Medicine and Health Sciences Commons^™

Prevalence And Natural History Of Neuropsychiatric Syndromes In Veteran Hospice Patients, Elizabeth R. Goy, Linda Ganzini

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Context. Prospective studies are needed to adequately describe the overall impact of neuropsychiatric syndromes on the course of hospice enrollment in outpatient settings.

Objectives. To determine the prevalence and natural history of delirium, cognitive impairment, alcohol abuse, anxiety, depression, and suicidal ideation (SI) in community-dwelling veteran hospice patients.

Methods. Home hospice patients were visited regularly from enrollment until their deaths, study withdrawal, or discharge from hospice. Family caregivers gave consent for those with Mini-Mental State Examination (MMSE) scores less than or equal to 23. Measures included the Structured Clinical Interview for DSM-IV for depression (past and current) …

Veterans Affairs General Surgery Service: The Last Bastion Of Integrated Specialty Care, Stephen Poteet, Margaret Tarpley, John L. Tarpley, A. Scott Pearson

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BACKGROUND: In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients.

METHODS: Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to …

The Department Of Veterans Affairs Nursing Academy (Vana): Forging Strategic Alliances With Schools Of Nursing To Address Nursing’S Workforce Needs, Candice C. Bowman, Linda Johnson, Malcolm Cox, Catherine Rick, Mary Dougherty, Anna C. Alt-White, Tamar Wyte, Jack Needleman, Aram Dobalian

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In 2007, the Department of Veterans Affairs (VA) established the VA Nursing Academy (VANA), a 5-year, $60-million pilot program funding 15 partnerships between schools of nursing and local VA health care facilities nationwide, to expand nursing faculty, enhance clinical faculty development, increase nursing student enrollment, and promote educational innovations. VA is an ideal setting for educating nursing students owing to a well-educated registered nurse staff, an array of traditional and nontraditional settings, a state-of-the-art computerized electronic health record system, and a unique patient population. Challenges related to the complex nature of VANA partnerships, conceptualized as strategic alliances created between disparate …

Survival Of Escherichia Coli O157:H7 On Cattle Hides, Terrance M. Arthur, Xiangwu Nou, Norasak Kalchayanard, Joseph M. Bosilevac, Tommy Wheeler, Mohammad Koohmaraie

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The objective of this study was to determine the time period that Escherichia coli O157:H7 survives on the hides of cattle. Extensive research has been conducted and is ongoing to identify and develop novel preharvest intervention strategies to reduce the presence of E. coli O157:H7 on live cattle and subsequent transfer to processed carcasses. If a reduction of E. coli O157:H7 levels in feces can be achieved through preharvest intervention, it is not known how long it would take for such reductions to be seen on the hide. In the study presented herein, three trials were conducted to follow E. …

Changes In Consumption Of Omega-3 And Omega-6 Fatty Acids In The United States During The 20th Century, Tanya L. Blasbalg, Joseph R. Hibbeln, Christopher E. Ramsden, Sharon F. Majchrzak, Robert R. Rawlings

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Background: The consumption of omega-3 (n–3) and omega-6 (n–6) essential fatty acids in Western diets is thought to have changed markedly during the 20th century.

Objective: We sought to quantify changes in the apparent consumption of essential fatty acids in the United States from 1909 to 1999.

Design:We calculated the estimated per capita consumption of food commodities and availability of essential fatty acids from 373 food commodities by using economic disappearance data for each year from 1909 to 1999. Nutrient compositions for 1909 were modeled by using current foods (1909-C) and foods produced by traditional early 20th century practices (1909-T). …

The Shaping Of Modern Human Immune Systems By Multiregional Admixture With Archaic Humans, Laurent Abi-Rached, Matthew J. Jobin, Subhash Kulkarni, Alasdair Mcwhinnie, Klara Dalva, Loren Gragert, Farbod Babrzadeh, Baback Gharizadeh, Ma Luo, Francis A. Plummer, Joshua Kimani, Mary Carrington, Derek Middleton, Raja Rajalingam, Meral Beksac, Steven G. E. Marsh, Martin Maiers, Lisbeth A. Guethlein, Sofia Tavoularis, Ann-Margaret Little, Richard E. Green, Paul J. Norman, Peter Parham

