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Furst A.J.,Stanford University | Furst A.J.,War Related Illness and Injury Study Center | Bigler E.D.,Brigham Young University
Neurology | Year: 2016

Over the past decade, the rate of traumatic brain injury (TBI)-related emergency department visits has increased by 70% and was estimated in 2010 at a staggering 2.5 million visits. This number is an underestimate as it does not include individuals who did not seek/receive medical care, are part of the US military service, or cared for by the Department of Veterans Affairs. One estimate states that 3 to 5 million Americans live with a TBI-related disability. 1 Of particular concern, recent data suggest an increased risk of dementia after TBI. However, it remains unclear whether there is indeed a specific link between the occurrence of Alzheimer disease (AD) later in life and a history of TBI. The suspicion of a causal relationship between TBI and AD mostly stems from the sudden emergence of the toxic β-amyloid (Aβ) protein observed in the brains of even young patients. This finding has been puzzling, as Aβ is a hallmark of AD, a late-life dementia. Whether the primarily axonal increase of Aβ is simply an epiphenomenon of TBI pathology or actually a precursor to the distinctively different extraneuronal fibrillar Aβ plaques seen in AD remains elusive. © 2016 American Academy of Neurology. Source


Abbi B.,War Related Illness and Injury Study Center | Natelson B.H.,Pain and Fatigue Study Center
QJM | Year: 2013

Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are medically unexplained syndromes that can and often do co-occur. For this reason, some have posited that the two are part of the same somatic syndrome-examples of symptom amplification. This hypothesis would suggest that few differences exist between the two syndromes. To evaluate this interpretation, we have searched the literature for articles comparing CFS to FM, reviewing only those articles which report differences between the two. This review presents data showing differences across a number of parameters- implying that the underlying pathophysiology in CFS may differ from that of FM. We hope that our review encourages other groups to look for additional differences between CFS and FM. By continuing to preserve the unique illness definitions of the two syndromes, clinicians will be able to better identify, understand and provide treatment for these individuals. © The Author 2012. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. Source


Dursa E.K.,Federal office of Public Health of Fribourg | Reinhard M.J.,War Related Illness and Injury Study Center | Barth S.K.,Federal office of Public Health of Fribourg | Schneiderman A.I.,Federal office of Public Health of Fribourg
Journal of Traumatic Stress | Year: 2014

Multiple studies have reported the prevalence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans; however, these studies have been limited to populations who use the Department of Veterans Affairs (VA) for health care, specialty clinic populations, or veterans who deployed. The 3 aims of this study were to report weighted prevalence estimates of a positive screen for PTSD among OEF/OIF and nondeployed veterans, demographic subgroups, and VA health care system users and nonusers. The study analyzed data from the National Health Study for a New Generation of U.S. Veterans, a large population-based cohort of OEF/OIF and OEF/OIF-era veterans. The overall weighted prevalence of a positive screen for PTSD in the study population was 13.5%: 15.8% among OEF/OIF veterans and 10.9% in nondeployed veterans. Among OEF/OIF veterans, there was increased risk of a positive screen for PTSD among VA health care users (OR = 2.71), African Americans (OR = 1.61), those who served in the Army (OR = 2.67), and those on active duty (OR = 1.69). The same trend with decreased magnitude was observed in nondeployed veterans. PTSD is a significant public health problem in OEF/OIF-era veterans, and should not be considered an outcome solely related to deployment. © 2014. Source


Earhart G.M.,University of Washington | Falvo M.J.,War Related Illness and Injury Study Center | Falvo M.J.,The New School
Comprehensive Physiology | Year: 2013

Parkinson disease (PD) is a progressive, neurodegenerative movement disorder. PD was originally attributed to neuronal loss within the substantia nigra pars compacta, and a concomitant loss of dopamine. PD is now thought to be a multisystem disorder that involves not only the dopaminergic system, but other neurotransmitter systems whose role may become more prominent as the disease progresses (189). PD is characterized by four cardinal symptoms, resting tremor, rigidity, bradykinesia, and postural instability, all of which are motor. However, PD also may include any combination of a myriad of nonmotor symptoms (195). Both motor and nonmotor symptoms may impact the ability of those with PD to participate in exercise and/or impact the effects of that exercise on those with PD. This article provides a comprehensive overview of PD, its symptoms and progression, and current treatments for PD. Among these treatments, exercise is currently at the forefront. People with PD retain the ability to participate in many forms of exercise and generally respond to exercise interventions similarly to age-matched subjects without PD. As such, exercise is currently an area receiving substantial research attention as investigators seek interventions that may modify the progression of the disease, perhaps through neuroprotective mechanisms. © 2013 American Physiological Society. Source


Yan G.W.,War Related Illness and Injury Study Center | Beder J.,Yeshiva University
Military Medicine | Year: 2013

Chaplains play a unique role in the Veterans Affairs (VA) health care systems and have numerous responsibilities. Compassion satisfaction (CS), compassion fatigue (CF), and burnout (BO) are three major phenomenons that have been documented in other helping professions, but little is known about VA Chaplains' professional quality of life. This study examines a national sample of VA Chaplains and their professional quality of life along with associated factors. Two-hundred and seventeen VA Chaplains completed an anonymous Internet survey, and regression analyses were conducted to determine which variables affect professional quality of life. On average, participants report high levels of CS and low levels of CF and BO. Gender, perceived support from VA administration, and mental health (MH) integration were significant predictors for CS. MH integration and perceived support significantly affected CF. Age, MH integration, and perceived support affected BO. Significant interaction effects were found for CF and BO. In summary, younger Chaplains and Chaplains who report low levels of collaboration with MH professionals are most likely to develop CF and BO. This supports continued support from the VA for interdisciplinary initiatives and mentorship of younger Chaplains. Source

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