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  • MeToo

     

    Advocates for military women are planning a #MeToo demonstration outside the Pentagon next month to add their voices to the movement that has put a spotlight on workplace sexual harassment and extinguished the careers of powerful men in entertainment, media, technology and politics.

  • Amputees in High Heels

     

    Researchers from the Department of Veterans Affairs have played roles in a number of scientific and medical breakthroughs that have had a profound impact on modern life: the liver transplant, the nicotine patch and artificial lungs, to name just three.

    And now, as they seek to meet the needs of an increasingly diverse population of wounded and disabled Veterans from the current era of war, VA design experts say they're going beyond barebones medical needs and aiming to help Vets live more comfortably, with technology adapted to their lifestyle and interests. It's work that requires them to listen to Veterans more closely and involve them and their feedback in the development process to a greater extent than ever before.

    One example of this work can be seen at the Office of Research and Development of the Department of Veterans Affairs, where they've come up with a 3D-printed ankle and foot device for a prosthetic leg to give amputees adjustable heels.

    Thanks to this research, stilettos are no longer out of the question for Veteran amputees. Outside researchers at Johns Hopkins University and elsewhere have developed similar devices, but Dr. Andrew Hansen of the Minneapolis VA Healthcare System said the VA's "Shape & Roll" prosthetic foot is unisex.

    "This study focused on high heels, but the results work just as well for cowboy boots," Hansen said in a VA release.

    The adjustable-heel prosthetic was an example of VA's commitment to research in areas that haven't been pursued by the private sector, said Dr. Rachel Ramoni, the VA's chief research and development officer.

    "Actually, there's a couple of things going on with 3D printing; you can print a foot for every type of shoe," Ramoni told Military.com.

    The foot-ankle prosthetic also demonstrates a willingness at the VA to take feedback from wounded and disabled Veterans themselves on what they need to accommodate the lifestyles they wish to return to or pursue, she said.

    Ramoni also cited current research into upper-arm prosthetics for women as an example of this work.

    "That's a small segment of the population; it's a small market," Ramoni said. "It's not an area where somebody would say 'Well, it's an obvious money making opportunity.' So it might not be good business, but it's the right thing to do."

    The other challenge with research on upper-arm prosthetics for women is that so little work has been done in the field previously, Ramoni said.

    "The sizing of the prosthetic is a big deal," she said, and "we don't know about women's upper arm satisfaction, because all of the surveys were designed for men."

    The work on adjustable heels and the upper-arm prosthetic research are among more than 2,000 projects involving 3,400 researchers now underway at the Office of Research and Development. ORD operates on a budget of about $722 million from the VA, supplemented by contributions from the National Institutes of Health, the Department of Defense and others, for a total of about $1.5 billion, Ramoni said.

    The money is being spent with a new emphasis on listening to Vets regarding where they want the research to go, Ramoni said.

    A Disabled Vet Tackles Design

    Dr. Rory Cooper was an Army sergeant in Germany in 1980 when he lost the use of his legs from spinal cord injuries in a bicycle accident.

    He now is a director and senior research career scientist for the Human Engineering Research Laboratories, a VA Rehabilitation Research and Development Center and home of the VA Technology Transfer Assistance Program.

    Cooper is also a Paralyzed Veterans of America distinguished professor at the University of Pittsburgh. As such, he is an advocate for what leaders in his field call "participatory action engineering," or, more simply put, listening to the people you're trying to help.

    Cooper said his frustration with the ivory-tower approach to human engineering grew out of his own experience trying to get a better wheelchair.

    "I was trying to solve some of my own problems," he said of his approach to design research. He found that he and other Veterans often were in "isolation" from the researchers.

    Cooper said that surveys and talking to the Veterans themselves are "ways to initiate the design process, rather than having somebody sitting at their desk or surfing their computer, trying to understand what you want."

    Designers and researchers should "start by asking [the Veterans]... to prioritize," Cooper said.

    He said his current research was focused on robotics, artificial intelligence and what he called "adaptive reconditioning technology" to help Veterans participate in sports and recreation.

    One such example: a robotic bed. One of the little-known everyday problems for disabled Veterans, and their caregivers, is getting in and out bed, Cooper said.

    "If you don't have the use of your arms or legs, or you're weakened, that's a huge problem," he said.

    The bed is currently a work in progress, but Cooper said the initial thought was to have a "chair-into-bed kind of a docking system, and the chair kind of puts you into the bed while a conveyer pulls you into the bed."

    A Secret Weapon: Veterans

    The VA has a major advantage over the teaching hospitals and the private sector in conducting wide-ranging tests and surveys that require huge numbers of volunteers, said Ramoni, the VA's chief research officer.

    "Veterans are absolutely core to our program," she said. "Our program is able to make these discoveries because of the thousands of VA patients volunteering here," and "what we do is driven by their needs."

