Stanford Pilot Program For At-Home Caregivers Of Veterans Seeks Participants

Main Category: Caregivers / Homecare
Also Included In: Veterans / Ex-Servicemen
Article Date: 13 Mar 2009 - 6:00 PDT

Researchers at the Stanford University School of Medicine are recruiting participants for a pilot program aimed at improving at-home caregiving for U.S. veterans. The study will assess the effectiveness of an online workshop that provides training to at-home caregivers of veterans who suffer from traumatic brain injury, post-traumatic stress disorder, Alzheimer's disease or other forms of dementia. Veterans who are caring for people with these disorders are also eligible.

The six-week-long workshop, called "Building Better Caregivers," will train informal caregivers, such as family members and friends, how to not only provide better care, but also to manage their own emotions, stress and physical health. The interactive online workshop will also provide a forum in which small groups of caregivers can share personal experiences and insights on solving problems, handling difficult emotions and celebrating milestones. Each week, participants will be asked to log on at least three times and spend two hours on lessons and homework.

A major impetus for this study has been the conflicts in Iraq and Afghanistan. The Brain Trauma Foundation, a national nonprofit organization whose mission is to improve outcomes for TBI patients, estimates that between 150,000 and 300,000 Iraq veterans have some level of traumatic brain injury. That's 10 to 20 percent of Iraq veterans. Shock-wave blasts from explosive devices, land mines and rocket-propelled grenades are the leading cause of TBI for active duty military personnel in combat zones, according to the Brain Injury Association of America. Such dramatic events can lead to relatively subtle symptoms, such as confusion, headache, dizziness, mood changes, sleep disturbances, agitation and problems with memory and attention.

"Caregiving has become a major, major problem," said Kate Lorig, RN, DrPH, emeritus professor of immunology and rheumatology, currently at the Stanford Patient Education Research Center. "Usually, older caregivers stay in caregiving relationships, despite the challenges. But increasingly, young wives and, in some cases, husbands are affected. It's a hellishly difficult task that may cause young relationships to end. As a result, siblings and parents, who never expected to be caregivers at that stage in life, must step in."

Currently, resources for these serendipitous caregivers are lacking. "There are some small group networks and call centers that caregivers can rely on, but there are very few resources for them on the Internet. In particular, there's not much structured interaction among caregivers outside of the hospital. The hardest problem is reaching folks who are really isolated," said Lorig.

In response to this growing need for caregiver training, the Department of Veterans Affairs announced in December 2007 a nationwide initiative that would provide nearly $4.7 million for eight caregiver assistance pilot programs. "Building Better Caregivers" is one of the projects. Its focus is to help caregivers cope with difficult behaviors - angry outbursts and violence - as well as the inability to make decisions, and fears about the future. "The course teaches strategies for coping with stress," said Lorig. "If they can reduce stress, caregivers will be healthier."

If the program proves successful, it may be used nationally, she said. Eventually, she would like to extend this program to rural areas, where caregivers are the hardest to reach. "This is a real opportunity for people in difficult situations to help others help themselves."

Potential participants must be either a veteran who is a caregiver or a caregiver of a veteran; provide caregiving services for at least 10 hours a week; be over age 18; and reside in Hawaii, California or southern Nevada. The injured person must have TBI, PTSD or physician-diagnosed memory loss. To learn more, visit http://caregivers.stanford.edu, call Diana Laurent at (650) 723-7935, or e-mail caregivers@med.stanford.edu.

The study is being conducted jointly by the Stanford Patient Education Research Center and the VA Greater Los Angeles Healthcare System. Collaborators include Dolores Gallagher-Thompson, PhD, professor of psychiatry and behavioral sciences; Laurent, MPH, social science research assistant at the Stanford Patient Education Research Center; Theodore Hahn, MD, VA Greater Los Angeles Healthcare System; and Laural Traylor, MSW, VA Desert Pacific Healthcare System. Support for this study has been provided by a grant from the Department of Veterans Affairs, Patient Care Services, Office of Care Management and Social Work.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at http://mednews.stanford.edu.

