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Robles-Vera PI, Molina-Vicenty IL, Borrás-Fernandez IC, Jovet-Toledo G, Motta-Valencia K, Dismuke CE, Pope C, Reyes-Rosario C, Ríos-Padín J. Sociodemographic and Health Characteristics of Hispanic Veteran Patients With Traumatic Brain Injury and Its Association to Mortality: A Pilot Study. Mil Med 2024:usae346. [PMID: 39042559 DOI: 10.1093/milmed/usae346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/04/2024] [Accepted: 06/24/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) is among the most common conditions in the military. VA Caribbean Healthcare System (VACHS) patients with Traumatic Brain Injury (TBI) have a higher mortality rate than Veterans in other VA health care systems in the United States. The main goal of this study was to develop sociodemographic profiles and outline health characteristics of Hispanic patients with TBI treated at the VA Caribbean Healthcare System in a search for potential explanations to account for the higher mortality rate. This study advocates for equity in health services provided for minorities inside the militia. MATERIALS AND METHODS Data collected from electronic medical records and VA databases were used to create sociodemographic and health characteristics profiles, in addition to survival models. The population of the study were post 911 Veteran soldiers who had been diagnosed with TBI. Adjusted models were created to provide hazard ratios (HR) for mortality risk. RESULTS Out of the 16,549 files available from all 10 selected VA sites, 526 individuals were identified as treated at the VACHS. Of 526 subjects screened, 39 complied with the inclusion/exclusion criteria. Results include: 94.4% male, 48.7% between the ages of 21 and 41 years, 89.7% have depression, 66.7% have post-traumatic stress disorder (PTSD), 82.1% receive occupational therapy, 94.9% have severe headaches, 100% suffer from pain, 94.9% have memory problems, and 10.3% have had suicidal thoughts. Over 60% had a first-hand explosion experience, be it just the explosion or with another type of injury. Data showed that 33% of our patients had a Magnetic Resonance Imaging (MRI), 31% had a CT, 15.4% had a SPECT, and 2.6% had PET scan. Significant associations were found between MRIs and speech therapies, and MRIs and total comorbidities. The Cox proportional-hazards model for survival adjusted for age, gender, race/ethnicity, and comorbidities shows that VACHS Veterans diagnosed with a TBI had a higher mortality risk rate (HR 1.23 [95% CI 1.10, 1.37]) when compared to the other 9 health centers with the highest percentage of Hispanic Veterans. CONCLUSIONS Since explosions were the most common mechanism of injury, further research is needed into the experiences of Veterans in connection with this specific variable. A high percentage of the patients suffered from depression and PTSD. Additionally, over half of the patients had an unmeasured TBI severity. The effects these aspects have on symptomatology and how they hinder the recovery process in Hispanic patients should be examined in further detail. It is also important to highlight that family and friends' support could be key for injury treatment. This study highlights the use of the 4 types of scans (MRI, CT, PET/CT, and SPECT/CT) as ideal diagnosis tools. The alarming number of patients with suicidal thoughts should be a focus in upcoming studies. Future studies should aim to determine whether increased death rates in TBI Veterans can be linked to other United States islander territories. Concepts, such as language barriers, equal resource allocation, and the experiences of Veterans with TBIs should be further explored in this Veteran population.
