Agent Orange linked to doubled cancer risk in Vietnam veterans (San Antonio Express News)
U.S. Air Force personnel who conducted aerial spray missions of the Agent Orange herbicide during the Vietnam War were twice as likely to have a disorder that can lead to a type of blood cancer, says a new study published in JAMA Oncology online Sept. 3. This is the first study to uncover an association between exposure to Agent Orange and multiple myeloma among Vietnam veterans. Previous research showing an association between similar herbicides and multiple myeloma examined agricultural workers in the United States and Canada. “We have, for the first time, biological evidence of a connection between this particular cancer and exposure to Agent Orange and its dioxin contaminant,” said Joel Michalek, a professor of biostatistics at San Antonio’s University of Texas Health Science Center and an author on the paper. Multiple myeloma is a relatively rare blood cancer that can damage the kidneys and other organs, weaken bones and cause high calcium levels in the blood, the National Cancer Institute says. Agent Orange has been linked to other cancers and diseases, including Type 2 diabetes. U.S. Air Force personnel sprayed Agent Orange from aircraft to destroy forests and foliage that provided enemy cover in Vietnam from 1962 to 1971 as part of the Operation Ranch Hand program. The study examined blood samples collected and stored in 2002 from 479 Ranch Hand veterans and compared them to blood samples from 479 veterans who served in Southeast Asia during the same time period but weren’t involved in the aerial spray missions. Researchers found a 2.4-fold increased risk for a condition called monoclonal gammopathy of undetermined significance, a precursor disease for multiple myeloma, in the Ranch Hand veterans compared to the other veterans. Of 479 Ranch Hand veterans, 34 of them, or 7.1 percent, had the precursor for the cancer, compared to 15 of 479, or 3.1 percent, in the other veterans. The majority of people with the multiple myeloma precursor do not develop the cancer, but previous research has shown multiple myeloma is consistently preceded by that blood disorder, said Dr. Ola Landgren, a hematologic oncologist at Memorial Sloan Kettering Cancer Center in New York and the study’s lead author.
On 9/11, let’s resolve to finally fix VA health care (Minneapolis Star Tribune)
Commentary: “The anniversary of the Sept. 11, 2001, terror attacks is an unmistakable reminder of just how fragile freedom is. Each American citizen has a role in defending it, but the most obvious burden goes to millions who’ve served in our armed forces. Unfortunately, our nation too often fails in its responsibility to support them when they return from the fight. Although last year’s VA hospital scandal should’ve been a turning point, there’s still a rotten culture at work within the Department of Veterans Affairs bureaucracy — a culture that encourages neglect of our nation’s veterans and defies every well-intentioned effort for change. Despite these problems, VA Secretary Robert McDonald is touring the country touting “progress,” even though excessive health care wait times across the system have increased since last year. It seems like shocking examples of VA failure show up in headlines daily. Minnesota is no exception. Here in the Twin Cities, wait times for thousands of VA health care appointments drag on longer than 30 days. Adding to this failure, hundreds of local veterans were denied the disability benefits to which they’re entitled. The VA allowed unqualified staff to conduct evaluations properly reserved for physicians, misdiagnosing patients and leaving them without access to the care they needed. Most disturbingly, a recent VA probe of the St. Cloud VA Medical Center revealed “a work environment where employees are scared to report problems” and face “fear of reprisal and not wanting to get on the bad side of the medical center director and chief of staff.” This toxic culture left doctors saddled with a workload of 1,800 patients per physician. Yet this is all too often the VA’s standard operating procedure. The agency prefers burying its problems instead of encouraging staff to speak up or propose solutions. That’s why changing leadership, constant budget increases, hiring new staff, and even acts of Congress have done little to fix the VA’s lackluster service and results. What good are new staff members at what’s already the second-largest federal agency if they’re stifled by bureaucracy and punished for challenging the status quo? It’s urgent that Congress uses its power to push past the VA’s resistance and reform veterans’ health care.”
Official calls for more VA access for Guard, Reserve members (Military.com)
Curbing military suicides among Guard and Reserve members may require a change in federal law to extend Veterans Affairs benefits to those who have never deployed or been activated, an official said Wednesday. “Some of the members don’t qualify for the VA. Some of our members don’t have health insurance at all. We need to make sure that our service members have coverage,” said U.S. Public Health Service Rear Adm. Joan Hunter, who leads the National Guard’s psychological health program. “As we wind down the war, we’re going to see more and more domestic operations and we need to make sure that our guardsmen and our reserves have parity and access to care.” Currently Guard and Reserve members only qualify for VA care if they served on federal duty. Those who served on active duty in a war zone after 1998 qualify for care for five years from the time they are discharged. Deploying on state-issued orders, even to a potentially hazardous or traumatic disaster area, does not qualify Guard and Reserve members for VA assistance, including mental health care, according to VA policy. “What are we going to do to support them as a special population?” she said. “There are loops and hoops that we have to go through in order to get them the care they need at the level they need.”