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Whole genome comparisons identified introgression from archaic to modern humans. Our analysis of highly polymorphic HLA class I, vital immune system components subject to strong balancing selection, shows how modern humans acquired the HLA-B*73 allele in west Asia through admixture with archaic humans called Denisovans, a likely sister group to the Neandertals. Virtual genotyping of Denisovan and Neandertal genomes identified archaic HLA haplotypes carrying functionally distinctive alleles that have introgressed into modern Eurasian and Oceanian populations. These alleles, of which several encode unique or strong ligands for natural killer cell receptors, now represent more than half the HLA alleles of …

Hla/Kir Restraint Of Hiv: Surviving The Fittest, Arman A. Bashirova, Rasmi Thomas, Mary Carrington

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Multiple epidemiological studies have demonstrated associations between the human leukocyte antigen (HLA) loci and human immunodeficiency virus (HIV) disease, and more recently the killer cell immunoglobulin-like (KIR) locus has been implicated in differential responses to the virus. Genome-wide association studies have convincingly shown that the HLA class I locus is the most significant host genetic contributor to the variation in HIV control, underscoring a central role for CD8 T cells in resistance to the virus. However, both genetic and functional data indicate that part of the HLA effect on HIV is due to interactions between KIR …

Diversity Of The Kir Gene Cluster In An Urban Brazilian Population, D. G. Augusto, L. Zehnder-Alves, M. R. Pincerati, M. P. Martin, Mary Carrington, Maria Luiza Petzl-Erler

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The activity of natural killer cells depends on the balance between activating and inhibitory signals coming from their receptors. Among these are the killer cell immunoglobulin-like receptors (KIR) that recognize specific HLA class I allotypes. Here we characterized KIR genetic diversity and their HLA ligands in the population of Curitiba, Paraná State (n=164), and compared it with other worldwide populations. The distribution of 2DL4 alleles was also analyzed. The Curitiba population did not differ significantly from European and Euro-descendant populations, but as an admixed population showed higher genetic diversity. We found 27 KIR profiles, many of them uncommon in European …

Analysis Of Binding Of Kir3ds1*014 To Hla Suggests Distinct Evolutionary History Of Kir3ds1, Geraldine M. O'Connor, Eriko Yamada, Andy Rampersaud, Rasmi Thomas, Mary Carrington, Daniel W. Mcvicar

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NK cell activity is regulated by the integration of positive and negative signals. One important source of these signals for human NK cells is the killer Ig-like receptor (KIR) family, which includes both members that transduce positive and those that generate negative signals. KIR3DL1 inhibits NK cell activity upon engagement by its ligand HLA-Bw4. The highly homologous KIR3DS1 is an activating receptor, which is implicated in the outcome of a variety of pathological situations. However, unlike KIR3DL1, direct binding of KIR3DS1⁺ cells to HLA has not been demonstrated. We analyzed four key amino acid differences between KIR3DL1*01502 and KIR3DS1*013 …

Factors Associated With Viral Rebound In Hiv-1-Infected Individuals Enrolled In A Therapeutic Hiv-1 Gag Vaccine Trial, Jonathan Z. Li, Zabrina L. Brumme, Chanson J. Brumme, Hongying Wang, John Spritzler, Michael N. Robertson, Michael M. Lederman, Mary Carrington, Bruce D. Walker, Rovert T. Schooley, Daniel R. Kuritzkes

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Background. Human immunodeficiency virus type 1 (HIV-1) vaccines directed to the cell-mediated immune system could have a role in lowering the plasma HIV-1 RNA set point, which may reduce infectivity and delay disease progression.

Methods. Randomized, placebo-controlled trial involving HIV-1-infected participants who received a recombinant adenovirus serotype 5 (rAd5) HIV-1 gag vaccine or placebo. Sequence-based HLA typing was performed for all 110 participants who initiated analytic treatment interruption (ATI) to assess the role of HLA types previously associated with HIV prognosis. Plasma HIV-1 gag and pol RNA sequences were obtained during the ATI. Virologic endpoints and HLA groups …

Common Hiv-1 Peptide Variants Mediate Differential Binding Of Kir3dl1 To Hla-Bw4 Molecules, Lena Fadda, Geraldine M. O'Connor, Swati Kumar, Alicja Piechocka-Trocha, Clair M. Gardiner, Mary Carrington, Daniel W. Mcvicar, Marcus Altfeld