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Affiliation(s)
- Paola I Robles-Vera
- VA Caribbean Health Care System, Research and Development Service, Nuclear Medicine and Molecular Imaging Research Section, San Juan, PR 00921, USA
- Biology Department, Universidad de Puerto Rico, Río Piedras Campus, San Juan, PR 00925, USA
| | - Irma L Molina-Vicenty
- VA Caribbean Health Care System, Research and Development Service, Nuclear Medicine and Molecular Imaging Research Section, San Juan, PR 00921, USA
- Biology Department, Universidad de Puerto Rico, Río Piedras Campus, San Juan, PR 00925, USA
- Student Mentorship Program for Hispanic Health Research (sMPH2r), Hispanic -Serving Health Professions Schools (HSHPS), Washington, DC 20005, USA
| | - Isabel C Borrás-Fernandez
- Student Mentorship Program for Hispanic Health Research (sMPH2r), Hispanic -Serving Health Professions Schools (HSHPS), Washington, DC 20005, USA
- VA Caribbean Health Care System, Physical Medicine & Rehabilitation Service, San Juan, PR 00921, USA
| | - Gerardo Jovet-Toledo
- VA Caribbean Health Care System, Research and Development Service, Nuclear Medicine and Molecular Imaging Research Section, San Juan, PR 00921, USA
| | - Keryl Motta-Valencia
- Student Mentorship Program for Hispanic Health Research (sMPH2r), Hispanic -Serving Health Professions Schools (HSHPS), Washington, DC 20005, USA
- VA Caribbean Health Care System, Physical Medicine & Rehabilitation Service, San Juan, PR 00921, USA
| | - Clara E Dismuke
- Student Mentorship Program for Hispanic Health Research (sMPH2r), Hispanic -Serving Health Professions Schools (HSHPS), Washington, DC 20005, USA
- Ralph H. Johnson VA Medical Center, COIN: Charleston Health Equity and Rural Outreach Innovation Center (HEROIC) Charleston SC, Charleston, SC 29401, USA
- Health Economics Resource Center (HERC), VA Palo Alto Health Care System Palo Alto, Palo Alto, CA 94025, USA
| | - Charlene Pope
- Ralph H. Johnson VA Medical Center, COIN: Charleston Health Equity and Rural Outreach Innovation Center (HEROIC) Charleston SC, Charleston, SC 29401, USA
| | - Coral Reyes-Rosario
- VA Caribbean Health Care System, Research and Development Service, Nuclear Medicine and Molecular Imaging Research Section, San Juan, PR 00921, USA
- Biology Department, Universidad de Puerto Rico, Río Piedras Campus, San Juan, PR 00925, USA
- Student Mentorship Program for Hispanic Health Research (sMPH2r), Hispanic -Serving Health Professions Schools (HSHPS), Washington, DC 20005, USA
| | - José Ríos-Padín
- VA Caribbean Health Care System, Research and Development Service, Nuclear Medicine and Molecular Imaging Research Section, San Juan, PR 00921, USA
- Biology Department, Universidad de Puerto Rico, Río Piedras Campus, San Juan, PR 00925, USA
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Chao LL. Examining the current health of Gulf War veterans with the veterans affairs frailty index. Front Neurosci 2023; 17:1245811. [PMID: 37746142 PMCID: PMC10512703 DOI: 10.3389/fnins.2023.1245811] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Gulf War Illness (GWI) is a chronic, multisymptom (e.g., fatigue, muscle/joint pain, memory and concentration difficulties) condition estimated to affect 25-32% of Gulf War (GW) veterans. Longitudinal studies suggest that few veterans with GWI have recovered over time and that deployed GW veterans may be at increased risks for age-related conditions. Methods We performed a retrospective cohort study to examine the current health status of 703 GW veterans who participated in research studies at the San Francisco VA Health Care System (SFVAHCS) between 2002 and 2018. We used the Veterans Affairs Frailty Index (VA-FI) as a proxy measure of current health and compared the VA-FIs of GW veterans to a group of randomly selected age- and sex-matched, non-GW veterans. We also examined GW veterans' VA-FIs as a function of different GWI case definitions and in relationship to deployment-related experiences and exposures. Results Compared to matched, non-GW veterans, GW veterans had lower VA-FIs (0.10 ± 0.10 vs. 0.12 ± 0.11, p < 0.01). However, the subset of GW veterans who met criteria for severe Chronic Multisymptom Illness (CMI) at the time of the SFVAHCS studies had the highest VA-FI (0.13 ± 0.10, p < 0.001). GW veterans who had Kansas GWI exclusionary conditions had higher VA-FI (0.12 ± 0.12, p < 0.05) than veterans who were Kansas GWI cases (0.08 ± 0.08) and controls (i.e., veterans with little or no symptoms, 0.04 ± 0.06) at the time of the SFVAHCS research studies. The VA-FI was positively correlated with several GW deployment-related exposures, including the frequency of wearing flea collars. Discussion Although GW veterans, as a group, were less frail than non-GW veterans, the subset of GW veterans who met criteria for severe CDC CMI and/or who had Kansas GWI exclusionary conditions at the time of the SFVAHCS research studies were frailest at index date. This suggests that many ongoing studies of GWI that use the Kansas GWI criteria may not be capturing the group of GW veterans who are most at risk for adverse chronic health outcomes.
