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Tag: Veterans Affairs

  • Blast exposure can cause intestinal permeability, study shows

    Blast exposure can cause intestinal permeability, study shows

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    A study by New York and Rocky Mountain U.S. Department of Veterans Affairs researchers showed blast exposure can cause intestinal permeability, a condition that can lead to gut bacteria entering the bloodstream and causing problems in other parts of the body. The study was the first to show a connection between blasts and intestinal permeability in a real-world operational setting.

    Researchers found biomarkers of intestinal permeability and signs of bacteria in the blood in 23 of 30 military breachers who were exposed to controlled, low-level explosive blasts during training. The biomarkers were observed between one and 16 hours after blast exposure, suggesting a direct connection.

    Intestinal permeability is a condition in which materials in the gastrointestinal tract can pass through the cells lining the intestinal walls. While the human body naturally has some intestinal permeability to allow nutrients to pass through the gut, when the barrier is too loose harmful substances such as bacteria can pass through into the rest of the body.

    Participants also reported headache, dizziness, concentration problems, and slow thinking after blast exposure. These symptoms are often seen in people with mild traumatic brain injury (TBI). Analysis suggested bacterial leakage could add to mild traumatic brain injury to increase mental symptoms. Previous research has shown a connection between gut bacteria and cognitive performance.

    About 20% of post-9/11 active duty Service members and Veterans have reported at least one mild TBI, with more than a third of these being caused by blast-related injuries. TBI research has shown pressure waves caused by explosions can cause internal injuries to the vasculature of the brain. While the entire body is susceptible to this type of damage from blasts, less is known about how the digestive tract may be affected. To the best of the author’s knowledge, this is the first study to show a direct connection between blasts and intestinal permeability with associated cognitive symptoms.

    The authors suggest treatment of blast-related TBI should also take into consideration intestinal integrity, the gut microbiota, and bacterial effects such as systemic inflammation.

    The study appeared in the March 21, 2024, issue of the International Journal of Molecular Sciences.

    Source:

    Veterans Affairs Research Communications

    Journal reference:

    Liu, Q., et al. (2024). Association of Blast Exposure in Military Breaching with Intestinal Permeability Blood Biomarkers Associated with Leaky Gut. International Journal of Molecular Sciences. doi.org/10.3390/ijms25063549.

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  • Bridging the gap in mental health services for pregnant women with serious mental illness

    Bridging the gap in mental health services for pregnant women with serious mental illness

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    Women with serious mental illness (SMI) who are pregnant or planning a pregnancy face gaps in information, support and resources in mental health services, new research suggests.

    The findings, published April 1 in the peer-reviewed journal Health Affairs, highlight the need to integrate pregnancy and parenting interventions, education, and other resources for women with SMI into mental health services.

    Policies that increase mental health provider and clinic capacity to address pregnancy and parenting can dramatically improve care for women living with mental illness, which would ultimately advance maternal and child outcomes, said Dr. Nichole Goodsmith, psychiatrist and health services researcher at Veterans Affairs Greater Los Angeles Healthcare System, and assistant clinical professor of psychiatry at the David Geffen School of Medicine at UCLA.

    Our study suggests that the topic of pregnancy may be under-discussed in mental health care, leading to a missed opportunity to understand patients’ pregnancy goals and desires and offer appropriate support and services. The women we spoke to wanted more information on the potential impact of their psychiatric medications on fertility, pregnancy, fetal development, and breastfeeding. The mothers we interviewed expressed needing more parenting support and resources-;things like parenting classes, on-site childcare during mental health visits, and referrals for resources like baby supplies.”


    Dr. Nichole Goodsmith, study’s senior author 

    Goodsmith conducted the research while in the National Clinician Scholars Program at UCLA.

    The researchers conducted telephone interviews with 22 reproductive-age women being served at four Los Angeles County Department of Mental Health outpatient clinics in 2020 and 2021. Most participants were Black or Latina and had children.

    Among the findings, few women recalled discussions of pregnancy with their mental health providers, and those who did described them as “quick conversations.” In addition, many were dissatisfied with the information they received about potential safety concerns of taking their psychiatric medications in pregnancy.

    As for parenting, most described their mental health providers as helpful and supportive, though some were concerned that even talking about their mental health symptoms could lead to losing custody of their children.

    The study has some limitations, the researchers write. It was conducted in a large, urban safety-net mental health system, so the findings may not apply to other locations or populations, it surveyed only English-speaking women did not include other languages or gender identities.

    But the findings shed light on the need to build mental health providers’ capacity to discuss and address their patients’ pregnancy- and parenting-related needs.

    “Overall, results underscore the need for greater integration of pregnancy and parenting interventions, education, support, and resources into mental health services for women living with SMI,” the researchers write. “Incorporating educational content related to pregnancy and parenting into academic, professional, and continuing education curriculums can help close this knowledge gap.”

    Additional authors are Karissa Fenwick, Kristina Cordasco, and Alison Hamilton of Veterans Affairs (VA) Greater Los Angeles Healthcare System; Emily Dossett of the University of Southern California, and Rebecca Gitlin of the Los Angeles County Department of Mental Health.

    The project was funded by the National Clinician Scholars Program at UCLA, the Veterans Affairs (VA) Office of Academic Affiliations through the Health Services Research Fellowship Program (TPH 65-000-15), the VA Research Career Scientist (VA Health Services Research and Development Grant No. RCS 21-135), the VA Office of Academic Affiliations, and a K12 (K12HS26407) career development award from the Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute.

    Source:

    University of California – Los Angeles Health Sciences

    Journal reference:

    Fenwick, K., et al. (2024) Addressing Pregnancy And Parenting In Mental Health Care: Perspectives Of Women With Serious Mental Illness. Health Affairs. doi.org/10.1377/hlthaff.2023.01450.

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