA Blueprint for Change
Carolyn M. Clancy, MD, Interim Under Secretary for Health at the VA outlined strategic aims for reshaping and restructuring into a more unified veteran-focused health care system. The ultimate goal for the plan is to put the veteran in control of his or her health care by providing a single phone number, a website, and well-trained VA employees who understand all the VA’s offerings. According to Dr. Clancy, “[this restructuring's] success will be defined from the veteran’s perspective."
- Operate a health care network that anticipates and meets the needs of veterans;
- Deliver high-quality, veteran-centered care that compares favorably to private sector health care;
- Leverage information technology, analytics, and models of delivery to optimize health care;
- Grow an organizational culture rooted in the VA’s core values and mission and prioritize veterans;
- Foster an environment of continuous learning, responsible risk taking, and personal accountability;
- Advance a model of health care that is personalized, proactive, and patient-driven;
- Lead the nation in research and treatment of military service-related conditions;
- Support innovation in health services through academic affiliations;
- Operate and communicate with integrity, transparency, and accountability; and
- Modernize VA management, including human resources, accounting, and other support services.
An Update on the Defense Health Agency
The Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD, outlined the strategic challenges and plans for changes at the $50 billion Defense Health Agency (DHA). “Get ready, this train is going to move very fast and you are part of it,” he challenged active service health care providers. "We understand this is a complicated world, and we need to get energized to find the solutions.”
Dr. Woodson also promised to develop better telehealth capabilities. “Telehealth is going to be an important tool, because it gives us the capability to reach forward and reach back,” he said, “We are a highly distributed system, and we need to develop it as a system, not just as a technology.”
PHS Officials Discuss 50-Year Battle Against Tobacco Use
RADM Lushniak noted that the PHS became the first uniformed service to go tobacco-free while in uniform. Joining the Acting Surgeon General in the presentation was RADM David L. Ashley who discussed how the PHS eliminated tobacco use within its ranks. RADM Ashley outlined 10 guidelines for clinicians to support patients in battling a tobacco addiction.
CAPT Kimberly Elenberg also outlined the steps PHS is taking to help the other uniformed services in their efforts to reduce and eliminate tobacco use. According to CAPT Elenberg, it is essential to recognize the specific and unique deployment challenges that active service members face and the rationales behind tobacco use before being able to reduce its use.
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
Dr. Clancy Outlines VA Blueprint for Change
Carolyn M. Clancy, MD, Interim Under Secretary for Health at the VA outlined strategic aims for reshaping and restructuring into a more unified veteran-focused health care system. The ultimate goal for the plan is to put the veteran in control of his or her health care by providing a single phone number, a website, and well-trained VA employees who understand all the VA’s offerings. According to Dr. Clancy, “[this restructuring's] success will be defined from the veteran’s perspective."
- Operate a health care network that anticipates and meets the needs of veterans;
- Deliver high-quality, veteran-centered care that compares favorably to private sector health care;
- Leverage information technology, analytics, and models of delivery to optimize health care;
- Grow an organizational culture rooted in the VA’s core values and mission and prioritize veterans;
- Foster an environment of continuous learning, responsible risk taking, and personal accountability;
- Advance a model of health care that is personalized, proactive, and patient-driven;
- Lead the nation in research and treatment of military service-related conditions;
- Support innovation in health services through academic affiliations;
- Operate and communicate with integrity, transparency, and accountability; and
- Modernize VA management, including human resources, accounting, and other support services.
An Update on the Defense Health Agency
The Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD, outlined the strategic challenges and plans for changes at the $50 billion Defense Health Agency (DHA). “Get ready, this train is going to move very fast and you are part of it,” he challenged active service health care providers. "We understand this is a complicated world, and we need to get energized to find the solutions.”
Dr. Woodson also promised to develop better telehealth capabilities. “Telehealth is going to be an important tool, because it gives us the capability to reach forward and reach back,” he said, “We are a highly distributed system, and we need to develop it as a system, not just as a technology.”
PHS Officials Discuss 50-Year Battle Against Tobacco Use
RADM Lushniak noted that the PHS became the first uniformed service to go tobacco-free while in uniform. Joining the Acting Surgeon General in the presentation was RADM David L. Ashley who discussed how the PHS eliminated tobacco use within its ranks. RADM Ashley outlined 10 guidelines for clinicians to support patients in battling a tobacco addiction.