Veteran credentialing problems persist despite jobs boost (Military Times)
Veterans unemployment is at its lowest point in years, but veterans credentialing and military skills translation is still a headache. Employment experts told Congress on Thursday that just because more veterans are finding civilian jobs doesn’t mean the process of recognizing military skills for post-military careers has been fixed. Differing state rules and unclear training programs still leave many veterans confused and frustrated, and employers without a valuable talent pool. “This situation creates an artificial barrier to employment for veterans,” said Roy Swift, executive director of Workcred, an affiliate of the American National Standards Institute. “With an estimated 250,000 military personnel expected to leave service every year, the need to translate military skills into civilian careers is as important as ever.” Last week, the Labor Department announced that the unemployment rate for all veterans fell to 4.2 percent in August, the lowest monthly mark since May 2008. Despite that good news, lawmakers on the House Veterans’ Affairs Committee said they still worry about underemployment among highly-skilled service members who have to wade through various licensing and certification standards, sometimes at a high cost. “We simply can’t continue to spend millions of dollars training service members to do a job in the military and then require them to turn right around and re-take unnecessary courses or exams for the same job in the civilian world,” said Rep. Brad Wenstrup, R-Ohio, chairman of the subcommittee on economic opportunity. Wenstrup and witnesses said they believe that the federal government has made significant strides in addressing those problems — particularly in specialties such as medical training — but still must do more to find ways to make it easier for states to understand military jobs and skills.
More work needed long-term as wounded troops transition (Military Times)
While more attention is being paid to caring for wounded warriors and their families, some key aspects of that need five or more years down the road must be addressed, according to a panel of experts at a warrior-family symposium in Washington. The nation must change its thinking about mental health, in particular the stigma that still surrounds seeking mental health services — not just within the military but also in the civilian community, too, a panelist said. “We have an opportunity in this country to change the discussion about mental health,” said clinical psychologist Jerry Sullivan, general manager of Medicare and federal channels for Optum Behavioral Health Solutions. The symposium was sponsored by the Military Officers Association of America and Wounded Warrior Project. Groups are focusing on a variety of solutions to ensure veterans get access to the care they need. That includes making those in the civilian community more aware of ways they can help, especially in rural areas. School teachers, religious leaders, neighbors, judges and police officers are among key groups that should be “aware and knowledgeable and ready to make a good catch” to help a veteran, said Shelley MacDermid Wadsworth, director of the Military Family Research Institute at Purdue University. “Every story you hear about someone who almost committed suicide, but didn’t, there’s usually an element of somebody who made a good catch — someone who picked up the phone or answered the phone, someone who reached out,” Wadsworth said. Those who are thinking of suicide usually tell someone, said Marjorie Morrison, CEO and founder of the nonprofit PsychArmor Institute, but those people don’t always know where to seek help. One of PsychArmor’s recent initiatives involves working with the Department of Veterans Affairs and others to provide an outlet for those in the civilian community to get information when they need to know how to help troubled veterans. Wadsworth also cautioned that “it’s easy to slip into the discourse about how veterans and military families returning to civilian communities are broken.”
Reduced heart rate variability may indicate greater vulnerability to PTSD (UC San Diego Health)
A prospective longitudinal study of U.S. Marines suggests that reduced heart rate variability – the changing time interval between heartbeats – may be a contributing risk factor for post-traumatic stress disorder (PTSD). The findings are reported in the September 9 online issue of JAMA Psychiatry by researchers at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System. Even at rest, the normal rhythm of the heart fluctuates, reflecting influences and changes in other parts of the body. Generally speaking, the greater the heart rate variability or HRV, the better. Conversely, reduced HRV suggests poorer functioning of regulatory systems in the body and has been cited as an indicator or predictor for a number of conditions, such as fetal distress, heart disease, depression, asthma, diabetic neuropathy and disorders of the autonomic nervous system, which controls bodily functions not consciously directed, such as heartbeat, breathing and digestion. HRV has been associated with PTSD, a mental health condition linked to a number of maladies, including anger, insomnia, substance abuse and chronic depression. PTSD is particularly associated with persons deployed to war. For example, the lifetime prevalence in Vietnam-era combat veterans is 19 percent. For veterans of Iraq and Afghanistan, it is 13 to 15 percent. In the general U.S. population, the PTSD prevalence rate is 8 percent. Researchers investigated whether reduced HRV before combat deployment conferred increased risk of a PTSD diagnosis after deployment. From July 2008 to October 2013, they assessed two large cohorts of active-duty Marines one to two months before combat deployment and again four to six months after their return. After accounting for deployment-related combat exposure, the researchers found that U.S. Marines with reduced HRV prior to deployment displayed increased vulnerability to PTSD upon return.
