Caregiver Assistance and Resource Enhancement Act passes U.S. House

H.R. 3155, the Caregiver Assistance and Resource Enhancement Act, was introduced by Representative Michael H. Michaud of Maine, Chairman of the Subcommittee on Health of the Committee on Veterans' Affairs, on July 9, 2009. H.R. 3155, as amended, would create a new caregiver program to help family and non-family members who provide care for disabled, ill, or injured veterans enrolled in the U.S. Department of Veterans Affairs (VA) health care system.

The VA would also be required to conduct a survey on caregivers in order to better understand this population. Key components of the new caregiver program would include support services such as educational sessions, access to a comprehensive one-stop resource directory, counseling and mental health services, and respite care. In addition, this legislation would provide a monthly financial stipend, health care through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), and lodging and subsistence to eligible caregivers of certain veterans.

BACKGROUND AND NEED FOR LEGISLATION

Today, more servicemembers are surviving the wounds of war than those injured in previous conflicts. For example, the ratio of wounded to killed averaged approximately 1.7 wounded for every fatality for the first two World Wars. In Korea and Vietnam, the ratio improved to three wounded per fatality, largely due to air medical evacuation. In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), improved body armor and superior battlefield medicine techniques have resulted in seven wounded per fatality. The increasing number of wounded OEF/OIF servicemembers surviving the war brings to the forefront the question of who will provide continuing care for these injured men and women once they transition to veteran status.

It is estimated that for any given year there are more than 50 million people who provide informal caregiving for a chronically ill, disabled, or aged family member or friend. These caregivers serve as the foundation of the country's long-term care system. It is estimated that about 80 percent of adults living in the community and in need of long-term care depend on a family member or a friend, thereby avoiding costly institutional nursing home care. The majority of these caregivers are women. Caregiving exacts both a financial and physical toll on these individuals. For example, women caregivers are more than twice as likely to live in poverty and are five times more likely to receive Supplemental Security Income (SSI) than their non-caregiver counterparts. Also, individuals serving as caregivers for a family or friend report having a chronic health condition at twice the rate of non-caregivers and those who provide 36 or more hours of weekly care are more likely to experience symptoms of depression and anxiety than non-caregivers.

Because the VA does not collect data on this population, the number of family members and friends who provide care for veterans is unknown. However, the July 2007 report of the President's Commission on Care for America's Returning Wounded Warriors (Dole-Shalala Commission) found that of the 1,730 injured OEF/OIF veterans surveyed, about 21 percent of active duty, 15 percent of the reserve, and 24 percent of retired or separated servicemembers had friends or family who gave up a job to be a caregiver. In order to better understand the caregiver population providing care to veterans, H.R. 3155 would require the VA to conduct a caregivers survey at least once every three years to individuals caring for veterans enrolled in the VA health care system. It would also require a report to Congress providing the findings of the survey no later than 180 days after the date on which the survey is completed. The Committee believes that this study would be an essential component in meeting the needs of caregivers in the future.

H.R. 3155 would establish a new caregiver program in order to provide coordinated support services to caregivers. Caregivers often have a poor understanding of the services they are eligible for, thereby resulting in an underutilization of caregiver support services available through the VA. H.R. 3155 would require the VA to train existing case managers to also provide information about support services and benefits available to the caregivers of such veterans. This legislation would also require the VA to provide information and conduct outreach using all mediums of communication to spread the message about caregiver support services available through the VA, including new services made available through this Act.

Although VA offers support services to caregivers of veterans, additional services are needed for those who forego their employment, education, or make other major life changes in order to care for their wounded veteran family member. The well-being of the caregiver is important as it affects the quality of care that the wounded veteran receives. Ensuring the best care for our veterans means equipping family caregivers with the right tools and support services.

H.R. 3155 would provide a range of support services to help both family and non-family caregivers of veterans of all eras. This includes educational sessions for caregivers, a one-stop caregiver resource directory, and respite care which is age-appropriate and meets the needs of the veteran. This legislation would also provide counseling and mental health services, and include peer support groups to help caregivers cope with the daily stress of caregiving.

H.R. 3155 would also provide key benefits of lodging and subsistence, a financial stipend, and health care for a select group of caregivers of certain eligible veterans who were deployed in support of OEF/OIF, are determined by the Secretary of VA to have a severe service-connected injury or illness, are unable to carry out activities of daily living (including instrumental activities), and are in need of caregiver services such that without them the veteran would require hospitalization, nursing home care, or other residential institutional care. This legislation would authorize the VA to reimburse caregivers for lodging and subsistence when they accompany certain eligible veterans on medical visits. Such caregivers must meet the definition of an attendant under the current statute. This would help to address the plight of some family caregivers who depend on the travel, meals, and lodging allowance provided by the Department of Defense (DoD), which is suddenly discontinued when the wounded warrior transitions to veteran status. This provision would be a step forward in establishing some parity and continuity in caregiver benefits provided by DoD and VA. This legislation would also provide a monthly financial stipend to primary family caregivers of certain eligible veterans through October 1, 2012. To be eligible, the caregiver may not be employed by a home health care agency to provide caregiver services to a family member veteran, or otherwise receive payment for such services. Finally, H.R. 3155 would provide health care through the CHAMPVA program through October 1, 2012, to primary family caregivers of certain eligible veterans if they are without health insurance or are not eligible for other public health insurance options.