CAPT Kimberly Elenberg also outlined the steps PHS is taking to help the other uniformed services in their efforts to reduce and eliminate tobacco use. According to CAPT Elenberg, it is essential to recognize the specific and unique deployment challenges that active service members face and the rationales behind tobacco use before being able to reduce its use.
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
Dr. Clancy Outlines VA Blueprint for Change
Carolyn M. Clancy, MD, Interim Under Secretary for Health at the VA outlined strategic aims for reshaping and restructuring into a more unified veteran-focused health care system. The ultimate goal for the plan is to put the veteran in control of his or her health care by providing a single phone number, a website, and well-trained VA employees who understand all the VA’s offerings. According to Dr. Clancy, “[this restructuring's] success will be defined from the veteran’s perspective."
- Operate a health care network that anticipates and meets the needs of veterans;
- Deliver high-quality, veteran-centered care that compares favorably to private sector health care;
- Leverage information technology, analytics, and models of delivery to optimize health care;
- Grow an organizational culture rooted in the VA’s core values and mission and prioritize veterans;
- Foster an environment of continuous learning, responsible risk taking, and personal accountability;
- Advance a model of health care that is personalized, proactive, and patient-driven;
- Lead the nation in research and treatment of military service-related conditions;
- Support innovation in health services through academic affiliations;
- Operate and communicate with integrity, transparency, and accountability; and
- Modernize VA management, including human resources, accounting, and other support services.
An Update on the Defense Health Agency
The Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD, outlined the strategic challenges and plans for changes at the $50 billion Defense Health Agency (DHA). “Get ready, this train is going to move very fast and you are part of it,” he challenged active service health care providers. "We understand this is a complicated world, and we need to get energized to find the solutions.”
Dr. Woodson also promised to develop better telehealth capabilities. “Telehealth is going to be an important tool, because it gives us the capability to reach forward and reach back,” he said, “We are a highly distributed system, and we need to develop it as a system, not just as a technology.”
PHS Officials Discuss 50-Year Battle Against Tobacco Use
RADM Lushniak noted that the PHS became the first uniformed service to go tobacco-free while in uniform. Joining the Acting Surgeon General in the presentation was RADM David L. Ashley who discussed how the PHS eliminated tobacco use within its ranks. RADM Ashley outlined 10 guidelines for clinicians to support patients in battling a tobacco addiction.
CAPT Kimberly Elenberg also outlined the steps PHS is taking to help the other uniformed services in their efforts to reduce and eliminate tobacco use. According to CAPT Elenberg, it is essential to recognize the specific and unique deployment challenges that active service members face and the rationales behind tobacco use before being able to reduce its use.
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
Acting Surgeon General RADM Boris D. Lushniak on Zeroing Out Tobacco Use
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
Part II: Ebola and the Public Health Service
Part III: National Prevention Strategy
Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, is the Acting United States Surgeon General and oversees the operations of the U.S. Public Health Service Commissioned Corps. He served as Deputy Surgeon General from November 2010 until July 17, 2013, when he assumed the duties of Acting Surgeon General. RADM Lushniak brings 26 years of experience in the PHS to the position. He has served with the Epidemic Intelligence Service and the National Institute for Occupational Safety and Health, both at the CDC. He also served at the FDA as the Chief Medical Officer of the Office of Counterterrorism and later the Assistant Commissioner, Counterterrorism Policy and Director of the Office of Counterterrorism and emerging Threats within the Office of the Commissioner. After Hurricane Katrina, RADM Lushniak served as the HHS representative in San Antonio, Texas.
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
Part II: Ebola and the Public Health Service
Part III: National Prevention Strategy
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
Part II: Ebola and the Public Health Service
Part III: National Prevention Strategy
Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, is the Acting United States Surgeon General and oversees the operations of the U.S. Public Health Service Commissioned Corps. He served as Deputy Surgeon General from November 2010 until July 17, 2013, when he assumed the duties of Acting Surgeon General. RADM Lushniak brings 26 years of experience in the PHS to the position. He has served with the Epidemic Intelligence Service and the National Institute for Occupational Safety and Health, both at the CDC. He also served at the FDA as the Chief Medical Officer of the Office of Counterterrorism and later the Assistant Commissioner, Counterterrorism Policy and Director of the Office of Counterterrorism and emerging Threats within the Office of the Commissioner. After Hurricane Katrina, RADM Lushniak served as the HHS representative in San Antonio, Texas.