Panel: Stigma is obstacle to mental health care (Military Times)
The Pentagon and VA have “nudged the needle” forward in promoting mental health treatment to troops and veterans but many still refuse to get care, concerned about stigma, their jobs and psychiatric medications, a panel of experts said Wednesday at a military and family symposium in Washington, D.C. Negative perceptions of mental health conditions and treatment continue to keep troops and veterans from seeking care, but the issue is larger than just the stigma of a diagnosis; it is complicated by concerns over keeping their careers and not wanting to be medicated, panelists said. “The government is trying really, really hard. [The continued problems] are not for lack of effort. Issues of mental health are hard to address. People don’t want to be seen as a weak link. Even if those who want to raise their hands for help say ‘I don’t want to do this. I might not get deployed. I might not get that promotion,’ ” said retired Army Col. Elspeth Cameron Ritchie, now chief clinical officer at the D.C. Department of Mental Health. Stigma regarding mental health conditions is not unique to the military; it’s a national issue. But while the White House, community organizations and the Health and Human Services, Veterans Affairs and Defense departments have embarked on national initiatives to make seeking treatment acceptable, the issues are so personal that it’s difficult to reach individuals, according to the panel. Retired Army Maj. Gen. Mark Graham, director of the veterans counseling hotline Vets4Warriors, became involved after a personal experience with a service member in crisis: His son, Kevin Graham, an Army ROTC student at the University of Kentucky, died by suicide in 2003. He had taken himself off Prozac before summer training to keep the Army from finding out about his mental illnesses. Even at school, his roommates — who were his brother and his sister — were unaware he was on medication. “We have got to get rid of this stigma,” Graham said. “Kevin was embarrassed. And I didn’t know know you could die by being too sad.”
VA triples volunteers nationwide (Fort Campbell Courier)
The Department of Veterans Affairs (VA) announced that its 2015 Summer of Service initiative, which launched in May, exceeded the goals set for community volunteers serving Veterans and the development of new partnerships to reach Veterans and their family members. VA’s Summer of Service mobilized approximately 300,000 citizens across the country to honor the nation’s sacred commitment to caring for Veterans. “Community by community, state by state, VA and the country came together to serve those who have served this nation. I am incredibly proud of the hundreds of thousands of volunteers who came into VA facilities to stand alongside our hard-working employees to help America’s Veterans,” said Secretary of Veterans Affairs Robert A. McDonald. “At VA, we know that there is more work to do to serve America’s heroes. We cannot do it alone. This summer, the American people recognized our vital role caring for those who have borne the battle and joined us in this sacred mission. Committed employees and volunteers, and strong partnerships, are the cornerstone of our efforts to transform this Department into one that Veterans and all citizens can be proud of.” The Summer of Service built upon the Department’s existing partnerships to grow the number of individuals and organizations serving Veterans in their communities. VA facilities nationwide worked closely with their Congressional partners, Veterans Service Organizations, Mayors and local communities, private sector and non-profit organizations, and VA employees in unprecedented ways to support VA’s commitment to care for those who “have borne the battle” and their families. Through VA’s volunteer program, the Department engaged approximately 300,000 volunteers around the country, far exceeding our goal of 100,000 volunteer connections. Through the work of Veterans Service Organizations and other community/civic groups, supplemental services and programs were made available for America’s Veterans.
Summit planned in Chicago on veterans and mental health (The Washington Times)
Veterans groups, elected officials and others have been invited to attend a summit in Chicago on veterans’ mental health. The Department of Veterans Affair says the event will take place Thursday at Jesse Brown VA Medical Center in Chicago. It’s the third year the medical center has hosted the event as a way to strengthen its community ties and work toward ending homelessness among vets. Staff from many disciplines at the medical center will attend. Representatives from local law enforcement, Vet Centers, Veteran Service Organizations, elected officials and others have been invited. The summit will begin with an overview of mental health issues facing veterans and then will feature discussions of smaller groups in an effort to develop strategies to address the needs of veterans.