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Affiliation(s)
- Linda L. Chao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States
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Treating sleep disorders following traumatic brain injury in adults: time for renewed effort? Sleep Med Rev 2022; 63:101631. [DOI: 10.1016/j.smrv.2022.101631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/21/2022]
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Kornblith E, Peltz CB, Xia F, Plassman B, Novakovic-Apopain T, Yaffe K. Sex, race, and risk of dementia diagnosis after traumatic brain injury among older veterans. Neurology 2020; 95:e1768-e1775. [PMID: 32887780 DOI: 10.1212/wnl.0000000000010617] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 04/06/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To investigate whether sex and race differences exist in dementia diagnosis risk associated with traumatic brain injury (TBI) among older veterans. METHODS Using Fine-Gray regression models, we investigated incident dementia diagnosis risk with TBI exposure by sex and race. RESULTS After the exclusion of baseline prevalent dementia, the final sample (all veterans ≥55 years of age diagnosed with TBI during the 2001-2015 study period and a random sample of all veterans receiving Veterans Health Administration care) included nearly 1 million veterans (4.3% female; 81.8% White, 11.5% Black, and 1.25% Hispanic), 96,178 with TBI and 903,462 without TBI. Compared to those without TBI, Hispanic veterans with TBI were almost 2 times more likely (17.0% vs 10.3%; hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.51-2.01), Black veterans with TBI were >2 times more likely (11.2% vs 6.4%; HR 2.15, 95% CI 2.02-2.30), and White veterans with TBI were nearly 3 times more likely to receive a dementia diagnosis (12.0% vs 5.9%; HR 2.71, 95% CI 2.64-2.77). A significant interaction between TBI and race for dementia diagnosis was observed (p < 0.001). Both male and female veterans with TBI were more than twice as likely (men 11.8% vs 5.9%, HR 2.60, 95% CI 2.54-2.66; women 6.3% vs 3.1%, HR 2.36, 95% CI 2.08-2.69) to receive a diagnosis of dementia compared to those without. There was a significant interaction effect between sex and TBI (p = 0.02), but the magnitude of differences was small. CONCLUSIONS In this large, nationwide cohort of older veterans, all race groups with TBI had increased risk of dementia diagnosis, but there was an interaction effect such that White veterans were at greatest risk for dementia after TBI. Further research is needed to understand the mechanisms for this discrepancy. Differences in dementia diagnosis risk for men and women after TBI were significant but small, and male and female veterans had similarly high risks of dementia diagnosis after TBI.
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Affiliation(s)
- Erica Kornblith
- From the San Francisco Veterans Affairs Health Care System (E.K., C.B.P., F.X., T.N.-A., K.Y.); Department of Neurology (B.P.), Duke University, Durham, NC; and Departments of Psychiatry (E.K., T.N.-A., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco.