Rear Admiral (RADM) Boris D. Lushniak, MD, MPH, is the Acting United States Surgeon General and oversees the operations of the U.S. Public Health Service Commissioned Corps. He served as Deputy Surgeon General from November 2010 until July 17, 2013, when he assumed the duties of Acting Surgeon General. RADM Lushniak brings 26 years of experience in the PHS to the position. He has served with the Epidemic Intelligence Service and the National Institute for Occupational Safety and Health, both at the CDC. He also served at the FDA as the Chief Medical Officer of the Office of Counterterrorism and later the Assistant Commissioner, Counterterrorism Policy and Director of the Office of Counterterrorism and emerging Threats within the Office of the Commissioner. After Hurricane Katrina, RADM Lushniak served as the HHS representative in San Antonio, Texas.
Ebola, Surgeon General Top AMSUS Meeting Agenda
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
For more information on the 2014 AMSUS Annual Continuing Education Meeting, visit http://amsusmeetings.org/annual-meeting.
The Challenges of Treating the Military’s “Young Invincibles”
By Reid A. Paul
Providing health care to special operations personnel can pose unique challenges. On one hand, health care providers are tasked with much of the routine care that is the bread and butter of primary care; on the other hand, they need to work with patients who are especially averse to getting the care they need. The term “young invincibles” takes on a whole new meaning with this group.
That way of thinking was abundantly clear in “Special Operations Training: An Atypical Presentation of Aspiration Pneumonia.” Federal Practitioner recently spoke with one of the authors, Capt. Riley J. Burke, DO, USAF, MC (the other author was Michael C. Ott, MD), to better understand the challenges of working with this patient population and to get the story behind this fascinating case study. The audio of the entire conversation is below.
Federal Practitioner will bring you more of these conversations with the authors of original research, program profiles, case studies, and more. Sometimes the article is only the beginning of the story, so listen and let us know what you think. Join the conversation on Facebook and Twitter anytime.
By Reid A. Paul
Providing health care to special operations personnel can pose unique challenges. On one hand, health care providers are tasked with much of the routine care that is the bread and butter of primary care; on the other hand, they need to work with patients who are especially averse to getting the care they need. The term “young invincibles” takes on a whole new meaning with this group.
That way of thinking was abundantly clear in “Special Operations Training: An Atypical Presentation of Aspiration Pneumonia.” Federal Practitioner recently spoke with one of the authors, Capt. Riley J. Burke, DO, USAF, MC (the other author was Michael C. Ott, MD), to better understand the challenges of working with this patient population and to get the story behind this fascinating case study. The audio of the entire conversation is below.
Federal Practitioner will bring you more of these conversations with the authors of original research, program profiles, case studies, and more. Sometimes the article is only the beginning of the story, so listen and let us know what you think. Join the conversation on Facebook and Twitter anytime.
By Reid A. Paul
Providing health care to special operations personnel can pose unique challenges. On one hand, health care providers are tasked with much of the routine care that is the bread and butter of primary care; on the other hand, they need to work with patients who are especially averse to getting the care they need. The term “young invincibles” takes on a whole new meaning with this group.
That way of thinking was abundantly clear in “Special Operations Training: An Atypical Presentation of Aspiration Pneumonia.” Federal Practitioner recently spoke with one of the authors, Capt. Riley J. Burke, DO, USAF, MC (the other author was Michael C. Ott, MD), to better understand the challenges of working with this patient population and to get the story behind this fascinating case study. The audio of the entire conversation is below.
Federal Practitioner will bring you more of these conversations with the authors of original research, program profiles, case studies, and more. Sometimes the article is only the beginning of the story, so listen and let us know what you think. Join the conversation on Facebook and Twitter anytime.
Link Between PTSD and TBI Is Only the Beginning for MRS Study
April 25, 2014
A fundamental challenge for any study examining the impact of military service on the health of military personnel is establishing a baseline. Whether heart disease or posttraumatic stress disorder (PTSD), the symptoms often appear after (sometimes long after) the service has ended. The longitudinal Marine Resiliency Study (MRS I) and its successor MRS II are seeking to resolve that issue in a novel approach that brings together the Department of Veterans Affairs, U.S. Marine Corps, and Navy Medicine.