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Epidemiological studies have shown the protective effect of KIR3DL1/HLA-Bw4 genotypes in human immunodeficiency virus type 1 (HIV-1) infection; however, the functional correlates for the protective effect remain unknown. We investigated whether human leukocyte antigen (HLA)-Bw4-presented HIV-1 peptides could affect the interaction between the inhibitory natural killer (NK) cell receptor KIR3DL1 and its ligand HLA-Bw4. Distinct HIV-1 epitopes differentially modulated the binding of KIR3DL1 to HLA-Bw4. Furthermore, cytotoxic T lymphocyte (CTL) escape mutations within the immunodominant HLA-B57 (Bw4)-restricted Gag epitope TSTLQEQIGW abrogated KIR3DL1 binding to HLA-B57, suggesting that sensing of CTL escape variants by NK cells can contribute to the protective …

Human Leukocyte Antigen Genotype And Risk Of Hiv Disease Progression Before And After Initiation Of Antiretroviral Therapy, Mark H. Kuniholm, Xiaojiang Gao, Andrea Kovacs, Kathryn Anastos, Darlene Marti, Ruth M. Greenblatt, Mardge H. Cohen, Howard Minkoff, Stephen J. Gange, Melissa Fazzari, Mary A. Young, Howard D. Strickler, Mary Carrington

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While the human leukocyte antigen (HLA) genotype has been associated with the rate of HIV disease progression in untreated patients, little is known regarding these relationships in patients using highly active antiretroviral therapy (HAART). The limited data reported to date identified few HLA-HIV disease associations in patients using HAART and even occasional associations that were opposite of those found in untreated patients. We conducted high-resolution HLA class I and II genotyping in a random sample (n = 860) of HIV-seropositive women enrolled in a long-term cohort initiated in 1994. HLA-HIV disease associations before and after initiation of HAART were examined …

Differential Microrna Regulation Of Hla-C Expression And Its Association With Hiv Control, Smita Kulkarni, Ram Savan, Ying Qi, Xiaojiang Gao, Yuko Yuki, Sara E. Bass, Maureen P. Martin, Peter Hunt, Steven G. Deeks, Amalio Telenti, Florencia Pereyra, David Goldstein, Steven Wolinsky, Bruce Walker, Howard A. Young, Mary Carrington

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The HLA-C locus is distinct relative to the other classicalHLA class I loci in that it has relatively limited polymorphism1, lower expression on the cell surface, and more extensive ligand–receptor interactions with killer-cell immunoglobulin-like receptors. A single nucleotide polymorphism (SNP) 35 kb upstream of HLA-C (rs9264942; termed -35) associates with control of HIV, and with levels of HLA-C messenger RNA transcripts and cell-surface expression, but the mechanism underlying its varied expression is unknown. We proposed that the -35 SNP is not the causal variant for differential HLA-C expression, but rather is marking another polymorphism that directly affects levels of HLA-C. …

Hiv-1 Adaptation To Nk-Cell-Mediated Immune Pressure, Galit Alter, David Heckerman, Arne Schneidewind, Lena Fadda, Carl M. Kadie, Jonathan M. Carlson, Cesar Oniangue-Ndza, Maureen Martin, Bin Li, Salim I. Khakoo, Mary Carrington, Todd M. Allen, Marcus Altfeld

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Natural killer (NK) cells have an important role in the control of viral infections, recognizing virally infected cells through a variety of activating and inhibitory receptors. Epidemiological and functional studies have recently suggested that NK cells can also contribute to the control of HIV-1 infection through recognition of virally infected cells by both activating and inhibitory killer immunoglobulin-like receptors (KIRs). However, it remains unknown whether NK cells can directly mediate antiviral immune pressure in vivo in humans. Here we describe KIR-associated amino-acid polymorphisms in the HIV-1 sequence of chronically infected individuals, on a population level. We show that these KIR-associated …

Hla-A*3101 And Carbamazepine-Induced Hypersensitivity Reactions In Europeans, Mark Mccormack, Ana Alfirevic, Stephane Bourgeois, John J. Farrell, Dalia Kasperavičiūtė, Mary Carrington, Graeme J. Sills, Tony Marson, Xiaoming Jia, Paul I. W. De Bakker, Krishna Chinthapalli, Mariam Molokhia, Michael R. Johnson, Gerard D. O'Connor, Elijah Chaila, Saud Alhusaini, B. Kevin Park, Chantal Depondt, Sanjay M. Sisodiya, David B. Goldstein, Panos Deloukas, Norman Delanty, Gianpiero L. Cavalleri, Munir Pirmohamed, Werner Pichler, Kevin V. Shianna, Rodney A. Radtke, Massimo Pandolfo

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Background

Carbamazepine causes various forms of hypersensitivity reactions, ranging from maculopapular exanthema to severe blistering reactions. The HLA-B*1502 allele has been shown to be strongly correlated with carbamazepine-induced Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS–TEN) in the Han Chinese and other Asian populations but not in European populations.