| | - Carrie B Peltz
- From the San Francisco Veterans Affairs Health Care System (E.K., C.B.P., F.X., T.N.-A., K.Y.); Department of Neurology (B.P.), Duke University, Durham, NC; and Departments of Psychiatry (E.K., T.N.-A., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco
| | - Feng Xia
- From the San Francisco Veterans Affairs Health Care System (E.K., C.B.P., F.X., T.N.-A., K.Y.); Department of Neurology (B.P.), Duke University, Durham, NC; and Departments of Psychiatry (E.K., T.N.-A., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco
| | - Brenda Plassman
- From the San Francisco Veterans Affairs Health Care System (E.K., C.B.P., F.X., T.N.-A., K.Y.); Department of Neurology (B.P.), Duke University, Durham, NC; and Departments of Psychiatry (E.K., T.N.-A., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco
| | - Tatjana Novakovic-Apopain
- From the San Francisco Veterans Affairs Health Care System (E.K., C.B.P., F.X., T.N.-A., K.Y.); Department of Neurology (B.P.), Duke University, Durham, NC; and Departments of Psychiatry (E.K., T.N.-A., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco
| | - Kristine Yaffe
- From the San Francisco Veterans Affairs Health Care System (E.K., C.B.P., F.X., T.N.-A., K.Y.); Department of Neurology (B.P.), Duke University, Durham, NC; and Departments of Psychiatry (E.K., T.N.-A., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco
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Kornblith ES, Yaffe K, Langa KM, Gardner RC. Prevalence of Lifetime History of Traumatic Brain Injury among Older Male Veterans Compared with Civilians: A Nationally Representative Study. J Neurotrauma 2020; 37:2680-2685. [PMID: 32762279 DOI: 10.1089/neu.2020.7062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Traumatic brain injury (TBI) is common among older adults as well as among veterans in the United States and can increase risk for dementia. We compared prevalence of TBI in older male veterans and civilians using a nationally representative sample. We examined data from 599 male respondents to the 2014 wave of the Health and Retirement Study (HRS), a nationally representative survey of older adults, randomly selected to participate in a comprehensive TBI survey. Respondents self-reported no injury, non-TBI head/neck injury (NTI), or TBI. We used weighted analyses to examine prevalence of injury and relative risk of injury subtypes. Among male veterans, we found a national prevalence of more than 70% for lifetime history of any head/neck injury (TBI plus NTI), 14.3% for multiple NTI, and 36% for lifetime history of at least one TBI. In contrast, prevalence estimates for male civilians were 58% for lifetime history of head/neck injury, 4.8% for multiple NTI, and 45% for lifetime history of at least one TBI (all comparisons, p < 0.001). Male civilians have higher self-reported TBI prevalence, whereas male veterans have higher self-reported NTI and multiple-NTI prevalence. Further research on drivers of the unexpectedly higher prevalence of lifetime history of TBI in male civilians, as well as on mechanisms and sequelae of the highly prevalent non-TBI head/neck injuries among older male veterans, is warranted.
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Affiliation(s)
- Erica S Kornblith
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.,Department of Neurology, University of California, San Francisco, San Francisco, California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Kenneth M Langa
- Division of General Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.,Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan, USA.,Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.,Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Raquel C Gardner
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Bacal D. Introduction to Traumatic Brain Injury in Children. J Binocul Vis Ocul Motil 2020; 70:116-118. [PMID: 32149592 DOI: 10.1080/2576117x.2020.1728181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Over the last decade, the reported rates of traumatic brain injury (TBI) have increased dramatically in all age groups, but particularly in children. However, these reports likely underestimate the scope of the problem for several reasons. There is no uniformly accepted definition of mild TBI (concussion). There are often no outward and obvious physical signs of TBI. Interpersonal and psychological issues, which may be significant, may be misdiagnosed or misinterpreted. And there is no uniformly accepted neuroimaging protocol. This presentation will outline the major issues surrounding the cause, diagnosis, and treatment of concussion, particularly in children.
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Mesley MS, Edelman K, Sharpless J, Borrasso A, Billigen JB, Puffer R, Williams D, Benso S, Puccio AM, Schneider W, Soose R, Beers S, Kontos A, Collins M, Okonkwo DO. Impact of Multi-Disciplinary Care and Clinical Coach Coordinators on Participant Satisfaction and Retention in TBI Clinical Trials: A TEAM-TBI Study. Mil Med 2019; 184:155-159. [PMID: 30901471 DOI: 10.1093/milmed/usy386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/13/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Targeted Evaluation Action and Monitoring of Traumatic Brain Injury (TEAM-TBI) is a monitored, multiple interventional research identifying clinical profiles and assigns individualized, evidence-based treatment program. The objective of the current study was to assess overall participant satisfaction of the multi-disciplinary care team and approach. METHODS Between 2014 and 2017, 90 participants completed the 4-day TEAM-TBI clinical intake evaluation resulting in individualized treatment recommendations followed by a six-month intervention phase follow-up. Inclusion criteria were: age 18-60, history of chronic TBI (>6 months post-injury) with refractory clinical sequelae at screening (Post-Concussion Symptom Scale [PCSS] score >30). RESULTS A total of 85/90 (94%) participants completed the survey at baseline focusing on intake evaluation and approach; 90% of eligible participants also completed the follow-up time-point. Hundred percent of participants had a mean score of >4 across all questions at the initial time point." CONCLUSIONS The multi-disciplinary care approach and individualized treatment plans of the TEAM-TBI study yielded high participant retention and satisfaction scores. The Clinical Coach component of the trial was one of the highest rated aspects of the program and was associated with participant motivation and high retention rates.