In the MRS study, a cohort of about 2,600 Marines (MRS-I) in 4 battalions and about 1,300 Marines (MRS-II) in 2 battalions deployed to Iraq or Afghanistan underwent a scientifically rigorous examination a month prior to deployment. This baseline was established using self-reported questionnaires, clinical interviews, and laboratory examinations. Follow-up examinations were repeated at 3 months (MRS-I and MRS-II) and again at 6 months post-deployment (MRS-I).
The program is ambitious, Dr. Dewleen Baker of the VA San Diego Health Care System told Federal Practitioner. “MRS was designed to provide broad-based (psychosocial, psychophysiological, and biological) prospective, longitudinal data, with a goal toward ultimate integrated analyses of variables, to determine risk and resilience for post-deployment mental health outcomes, i.e,. PTSD and co-occurring disorders,” she explained. “Analyses have just begun, and we are working our way through aspects of the data toward more integrated approaches.”
In one of the first of many reports to come out of MRS, the researchers found that the probability of developing PTSD was highest for participants with severe pre-deployment symptoms, high combat intensity, and deployment-related traumatic brain injury (TBI). Most significant, the researchers found that TBI doubled or nearly doubled the PTSD rates for participants with less severe pre-deployment PTSD symptoms. According to Baker:
By contrast, deployment-related mild TBI increases post-deployment symptom scores by 23%, and moderate-to-severe injuries increase scores by 71%. Our findings suggest that TBI may be a very important risk factor of PTSD, even when accounting for preexisting symptoms and combat intensity.
Our study focused on the impact of pre-deployment symptoms, combat intensity and TBI; however, it is important to consider other factors of psychological risk and resilience. Genes, coping style, and social support are just a few of the many other factors that may influence an individual’s response to stress.
Creating a rigorous cross-agency research study required tact, diligence, and patience from the MRS team. “Each agency has their own unique culture and institutional rules, regulations, and bureaucracy, so ideas, programs, etc, must be vetted across all agencies and reconciled—the various cultures/agencies to be reconciled include DoD, VA and academia.” Baker explained. “In addition in regards to initiation of studies for MRS II, for the past couple years, we also interface with NIMH as well as Headquarters Marine Corps; NIMH has the role of scientific review of MRS-II studies carried out under Headquarters Marine Corps/BUMED funding.”
The MRS-I and II studies may very well provide a template for future studies. The MRS team included a military liaison to work with the active duty Marines and attached Sailors, gather data, schedule meetings, and to report findings. “This study has a lot of experience working within and across these agencies,” Baker noted, “It’s an excellent model for future VA/DOD joint projects.”
April 25, 2014
A fundamental challenge for any study examining the impact of military service on the health of military personnel is establishing a baseline. Whether heart disease or posttraumatic stress disorder (PTSD), the symptoms often appear after (sometimes long after) the service has ended. The longitudinal Marine Resiliency Study (MRS I) and its successor MRS II are seeking to resolve that issue in a novel approach that brings together the Department of Veterans Affairs, U.S. Marine Corps, and Navy Medicine.
In the MRS study, a cohort of about 2,600 Marines (MRS-I) in 4 battalions and about 1,300 Marines (MRS-II) in 2 battalions deployed to Iraq or Afghanistan underwent a scientifically rigorous examination a month prior to deployment. This baseline was established using self-reported questionnaires, clinical interviews, and laboratory examinations. Follow-up examinations were repeated at 3 months (MRS-I and MRS-II) and again at 6 months post-deployment (MRS-I).
The program is ambitious, Dr. Dewleen Baker of the VA San Diego Health Care System told Federal Practitioner. “MRS was designed to provide broad-based (psychosocial, psychophysiological, and biological) prospective, longitudinal data, with a goal toward ultimate integrated analyses of variables, to determine risk and resilience for post-deployment mental health outcomes, i.e,. PTSD and co-occurring disorders,” she explained. “Analyses have just begun, and we are working our way through aspects of the data toward more integrated approaches.”
In one of the first of many reports to come out of MRS, the researchers found that the probability of developing PTSD was highest for participants with severe pre-deployment symptoms, high combat intensity, and deployment-related traumatic brain injury (TBI). Most significant, the researchers found that TBI doubled or nearly doubled the PTSD rates for participants with less severe pre-deployment PTSD symptoms. According to Baker:
By contrast, deployment-related mild TBI increases post-deployment symptom scores by 23%, and moderate-to-severe injuries increase scores by 71%. Our findings suggest that TBI may be a very important risk factor of PTSD, even when accounting for preexisting symptoms and combat intensity.
