Health on the Homefront:
|
|
- Alexia Nelson
- 8 years ago
- Views:
Transcription
1 Health on the Homefront: TRAUMATIC BRAIN INJURY SURVEILLANCE, DEPARTMENT OF THE NAVY, SAILORS AND MARINES IN VIRGINIA, Jean Slosek, MS, Epidemiologist Deployment Health Division, Epidemiology Data Center Department (EDC), Navy and Marine Corps Public Health Center, Department of the Navy ACKNOWLEDGEMENTS: Dagny B. Magill, MPH (EDC Epidemiologist) Tina M. Luse, MPH (EDC Deployment Division Head, Epidemiologist) Vo Vang, MSc (EDC Programmer) Viann N. Nguyen, MPH (EDC ORISE Fellow Epidemiologist) Serah Iheasirim, Dual-MPH,SSGB (EDC ORISE Fellow Epidemiologist) DISCLAIMER: The views expressed in this session are those of the presenter(s) and do not necessarily reflect the official policy or position of the U.S. Government or the Commonwealth of Virginia. The views expressed in this presentation are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U. S. Government. CONFLICT OF INTEREST DISCLOSURE: Jean Slosek, M.S. has no real or apparent conflicts of interest to report. Navy and Marine Corps Public Health Center 1 1
2 Overview What is the Deployment Health Division, EDC? What is traumatic brain injury (TBI)? What is TBI surveillance and why does EDC do it? How does the EDC do TBI surveillance for the Department of the Navy (DON)? Methods TBI surveillance data for active duty (AD) Sailors and Marines (examples from TBI surveillance) Conference-specific TBI data: TBI surveillance data for Virginia residents, AD Sailors and Marines TBI treated in fixed military treatment facilities (MTFs) in Virginia Navy and Marine Corps Public Health Center 2 Background What is the EpiData Center (EDC)? Created in 2005 Provides epidemiologic services to Department of the Navy customers 5 product lines: Communicable Disease Clinical Epidemiology Occupational/Environmental Epidemiology Deployment Health IT Navy and Marine Corps Public Health Center 3 2
3 Background What is traumatic brain injury (TBI)? In the U.S. Military Health System (MHS), traumatic brain injury (TBI) is defined as traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force that is indicated by new onset or worsening of at least one of the following clinical signs, immediately following the event: any period of loss of or decreased level of consciousness; any loss of memory for events immediately before or after the injury; any alteration in mental state at the time of the injury (confusion, disorientation, slowed thinking, etc.); neurological deficits (weakness, loss of balance, change in vision, praxis, paresis/plegia, sensory loss, aphasia, etc.) that may or may not be transient; intracranial lesion. Source: Memorandum from the Assistant Secretary of Defense (Health Affairs). Traumatic brain injury: definition and reporting, dated 1 Oct U.S Department of Defense, Washington, DC., In AFHSC Surveillance Case Definitions FINAL October Navy and Marine Corps Public Health Center 4 Background What is TBI surveillance? Public health surveillance is the routine analysis and reporting of summary data over time for a particular disease or type of injury. For TBI surveillance this may include Number of TBI new cases (incidence) Incidence rates (new TBI cases per population) Information on follow-up visits or total encounters Prevalence (number of people with TBI) Information on specific populations (for example by service branch, age, or sex) Information over time (months, years, cumulative totals) Navy and Marine Corps Public Health Center 5 3
4 Background Why does the Deployment Health Division, EDC do TBI surveillance? TBI is considered a signature injury for the war in Iraq and Afghanistan, affecting about 20% of injured troops. a Blasts from improvised explosive devices (IEDs) are a common cause of TBI in military personnel during combat (almost never seen in civilians) an estimated 60% of all blast injuries result in TBI. b Other TBI risks include motor vehicle crashes, sports, falls, and fights. TBI affects force readiness. Even mild TBI requires adequate rest to recuperate. TBI may require medical evacuation if severe enough or if symptoms not resolved. a. Defense Veterans Brain Injury Center, DVBIC Brainwaves, Winter 2009 b. Warden, D. L., Ryan, L. M., Helmick, K. M., Schwab, K., French, L., Lu, W., et al. (2005). War neurotrauma: the Defense and Veterans Brain Injury Center (DVBIC) experience at Walter Reed Army Medical Center (WRAMC). Journal of Neurotrauma, 22(10), Navy and Marine Corps Public Health Center 6 Background Military TBI surveillance methods are very different from civilian methods. What are differences in how the Centers for Disease Control and Prevention (CDC) and the DON do TBI surveillance? Data sources Populations Access to care TBI surveillance cases definition, including diagnosis codes Timeliness of data availability Navy and Marine Corps Public Health Center 7 4
5 Figure 1: TBI Data Sources, Centers for Disease Control and Prevention, % 16% 81% Source: Faul M, Xu L, Wald MM, Coronado V. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths, Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010, Figure 1: Estimated Average Annual Number of Traumatic Brain Injury Related Emergency Department Visits, Hospitalizations, and Deaths, United States, Navy and Marine Corps Public Health Center 8 Figure 2: TBI Data Sources, TBI New Cases (Incidence), AD DON, Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 9 5