CONGRESSIONAL HEARINGS

On June 4, 2009, the Subcommittee on Health held an oversight on `Meeting the Needs of Family Caregivers of Veterans.' The following witnesses testified: Anna Frese, Caregiver, Wounded Warrior Project; Commander Rene A. Campos, U.S. Navy (Ret.), Deputy Director, Government Relations, Military Officers Association of America; Barbara Cohoon, Ph.D., RN, Government Relations Deputy Director, National Military Family Association; Jill Kagan, MPH, Chair, ARCH National Respite Coalition; Suzanne G. Mintz, President and Co-Founder, National Family Caregivers Association; Mark S. Heaney, President and Chief Executive Officer, Addus Healthcare, Inc., Home Care Aide Section Representative Officer, National Association for Home and Hospice Care; Madhulika Agarwal, M.D., MPH, Chief Patient Care Services Officer, Veterans Health Administration, U.S. Department of Veterans Affairs accompanied by Lucille Beck, Ph.D., Chief Consultant, Rehabilitation Services, Veterans Health Administration, U.S. Department of Veterans Affairs; Thomas E. Edes, MS, Director of Home and Community-Based Care, Office of Geriatrics and Extended Care, Veterans Health Administration, U.S. Department of Veterans Affairs; Thomas J. Kniffen, Chief, Regulations Staff, Compensation and Pension Service, Veterans Benefits Administration, U.S. Department of Veterans Affairs; Edwin L. Walker, Acting Assistant Secretary for Aging, Administration on Aging, U.S. Department of Health and Human Services; and, Noel Koch, Deputy Under Secretary, Office of Transition Policy and Care Coordination, U.S. Department of Defense. Adrian Atizado, Assistant National Legislative Director, Disabled American Veterans submitted a statement for the record.

On July 9, 2009, the Subcommittee on Health met in open markup session and ordered favorably forwarded to the full Committee H.R. 3155 by voice vote.

On July 15, 2009, the full Committee met in an open markup session, a quorum being present, and ordered H.R. 3155, as amended, reported favorably to the House of Representatives, by voice vote. During consideration of the bill, An amendment in the nature of a substitute by Mr. Michaud of Maine to establish a new caregiver program and to provide for a monthly stipend was agreed to by voice vote.

HOUSE CONSIDERATION

On July 27, 2009, H.R. 3155 as amended was passed by the U.S. House of Representatives by a voice vote.

The bill has been referred to the Senate Committee on Veterans' Affairs, where it now awaits further action.


HOW YOU CAN HELP

Letters and emails expressing support for the Caregiver Assistance and Resource Enhancement Act should be addressed to:

Rep. Bob Filner, Chair and Rep. Steve Buyer, Ranking Member, U.S. House of Representatives Committee on Veterans' Affairs, 335 Cannon House Office Building, Washington, D.C. 20515

Senator Daniel Akaka, Chair and Senator Richard Burr, Ranking Member, U.S. Senate Committee on Veterans' Affairs, 412 Russell Senate Office Building, Washington, D.C. 20510

Courtesy copies of the original letters or emails should be sent to the Senator and Representative who represent the state and Congressional district where you live. A nationwide database providing complete contact information on local Congressional representation is available at www.house.gov/writerep.

UK MP testifies on 'genocide', use of chemical warfare agents against Marsh Arabs following 1991 Gulf War

Iraqi use of chemical warfare agents in southern Iraq came while U.S., Coalition troops still nearby

Written by Aubrey Belford, AFP

(BAGHDAD - August 7, 2009) — A member of the British House of Lords has described witnessing "genocide" by executed dictator Saddam Hussein's regime against Iraq's Marsh Arabs in the early 1990s.

Baroness Emma Nicholson was this week the first foreigner to testify in the Baghdad trial of 42 Iraqis, including Saddam's hatchet-man "Chemical Ali" Hassan al-Majid, over the brutal crackdown that followed a Shiite uprising after the 1991 Gulf War.

The mass expulsion of locals and the draining of around 90 percent of the marshes in the country's south, which sent around 50,000 refugees into Iran, is considered by the United Nations to be one of the worst environmental disasters in history.

Nicholson told AFP late Thursday after testifying in the tightly guarded trial in the Iraqi capital that she saw first-hand the destruction of the region, including through the alleged use of chemical weapons, on a series of around 75 visits to Iraq and neighbouring Iran during the 1990s.

"The people were farmers and fishermen whose farms and fishing grounds were being destroyed," said Nicholson, head of the AMAR charity which provides assistance to Iraqi refugees and internally displaced people, including the Marsh Arabs.

"Their villages, their towns, their cities were being bombed, being shelled, being burnt, and over the next few years the Marsh Arabs were forcibly displaced," she said.

"After 1995 there was no point going in to the marshes because they were completely drained.

"I'd certainly use the word genocide (in describing the campaign) against the Marsh Arab people."

The trial, which began in June and is expected to reach a verdict by the end of the year, is the latest in a string of cases to come to trial in Iraq since the overthrow of Saddam in a 2003 US-led invasion.

Also in the dock are Saddam half-brothers former interior minister Watban Ibrahim al-Hassan and security service chief Sabawi Ibrahim.

The draining of the marshes, considered by some to be the location of the Biblical Garden of Eden, was carried out by Saddam in a bid to flush out Shiite rebels hiding out in the sprawling network of waterways.

Footage of the trial on state-run television showed Nicholson speaking through a translator and displaying pictures of the victims of the crackdown, as "Chemical Ali" Majid and others sat in the dock.

Nicholson told AFP she witnessed the result of apparent chemical weapons use by Iraqi forces, with medical workers under her direction treating "people coughing their insides out."

"Some of the chemical weapons turned people blue and they'd blown up and died.

"Others were clearly mustard gas because (the victims) talked about yellow bombs coming from the sky and no one could breathe, they were burning all over."

Nicholson however said she had no evidence of individual complicity by any member of Saddam's regime on trial before the tribunal.

"Indeed I would have wanted at the time to find people who were responsible but it was not within my capacity to do so. I would have very much wanted indeed to face them," she said.

The trial is not the first time senior Iraqi officials have been accused of using chemical weapons to crush resistance.