Methods

We performed a genomewide association study of samples obtained from 22 subjects with carbamazepine-induced hypersensitivity syndrome, 43 subjects with carbamazepine- induced maculopapular exanthema, and 3987 control subjects, all of European descent. We tested for an association between disease and HLA alleles through proxy single-nucleotide polymorphisms and imputation, confirming associations by high-resolution …

Prevalence And Predictors Of Food Insecurity In Migrant Farmworkers In Georgia, Brittany G. Hill, Ashley G. Moloney, Terry Mize, Tom Himelick, Jodie L. Guest

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We examined the prevalence of food insecurity in migrant farmworkers in Georgia.Of these workers 62.83% did not have enough food, and non–H-2A workers had an adjusted risk of food insecurity almost 3 times higher than did H-2A workers. Lack of access to cooking facilities, transportation problems, and having children were additional risk factors. Migrant farmworkers are at extreme risk for food insecurity, although being an H-2A guestworker was protective within this population. Policy interventions are needed to protect these vulnerable farmworkers.

Coordinate Linkage Of Hiv Evolution Reveals Regions Of Immunological Vulnerability, Vincent Dahirel, Karrthik Shekhar, Florencia Pereyra, Toshiyuki Miura, Mikira Artyomov, Shiv Talsania, Todd M. Allen, Marcus Altfeld, Mary Carrington, Darrell J. Irvine, Bruce D. Walker, Arup K. Chakraborty

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Cellular immune control of HIV is mediated, in part, by induction of single amino acid mutations that reduce viral fitness, but compensatory mutations limit this effect. Here, we sought to determine if higher order constraints on viral evolution exist, because some coordinately linked combinations of mutations may hurt viability. Immune targeting of multiple sites in such a multidimensionally conserved region might render the virus particularly vulnerable, because viable escape pathways would be greatly restricted. We analyzed available HIV sequences using a method from physics to reveal distinct groups of amino acids whose mutations are collectively coordinated (“HIV sectors”). From the …

Nih And Usda Funding Of Dietary Supplement Research, 1999–2007, Karen S. Regan, Edwina A. Wambogo, Carol J. Haggans

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Over one-half of U.S. adults use dietary supplements, so federally supported research into the safety and effectiveness of these compounds is important for the health of many Americans. Data collected in the Computer Access to Research on Dietary Supplements database, which compiles federally sponsored dietary supplement-related research, are useful to scientists in determining the type of dietary supplement research that federal agencies are currently funding and where research gaps exist. This article describes the dietary supplement-related research funded by the NIH and the USDA. Between fiscal years 1999 and 2007, the number of research projects and funding for dietary supplement …

A Cancer And Leukemia Group B Multi-Center Study Of Da-Epoch-Rituximab In Untreated Diffuse Large B-Cell Lymphoma With Analysis Of Outcome By Molecular Subtype, Wyndham Wilson, Sin-Ho Jung, Pierluigi Porcu, David Hurd, Jeffrey Johnson, S. Eric Martin, Myron Czuczman, Raymond Lai, Jonathan Said, Amy Chadburn, Dan Jones, Kieron Dunleavy, George Canellos, Andrew D. Zelenetz, Bruce D. Cheson, Eric D. Hsi

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Background

A phase II trial of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab (DA-EPOCH-R) from the National Cancer Institute showed promising activity in untreated diffuse large B-cell lymphoma. The Cancer and Leukemia Group B conducted a study to determine if these results could be reproduced in a multi-institutional setting.

Design and Methods

The study included 69 patients with untreated diffuse large B-cell lymphoma at least 18 years of age and at least stage II. Radiaton therapy was not permitted on study. Median age was 58 years (range 23-83) and 40% had high-intermediate or high International Prognostic Index risk. Immunohistochemical …

Hippocampal Volume Differences In Gulf War Veterans With Current Versus Lifetime Posttraumatic Stress Disorder Symptoms, Brigitte A. Apfel, Jessica Ross, Jennifer Hlavin, Dieter J. Meyerhoff, Thomas J. Metzler, Charles R. Marmar, Michael W. Weiner, Norbert Schuff, Thomas C. Neylan

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Background: Decreased hippocampal volume is described in posttraumatic stress disorder (PTSD) and depression. However, it is not known whether it is a risk factor for the development of PTSD or a consequence of PTSD. We sought to determine the effects of PTSD and depressive symptoms on hippocampal volume.