6 Figure 3: Population Distribution by Age, Total US Population and AD DON Percent of Total Population Data are from the US Census Bureau (single year population estimates, July 2012) and DMED (DON) averages for Percentage calculations by the EpiData Center Department. Prepared by the EpiData Center Department, Navy and Marine Corps Public Health Center on 06 August Navy and Marine Corps Public Health Center 10 Table 1: Civilian vs. DON: Population Characteristics Navy and Marine Corps Public Health Center 11 6
7 Civilian vs. DON: TBI Surveillance Case Definitions United States Civilian TBI surveillance: Focuses on cause of injury and intent for TBI (requires E-codes or ICD-10 codes). Except for ER data, only includes data when information is available on the injury that caused the TBI. Fewer diagnosis codes are used. Not timely (death data usually not available for two or more years after event; hospital and ER data may also be distant from when TBI first occurred). AD DON TBI surveillance: E-codes are not widely available in data sources used. TBI case definition includes encounters without information on the injury event that caused the TBI. All diagnosis fields used (up to 20). Most TBI incidence are identified using outpatient data. Includes people whose first encounter with a TBI diagnosis was post-concussive syndrome. Timely outpatient and theater data are available weekly, hospital data is available monthly. Over 80% of TBIs in the military occur in a non-deployed setting a a. Source: DoD Worldwide Numbers for TBI, Navy and Marine Corps Public Health Center 12 Table 2: Civilian vs. US Military (including DON): Comparison of TBI Surveillance Case Definition a a. There are other (minor) discrepancies in list of TBI codes used. b. Faul M, Xu L, Wald MM, Coronado V. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths, Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; c. AFHSC Surveillance Case Definitions, FINAL October Navy and Marine Corps Public Health Center 13 7
8 TBI Surveillance Case Definition: DON Case Definition For surveillance purposes, a case of TBI is defined as: One inpatient or outpatient medical encounter, with any of the defined ICD-9-CM diagnosis codes for TBI in any diagnostic position. a Incidence Rules For individuals who meet the case definition: The incident date is the date of the first inpatient or outpatient medical encounter that includes a diagnosis of TBI. An individual is considered an incident case only once per lifetime. a. Source: Armed Forces Public Health Surveillance Center (AFPHSC), TBI surveillance case definitions, FINAL October Navy and Marine Corps Public Health Center 14 Figure 4: Timeline for TBI Surveillance in DON INJURY OCCURS Initial visit in Theater or Military Treatment Facility (MTF) diagnosed as TBI TBI surveillance begins (Incidence case date) Navy and Marine Corps Public Health Center 15 8
9 Methods: Strengths What are the strengths of DON TBI surveillance? TBI surveillance data is timely Inpatient data from any US fixed military treatment facility (MTF) worldwide is available and updated monthly, from 2002 to present. Ambulatory data from any MTF worldwide is available and updated weekly, from 2002 to present. Inpatient and ambulatory data in theater is available and updated weekly, from 2008 to present (includes shipboard facilities, battalion aid stations, or other in-theater facilities). Ambulatory data include both ER and outpatient appointments. Includes TBI severity (mild to severe), based on ICD-9-CM and V-codes. Can be broken down by place of residence or treatment facility TBI surveillance anywhere in the world, if treated in theater or at an MTF Data collection is standardized in the data sources used by DON for TBI surveillance Navy and Marine Corps Public Health Center 16 Methods: Limitations What are the limitations of DON TBI surveillance? Due to data source changes, ambulatory data before 1 January 2012 have four diagnosis fields, and data after this date have ten. Diagnoses in medical encounters depend on correct ICD-9-CM coding practices. Use of E-codes is limited, so cause of injury and intent not reported. Data for medical surveillance are considered provisional and medical case counts may change if the record is updated after the report is generated. In many cases, a lag time exists between the injury event and the screening or diagnosis of TBI cases. No TBI data from shipboard facilities, battalion aid stations, or in-theater facilities prior to 2008; some data may be missing from some shipboard facilities after that year. Navy and Marine Corps Public Health Center 17 9
10 TBI Surveillance in DON: Examples from the TBI Surveillance Data for AD Sailors and Marines from TBI Monthly Report, TBI Annual Report, and TBI Metrics for the Wounded, Ill, and Injured (WII) Program Navy and Marine Corps Public Health Center 18 Figure 5: Traumatic Brain Injury Cases, Active Duty Department of the Navy (AD DON), Note: Analyses were restricted to patients without missing values. Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 19 10
11 Figure 5: Traumatic Brain Injury Cases, Active Duty Department of the Navy (AD DON), Note: Analyses were restricted to patients without missing values. Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 20 Figure 5: Traumatic Brain Injury Cases, Active Duty Department of the Navy (AD DON), Note: Analyses were restricted to patients without missing values. Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 21 11