Majid was first sentenced to death in June 2007 for ordering the gassing of tens of thousands of Kurds in the 1998 Anfal campaign, which earned him his grim moniker.

He has received two other death sentences for crimes including war crimes and crimes against humanity during the brutal 1991 crackdown on the Shiite uprising.

Iraq's southern marshes had been home to a unique culture for centuries before Saddam's crackdown turned much of it to desert. Programmes to reflood the marshlands since the dictator's fall have seen some limited success in restoring lost habitats.

Ill Calif. Gulf War Veteran Among Entrepreneurship Boot Camp Participants

Written by Jane Wells, Correspondent / Funny Business with Jane Wells - CNBC

(CNBC - August 7, 2009) In a classroom at the UCLA Anderson School of Management, a professor is running through the calculations needed to figure out "the IRR". That's the internal rate of return. A group of 20 men and women take notes. "The cash flow I get in year one needs to be brought back by some rate of return," he tells them, scribbling on a whiteboard.

The students listening intently are not aspiring Wall Street titans. They are disabled veterans who have either started small businesses, or hope to.

They're here for a 9-day "Entrepreneurship Boot Camp", and UCLA isn't charging them a dime.

"I was injured in operations in Iraq and Afghanistan," says Army combat veteran Edward Ruvalcaba. He joined the military right out of high school and says he's witnessed "the History Channel" up close: Panama when Noriega lost power, Berlin when the wall came down, Gulf War I and II. Somewhere in the first Gulf War he contracted serious respiratory and skin problems (remember the oil field fires?) which require him to be on several medications. "I'm working through it," he says, without an ounce of self-pity.

Last year Ruvalcaba started a janitorial company called Guaranteed Cleaning Services, in Brea, California. "I've been somewhat successful," he says, adding, "this boot camp here has really shed a lot of light on some of the errors I've made." He's learned that his pricing isn't competitive. He isn't charging too much, but too little. "That's in my nature of serving my country and believing that I'm just being humble, and I'm learning here that if you're not profitable, then you shouldn't be in that type of business."

The "boot camp" for disabled vets started at Syracuse University, and has since spread to four other universities: UCLA, Purdue, Texas A&M, and Florida State. If you had to pay for this education, it would probably cost $10,000. But donations cover all expenses.

AP

"It's a battlefield out there, you need to be a good strategist," says Anderson's Al Osborne, who says at least 45,000 disabled vets have returned from war, with injuries that are not always visible.

Osborne says veterans, by experience, "understand what needs to be done now, what needs to be done later, how I can delegate, they understand how to work and build teams." Those are important tools for entrepreneurs.

They are traits which have served Amy Sufak well as she transitioned into civilian life. The 11-year Air Force veteran hurt her back traveling the world as a public affairs officer. Now she's started Red Energy PR in Colorado Springs. "I was very fortunate to start this business during a down economy," she says. Companies are letting go their in-house PR and marketing staff and contracting out to firms like her's. One downside? Some clients don't know what to make of her. "There's a whole generation behind me that has not been touched by the military at all, so that's difficult because they don't see the value in that." Still, at the boot camp, she's learning important tips, like how to increase staffing without increasing costs-bill clients for extra personnel. "It's helped us critique our business plans."

But why start a small business now? In this economy? "I'll tell you one thing, it's been my family," Edward Ruvalcaba says, suddenly choking up with emotion. "Being away from them..." As demanding as it is to run a small business, it provides more time at home than being half a world away in a foxhole.

"You and I maybe don't have the luxury of understanding of what it is to be in an arena where somebody is shooting at you," Al Osborne says, explaining one reason these vets may excel. "That gets you focused, I think, on things you need to survive. Business today is not unlike war."

Questions? Comments? Funny Stories? Email funnybusiness@cnbc.com

Veteran with Gulf War Illness airs graphic video about his condition

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com - Friday, August 7, 2009) -- An Indiana veteran of the 1991 Gulf War has publicly released a groundbreaking video regarding his personal experience with Gulf War Illness.

"Dale," an Indianapolis, Ind. veteran, who goes by an online name of The Alpha Dale, posted the graphic, home-shot video on the Internet on August 5. The video includes panning and close-ups of his persistent skin rashes and cut-aways to on-screen text narration providing a broader context of his experiences with Gulf War illness.

"Having Gulf War Illness, affects every aspect of my life," says Dale in the video's opening text narrative. "Until recently, I like most veterans, have been to [sic] embarrassed and shamed into feeling bad about letting others know that I am ill."



This video can also be viewed online on YouTube.

DEET, Already linked to Gulf War illness, Now linked to Neural Damage in Mice

More research needed to see if compound has same effect in humans, experts say

By Amanda Gardner, HealthDay Reporter

WEDNESDAY, Aug. 5 (HealthDay News) -- New French research suggests the main ingredient used in many insect repellants may affect the central nervous system, at least in mice.

And combining this ingredient -- DEET (N,N-Diethyl-3-methylbenzamide) -- with carbamates, a type of pesticide that is often used with DEET, compounded the effects.

Although the authors, publishing online Aug. 5 in BMC Biology, warn of potential dangers to humans, they also acknowledge the need for more studies on the subject.

Meanwhile, people should probably worry more about the health risks from mosquitoes and other insects than about the potential harms of DEET, experts said.

"This work was done primarily in test tubes in order to try to understand some of the mechanisms," said Dr. Ted Schettler, science director of the Science & Environmental Health Network. "The mechanistic information is very useful but the jury is still out on what implications this has for humans."

"DEET has been used for a very long time with very few bad outcomes," added Susan Paskewitz, a professor of entomology at the University of Wisconsin, Madison. "People have killed themselves by drinking it, but you can do that with alcohol or salt. And a few have had neurological symptoms after application for long periods and high doses."

