Mild traumatic brain injury in U.S. soldiers returning from Iraq

http://stinet.dtic.mil/cgi-bin/GetTRDoc?AD=ADA479403&Location=U2&doc=GetTRDoc.pdf

Background: An important medical concern of the Iraq war is the potential long-term effect of mild traumatic brain injury, or concussion, particularly from blast explosions. However, the epidemiology of combat-related mild traumatic brain injury is poorly understood. Methods: We surveyed 2525 U.S. Army infantry soldiers 3 to 4 months after their return from a year-long deployment to Iraq. Validated clinical instruments were used to compare soldiers reporting mild traumatic brain injury, defined as an injury with loss of consciousness or altered mental status (e.g., dazed or confused), with soldiers who reported other injuries. Results: Of 2525 soldiers, 124 (4.9%) reported injuries with loss of consciousness, 260 (10.3%) reported injuries with altered mental status, and 435 (17.2%) reported other injuries during deployment. Of those reporting loss of consciousness, 43.9% met criteria for post-traumatic stress disorder (PTSD), as compared with 27.3% of those reporting altered mental status, 16.2% with other injuries, and 9.1% with no injury. Soldiers with mild traumatic brain injury, primarily those who had loss of consciousness, were significantly more likely to report poor general health, missed workdays, medical visits, and a high number of somatic and postconcussive symptoms than were soldiers with other injuries. However, after adjustment for PTSD and depression, mild traumatic brain injury was no longer significantly associated with these physical health outcomes or symptoms, except for headache. Conclusions: Mild traumatic brain injury (i.e., concussion) occurring among soldiers deployed in Iraq is strongly associated with PTSD and physical health problems 3 to 4 months after the soldiers return home. PTSD and depression are important mediators of the relationship between mild traumatic brain injury and physical health problems.

POST-TRAUMATIC STRESS DISORDER AND THE MILITARY

http://stinet.dtic.mil/cgi-bin/GetTRDoc?AD=ADA479123&Location=U2&doc=GetTRDoc.pdf


Over the past several years, the topic of military mental healthcare has received renewed attention, both inside and outside the Armed Forces. This selected bibliography focuses on posttraumatic stress disorder (PTSD) and its presentation in military personnel. Included are references to books, documents, periodical articles, multimedia, and web sites related to this topic. A separate section concentrates on PTSD in members of the military and its relationship to
age, gender, or ethnicity. This is followed by a section focusing on disability claims as the result of PTSD.
With a few notable exceptions, the materials in this bibliography are dated 2005 to the present. For information prior to this period, please refer to the previous edition of Post-Traumatic Stress Disorder and the Military: A Selected Bibliography (November 2005). All items in this bibliography are available through the USAWC Library. For your convenience, at the end of all entries, we have added library call numbers, Internet addresses, or database links.
Web sites were accessed during March 2008.

Invisible Wounds of War

Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Edited by Terri Tanielian and Lisa H. Jaycox

http://rand.org/pubs/monographs/2008/RAND_MG720.pdf

The study discussed in this monograph focuses on post-traumatic stress disorder,
major depression, and traumatic brain injury, not only because of current high-level
policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members,and society in general. All three conditions affect mood, thoughts, and behavior;yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it.
RAND conducted a comprehensive study of the post-deployment health-related
needs associated with post-traumatic stress disorder, major depression, and traumatic
brain injury among OEF/OIF veterans, the health care system in place to meet those
needs, gaps in the care system, and the costs associated with these conditions and with providing quality health care to all those in need. This monograph presents the results of that study. These results should be of interest to mental health treatment providers;health policymakers, particularly those charged with caring for our nation’s veterans; and U.S. service men and women, their families, and the concerned public. All the research products from this study are available at http://veterans.rand.org.

Invisible Wounds

http://rand.org/pubs/research_briefs/2008/RAND_RB9336.pdf

Invisible Wounds
Mental Health and Cognitive Care Needs of America's Returning Veterans

By: Terri Tanielian, Lisa H. Jaycox, Terry L. Schell, Grant N. Marshall, M. Audrey Burnam, Christine Eibner, Benjamin R. Karney, Lisa S. Meredith, Jeanne S. Ringel, Mary E. Vaiana

This research brief summarizes a comprehensive RAND study of the mental health and cognitive needs of returning servicemembers and veterans of Operations Enduring Freedom and Iraqi Freedom.

A Physiological and Human Factors Evaluation of a Novel Personal Helicopter Oxygen Delivery System

http://www.usaarl.army.mil/TechReports/2007-14.PDF

In current U.S. Army operations, rotary-wing aircrew can be repeatedly exposed to moderately high altitude (up to 18,000 feet pressure altitude), making hypoxia, and its performance effects, a real hazard. The United States Army Aeromedical Research Laboratory (USAARL) was tasked by the Product Manager Air Warrior to evaluate a portable oxygen system for potential use by U.S. Army helicopter aircrew. The system described below provided capability for oxygen production, charging of the portable system, as well as in-flight use by aircrew. The system was tested for its compatibility with current Aircrew Assemblies, Night Vision Goggles, aircrew duties, and emergency egress. The system was also tested on pilot volunteers at altitude to determine efficacy. The Personal Helicopter Oxygen Delivery System (PHODS) was able to maintain aircrew blood oxygen at acceptable levels up to and including 18,000 feet.

Apache Aviator Evaluation of Dual-Technology Night Vision Systems in Operation Iraqi Freedom (OIF) Urban Combat (Master’s Thesis)

http://www.usaarl.army.mil/TechReports/2008-05.PDF
The U. S. Army currently fields two variants of night vision devices (NVDs), the Aviator Night Vision Imaging System (ANVIS) and the Pilot Night Vision System/Target Acquisition and Designation System (PNVS/TADS). The effectiveness of these sensors in the AH-64D during urban missions in Iraq from November 2005 thru October 2006 was assessed with a questionnaire administered to 38 Apache AH-64D aviators. The survey compared sensors with regard to reconnaissance, situational awareness, and human factors issues. Results showed that the I2 ANVIS was preferable to the FLIR for reconnaissance missions. ANVIS was also preferred for wire and aircraft avoidance. The primary benefit of the PNVS/TADS system, as reported by aviators, was the flight symbology cues provided through the helmet-mounted display (HMD).