12 Figure 6: TBI Cases, AD Navy and Marines, January 2013 January 2014, by Service Branch Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 22 Figure 7: TBI Incidence Rate (per 100,000), AD Navy and Marines, January 2013 January 2014 Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), Theater Medical Data Store (TMDS), and Defense Manpower Data Center (DMDC). Navy and Marine Corps Public Health Center 23 12
13 Figure 8: Percent of TBI Cases with Follow-up, AD Navy and Marines, January 2013-January 2014, by TBI Severity Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 24 Figure 9: TBI New Cases (Incidence), AD DON, by TBI Severity and Year, Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and the Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 25 13
14 Figure 10: TBI New Cases (Incidence), AD DON, Age-Specific Rate (per 100,000), by Year Note: Analyses were restricted to patients without missing values. Age-specific incidence rates are the number of new cases in a given age group, per 100,000 service members in that same age group. Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), Theater Medical Data Store (TMDS), and Defense Medical Epidemiology Database (DMED). Prepared by the EpiData Center Department, Navy and Marine Corps Public Health Center on 06 May Navy and Marine Corps Public Health Center 26 Other TBI Surveillance Activities: TBI Incident Cases Data in Force Health Reports The TBI case database is updated monthly and shared with the team that prepares comprehensive Force Health Surveillance Reports (FHSR) which include a wide range of data shared with Navy and Marine Corps commands. TBI Rosters Special requests for TBI data that may include personal identifiers. As such, access to TBI rosters is restricted. TBI Surveillance Special Projects Long-term studies intended to improve TBI surveillance in DON. TBI Taskers Data requested by our customers that is not available through our routine reports. Typically these are requests for TBI surveillance data with a tight deadline. Navy and Marine Corps Public Health Center 27 14
15 Conference-Specific TBI Surveillance Data: TBI in AD DON Virginia Residents and TBI Surveillance in Virginia MTFs Navy and Marine Corps Public Health Center 28 Figure 11: TBI Cases, Virginia Residents in DON, January 2013-January 2014, by Service Branch Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 29 15
16 Figure 12: TBI Incidence Rate (per 100,000), Virginia Residents in DON, January 2013-January 2014 Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), Theater Medical Data Store (TMDS), and Defense Manpower Data Center (DMDC). Prepared by the EpiData Center Department, Navy and Marine Corps Public Health Center on 06 May 2014 Navy and Marine Corps Public Health Center 30 Figure 13: Percent of TBI Cases with Follow-up, Virginia Residents in DON, January 2013-January 2014 Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), and Theater Medical Data Store (TMDS). Navy and Marine Corps Public Health Center 31 16
17 Figure 14: TBI New Cases (Incidence), Virginia Residents in DON, by TBI Severity and Year, Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), Theater Medical Data Store (TMDS), and Defense Manpower Data Center (DMDC). Navy and Marine Corps Public Health Center 32 Figure 15: Average TBI Rates Compared: DON and Virginia Residents in DON, Note: Analysis was restricted to patients without missing values. Incidence rates are the number of new cases in each group per 100,000 service members in each group. Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), Theater Medical Data Store (TMDS), and Defense Manpower Data Center (DMDC). Navy and Marine Corps Public Health Center 33 17
18 Figure 16: New TBI Cases (Incidence), AD Navy and Marines, First Diagnosed and Treated in Virginia MTFs, January January 2014 Data are from the Standard Inpatient Data Record (SIDR), Standard Ambulatory Data Record (SADR), Comprehensive Ambulatory/Professional Encounter Record (CAPER), Theater Medical Data Store (TMDS), and Defense Manpower Data Center (DMDC). Navy and Marine Corps Public Health Center 34 Conclusions: TBI surveillance in DON and other military is different from civilian TBI surveillance. TBI surveillance in DON, done by EDC, can be customized to the special needs of the DON. AD Sailors and Marines have risks for TBI related to their deployment experience, but also have risks for TBI common to civilians. Most TBI in DON and the US military is classified as mild TBI, with good prospects for recovery. Navy and Marine Corps Public Health Center 35 18
19 Contact Information EpiData Center Department Navy and Marine Corps Public Health Center 620 John Paul Jones Circle, Suite 1100 Portsmouth, VA QUESTIONS? 19
Analysis of VA Health Care Utilization among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans
Analysis of VA Health Care Utilization among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans Cumulative from 1 st Qtr FY 2002 through 4th Qtr FY 2011
More informationAnalysis of VA Health Care Utilization Among US Global War on Terrorism (GWOT) Veterans
Analysis of VA Health Care Utilization Among US Global War on Terrorism (GWOT) Veterans Operation Enduring Freedom Operation Iraqi Freedom VHA Office of Public Health and Environmental Hazards January
More informationUnited States Military Casualty Statistics: Operation Iraqi Freedom and Operation Enduring Freedom
: Operation Iraqi Freedom and Operation Enduring Freedom Hannah Fischer Information Research Specialist May 4, 2010 Congressional Research Service CRS Report for Congress Prepared for Members and Committees