As for the combination of DEET and carbamates, Paskewitz added, "if there are the kinds of synergies suggested by the study, they aren't happening very often. I also would guess that the actual concentration in the body is much lower than they had to use in the study to see an effect in the mouse tissues."

But by better understanding the mechanisms by which DEET works, scientists may be able to come up with better repellant products, said Paul Sanberg, distinguished professor of neurosurgery and director of the University of South Florida Center for Aging and Brain Repair in Tampa.

DEET is the most common active ingredient in insect repellents and is used worldwide by about 200 million people annually. However, relatively little is known about how the compound actually works.

From this study, it now appears that not only does DEET change the behavior of insects, it also inhibits the acetylcholinesterase enzyme, which is involved in the central nervous system, in both insects and mice.

Organophosphates and carbamate insecticides employ the same mechanism of action and, when combined with DEET in these experiments, increased the toxicity of the chemicals.

"This study demonstrates the vital importance of looking at chemicals in combination," Schettler said. "This shows that when you combine chemicals, you can get unpredictable results."

The authors, from different research institutions in France, say this is the first time a molecular target for DEET has been identified.

Interestingly, the class of drugs known as cholinesterase inhibitors are used to treat Alzheimer's and can delay the decline of symptoms for up to a year.

Sanberg said the effects of DEET, like many chemicals and drugs, can simply depend on the individual using it.

An earlier study found a strong association between exposure to acetylcholinesterase inhibitors and the Gulf War illness suffered by many veterans. Organophosphates have also been linked with acute lymphoblastic leukemia, the most common form of leukemia in children.

More information

The U.S. Environmental Protection Agency has more on DEET.

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Popular Insect Repellent Deet Is Neurotoxic

(ScienceDaily - Aug. 6, 2009) — The active ingredient in many insect repellents, deet, has been found to be toxic to the central nervous system.

Researchers say that more investigations are urgently needed to confirm or dismiss any potential neurotoxicity to humans, especially when deet-based repellents are used in combination with other neurotoxic insecticides.

Vincent Corbel from the Institut de Recherche pour le Développement in Montpellier, and Bruno Lapied from the University of Angers, France, led a team of researchers who investigated the mode of action and toxicity of deet (N,N-Diethyl-3-methylbenzamide). Corbel said, "We've found that deet is not simply a behavior-modifying chemical but also inhibits the activity of a key central nervous system enzyme, acetycholinesterase, in both insects and mammals".

Discovered in 1953, deet is still the most common ingredient in insect repellent preparations. It is effective against a broad spectrum of medically important pests, including mosquitoes. Despite its widespread use, controversies remain concerning both the identification of its target sites at the molecular level and its mechanism of action in insects. In a series of experiments, Corbel and his colleagues found that deet inhibits the acetylcholinesterase enzyme – the same mode of action used by organophosphate and carbamate insecticides.

These insecticides are often used in combination with deet, and the researchers also found that deet interacts with carbamate insecticides to increase their toxicity. Corbel concludes, "These findings question the safety of deet, particularly in combination with other chemicals, and they highlight the importance of a multidisciplinary approach to the development of safer insect repellents for use in public health".

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Journal reference:

1. Vincent Corbel, Maria Stankiewicz, Cedric Pennetier, Didier Fournier, Jure Stojan, Emmanuelle Girard, Mitko Dimitrov, Jordi Molgo, Jean Marc Hougard and Bruno Lapied. Evidence for inhibition of cholinesterases in insect and mammalian nervous systems by the insect repellent deet. BMC Biology, (in press) [link]

Adapted from materials provided by BioMed Central, via EurekAlert!, a service of AAAS.

UK Gulf War veterans suffering from IBS, PTSD, joint issues supports Debt of Honour campaign

Written by Nicola Fifield, The Press [York, UK]

(York, UK - 10:20am Friday 7th August 2009) -- A Gulf War veteran who is still coping with Post-Traumatic Stress Disorder (PTSD) 18 years after returning from combat has thrown her weight behind The Press’s Debt of Honour campaign.

Marianna Proietti, 39, of Acomb, in York, said she has to fight a constant battle to receive the full war pension she is entitled to and has given up trying to receive psychiatric treatment for her problems.

The mother-of-four also suffers from Irritable Bowel Syndrome and has undergone several operations to her shoulders and knees after they were damaged in service.

She said she strongly believed her problems were caused by exposure to inoculations and radiation in the Gulf, as well as the trauma of being at war.

“I still have nightmares and flashbacks and suffer serious mood swings,” she said.

“Low-flying aircraft and any loud bangs and noises take me back to when I was in the Gulf and make me feel sick.

“I was sat with a guy for four hours while he was dying and there was nothing I could do; I was held up in an Iraqi prisoner-of-war hospital.”

She said she had also had to clear up a soldier’s remains after he was killed in combat.

“But I’ve got no-one to discuss these things with,” she said. “People have said to me surely Combat Stress can help, but when I asked for their help they wouldn’t help me because I was going through my local mental health service.

“I’ve given up because I’m fed up with trying to fight the system.”

Marianna, who joined the Territorial Army in 1987, was the first woman soldier below the rank of officer to be sent to the Gulf in 1991 as a member of the Royal Medical Army Corps.

“I believe ex-servicemen deserve to be treated much better than they are,” she said. “It’s just one fight after another and the system needs to change so we get the support we deserve.”

Marianna feels so strongly about the issue she has set up a petition on the social networking site Facebook calling on the Government to reopen military hospitals. “If you’re on a ward with lots of other squaddies who have lost limbs, it helps the healing process because you can all talk and relate to each other,” she said.

Study: In 1991, tobacco companies saw war as a marketing opportunity

By Travis J. Tritten, Stars and Stripes Pacific edition

(Sunday, August 9, 2009) -- A study published in July in the American Journal of Public Health looked at internal tobacco company documents to determine if marketing efforts were aimed at servicemembers during the Gulf War.