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Affiliation(s)
- Matthew S Mesley
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Kathryn Edelman
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Jane Sharpless
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Allison Borrasso
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Julia B Billigen
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Ross Puffer
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Dana Williams
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Steven Benso
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Ava M Puccio
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Walt Schneider
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Ryan Soose
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Sue Beers
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Anthony Kontos
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - Michael Collins
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
| | - David O Okonkwo
- University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA
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Oster C, Morello A, Venning A, Redpath P, Lawn S. The health and wellbeing needs of veterans: a rapid review. BMC Psychiatry 2017; 17:414. [PMID: 29284431 PMCID: PMC5747125 DOI: 10.1186/s12888-017-1547-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND For the majority of serving members, life in the military has a positive effect on wellbeing. However, the type, intensity and duration of service, along with the transition from fulltime military to civilian life, may have a negative effect on veterans' wellbeing. Such negative consequences, alongside the growing veteran population, indicate the need for greater exploration of veterans' physical, mental and social wellbeing. METHODS The current paper reports on the findings of a rapid review of the literature on the health and wellbeing needs of veterans, commissioned by the Australian Department of Veterans' Affairs to inform future programs and services. The databases Embase, Medline, Cinahl, PubMed, Web of Science and Cochrane Database were searched for systematic reviews reporting on veterans' physical, mental and social wellbeing published in English in peer-reviewed journals. RESULTS A total of 21 systematic reviews were included. The reviews reported on a range of mental, physical and social health problems affecting veterans. While there was limited information on prevalence rates of physical, mental and social health problems in veterans compared to civilian populations, the reviews demonstrated the interconnection between these domains and the effect of demographic and military service factors. CONCLUSIONS A key finding of the review is the interconnection of the mental, physical, and social health of veterans, highlighting the importance that an integrated approach to veterans' wellbeing is adopted. It is suggested that understanding key factors, such as demographic factors and factors relating to military service, can support improved service provision for veterans.
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Affiliation(s)
- Candice Oster
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia.
| | - Andrea Morello
- 0000 0004 0367 2697grid.1014.4Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 Australia
| | - Anthony Venning
- 0000 0004 0367 2697grid.1014.4Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 Australia
| | | | - Sharon Lawn
- 0000 0004 0367 2697grid.1014.4Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 Australia
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Muralidhar V. Forensic investigation into a death: post-traumatic amnesia in a worker with a work-related head injury sustained in a coal-fired thermal power plant in India. BMJ Case Rep 2017; 2017:bcr-2016-218103. [PMID: 28298379 DOI: 10.1136/bcr-2016-218103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This is the first reported case of a work-related head injury in a coal-fired thermal power plant in India. This case highlights the trend of not reporting work injuries due to fears of reprisal from the management team that may include the termination of employment. Post-traumatic amnesia in a worker presenting with head trauma must be recognised by coworkers, so the cause of injury can be elicited early and the victim gets timely medical help. There are few published studies on work-related traumatic brain injury, and they provide no information on either anatomical localisation or signs and symptoms. It is imperative that this under-researched area is studied, so detailed epidemiology and accurate national and global statistics are made available to address this dangerous yet preventable condition.
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Affiliation(s)
- Venkiteswaran Muralidhar
- Department of Surgery, Sri Balaji Medical college, Royal Balaji hospital, Chromepet, Chennai 600044
- Mèdecins Sans Frontiérs International (MSF), Amsterdam, The Netherlands
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