    Outside researchers, she said, often ask how they can learn from current VA practices and how VA scientists get so many people involved in the development process.

    "We say what we have is not something you can learn; that you have a population of Veterans who want to continue to serve their fellow Veterans and the entire nation by participating in these studies," Ramoni said. "It's just amazing to me how committed Veterans are to continuing to serve and continuing to make discoveries that will help everybody."

    The Next Big Breakthrough

    Ramoni noted that VA's ongoing Million Veteran Program (MVP) on genome research has now enrolled more than 670,000 Veteran volunteers, to make it by far the world's largest genome database.

    In the program, begun in 2011, participants donate blood, from which DNA is extracted. Then a baseline and periodic follow-up surveys track the Veterans' military careers, and their health and lifestyles.

    The research seeks to determine whether the genetic information in the database could hold keys to preventing and treating diseases.

    "We believe MVP will accelerate our understanding of disease detection, progression, prevention and treatment by combining this rich clinical, environmental and genomic data," former VA Secretary Dr. David Shulkin said.

    The MVP research opened the possibility for determining whether genetic factors were contributors to PTSD and Gulf War illness, Ramoni said.

    Many Veterans shared the same experiences in the same places in combat, and others were in the same places in the Gulf War; some developed PTSD and Gulf War illness, others didn't, Ramoni said.

    "The question we all ask is, why is that? Are there genetic markers for PTSD susceptibility, or are there genetic markers for Gulf War illness? Genes might help reveal that," she said.

    Source

    #veterans #military #amputees #womenvets

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  • Burn Pit Widower

     

    It was in 2009 when Brian Muller first met his wife, Amie.

    "We actually met at a music venue. And at the time I was playing music in a band and she had some friends there that were at the event," Muller, 45, from Woodbury, Minn., recalls in a recent interview with Fox News. "Her friends forced her to go out. I forced myself to go out and just to see some music."

    He remembers how they discussed her service with the Minnesota Air National Guard.

    "We ended up talking about what she does with the military," he says, "and at that time, she was doing a project to make video memorials for gold star families. Families that lost loved ones in Iraq or Afghanistan or any type of war."

    "She asked me to write a song for those videos. And that's how we kind of started our relationship, as-- friends, and then it developed from there."

    Brian has never served in the military but was impressed by Amie's service -- including her two tours in Iraq.

    "She wanted to fly, and she joined the Air Force. And she got deployed and had her life kind of uprooted there for a while."

    Amie was stationed at the Iraqi air base in Balad during both of her tours in 2005 and 2007. While her active service was already behind her, the effects from her time on that base still lingered.

    "She didn't really want to talk about her time over there," Brian says. "Anytime a door would slam or a loud noise, she'd get startled very easily. She had a lot of PTSD [episodes] from just little things."

    A decade after returning from Iraq, Amie's physical health also suffered. She was diagnosed with Stage III Pancreatic Cancer.

    "I still remember Amie getting the call, and she looked at me," Muller says about the day they found out about her diagnosis back in April 2016.

    "We walked around the corner just to make sure the kids didn't see. I could tell by the look in her face how scared she was. And I just kind of listening in to the call. And we just started shaking.

    Both she and Brian believed it was related to her exposure to open-air burn pits used to destroy trash generated on the base. Nearly every U.S. military installation in Iraq during the war used the crude method of burn pit disposal, but Balad was known for having one of the largest operations, burning nearly 150 tons of waste a day.

    The smoke generated from these pits hung above Amie's barracks daily.

    "She talked about the burn pits even before she got cancer," Muller recalls, "and how the fact that they would change the filters on these ventilation systems quite frequently. And every time they'd change it would just be this black soot, so thick that you would think you'd have to change it every hour."

    "After she told me what they were burning, you know, all I thought about is all the campfires that we had in our backyard. You don't burn Styrofoam. You don't burn plastic. We all know that, but they were burning all those things. Highly toxic."

    As early as Operation Desert Storm in 1991, burn pits were used at U.S. military bases in Iraq. At the height of the Iraq War in 2005, more than 300,000 troops were stationed there and potentially exposed to the smoke and fumes from burn pits.

    Thousands of Veterans and former contractors returned from the Middle East and have developed rare cancers, respiratory problems, and blood disorders from what they claim are their exposure to toxins from the flaming pits. More than 140,000 active-service members and retirees have put their names on a Burn Pit Registry created by the Department of Veterans Affairs.

    After Amie was diagnosed and her treatment began, she and her family went public with her story in the hopes that it would bring awareness to the dangers she and countless Veterans faced after what they believe was a result of burn pit exposure.

    Amie succumbed to her illness just nine months after she first diagnosed.