More informationGAO VA HEALTH CARE. Mild Traumatic Brain Injury Screening and Evaluation Implemented for OEF/OIF Veterans, but Challenges Remain
GAO United States Government Accountability Office Report to Congressional Requesters February 2008 VA HEALTH CARE Mild Traumatic Brain Injury Screening and Evaluation Implemented for OEF/OIF Veterans,
More informationDepartment of Defense INSTRUCTION. SUBJECT: Medical Encounter and Coding at Military Treatment Facilities
Department of Defense INSTRUCTION NUMBER 6040.42 June 10, 2004 SUBJECT: Medical Encounter and Coding at Military Treatment Facilities ASD(HA) References: (a) DoD Instruction 6040.40, "Military Health System
More informationPopulation Health: Veterans. Humble Beginnings
Population Health: Veterans Randy Moore, MSN, RN VA Nursing Academy partnership with UAB SON; Clinical Instructor Humble Beginnings Colonial Period From the beginning, the English colonies in North America
More informationThe Military Acute Concussion Evaluation (MACE)
The Military Acute Concussion Evaluation (MACE) Louis French, PsyD, Michael McCrea, PhD, Mark Baggett, PhD ABSTRACT Traumatic brain injury (TBI), in both times of peace and times of war is a significant
More informationTBI Global Synapse Town Hall: Your TBI Information Connection
Today s webinar is: TBI Global Synapse Town Hall: Your TBI Information Connection Nov. 20, 2013, 2:30-4 p.m. (EST) Moderator: Alison Cernich, Ph.D., ABPP Deputy Director Defense Centers of Excellence for
More informationDepartment of Defense INSTRUCTION. DoD Policy Guidance for Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting
Department of Defense INSTRUCTION NUMBER 6490.11 September 18, 2012 USD(P&R) SUBJECT: DoD Policy Guidance for Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting References: See
More informationTHE ASSISTANT SECRETARY OF DEFENSE
THE ASSISTANT SECRETARY OF DEFENSE 1200 DEFENSE PENTAGON WASHINGTON, DC 20301-1200 HEALTH AFFAIRS MEMORANDUM FOR ASSISTANT SECRETARY OF THE ARMY (MANPOWER AND RESERVE AFFAIRS) ASSISTANT SECRETARY OF THE
More informationTraumatic Brain Injury State of the State
TBI Treatment Development Meeting February 19, 2015 Washington, DC Traumatic Brain Injury State of the State Geoffrey Ling, MD, PhD Director, Biological Technologies Office, DARPA Professor of Neurology,
More informationIntroduction to Veteran Treatment Court
Justice for Vets Veterans Treatment Court Planning Initiative Introduction to Veteran Treatment Court Developed by: Justice for Vets Justice for Vets, 10 February 2015 The following presentation may not
More informationPopulation Reference Bureau and Hopkins Population Center 5 th Annual Symposium on Policy and Health
Population Reference Bureau and Hopkins Population Center 5 th Annual Symposium on Policy and Health The Effects of Military Deployment on Family Health Oct. 28, 2011 National Press Club, Washington, DC
More informationDoD Needs to Improve the Billing System for Health Care Provided to Contractors at Medical Treatment Facilities in Southwest Asia
Report No. DODIG-2012-106 June 27, 2012 DoD Needs to Improve the Billing System for Health Care Provided to Contractors at Medical Treatment Facilities in Southwest Asia Additional Copies To obtain additional
More informationSoldiers, Families, and Army Civilians. 12-05 Army Health Care
Soldiers, Families, and Army Civilians 1 1 1 1 0 1 1-0 Army Health Care High quality health care is a critical aspect of caring for Soldiers and their Families and is imperative for sustaining the Army.
More informationALCOHOL RELATED DISORDERS Includes Alcohol Abuse and Alcohol Dependence; Does Not Include Alcohol Use Disorders
1 MH 12 ALCOHOL RELATED DISORDERS Includes Alcohol Abuse and Alcohol Dependence; Does Not Include Alcohol Use Disorders Background This case definition was developed by the Armed Forces Health Surveillance
More informationTBI TRAUMATIC BRAIN INJURY WITHIN THE MILITARY/VETERAN POPULATION
TBI TRAUMATIC BRAIN INJURY WITHIN THE MILITARY/VETERAN POPULATION What is TBI? An external force that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The
More informationBUMEDINST 6300.17 23 Nov 2009
Government (including those provided by the DoD, VA, Department of Labor, and the Social Security Administration), references (f), (g), and (i). As appropriate, Navy case managers shall support these programs.
More informationFederal Recovery Coordination Program. Karen Guice, MD, MPP Executive Director
Federal Recovery Coordination Program Karen Guice, MD, MPP Executive Director CONCEPT The President s Commission on Care for America s Returning Wounded Warriors Immediately create comprehensive patient-centered
More informationHow To Manage A Personal Injury Case Management
Neurological Case Management Associates Providing a specialized approach to personal injury Mission Statement To direct and facilitate the functional recovery of the client and their family by prioritizing
More informationGAO TRAUMATIC BRAIN INJURY
GAO January 2009 United States Government Accountability Office Report to the Ranking Member, Committee on Oversight and Government Reform, House of Representatives TRAUMATIC BRAIN INJURY Better DOD and
More informationALCOHOL RELATED DISORDERS Includes Alcohol Abuse and Alcohol Dependence; Does Not Include Alcohol Use Disorders
1 MH 12 ALCOHOL RELATED DISORDERS Includes Alcohol Abuse and Alcohol Dependence; Does Not Include Alcohol Use Disorders Background This case definition was developed by the Armed Forces Health Surveillance