Researchers found tobacco companies saw the conflict as a commercial opportunity and targeted servicemembers with free cigarettes, direct advertising, phone cards and homecoming parties.

The military, which often viewed the tobacco companies as benefactors, restricted the activity at times but frequently allowed it, according to “Everywhere the Soldier will Be: Wartime Tobacco Promotion in the U.S.”

Tobacco companies began producing and shipping free cigarettes within the first month of the war.

One company sent 10,000 cartons via the Department of Defense and others were on deck with 42,000 before the DOD acknowledged the free cigarettes were against policy and blocked further shipments, according to the study’s two researchers, Elizabith Smith and Ruth Malone, who are on staff at the University of California’s Department of Social and Behavioral Sciences, San Francisco.

Barred from providing free cigarettes, tobacco companies turned to branded merchandise such as baseball caps and playing cards.

“RJ Reynolds noted that ‘troops in Saudi Arabia definitely know that Camel Joe is behind them’ as they had received ‘over 5,000 packs of Camel playing cards … [and] a variety of premium items including sunglasses, audio cassettes and cup cozies,’” the study said.

During Desert Storm, the DOD bent the rules and allowed RJ Reynolds to advertise its logo on the cover of magazines donated to servicemembers despite rules against direct advertising, Smith and Malone found.

In another marketing campaign, Philip Morris distributed “Marlboro Holiday Voice Cards,” voice recordings sent to servicemembers downrange from families and loved ones. The company said its goals were positive publicity for Marlboro, brand recognition among young adult smokers and influence of a “broad base of opinion leaders,” according to the study.

The voice cards triggered a mild rebuke from the DOD, which reminded the company that ads directly identifying a tobacco product were not allowed. Meanwhile, the cards got Philip Morris about 94 million “media impressions”, television coverage around the world and a stream of goodwill letters from the public, the researchers said.

One military wife wrote a letter to Philip Morris saying she had asked her husband to quit smoking but changed her mind after using the voice card.

“If we ever get to see him again, I don’t believe I will ever fuss about it again,” the study quoted the woman.

Cigarette companies also saw an opportunity in the end of the war. Philip Morris executives said they were “keenly interested in capitalizing on the successful military operation” and “continuing the association we started last year with the troops.”

“Over forty locations now have welcome home signs in place featuring Marlboro brand identification,” a military sales manager said in June 1991, according to the study. The company also produced the largest homecoming event for Desert Storm at Camp Lejeune, N.C., and similar events in Germany featured “extensive signage for Marlboro,” the study said.

Beetroot Juice May Boost Stamina

Study findings could apply to athletes, elderly, researchers say

Written by Robert Preidt. SOURCE: University of Exeter, news release, Aug. 6, 2009

(HealthDay News, FRIDAY, Aug. 7) -- Beetroot juice can boost physical stamina and increase exercise endurance by up to 16 percent, a new British study shows.

The researchers found that nitrate in beetroot juice reduces oxygen uptake to a degree that can't be achieved by any other means. The findings could benefit endurance athletes, elderly people and those with cardiovascular, respiratory or metabolic diseases, the study authors suggest. [Editor's note: ...such as Gulf War Illness]

The study included eight men, aged 19 to 38, who drank 500 milliliters a day of organic beetroot juice for six consecutive days. They then completed a series of tests on an exercise bike. The same tests were repeated after the men drank the same amount of a placebo (blackcurrant cordial) for six days.

After drinking the beetroot juice, the men were able to cycle for an average of 11.25 minutes -- 92 seconds longer than after consuming the placebo drink. The men also had a lower resting blood pressure after they drank the beetroot juice, the researchers found.

The study was published Aug. 6 in the Journal of Applied Physiology.

"Our study is the first to show that nitrate-rich food can increase exercise endurance," corresponding author Andy Jones, a professor in the University of Exeter's School of Sport and Health Sciences, said in a news release from the university.

"We were amazed by the effects of beetroot juice on oxygen uptake because these effects cannot be achieved by any other known means, including training. I am sure professional and amateur athletes will be interested in the results of this research. I am also keen to explore the relevance of the findings to those people who suffer from poor fitness and may be able to use dietary supplements to help them go about their daily lives," Jones added.

He and his colleagues don't know the exact mechanism that causes nitrate in beetroot juice to increase stamina, but they suspect that nitrate may turn into nitric oxide in the body, leading to a reduction in oxygen uptake and making exercise less tiring.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.

Obama says Iraq War burn pits won't become another Agent Orange

Obama's VA Secretary Provides First Official Mention of Agent Orange, Gulf War Illness as Problem needing Change

Written by Leo Shane III, Stars and Stripes online edition

(WASHINGTON, D.C. - Tuesday, August 4, 2009) -- President Barack Obama promised Tuesday that health concerns related to burn pits in Iraq and Afghanistan will not become another Agent Orange, with the military denying their dangers for decades.

In a White House roundtable Tuesday with Stars and Stripes and other military reporters, Obama said he is tracking reports from the Defense and Veterans Affairs departments about the burn pits, still in use at a number of bases in Iraq and Afghanistan to dispose of various equipment and supplies. He said officials are still working to get an "objective" view on the problem.

"I'm absolutely convinced that our commanders in theater are doing everything they can to protect their men and women," he said. "My overriding mandate is you get the best science possible, and then make decisions from that standpoint."

Agent Orange, a defoliant used by the U.S. military in Vietnam, was linked to a host of medical problems among Vietnamese citizens and American troops, but military officials denied its effects for decades.

Defense officials say the open-air burn pits do not pose a significant threat to servicemembers nearby, citing a 2008 Joint Army/Air Force study that sampled air quality near burn pits and found few new health risks.