    In her absence, Brian continued Amie's work in raising awareness by sharing her story. He also worked closely with Sen. Amy Klobuchar, D-Minn., toward getting "The Helping Veterans Exposed To Burn Pits Act" -- a bipartisan bill recently presented in Washington and signed by President Trump -- passed.

    The bill will help fund a new center by the Department of Veterans Affairs that will study the effects of burn pit exposure and eventually assist with treatment plans. He also started the Amie Muller Foundation, which helps other Veterans who were diagnosed with pancreatic cancer.

    "I just hope that our Vets are going to get the help they need," Brian says, "and it's not going bring back Amie, my wife, but it's going to get Veterans the help they need."

    But recent findings show that the Pentagon was aware of the dangers of burn pits during the height of the war in Iraq.

    Fox News recently obtained a series of memos drafted by top officials at Balad during the same years that Amie served at the base. The authors of the documents -- which include commanding officers as well as environmental officials -- stated that the operation of burn pits was a danger to those stationed there and that precautions needed to be taken urgently to improve conditions.

    "In my professional opinion, there is an acute health hazard for individuals," reads a line from one memo written by a Bioenvironmental Engineering Flight Commander and the Chief of Aeromedical Services at Balad in 2006. "There is also the possibility for chronic health hazards associated with the smoke."

    The memo also includes an assessment of the pits in Balad where one environmental inspector said that Balad's burn pit was "the worst environmental site I have personally visited."

    After inquiries by Fox News regarding the memos, Officials for the Department of Defense said that they would look into the matter and explained their procedural policy and that open-air burn pits are to be operated in a manner that prevents or minimizes risk.

    "DOD does not dispose of covered waste in open-air burn pits during contingency operations except when the combatant commander determines there are no feasible alternative methods available," reads the statement provided by a Defense Department spokeswoman. "DOD minimizes other solid waste disposal in open-air burn pits during contingency operations. Generally, open-air burn pits are a short-term solution. For the longer term, we use incinerators, engineered landfills, or other accepted solid waste management practices whenever feasible."

    Muller finds the memos troublesome.

    "I don't understand why they didn't do something," he says after being shown a copy of the memos. "These are people that volunteered to serve our country, and it just disgusts me to see memos like that, from high ranking officers that expressed this concern."

    Muller adds that the underlying issue is a lack of accountability.

    "The issue is they were doing something they shouldn't have done, that they constantly warned was an environmental hazard," he says. "And our Vets are getting sick. Our Vets are dying."

    "You know, there was a fellow that did a video--'Delay, Deny and Hope You Die.' And that's kind of what's been going on. They're delaying this as long as possible so that they won't have to deal with as many claims, because most of them will die before they do anything about it."

    Muller also believes that Amie would have never fallen ill if it wasn't for the fact that she was stationed at Balad.

    "I don't think she would have gotten cancer. I really don't. Maybe she would have later in life. Maybe it would have been some other type of cancer. I don't know," he says. "But something caused inflammation -- for something to grow in her body for a long period of time before it was ever seen and diagnosed. There was something going on with all of the Vets when they got back."

    In a recent interview with Fox News, Gen. David Petraeus, the former commander of U.S. Central Command and Multi-National Force-Iraq in 2007, offered an explanation when asked about why burn pits were used on military bases, conceding that the realities of war kept concerns about how to dispose of waste a low priority at that time.

    "At that time we weren't worried about burn pits," The general said back in September. "We were worried about just getting enough water for our troops in the really hot summer. We were looking forward to the time where we might get some real food, real rations, as opposed to MREs and so forth."

    The general also expressed that the U.S. has a commitment toward helping those Veterans.

    "It's a sacred obligation," Petraeus said. "But comparing what our VA does to any other country's care of Veterans... this is the gold standard. Certainly, a gold standard that can always improve, without question. This is an issue, though, where we have a sacred obligation, and we need to meet that obligation."

    Muller believes the general's recent comments to be a sign of a move in the right direction.

    "When you start seeing men in uniform, or women in uniform, people higher up in the military starting to voice their concerns, you know we're making progress."

    Source

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  • DVA Logo 005

     

    Today the U.S. Department of Veterans Affairs (VA) announced the appointment of a new chairwoman and four new members to the Advisory Committee on Women Veterans, an expert panel that advises the VA Secretary on issues and programs of importance to women Veterans, their families and caregivers.

  • Ponies Up

     

    TheLos Angeles City Council approved funding to build a homeless shelter for homeless Veterans.

    LOS ANGELES, CA — A proposal to fund the city's portion of a temporary homeless shelter to be located on the West Los Angeles Veterans Administration campus was approved by the Los Angeles City Council Friday.

    Under a partnership, the city and county of Los Angeles will split the cost of the construction of the $5 million facility, and the Department of Veterans Affairs will provide on-site services.