More informationRequest for Records Disposition Authority
Records Schedule: DAA-0330-20.14-0006 Records Schedule Number Schedule Status DAA-0330-2014-0006 Approved Agency o~ Establishment Record Group I Scheduling Group Records Schedule applies to Major Subdivision
More informationTraumatic brain injury (TBI)
Traumatic brain injury (TBI) A topic in the Alzheimer s Association series on understanding dementia. About dementia Dementia is a condition in which a person has significant difficulty with daily functioning
More informationServing our College Veterans in a Holistic Manner
Serving our College Veterans in a Holistic Manner NANCY L. MONTGOMERY RN, MSN, DIRECTOR HEALTH, WELLNESS & VETERANS, IRVINE VALLEY COLLEGE ERIC GARCIA, MS, VETERAN ACADEMIC COUNSELOR, COASTLINE COLLEGE
More informationdegenerative disc disease (DDD) is
Degenerative Disc Disease, Active Component, U.S. Armed Forces, 21-211 Dariusz Mydlarz, MD, MPH (MAJ, U.S. Army) Degeneration of intervertebral discs is a common disorder that often leads to pain syndromes
More information2014 GLS Grantee Meeting Service Members, Veterans, and Families Learning Collaborative Additional Resources
2014 GLS Grantee Meeting Service Members, Veterans, and Families Learning Collaborative Additional Resources Below are resources that address suicide prevention for service members, veterans, and their
More informationCase Management of Mild Traumatic Brain Injury and Case Management Resources
Case Management of Mild Traumatic Brain Injury and Case Management Resources Sue Kennedy, RN BSN CCM Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), case management
More informationRonald G. Riechers, II, M.D. Medical Director, Polytrauma Team Cleveland VAMC Assistant Professor Department of Neurology Case Western Reserve
Ronald G. Riechers, II, M.D. Medical Director, Polytrauma Team Cleveland VAMC Assistant Professor Department of Neurology Case Western Reserve University The opinions or assertions contained herein are
More informationTraffic Crashes: An unintended consequence of war. Karen Cutright, LISW-S Director of New Veteran Services Cincinnati VA
Traffic Crashes: An unintended consequence of war Karen Cutright, LISW-S Director of New Veteran Services Cincinnati VA LEADING CAUSE OF DEATH Motor Vehicle Accidents are a leading cause of death and disability
More informationDefense and Veterans Brain Injury Center
Defense and Veterans Brain Injury Center Traumatic Brain Injury Recovery Support Program Donna Dennis, RN BSN Recovery Support Specialist (RSS) Agenda Who We Are: MRMC> DCoE> DVBIC >RSP Severity Rating
More informationacbis Chapter 1: Overview of Brain Injury
acbis Academy for the Certification of Brain Injury Specialists Certification Exam Preparation Course Chapter 1: Overview of Brain Injury Module Objectives Describe the incidence, prevalence and epidemiology
More informationOutline of Presentation Opening Video
NACADA Executive Office Kansas State University 2323 Anderson Ave, Suite 225 Manhattan, KS 66502-2912 Phone: (785) 532-5717 Fax: (785) 532-7732 e-mail: nacada@ksu.edu 2013 National Academic Advising Association
More informationComing Home Injured: Care and Advocacy for America s Veterans
Exploring Justice Coming Home Injured: Care and Advocacy for America s Veterans Friday, October 29, 2010 Pike Conference Boston University School of Law Room 1270 8:45 a.m. Welcoming Remarks Deans of School
More informationNurses Knowledge and Self-Perceptions of Caring for Patients with TBI
Nurses Knowledge and Self-Perceptions of Caring for Patients with TBI Tolu Oyesanya, MS, RN, PhD Candidate Roger Brown, PhD Lyn Turkstra, PhD, CCC-SLP 4/16/2015 Background TBI is a chronic disease process
More informationANNALS OF HEALTH LAW Advance Directive VOLUME 20 FALL 2010 PAGES 77-85. Cost-Effectiveness of the Military Health Care System
ANNALS OF HEALTH LAW Advance Directive VOLUME 20 FALL 2010 PAGES 77-85 Cost-Effectiveness of the Military Health Care System Katie Tobin* I. INTRODUCTION Although there are no specific provisions addressing
More informationThe Role of the Military Nurse and Psychiatric Nurse Practitioner
The Role of the Military Nurse and Psychiatric Nurse Practitioner MISSION: Providing excellence in safety, quality and compassion to those entrusted to our care. VISION: A premier health care organization
More informationReport No. D-2009-078 May 4, 2009. Health Care Provided by Military Treatment Facilities to Contractors in Southwest Asia
Report No. D-2009-078 May 4, 2009 Health Care Provided by Military Treatment Facilities to Contractors in Southwest Asia Additional Information and Copies To obtain additional copies of the report, visit
More informationWoods Traumatic Brain Injury Symposium
Woods Traumatic Brain Injury Symposium Veterans Health Affairs (VHA) Polytrauma/Traumatic Brain Injury (TBI) System of Care Philadelphia, PA September 28, 2013 VHA/Polytrauma/TBI Program: Presenters Keith
More informationVeterans have been served by the various Collaborative Court programs which follow evidence based practices for 16 years
Orange County Veterans Treatment Court Community Court Superior Court of California 909 N. Main Street Santa Ana, CA 92701 1 MISSION STATEMENT The mission of the Orange County Veterans Treatment Court
More informationTHE HONORABLE WILLIAM WINKENWERDER, JR. M.D., M.B.A. ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS BEFORE THE SUBCOMMITTEE ON MILITARY PERSONNEL