But a 2008 study by researchers at Vanderbilt University found higher incidences of respiratory diseases among Kentucky soldiers after they returned from Iraq in 2003. And a VA study of more than 6,000 Iraq war troops found about 10 percent of suffered from nasal allergies, a rate twice that of troops stationed in the U.S.

Veterans Affairs Secretary Eric Shinseki said officials in his department may implement a burn-pit health screening, similar to the one vets undergo to check for brain injuries and stress disorders, in order to better track the potential problem.

"I know we are working with DOD to do the kinds of sampling we didn't do for Agent Orange, seeing what's there that is different from a control population," he said.

"My interest is how do we change what has been the 40-year journey of Agent Orange, the 20-year journey of Gulf War Illness."

[Editor's Note: This is the first official mention of Gulf War Illness by the new VA Secretary]

Obama would not say he is convinced the burn pits present a serious health threat to troops, but insisted that his staff and military officials are still researching the issue.

"Nobody is served by denial or sweeping things under the rug," he said.

Presentation on Gulf War veterans' illnesses released online

Written by Anglico, 91outcomes

(91outcomes.blogspot.com - Sunday, August 2, 2009) - A presentation on Gulf War veterans' illnesses in now available online for the first time.

Aimed at educating Gulf War veterans, their advocates and loved ones, and the general public, Veterans of the 1991 Gulf War: Bittersweet Victory, Treatments on the Way? details the toxic soup to which troops of the 1991 Gulf War were exposed, the causes and nature of the neurological and immunological condition now known Gulf War Illness, and other diseases and illnesses affecting Gulf War veterans at statistically significant higher rates than their non-deployed Gulf War counterparts.

The PowerPoint presentation was developed and delivered by Gulf War veteran Anthony Hardie of Madison, Wis., at a joint leadership conference of Vietnam Veterans of America (VVA), Associates of Vietnam Veterans of America (AVVA), Veterans of Modern Warfare (VMW), and the National Gulf War Resource Center (NGWRC). It is available on the VMW website.

Hardie is one of the one-fourth to one-third of veterans of the 1991 Gulf War still suffering from Gulf War Illness. No treatments currently exist for Gulf War Illness.

Kucinich Secures $8 Million For Gulf War Veterans Illness Research

Money Will Expand On Studies For Treatment, Bringing Us Closer To Identifying A Cure

Written by Nathan White, Office of Congressman Dennis Kucinich

(WASHINGTON - July 31, 2009) - Congressman Dennis Kucinich (D-OH) secured a major victory for veterans of the first Gulf War by garnering $8 million for Gulf War Illness (GWI) research in the Fiscal Year 2010 Appropriations bill that passed the House yesterday.

“This research will build on previous studies on Gulf War Illness.” Kucinich said. “This funding will take giant steps forward in identifying a treatment or a cure for Gulf War Veteran’s illness.”

In its landmark 454-page report delivered in November, the Congressionally-mandated Research Advisory Committee on Gulf War Veterans Illnesses at the Department of Veterans Affairs (RAC) reported that “Gulf War illness is real, that it is the result of neurotoxin exposures during Gulf War deployment and that few veterans have recovered or substantially improved with time.”

For the first time, the report identified several suspected causes and two known causes: exposure to pesticides and a drug given to troops to protect them from nerve gas.

“There are currently no effective treatments for these conditions. With research, we learn the true causes of GWI and the possibilities open up. We must continue to attack GWI and fund the research with an amount commensurate with the scope of the problem,” said Kucinich.

Kucinich’s request for funding received bipartisan support from U.S. Representatives Henry Brown (R-S.C.), Rush Holt (D-N.J.), Bob Filner (D-Calif.), Michael Michaud (D-Maine), Tammy Baldwin (D-Wis.), Corinne Brown (D-Fla.), John Conyers, Jr. (D-Mich.), Chet Edwards (D-Tex.), Raul Grijalva (D-Ariz.), John Hall (D-N.Y.), Carolyn Maloney (D-N.Y.), Jim McDermott, Dennis Moore (D-Kan.), Gwen Moore (D-Wis.), Bill Pascrell (D-N.J.), Chellie Pingree (D-Maine), Mike Ross (D-Ark.), Joe Sestak (D-Penn.), Pete Stark (D-Calif.), and John Yarmuth (D-Ken.).

Remains Found in Iraq are of Capt. Scott Speicher, First Gulf War Casualty

By Pauline Jelinek, Associated Press Writer

WASHINGTON – The remains of the first American lost in the Gulf War have been found in Iraq, the military said Sunday, a sorrowful resolution of a nearly two-decade old question about the fate of Navy pilot Capt. Michael "Scott" Speicher.

The Pentagon said the Armed Forces Institute of Pathology on Saturday positively identified the remains, buried in the desert and located after officials received new information from an Iraqi citizen about a crash.

Speicher's disappearance has bedeviled investigators since his fighter was shot down over the Iraq desert on the first night of the 1991 war.

The top Navy officer said the discovery is evidence of the military's commitment to bring its troops home. "Our Navy will never give up looking for a shipmate, regardless of how long or how difficult that search may be," said Adm. Gary Roughead, Chief of Naval Operations.

Over the years, critics contended the Navy had not done enough, particularly right after the crash, to search for the 33-year-old Speicher. A lieutenant commander when he went missing, Speicher later reached the rank of captain because he kept receiving promotions while his status was unknown.

The Pentagon initially declared Speicher killed. But uncertainty — and the lack of remains — led officials over the years to change his status a number of times to "missing in action" and later "missing-captured." The family Speicher left behind, from outside Jacksonville, Fla., continued to press for the military to do more to resolve the case.

Speicher's story has never waned in that city. A large banner flying outside a firefighters' credit union has a photo of him with the words: "Free Scott Speicher." At his church, a memorial was put up in his honor and the swimming complex at his alma mater, Florida State University, was named for the pilot.