Veterans Groups Protest Proposed Change In Coverage For Injuries, Conditions Related To Military Service

Main Category: Veterans / Ex-Servicemen
Also Included In: Rehabilitation / Physical Therapy; Health Insurance / Medical Insurance
Article Date: 11 Mar 2009 - 5:00 PDT

Several veterans groups "are lashing out" at the Obama administration over a policy proposal they say would "dramatically alter" how the Department of Veterans Affairs handles health insurance claims for veterans, The Hill reports. Under the policy, which is included in President Obama's fiscal year 2010 budget proposal, VA would bill health insurers for treatment of injuries and conditions sustained as a result of veterans' military service. Currently, VA covers those costs and bills health insurers only for treatment for conditions unrelated to veterans' military service.

Last month, 11 veterans groups, including Disabled American Veterans and the American Legion, wrote a letter to Obama, saying, "There is simply no logical explanation for billing a veteran's personal insurance for care that the VA has a responsibility to provide," adding, "While we understand the fiscal difficulties this country faces right now, placing the burden of those fiscal problems on the men and women who have already sacrificed a great deal for this country is unconscionable." They added that the policy would discourage employers from hiring disabled veterans, increase insurance premiums for disabled veterans and renege on the U.S. government's "sacred obligation" to care for the injuries veterans sustained during service.

Joe Violante, DAV's national legislative director, said, "If I had to point a finger at someone, it would be the Office of Management and Budget." According to Violante, the change would increase revenue by about $500 million from insurance collection on military service-related injuries. He said, "We hope that the administration will back away from this idea," adding, "If our government is not responsible for paying for the wounds of war, what else are they going to do?"

According to OMB spokesperson Tom Gavin, although concerns about policy changes in coverage are understandable, no official proposal is on the table. He said, "The details of the VA budget are being worked out right now and the details won't be available until April," adding, "The administration is committed to providing the VA with substantial resources to provide for our veterans" (Tiron, The Hill, 3/9).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

Biomoda Approved To Begin Screening Veterans For Lung Cancer

Main Category: Veterans / Ex-Servicemen
Also Included In: Lung Cancer; Medical Devices / Diagnostics
Article Date: 11 Mar 2009 - 0:00 PDT

Biomoda, Inc. (OTCBB: BMOD), a medical diagnostics company based in Albuquerque, received approval from an independent Institutional Review Board (IRB) to begin Phase I clinical trials of its cytology-based screening technology for early detection of cancer.

IRB review protects research subjects by reviewing the study protocol to make sure it adheres to U.S. Food and Drug Administration (FDA) and U.S. Department of Health and Human Services regulations, that risks to participants are minimized and acceptable in light of the possible benefits, that the informed consent document is accurate, and that the research is conducted in an ethical manner.

Citing the IRB's approval of Biomoda's protocol as a significant step forward, Biomoda President and CEO John Cousins said, "This not only launches our Phase I clinical study, but it also puts us in a position to have a meaningful impact on people's lives today. Our initial study is directed at military veterans who are at high risk for developing lung cancer. If our screening reveals early-stage cancer in one of our volunteers, that person's chance of being alive five years from now goes from 15 percent to 80 percent, all because of early diagnosis and treatment." It is our intent in this pilot program to identify five to ten such cases and have a dramatic impact on saving lives here in New Mexico now.

Working closely with the New Mexico Department of Veterans Services and the New Mexico Institute of Mining and Technology, Biomoda will begin recruiting volunteers for the study from New Mexico's veteran population. Volunteers must be "20 pack year" smokers, individuals who have smoked one pack a day for 20 years or two packs a day for 10 years.

The study will initially enroll approximately 200-300 participants who will provide a deep-lung sputum sample under the guidance of a respiratory therapist. Each volunteer will also undergo a computed tomography (CT) scan, currently the standard of care for early detection of lung cancer. Later this year, the study will expand to 2,500 volunteers.

"Our internal testing on a small sample of patients has shown 100 percent accuracy. With the IRB approval, we can now expand that sample to a statistically significant number of patients which we believe will push us to final FDA approval and commercialization," Cousins said.