Our study focused on the impact of pre-deployment symptoms, combat intensity and TBI; however, it is important to consider other factors of psychological risk and resilience. Genes, coping style, and social support are just a few of the many other factors that may influence an individual’s response to stress.
Creating a rigorous cross-agency research study required tact, diligence, and patience from the MRS team. “Each agency has their own unique culture and institutional rules, regulations, and bureaucracy, so ideas, programs, etc, must be vetted across all agencies and reconciled—the various cultures/agencies to be reconciled include DoD, VA and academia.” Baker explained. “In addition in regards to initiation of studies for MRS II, for the past couple years, we also interface with NIMH as well as Headquarters Marine Corps; NIMH has the role of scientific review of MRS-II studies carried out under Headquarters Marine Corps/BUMED funding.”
The MRS-I and II studies may very well provide a template for future studies. The MRS team included a military liaison to work with the active duty Marines and attached Sailors, gather data, schedule meetings, and to report findings. “This study has a lot of experience working within and across these agencies,” Baker noted, “It’s an excellent model for future VA/DOD joint projects.”
April 25, 2014
A fundamental challenge for any study examining the impact of military service on the health of military personnel is establishing a baseline. Whether heart disease or posttraumatic stress disorder (PTSD), the symptoms often appear after (sometimes long after) the service has ended. The longitudinal Marine Resiliency Study (MRS I) and its successor MRS II are seeking to resolve that issue in a novel approach that brings together the Department of Veterans Affairs, U.S. Marine Corps, and Navy Medicine.
In the MRS study, a cohort of about 2,600 Marines (MRS-I) in 4 battalions and about 1,300 Marines (MRS-II) in 2 battalions deployed to Iraq or Afghanistan underwent a scientifically rigorous examination a month prior to deployment. This baseline was established using self-reported questionnaires, clinical interviews, and laboratory examinations. Follow-up examinations were repeated at 3 months (MRS-I and MRS-II) and again at 6 months post-deployment (MRS-I).
The program is ambitious, Dr. Dewleen Baker of the VA San Diego Health Care System told Federal Practitioner. “MRS was designed to provide broad-based (psychosocial, psychophysiological, and biological) prospective, longitudinal data, with a goal toward ultimate integrated analyses of variables, to determine risk and resilience for post-deployment mental health outcomes, i.e,. PTSD and co-occurring disorders,” she explained. “Analyses have just begun, and we are working our way through aspects of the data toward more integrated approaches.”
In one of the first of many reports to come out of MRS, the researchers found that the probability of developing PTSD was highest for participants with severe pre-deployment symptoms, high combat intensity, and deployment-related traumatic brain injury (TBI). Most significant, the researchers found that TBI doubled or nearly doubled the PTSD rates for participants with less severe pre-deployment PTSD symptoms. According to Baker:
By contrast, deployment-related mild TBI increases post-deployment symptom scores by 23%, and moderate-to-severe injuries increase scores by 71%. Our findings suggest that TBI may be a very important risk factor of PTSD, even when accounting for preexisting symptoms and combat intensity.
Our study focused on the impact of pre-deployment symptoms, combat intensity and TBI; however, it is important to consider other factors of psychological risk and resilience. Genes, coping style, and social support are just a few of the many other factors that may influence an individual’s response to stress.
Creating a rigorous cross-agency research study required tact, diligence, and patience from the MRS team. “Each agency has their own unique culture and institutional rules, regulations, and bureaucracy, so ideas, programs, etc, must be vetted across all agencies and reconciled—the various cultures/agencies to be reconciled include DoD, VA and academia.” Baker explained. “In addition in regards to initiation of studies for MRS II, for the past couple years, we also interface with NIMH as well as Headquarters Marine Corps; NIMH has the role of scientific review of MRS-II studies carried out under Headquarters Marine Corps/BUMED funding.”
The MRS-I and II studies may very well provide a template for future studies. The MRS team included a military liaison to work with the active duty Marines and attached Sailors, gather data, schedule meetings, and to report findings. “This study has a lot of experience working within and across these agencies,” Baker noted, “It’s an excellent model for future VA/DOD joint projects.”