THE HONORABLE WILLIAM WINKENWERDER, JR. M.D., M.B.A. ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS BEFORE THE SUBCOMMITTEE ON MILITARY PERSONNEL ARMED SERVICES COMMITTEE U.S. HOUSE OF REPRESENTATIVES
More informationOntario Brain Injury Association
Ontario Brain Injury Association Sivan Raz Senior Policy Analyst Auto Insurance Policy Unit Financial Services Commission of Ontario 5160 Yonge Street Box 85 Toronto ON M2N 6L9 Dear Ms. Raz, On behalf
More informationThe Indiana Trial Lawyer Association s Lifetime Achievement Seminar. Honoring Peter L. Obremsky. May 23-24, 2005
The Indiana Trial Lawyer Association s Lifetime Achievement Seminar Honoring Peter L. Obremsky May 23-24, 2005 The Use of Medical Literature in the Brain Injury Case Thomas C. Doehrman Doehrman-Chamberlain
More informationLicensed Mental Health Counselors and the Military Health System
Licensed Mental Health Counselors and the Military Health System LT Rick Schobitz, Ph.D., USPHS Deputy Director, Behavioral Medicine Division Office of the Chief Medical Officer TRICARE Management Activity
More informationEYE-TRAC Advance. A research study funded by the Department of Defense
EYE-TRAC Advance A research study funded by the Department of Defense BROCHURE CONTENTS About BTF..................................................... 1 Eye-Trac Advance Overview....................................1
More informationObjectives. Definition. Epidemiology. The journey of an athlete
Sport Concussion Chantel Debert MD MSc FRCPC CSCN Physical Medicine and Rehabilitation Department of Clinical Neurosciences Hotchkiss Brain Institute, University of Calgary Objectives Definition Epidemiology
More informationPregnancy and Mental Health Care Among Military Veterans
Pregnancy and Mental Health Care Among Women Veterans Returning from Iraq and Afghanistan Kristin M. Mattocks 12 1,2, Melissa Skanderson 12 1,2, Joseph Goulet 1,2, Sally Haskell 1,2, Elizabeth Yano 3,4,
More informationAudit of the Transfer of DoD Service Treatment Records to the Department of Veterans Affairs
Inspector General U.S. Department of Defense Report No. DODIG-2014-097 JULY 31, 2014 Audit of the Transfer of DoD Service Treatment Records to the Department of Veterans Affairs INTEGRITY EFFICIENCY ACCOUNTABILITY
More informationDepartment of Defense INSTRUCTION
Department of Defense INSTRUCTION NUMBER 6000.11 May 4, 2012 USD(P&R) SUBJECT: Patient Movement (PM) References: See Enclosure 1 1. PURPOSE. This Instruction: a. Reissues DoD Instruction (DoDI) 6000.11
More informationSSI/SSDI Outreach, Access and Recovery for people who are homeless. A Key Component in Ending Veteran Homelessness
SSI/SSDI Outreach, Access and Recovery for people who are homeless September 2014 A Key Component in Ending Veteran Homelessness Jen Elder, MSc Connecting Veterans with Social Security Administration (SSA)
More informationEarly Response Concussion Recovery
Early Response Concussion Recovery KRISTA MAILEY, BSW RSW, CONCUSSION RECOVERY CONSULTANT CAREY MINTZ, PH.D., C. PSYCH., PRACTICE IN CLINICAL NEUROPSYCHOLOGY FOR REFERRAL: Contact Krista Mailey at (204)
More informationExploring Military & Civilian Tobacco Control Partnerships
Exploring Military & Civilian Tobacco Control Partnerships Colleen Haydon Project UNIFORM/CYAN Living Well: Strategies for Tobacco Free Recovery 6 March 2012 What is Project UNIFORM? Undoing Nicotine Influence
More informationOrange County Combat Veterans Court. Community Court Superior Court of California 909 N. Main Street Santa Ana, CA 92701
Orange County Combat Veterans Court Community Court Superior Court of California 909 N. Main Street Santa Ana, CA 92701 1 MISSION STATEMENT The mission of the Orange County Combat Veterans Court is to
More informationUNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHINGTON, DC 20301-4000
UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHINGTON, DC 20301-4000 PERSONNEL AND READINESS The Honorable Thad Cochran Chairman Committee on Appropriations United States Senate Washington, DC 20510
More informationResponding to the Needs of Justice-Involved Veterans. Mark Mayhew, LCSW VA Justice Outreach Coordinator
Responding to the Needs of Justice-Involved Veterans Mark Mayhew, LCSW VA Justice Outreach Coordinator There is inherent sympathy for those who sustain damage in defense of country, whether that damage
More informationOFFICE OF THE ASSISTANT SECRETARY OF DEFENSE WASHINGTON, DC 20301-1200
OFFICE OF THE ASSISTANT SECRETARY OF DEFENSE WASHINGTON, DC 20301-1200 HEAL11i AffAIRS DEC 1 3 2010 MEMORANDUM FOR SURGEON GENERAL OF THE ARMY SURGEON GENERAL OF THE NAVY SURGEON GENERAL OF THE AIR FORCE
More informationPhysical and Occupational. Treating Mild Traumatic. Injured Too. DoD Post Doctoral Research Team National Model Robyn Bolgla MSPT, CTRS
Physical and Occupational Therapy Guidance to Treating Mild Traumatic Brain Injury Women Get Injured Too DoD Post Doctoral Research Team National Model Robyn Bolgla MSPT, CTRS MAJ, USAR, SP Army Professional
More informationJanuary 25, 2008. Congressional Requesters
United States Government Accountability Office Washington, DC 20548 January 25, 2008 Congressional Requesters Subject: VA and DOD Health Care: Administration of DOD s Post-Deployment Health Reassessment
More informationDepartment of Defense MANUAL
Department of Defense MANUAL NUMBER 1341.12 August 10, 2015 USD(P&R) SUBJECT: Special Compensation for Assistance with Activities of Daily Living (SCAADL) Process References: See Enclosure 1 1. PURPOSE.