Dr. Thomas L. Bauer, thoracic surgeon and cancer researcher with the Christiana Care Health System in Delaware, is the national Principal Investigator (PI) overseeing the Biomoda study. Bauer has led several lung and esophageal cancer studies and heads up Christiana's participation in the International Early Lung Cancer Action Program (I-ELCAP). Bauer will work with Dr. Lara Patriquin, a diagnostic radiologist in Albuquerque, who has agreed to serve as the local PI for the study.

Biomoda's non-invasive diagnostic is based on a patented porphyrin application that preferentially binds to cancerous or aberrant cells extracted from lung sputum samples. Cancerous cells glow red under fluorescent light. The cytology-based assay is designed for cancer screening of large populations at a reasonable cost with expected commercial accuracy of at least 90 percent.

Biomoda

Goals In Health Care, Other Areas Outlined In Obama Budget Proposal Likely To Require Many New Federal Workers

Main Category: Health Insurance / Medical Insurance
Also Included In: Veterans / Ex-Servicemen; Public Health; Medicare / Medicaid / SCHIP
Article Date: 04 Mar 2009 - 6:00 PST

The fiscal year 2010 budget proposal that President Obama released last week likely would require the administration to hire tens of thousands of new federal employees to meet his "ambitious" goals in a number of areas, such as health care, the Washington Post reports. According to the Post, the proposal would provide billions of dollars for new initiatives and expansions of current programs, and "given Obama's insistence that he would scale back the use of private-sector contractors," his goals could "reverse a generational decline in the size of the government work force." Administration officials said that they cannot estimate the number of new federal employees they would need to hire until Obama releases a more detailed proposal this spring, but independent estimates range from 100,000 to 250,000 workers.

For example, officials at the Department of Veterans Affairs said that, by the end of 2009, they expect to hire more than 17,000 new employees, many at VA hospitals and other medical facilities to meet a goal of Obama's to expand access to health care for veterans. VA spokesperson Josephine Schuda said that the department plans to hire an additional 7,900 nurses, 3,800 clerks, 3,300 physicians and 2,400 practical nurses.

White House Office of Management and Budget Director Peter Orszag said, "It is premature to be making any assumptions about overall federal employment levels," adding, "We have no desire to bloat bureaucracy -- indeed, just the opposite -- and the budget will not do that." In "several key areas -- from properly auditing contracts to providing quality medical care to veterans and reducing errors in Medicare and other programs -- investing in skilled professionals will not only pay off over time but also immediately deliver better service to taxpayers," Orszag said (Rucker, Washington Post, 3/3).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

Army's January Suicide Rate Could Be Highest Monthly Total Ever

Main Category: Veterans / Ex-Servicemen
Also Included In: Mental Health; Psychology / Psychiatry
Article Date: 09 Feb 2009 - 1:00 PST

Seven soldiers committed suicide last month and 17 more suspicious deaths could be confirmed as suicides, which could bring the monthly total number of suicides to its highest level since the military began tracking such statistics in 1980, according to an Army report released on Thursday, the New York Times reports. According to the Times, while the suspicious deaths still are being investigated, the Army has said the "vast majority" of such deaths eventually are found to be suicide (Alvarez, New York Times, 2/6). The other military branches did not provide suicide rates for January, but the Army in the past few years consistently has had the highest rate (Jelinek, AP/Houston Chronicle, 2/5).

The Army last month announced that the suicide rate among U.S. soldiers in 2008 rose to its highest level since 1980. At least 128 soldiers in the Army, Army Reserve and National Guard committed suicide in 2008. That figure could increase, pending the outcome of investigations into 15 more deaths (Kaiser Daily Health Policy Report, 1/30). The annual rate rose for the fourth year in a row, according to the Times (New York Times, 2/6). Although specific reasons for the rate increase were not given, officials said longer deployments were a contributing factor, with other factors including job-related difficulties and financial, personal and legal problems (Kaiser Daily Health Policy Report, 1/30).