Family spokeswoman Cindy Laquidara said relatives learned on Saturday that Speicher's remains had been found.

"The family's proud of the way the Defense Department continued on with our request" to not abandon the search, she said. "We will be bringing him home."

Laquidara said the family would have another statement after being briefed by the defense officials; she did not know when that would be.

More than a decade after he was shot down in a combat mission, the U.S.-led invasion of Iraq in 2003 finally gave investigators the chance to search inside Iraq. That led to a number of new leads, including the discovery of what some believed were the initials "MSS" scratched into the wall of an Iraqi prison.

The search also led investigators to excavate a potential grave site in Baghdad in 2005, track down Iraqis said to have information about Speicher and make numerous other inquiries in what officials say was an exhaustive search.

Officials said Sunday that they got new information last month from an Iraqi citizen, prompting Marines stationed in the western province of Anbar to visit a location in the desert which was believed to be the crash site of Speicher's FA-18 Hornet.

The Iraqi said he knew of two other Iraqis who recalled an American jet crashing and the remains of the pilot being buried in the desert, the Pentagon said.

"One of these Iraqi citizens stated that they were present when Captain Speicher was found dead at the crash site by Bedouins and his remains buried," the Defense Department said in a statement.

The military recovered bones and multiple skeletal fragments and Speicher was positively identified by matching a jawbone and dental records, said Rear Adm. Frank Thorp.

He said the Iraqis told investigators that the Bedouins had buried Speicher. It was unclear whether the military had information on how soon Speicher died after the crash.

Some had said they believed Speicher ejected from the plane and was captured by Iraqi forces, and the initials were seen as a potential clue he might have survived. There also were reports of sightings.

While dental records have confirmed the remains to be those of Speicher, the pathology institute in Rockville, Md., is running DNA tests on the remains recovered and comparing them with DNA reference samples previously provided by family members.

"Our thoughts and prayers are with Captain Speicher's family for the ultimate sacrifice he made for his country," Navy Secretary Ray Mabus said in the Pentagon statement. "I am also extremely grateful to all those who have worked so tirelessly over the last 18 years to bring Captain Speicher home."

Speicher was shot down over west-central Iraq on Jan. 17, 1991.

Hours after his plane went down, the Pentagon publicly declared him killed. Then-Defense Secretary Dick Cheney went on television and announced the U.S. had suffered its first casualty of the war. But 10 years later, the Navy changed his status to missing in action, citing an absence of evidence that Speicher had died. In October 2002, the Navy switched his status to "missing/captured," although it has never said what evidence it had that he ever was in captivity.

A review in 2005 was conducted with information gleaned after Baghdad fell. The review board recommended then that the Pentagon work with the State Department, the U.S. Embassy in Baghdad and the Iraqi government to "increase the level of attention and effort inside Iraq" to resolve the question of Speicher's fate.

Last year, then Navy Secretary Donald Winter ordered yet another review of the case after receiving a report from the Defense Intelligence Agency, which tracks prisoners of war and service members missing in action.

Many in the military believed for years that Speicher had not survived the crash or for long after. Intelligence had never found evidence he was alive, and some officials felt last year that all leads had been exhausted and Speicher would finally be declared killed.

But after the latest review, Winter said Speicher would remain classified as missing, despite Winter's strong reservations about the pilot's status and cited "compelling" evidence that he was dead.

Announcing his decision, Winter criticized the board's recommendation to leave Speicher's status unchanged, saying the review board based its conclusions on the belief that Speicher was alive after ejecting from his plane. The board "chose to ignore" the lack of any parachute sighting, emergency beacon signal or radio communication, Winter said.

Speicher's family — including two college-age children who were toddlers when Speicher disappeared — believed more evidence would surface as Iraq becomes more stable.

One of Speicher's high school classmates who helped form the group "Friends Working to Free Scott Speicher" said Sunday his biggest fear was that Speicher had been taken alive and tortured.

"This whole thing has been so surreal for all of the people who have known Scott," said Nels Jensen, 52, who now lives in Arkansas.

Jensen said the group was frustrated the military didn't initially send a search and rescue team after the crash, and then grew more perplexed as reports of his possible capture emerged. "Never again will our military likely not send out a search and rescue party for a downed serviceman," Jensen said.

Sen. Bill Nelson, D-Fla., had pressed several years ago to get the military to renew a search for Speicher and he once visited the Baghdad prison cell where it was thought Speicher may have carved his initials in the wall.

"We all clung to the slim hope that Scott was still alive and would one day come home to his family," Nelson said Sunday.

The new informant told officials in Iraq of another possible location of Speicher's grave a site very near where his shattered airplane was found in 1993, Nelson said in a statement.

___

Associated Press writers Ron Word in Jacksonville, Fla., and Jacob Jordan in Atlanta contributed to this report.

Gulf War Veteran Struggles to Get VA Benefits after Failed VA health care

Written by Edward Marshall, Staff Writer, The [Harper's Ferry, W.V.] Journal

Disabled Gulf War veteran Philippe C. Cote sits recently with his daughter Anna at his side. The medications he takes daily for chronic pain resulting from a 1991 spinal injury sit in front of him. (Journal photo by Edward Marshall)

(HARPERS FERRY, W. Virginia - Sunday, August 2, 2009) - "It's almost like a war."

That's how local disabled U.S. Navy and Gulf War veteran Philippe C. Cote described his more than 16-year struggle with a spinal injury and the seemingly unending bureaucratic red tape he has faced while seeking treatment and disability benefits.

Cote, who graduated at the top of his class and who was awarded a National Defense Medal for his service, suffered a 20-foot fall onto concrete in 1991. He received an honorable medical discharge and in 1993 was given a 50 percent service-connected disability rating.