More informationPolytrauma System of Care South Texas Veterans Health Care System
Polytrauma System of Care South Texas Veterans Health Care System New Model of Care Polytrauma describes unique, complex patterns of injuries: Complex, multiple injuries occurring as result of same event
More informationServing Those Who Served: Creating Programs for Veteran Student Success
Sarah Sell, M.Ed. Director of Veteran Student Services First Sergeant, Kansas Air National Guard February 2015 Serving Those Who Served: Creating Programs for Veteran Student Success 1 2 Veterans in College
More informationTAKING CARE OF AMERICA S VETERANS
TAKING CARE OF AMERICA S VETERANS Freedom and Recovery Conference BARRY R. McCAFFREY GENERAL, USA (RETIRED) 211 N. Union Street, Suite 100 Alexandria, VA 22314 brm@mccaffreyassociates.com 703-519-1250
More informationHow To Manage A Polytrauma Program
VA Polytrauma System of Care Presentation to Recovering Warrior Task Force October 29, 2013 Lucille Beck, PhD Chief Consultant, Rehabilitation and Prosthetic Services Inquiry from Task Force Describe the
More informationReport to Congress Special Compensation for Members of the Uniformed Services with Catastrophic Injuries or Illnesses Requiring Assistance in Everyday Living Fiscal Year 2012 Report to Congress Required
More informationInspector General United States Department of Defense
Inspector General United States Department of Defense Vision One professional team strengthening the integrity, efficiency, and effectiveness of the Department of Defense programs and operations. Mission
More informationHow to Identify Military Veterans and Service Members
How to Identify Military Veterans and Service Members John D. Baker Attorney at Law Baker Williams, LLP Fighting for Those Who Fought for Us 2097 County Road D East Suite C-200 Maplewood, MN 55109 Phone:
More informationDepartment of Defense INSTRUCTION
Department of Defense INSTRUCTION NUMBER 1300.24 December 1, 2009 USD(P&R) SUBJECT: Recovery Coordination Program (RCP) References: See Enclosure 1 1. PURPOSE. In accordance with the authority in DoD Directive
More informationLAWYERS SERVING WARRIORS
Complete, sign and return to: National Veterans Legal Services Program, 1600 K. Street, N.W., Suite 500, Washington, DC 20006-2833; Email: LawyersServing@nvlsp.org; Fax: 202.223-9197 Name: Date of Birth:
More informationDEPARTMENT OF DEFENSE SURVEY OF HEALTH RELATED BEHAVIORS AMONG ACTIVE DUTY MILITARY PERSONNEL SERVICE PROGRAM OFFERINGS
DEPARTMENT OF DEFENSE SURVEY OF HEALTH RELATED BEHAVIORS AMONG ACTIVE DUTY MILITARY PERSONNEL SERVICE PROGRAM OFFERINGS MILITARY HEALTH SYSTEM DECEMBER 2009 HEALTH RELATED BEHAVIORS SURVEY SERVICE PROGRAM
More informationADMINISTRATIVE INSTRUCTION
Deputy Chief Management Officer of the Department of Defense ADMINISTRATIVE INSTRUCTION NUMBER 0118 September 11, 2015 FSD, WHS SUBJECT: Civilian Employees Occupational Health and Medical Services Program
More informationDepartment of Defense INSTRUCTION
Department of Defense INSTRUCTION NUMBER 6025.22 January 30, 2015 USD(P&R) SUBJECT: Assistive Technology (AT) for Wounded, Ill, and Injured Service Members References: See Enclosure 1 1. PURPOSE. In accordance
More informationReview of Way Forward
DEPARTMENT OF DEFENSE TASK FORCE ON THE CARE, MANAGEMENT, AND TRANSITION OF RECOVERING WOUNDED, ILL, AND INJURED MEMBERS OF THE ARMED FORCES Review of Way Forward Denise F. Dailey Executive Director The
More informationODIG-AUD (ATTN: Audit Suggestions) Department of Defense Inspector General 400 Army Navy Drive (Room 801) Arlington, VA 22202-4704
Additional Copies To obtain additional copies of this report, visit the Web site of the Department of Defense Inspector General at http://www.dodig.mil/audit/reports or contact the Secondary Reports Distribution
More informationBrain Injury Litigation. Peter W. Burg Burg Simpson Eldredge Hersh & Jardine, P.C. www.burgsimpson.com
Brain Injury Litigation Peter W. Burg Burg Simpson Eldredge Hersh & Jardine, P.C. www.burgsimpson.com Some General Facts About Traumatic Brain Injury TBIs contribute to a substantial number of deaths and
More informationort Office of the Inspector General Department of Defense YEAR 2000 COMPLIANCE OF THE STANDARD ARMY MAINTENANCE SYSTEM-REHOST Report Number 99-165
it ort YEAR 2000 COMPLIANCE OF THE STANDARD ARMY MAINTENANCE SYSTEM-REHOST Report Number 99-165 May 24, 1999 Office of the Inspector General Department of Defense Additional Copies To obtain additional
More informationDepartment of Defense INSTRUCTION
Department of Defense INSTRUCTION NUMBER 6025.19 June 9, 2014 USD(P&R) SUBJECT: Individual Medical Readiness (IMR) References: See Enclosure 1 1. PURPOSE. This instruction: a. Reissues DoD Instruction
More informationJoint Task Force National Capital Region Medical DIRECTIVE
Joint Task Force National Capital Region Medical DIRECTIVE NUMBER 1010.02 OCT Z 5 2011 SUBJECT: Outpatient Addictions Treatment Services J-3B References: See Enclosure 1 1. PURPOSE. This Directive, in
More informationFor More Information
CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INFRASTRUCTURE AND TRANSPORTATION INTERNATIONAL AFFAIRS LAW AND BUSINESS NATIONAL SECURITY The RAND Corporation
More informationHospitalizations for Hepatitis A, B, and C, Active Component, U.S. Armed Forces, 1991-2011
Hospitalizations for Hepatitis A, B, and C, Active Component, U.S. Armed Forces, 1991-2011 lthough genetically quite distinct from one another, hepatitis viruses A, B, and C all cause inflammatory liver
More informationDefense Health Program Fiscal Year (FY) 2014 Budget Estimates Appropriation Highlights
($ in Millions) Appropriation Summary FY 2012 Actual Price Change Program Change FY 2013 Estimate Price Change Program Change FY 2014 Estimate Operation & Maintenance 30,437.8 925.4-13.9 31,349.3 982.8-678.4
More informationObjectives. Care of the Returning Military Veteran. Recent Efforts. US Military. Screening at VA PCP Offices. Veterans 9/29/2014
Care of the Returning Military Veteran James Kravec, M.D., F.A.C.P. Chairman, Department of Internal Medicine, St. Elizabeth Health Center, Youngstown, Ohio Chief, General Internal Medicine Section, Northeast
More informationTraumatic Brain Injury in the United States: An Epidemiologic Overview Carl R. Summers, PhD, Brian Ivins, MS, and Karen A.