Methods: Clinical and magnetic resonance imaging data were collected in a cross sectional study of 244 GulfWarveterans. Measures included lifetime and current Clinician Administered PTSD Scale, Hamilton Depression Scale, Life Stressor Checklist, and Lifetime Drinking History. Magnetic resonance imaging data were acquired with a 1.5-T scanner and analyzed with automated …

Persistent Infection Or Successive Reinfection Of Deer Mice With Bartonella Vinsonii Subsp. Arupensis, Ying Bai, Charles H. Calisher, Michael Y. Kosoy, J. Jeffrey Root, Jeffrey B. Doty

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Bartonella infections are common in rodents. From 1994 to 2006, longitudinal studies of a rodent community, consisting mainly of deer mice (Peromyscus maniculatus), were conducted in southwestern Colorado to study hantaviruses. Blood samples from deer mice captured one or more times during the period 2003 to 2006 (n = 737) were selected to study bartonellae in deer mice. Bartonellae were found to be widely distributed in that population, with an overall prevalence of 82.4% (607/737 mice). No correlation was found between bartonella prevalence and deer mouse weight or sex. Persistent or successive infections with bartonellae were observed …

Long Term Depleted Uranium Exposure In Gulf War I Veterans Does Not Cause Elevated Numbers Of Micronuclei In Peripheral Blood Lymphocytes, M. V. Bakhmutskya, M. S. Oliver, M. A. Mcdiarmid, K. S. Squibb, J. D. Tucker

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Depleted uranium (DU) is a high density heavy metal that has been used in military munitions since the 1991 Gulf War. DU is weakly radioactive and chemically toxic. Long term exposure can cause adverse health effects. This study assessed genotoxic effects in DU exposed Gulf War I veterans as a function of uranium (U) body burden. Levels of urine U were used to categorize the cohort into low and high exposure groups. Exposure to DU occurred during friendly fire incidents in 1991 involving DU munitions resulting in inhalation and ingestion exposure to small particles of DU and soft tissue DU …

Receptor Specificity Of Subtype H1 Influenza A Viruses Isolated From Swine And Humans In The United States, Li-Mei Chen, Pierre Rivailler, Jaber Hossain, Paul Carney, Amanda Balish, Ijeoma Perry, C. Todd Davis, Rebecca Garten, Bo Shu, Xiyan Xu, Alexander Klimov, James C. Paulson, Nancy J. Cox, Sabrina L. Swenson, James Stevens, Amy Vincent, Marie Gramer, Ruben O. Donis

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The evolution of classical swine influenza viruses receptor specificity preceding the emergence of the 2009 H1N1 pandemic virus was analyzed in glycan microarrays. Classical swine influenza viruses from the α, β, and γ antigenic clusters isolated between 1945 and 2009 revealed a binding profile very similar to that of 2009 pandemic H1N1 viruses, with selectivity for α2-6-linked sialosides and very limited binding to α2-3 sialosides. Despite considerable genetic divergence, the ‘human-like’ H1N1 viruses circulating in swine retained strong binding preference for α2-6 sialylated glycans. Interspecies transmission of H1N1 influenza viruses from swine to humans or …

Characterizing Binge Drinking Among U.S. Military Veterans Receiving A Brief Alcohol Intervention, Michael A. Cucciare, Maura Darrow, Kenneth R. Weingardt

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Background: Brief web-based alcohol interventions (BAIs) are effective for reducing binge drinking in college students and civilian adults, and are increasingly being applied to U.S. military populations. However, little is known about factors associated with binge drinking in Veteran populations and therefore some concern remains on the generalizability of studies supporting BAIs for addressing binge drinking in this population. This study sought to better understand the characteristics (e.g., demographic, coping related mental health factors, prior exposure to traumatic events, and factors assessing motivation to change alcohol use) of a predominantly male sample of binge drinking Veterans receiving a BAI …

Prevalence Of Liver Disease In Veterans With Bipolar Disorder Or Schizophrenia, Bret E. Fuller, Veronica L. Rodriguez, Alex Linke, Mirko Sikirica, Riad Dirani, Peter Hauser

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Objective: To assess the prevalence of three liver diseases [hepatitis C virus (HCV), nonalcoholic fatty liver disease and alcohol-induced cirrhosis] in patients (veterans) with/without schizophrenia/schizoaffective disorder and bipolar disorder.