Over the years, his condition steadily grew worse, he said, as did the constant pain. More than a decade after the accident, he finally would seek help from the Virginia Spine Institute after he said Veterans Affairs Medical Center treatment failed to work. To his shock, he said his new doctor would tell him he had broken several small bones in his back and needed immediate surgery.

Cote blames what he says is the negligence of doctors within the VA for failing to realize the severity of the injury.

"If this is happening to me and this is happening to other veterans, what do you think is happening to the guys and girls coming back from Iraq and Afghanistan?" Cote asked. "The VA's medical care and their practices are exactly what this country is in for if we pass this nationalized health care system."

Today, Cote, who is married with a five-year-old daughter, is unable to walk without the use of a cane, suffers from permanent nerve damage and constant muscle spasms. The simple act of drinking coffee now requires that he use a large glass measuring cup for a container, because spasms have caused him to break nearly every coffee mug in his home.

Unable to work, he was fired from his job in 2007, losing his health insurance and nearly his home. He once made a six-figure salary in the private sector. Now he is forced to subsist on food stamps and about $900 a month in benefits while trying to take care of his family.

"I want to set the record straight. I am no war hero. I am not a purple heart (recipient), but I served my country," Cote said.

Finally, some answers

Since the fall that injured his spine, Cote has been in and out of VA Medical Centers in Washington, Martinsburg, Dallas and Fort Worth for his back pain and muscle seizures.

In December 1994, he moved to Jefferson County and shortly afterwards began treatment at the outpatient facility at the VA Medical Center in Martinsburg. As the years progressed, Cote said VA doctors told him they didn't see any reason for him to be in so much pain.

"Then it turned into 'Well, we're concerned about the fact that you are always wanting pain killers' and this and that," Cote said. "The whole issue ended up being turned around on me with the insinuation that I was just there for pain medication."

Earlier this week, The Journal contacted Barbara Corbin, public affairs officer for the VAMC in Martinsburg, seeking comment about Cote's claims. Corbin said she could not comment about a patient's medical history unless the patient had signed a release form.

In 2007, Cote sought help from the Virginia Spine Institute in Reston, Va., where doctors ordered a nerve test and an MRI. When images from the tests came back, Cote said he was told that he had broken several small bones in two vertebrae. He also discovered he had a fused joint at the bottom of his spine and permanent nerve damage.

"(My doctor) goes through the image, looks at me, turns around and says, 'When did you break your back?'" Cote said. "He looked up in amazement. He said 'How are you even walking around?' I said, 'Because I have to. I have a family to feed.'"

The diagnosis came from Dr. Thomas Schueller, the founder of the Spine Institute. Cote was immediately scheduled for surgery a week later in June 2007. The surgery would take four hours longer than expected, because of the amount of scar tissue that had accumulated.

"I slipped 11 millimeters," Cote said of his spinal injury. "(Schueller) said he'd never seen anything like it in his life."

In November 2007, Cote lost his job and his insurance, which forced him to discontinue any further surgeries on his spine. He continues to see a pain management specialist at the Spine Institute on a bi-monthly basis, though he pays for his medication out of pocket.

Hopes dashed

Cote said in the beginning of 2008, he felt optimistic that with continued home therapy, he would eventually be able to return to work, but that hasn't been the case.

He then decided to file a claim with the VA to have his disability status re-evaluated. He also filed a claim for dependent benefits.

The paperwork was sent at the end of May 2008, and Cote received a response from the VA in February, which increased his disability rating to 60 percent. That was despite the fact, Cote said, that he believes he is entitled to 100 percent disability and that his physician has stated he is unable to work.

Cote said the response didn't include dependent status or benefits for his family.

"I was counting on the 100 percent, and I was counting on the fact that I was entitled to my benefits for my child," Cote said.

Once Cote realized that the fight for his disability benefits was going to continue, he contacted the law firm of Binder & Binder to represent him while he filed for disability benefits with the Social Security Administration.

Cote officially filed for Social Security benefits in December 2008. His claim was denied in April, and Cote said it was denied because he was told he was too young to be disabled. He is appealing the decision.

Dan Moraski, public affairs specialist with Social Security Administration's press office, refuted that claim, stating the agency provides benefits to disabled individuals as young as 18 years old who, in some cases, have only worked for a year or a year-and-a-half.

"We don't deny people for being too young," he said.

Instead, it appears, Cote's claim likely was rejected because of his 60 percent disability status. Moraski said benefits only are provided to those who either have a medical condition that is so severe they are unable to work or those who have a terminal illness and are not expected to live long.

"We don't provide for partial disabilities," he said.

Brick walls

In July, Cote contacted the office of U.S Rep. Shelly Moore Capito, R-W.Va., for help.

"In cases like this, where a constituent is facing challenges in their interactions with a federal agency, the congresswoman's office can serve as a liaison to help constituents navigate the federal bureaucracy," Jonathan Coffin, Capito's press secretary, said. "In this case, we've made an inquiry to the VA on behalf of Mr. Cote. We're still awaiting the response from VA officials, but we'll continue to work with him and monitor his case as it moves forward."

Cote's monthly income is still $974 and his wife has been unable to find work.

His mortgage payment on his house was $850, but he filed a hardship claim with Wells Fargo. A loan modification has adjusted his interest rate, and he now pays about $364 a month.

His prescriptions cost about $250 a month.

Cote has filed with the Department of Health and Human Resources in Charles Town for Medicare and Medicaid coverage for his family, though only his daughter was granted coverage. He now receives $517 a month in food stamps.

"I'm to the point where I don't know what to do anymore," Cote said. "I can understand why people are driven to such extremes, because you are just running up against a brick wall to get what is rightfully yours."

-Staff writer Edward Marshall can be reached at (304) 263-8931, ext. 182, or emarshall@journal-news.net