MOUNT SINAI JOURNAL OF MEDICINE 76:105 110, 2009 105 Traumatic Brain Injury in the United States: An Epidemiologic Overview Carl R. Summers, PhD, Brian Ivins, MS, and Karen A. Schwab, PhD Defense and Veterans
More informationEVALUATION AND DISPOSITION OF PATIENTS PRESENTING WITH SUICIDAL IDEATION OR BEHAVIOR
DEPARTMENT OF THE NAVY BUREAU OF MEDICINE AND SURGERY 2300 E STREET NW WASHINGTON DC 20372 5300 tn REPl Y ~ FER TO BUMEDINST 6520.2 BUMED-MOOWII 7 Mar2011 BUMED INSTRUCTION 6520.2 From: Chief, Bureau of
More informationInjuries are a Major Public Health Problem in Massachusetts
Injury Surveillance Program, Massachusetts Department of Public Health January 2015 Injuries are a Major Public Health Problem in Massachusetts Injuries are the third leading cause of death among Massachusetts
More informationDEPARTMENT OF THE AIR FORCE PRESENTATION TO THE TACTICAL AIR AND LAND FORCES SUBCOMMITTEE COMMITTEE ON ARMED SERVICES
DEPARTMENT OF THE AIR FORCE PRESENTATION TO THE TACTICAL AIR AND LAND FORCES SUBCOMMITTEE COMMITTEE ON ARMED SERVICES UNITED STATES HOUSE OF REPRESENTATIVES SUBJECT: FORCE PROTECTION ISSUES STATEMENT OF:
More informationBrain Health and Fitness Overview
Brain Health and Fitness Overview UNCLASSIFIED CAPT C. Douglas Forcino Director, Military Operational Medicine Research Program Chair, Joint Program Committee 5 for Military Operational Medicine US Army
More informationDEPARTMENT OF DEFENSE
DEPARTMENT OF DEFENSE Funding Highlights: Provides $553 billion for the base budget, an increase of $22 billion above the 2010 appropriation. This reflects continued investment in national security priorities
More informationImplementing the DoD/VA Virtual Lifetime Electronic Record
Implementing the DoD/VA Virtual Lifetime Electronic Record SOA IN HEALTHCARE CONFERENCE July 14, 2010 Doug Felton Manager, Enterprise Framework DoD/VA Interagency Program Office (IPO) Agenda What is the
More informationStatement of. Vice Admiral William A. Brown, United States Navy. Deputy Commander, United States Transportation Command
Statement of Vice Admiral William A. Brown, United States Navy Deputy Commander, United States Transportation Command Before the House Armed Services Committee Subcommittee on Seapower and Projection Forces
More informationDepartment of Defense DIRECTIVE
Department of Defense DIRECTIVE NUMBER 6010.22 January 21, 2003 Certified Current as of November 24, 2003 SUBJECT: National Disaster Medical System (NDMS) ASD(HA) References: (a) DoD Directive 3020.36,
More informationThe Economic Impact of Motor Vehicle Crashes Involving Pedestrians and Bicyclists
The Economic Impact of Motor Vehicle Crashes Involving Pedestrians and Bicyclists Florida Department of Health Health Information and Policy Analysis Program Release Date: September 9, 2015 Date Range:
More informationSuicide, PTSD, and Substance Use Among OEF/OIF Veterans Using VA Health Care: Facts and Figures
Suicide, PTSD, and Substance Use Among OEF/OIF Veterans Using VA Health Care: Facts and Figures Erin Bagalman Analyst in Health Policy July 18, 2011 Congressional Research Service CRS Report for Congress
More informationGAO ARMY HEALTH CARE. Progress Made in Staffing and Monitoring Units that Provide Outpatient Case Management, but Additional Steps Needed
GAO United States Government Accountability Office Report to Congressional Requesters April 2009 ARMY HEALTH CARE Progress Made in Staffing and Monitoring Units that Provide Outpatient Case Management,
More informationMedical Surveillance of Injuries in the U.S. Military. Descriptive Epidemiology and Recommendations for Improvement
Medical Surveillance of Injuries in the U.S. Military Descriptive Epidemiology and Recommendations for Improvement Bruce H. Jones, MD, MPH, Michelle Canham-Chervak, PhD, MPH, Sara Canada, MPH, Timothy
More informationGolden West College VETERAN S SERVICES. You served us. Now we are here to serve you! Cerritos
Golden West College VETERAN S SERVICES You served us. Now we are here to serve you! 1 Cerritos Objectives This orientation will provide you with information about the following: Veterans Education Benefits
More informationThe Freedom Care Program
The Freedom Care Program Established October 1, 2007 Mission: Providing Mental Health and Chemical Dependency Care for Military Members, Veterans, Retirees and their Families Freedom Care Locations: Denton,
More informationA Conversation with the Department of Defense: Achieving Economies in DoD Human Research Review
A Conversation with the Department of Defense: Achieving Economies in DoD Human Research Review Ms. Patty Decot, MS Defense Directorate of Research and Engineering Department of Defense Ms. Marianne Elliott,
More informationVA BENEFITS ACTIVITY VETERANS DEPLOYED TO THE GLOBAL WAR ON TERROR
VA BENEFITS ACTIVITY VETERANS DEPLOYED TO THE GLOBAL WAR ON TERROR This report summarizes participation in VA benefits programs by veterans identified by the Department of Defense as having been deployed
More informationOff-road Motor Vehicle-related Injuries in Massachusetts
Off-road Motor Vehicle-related Injuries in Massachusetts Details from an Assessment of Medical Records Beth Hume, Project Director As part of a new initiative to evaluate the accuracy of injury codes,
More informationHow To Analyse The Causes Of Injury In A Health Care System
3.0 METHODS 3.1 Definitions The following three sections present the case definitions of injury mechanism, mortality and morbidity used for the purposes of this report. 3.1.1 Injury Mechanism Injuries
More information