Methods: A retrospective electronic chart review of Veterans Integrated Services Network 20 facilities from January 1, 2001 to December 21, 2006 selected patients to one of two groups: schizophrenia/schizoaffective disorder or bipolar disorder. Patients in both groups were compared with veterans in an equal-sized random sample from the same data set of veterans without psychiatric diagnoses. Logistic regression models evaluated risk for overall liver diseases as well as HCV, …

Factors Associated With Suicidal Ideation In Oef/Oif Veterans, Chad M. Lemaire, David P. Graham

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Background: The purpose of this projectwas to examine factors associated with suicidal ideation in returning Iraq and Afghanistan war veterans.

Methods: A cross-sectional review of 1740 veterans' initial mental health screening evaluations. One-hundred and thirteen (6.5%) OEF/OIF veterans reported active suicidal ideation at the time of the interview.

Results: Prior exposures of physical or sexual abuse and having a history of a prior suicide attempt(s) were associated with the presence of current suicidal ideation, as were having a diagnosis of a psychotic disorder, a depressive disorder, or posttraumatic stress disorder (PTSD). Deployment concerns related to training (protective), …

Imagery Rescripting And Exposure Group Treatment Of Posttraumatic Nightmares In Veterans With Ptsd, Mary E. Long, Mary E. Hammons, Joanne L. Davis, B. Christopher Frueh, Myrna M. Khan, Jon D. Elhai, Ellen J. Teng

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This study details results of an open trial of a group psychological treatment for Veterans with posttraumatic stress disorder (PTSD) and chronic posttraumatic nightmares called “Imagery Rescripting and Exposure Therapy” (IRET). IRET is a variant of a successful imagery rescripting treatment for civilian trauma-related nightmares that was modified to address the needs of the Veteran population. Thirtyseven male U.S. Veterans with PTSD and nightmares attended 6 multicomponent group sessions. Findings indicated that the intervention significantly reduced frequency of nightmares and PTSD severity, as well as increased hours of sleep. Unlike the few open trials examining treatment of nightmares in Veterans, …

The Impact Of Endorsing Spitzer’S Proposed Criteria For Ptsd In The Forthcoming Dsm-V On Male And Female Veterans, Lyndsey N. Miller, Kathleen M. Chard, Jeremiah A. Schumm, Carol O’Brien

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This study explored differences between Spitzer’s proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer’s proposed criteria. Veterans who met both DSM-IV and Spitzer’s proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed …

Two Sessions Of Sleep-Focused Mind–Body Bridging Improve Self-Reported Symptoms Of Sleep And Ptsd In Veterans: A Pilot Randomized Controlled Trial, Yoshio Nakamura, David L. Lipschitz, Richard Landward, Renee Kuhn, Gavin West

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Objective: Sleep disturbance is highly prevalent among veterans. As an alternative to sleep medications with their undesirable side effects, nonpharmacological mind–body interventions may be beneficial for sleep management in primary care. The aim of this pilot study was to investigate whether a novel mind–body intervention, mind–body bridging (MBB), focusing on sleep, could improve self-reported sleep disturbance and comorbid symptoms in veterans.

Methods: This pilot study was a randomized controlled trial at the Veterans Affairs Salt Lake City Health Care System in which 63 veterans with self-reported sleep disturbance received MBB or an active sleep education control. Both interventions …

Cerebrocerebellar Hypometabolism Associated With Repetitive Blast Exposure Mild Traumatic Brain Injury In 12 Iraq War Veterans With Persistent Post-Concussive Symptoms, Elaine R. Peskind, Eric C. Petrie, Donna J. Cross, Kathleen Pagulayan, Kathleen Mccraw, David Hoff, Kim Hart, Chang-En Yu, Murray A. Raskind, David G. Cook, Satoshi Minoshima

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Disagreement exists regarding the extent to which persistent post-concussive symptoms (PCS) reported by Iraq combat Veterans with repeated episodes of mild traumatic brain injury (mTBI) from explosive blasts represent structural or functional brain damage or an epiphenomenon of comorbid depression or posttraumatic stress disorder (PTSD). Objective assessment of brain function in this population may clarify the issue. To this end, twelve Iraq war Veterans (32.0±8.5 [mean±standard deviation (SD)] years of age) reporting one or more blast exposures meeting American Congress of Rehabilitation Medicine criteria for mTBI and persistent PCS and 12 cognitively normal community volunteers (53.0±4.6 years of age) without …