Gen. Peter Chiarelli, vice chief of staff of the Army, said, "The trend and trajectory ... heightens the seriousness and urgency that all of us must have in preventing suicides" (New York Times, 2/6). The Army last week said it would hold special training from Feb. 15 to Mar. 15 to help troops identify suicidal behavior in fellow soldiers. The Army later plans to establish a suicide prevention program for personnel at every level. In October 2008, the Army and the National Institute of Mental Health reached an agreement to conduct a five-year study to assess the mental and behavioral health of soldiers and develop periodic intervention strategies (AP/Houston Chronicle, 2/5).
Reaction
The January suicide figures raised concerns among veterans' advocates, who say the military for years has been unsuccessful in meeting the mental health needs of soldiers returning from war, the Times reports. Paul Rieckhoff, executive director for Iraq and Afghanistan Veterans of America, said the Department of Defense and the Department of Veterans Affairs "must take bold and immediate action." He said, "In January, we lost more soldiers to suicide than to Al Qaeda," adding, "If we lost this many soldiers to an enemy weapon, the entire country would know about it and we would demand defensive measures" (New York Times, 2/6).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

Detecting Suicidal Thoughts In Army Vets
Main Category: Veterans / Ex-Servicemen

Also Included In: Depression; Psychology / Psychiatry; IT / Internet / E-mail
Article Date: 09 Feb 2009 - 0:00 PST

University at Buffalo researcher John Violanti, Ph.D., a specialist in suicide among police officers, is preparing to conduct a study on suicide risk among returning veterans. The U.S. Army yesterday reported a "stunning spike" in the number of soldiers taking their own lives.

Violanti currently is testing a computer-based psychological "task" which measures how quickly persons associate feelings of self-harm, as a way of detecting "under the radar" suicidal thought.

"I feel that military personnel will not readily admit suicidal thoughts," Violanti says. "This new test gets to real feelings at a subconscious level. It is called IAT (Implicit Association Testing) and was developed at Harvard.

"Suicide among returning veterans is a big problem," says Violanti. "On their psychological evaluation when they return there is only one question on suicide - "Are You Depressed?" Who is going to answer that?"

Violanti is a Vietnam Vet and former member of the New York State Police. As a research associate professor in the UB School of Public Health and Health Profession, he has studied suicide among police officers and the effects of policing on officers' health for 16 years.

According to the Army's report, the number of soldiers who committed suicide in January could be as high as 24, which would be the highest monthly total since the Army began collecting data on suicides. January's suicide total may be more than the number of soldiers killed in combat in Iraq and Afghanistan during the month.

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Article adapted by Medical News Today from original press release.
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The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities. The School of Medicine and Biomedical Sciences, School of Dental Medicine, School of Nursing, School of Pharmacy and Pharmaceutical Sciences and School of Public Health and Health Professions are the five schools that constitute UB's Academic Health Center.

Source: Lois Baker
University at Buffalo

The University of Pittsburgh School of Medicine is conducting a research study to determine the efficacy of two therapies for sleep problems related to post-deployment stress disorder. The study will seek to determine if these therapies can reduce insomnia and nightmares.

Researchers are looking for military veterans over the age of 18 who have problems falling asleep, staying asleep or feel poorly rested after an adequate amount of sleep and have nightmares. Participants in the study will receive a physical examination and participate in a sleep study. They will be compensated up to $275 for their time.

Post-deployment stress symptoms that persist for more than one month after a highly stressful event are prevalent in military veterans. These reactions include flashbacks, nightmares, feelings of detachment from others, sleep disturbances and efforts to avoid people and places associated with the stressful event. Nightmares and insomnia often are resistant to traditional PTSD treatments, such as cognitive behavioral therapy and medication.
Military Veterans Who Have Problems Sleeping Needed For University Of Pittsburgh And VA Research Study

Main Category: Veterans / Ex-Servicemen
Also Included In: Clinical Trials / Drug Trials; Sleep / Sleep Disorders / Insomnia
Article Date: 18 Mar 2009 - 2:00 PDT

For more information or to see if you qualify for this research study, call Abdul Hakim at (412) 246-6409 or view the Web site at http://www.veteranssleep.pitt.edu.

University of Pittsburgh Medical Center, U.S. Steel Tower, 600 Grant St., 57th Floor, Pittsburgh, PA 15213 United States