    The City Council unanimously approved a motion seeking funding for the facility, which is to be located on the grounds of the VA campus.

    It will provide transitional housing beds for up to 100 homeless Veterans, along with laundry facilities, personal hygiene centers, 24-hour security and supportive services.

    "This is a really big deal for Veterans that the VA is finally starting to deliver, and I'm really glad that the city of Los Angeles and the county are helping them deliver," Councilman Mike Bonin said earlier this week at a Homelessness and Poverty Committee meeting before it moved the motion forward.

    The facility is scheduled to open in early 2019, and will be one of several new programs and facilities at the site aimed at helping homeless Vets.

    The VA also is working on its Draft Master Plan, which calls for 1,200 units of permanent supportive housing on the Westside campus.

    The VA additionally has opened a "safe parking" program for Veterans living in their vehicles, and started providing permanent supportive housing for homeless Veterans in existing buildings, with 54 Veterans currently housed in Building 209.

    With financial support from the city through HHH bond funds, two other buildings are being converted into permanent supportive housing for Veterans.

    The facility will be part of Mayor Eric Garcetti's "A Bridge Home" program, which calls for temporary homeless facilities in each of the city's 15 council districts. One temporary facility in Councilman Jose Huizar's district near the El Pueblo Historic Monument has already opened, with other sites at various stages of development.

    The VA bridge housing site will include two tension membrane structures along with modular trailers that will not be visible from the exterior of the VA campus, according to Bonin's motion.

    Source

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  • VA Failed Her

     

    She served her country for more than two decades but now believes the Department of Veterans Affairs (VA) is letting her down.

  • Female Vets Am Legion

     

    The Veterans of American Legion Post 204 ― the “Service Girls” ― as they’re known in their Pacific Northwest home, are speaking out about the American Legion’s membership policies, which currently exclude the spouses of female Veterans in every branch of their organization.

    The former commander of Post 204 and 35-year Army Veteran Carrol Stripling is getting ready to file a third resolution with the American Legion since 2015. Her first two resolutions were denied. Stripling said the denials were representative of a culture that hasn’t always respected the needs of female Vets.

    “We don’t want our service undervalued any longer,” Stripling said at a June 23 meeting in Bothell, Wash.

    Founded in 1946, Post 204 is one of the few all-female American Legion posts across the country. Located in Washington state, the post is open to any female service members who’d like to join.

    “We call ourselves Post two-zero-four ― never two-oh-four ― because it makes [people] remember our name and who we are,” said Sandy Cooper, a retired Air Force Veteran and the first female USAF fire chief.

    “As a woman Veteran, you can’t be average. You have to be better than the men to get respect,” Cooper continued.

    Respect is why Post 204 came into being. Born out of what the women said was a need for sharing in a way only female Vets can understand, the service members said they support each other in and out of meetings without judgment.

    But they said they also have a looming concern about the organization that has come to offer them so much comradery: they want the same benefits their male counterparts are offered. They want their husbands to have a place within the American Legion organization.

    Elizabeth Bissett, retired Army Veteran, echoes the concerns of the other members. “I want to be able to have a male auxiliary … all of us are in the same boat and we don’t have an official auxiliary,” Bissett said.

    The American Legion history

    Since it was chartered by Congress in 1919, the American Legion, or The Legion, is the largest wartime Veterans’ nonprofit organization.

    According to The Legion’s website, it was developed by “war-weary Vets from World War I” and it quickly grew into a unique reprieve for service members to connect.

    The organization offers a network for Vets to grow friendships, bonding over volunteering events and activities, as well as unifying members through shared experiences. The Legion prides itself on patriotism and support for its 2.4 million members across the nation, according to its mission statement.

    The American Legion Auxiliary (ALA), developed the same year as The Legion, is a club for spouses of male Veterans, as well as daughters of Veterans.

    Essentially, it’s a place for women to lend support for each other and their service members.

    The ALA offers similar kinship and events, offering “support to The American Legion and to honor the sacrifice of those who serve…” according to the ALA mission.

    Likewise, The Sons of the American Legion (SAL) is an organization that offers membership to sons of Veterans.

    While these organizations have independent rules and statutes which dictate membership eligibility, all are inclusive to most relatives of Veterans. But none offer memberships to spouses of female Veterans, despite a growing concern.

    Female membership in the military

    In 1948, the Women’s Armed Services Integration Act was passed by Congress, allowing women to have a permanent place in the military. But long before it was a law, women have inserted themselves in military efforts dating back to the late 18th century.

    Today, women represent 16 percent of all enlisted service members and 18 percent of officers. These numbers are up from 1973, when women represented 2 percent and 8 percent, respectively.

    The influx of female armed service members over the last 40 years are not reflected in the American Legion’s membership policies, which haven’t changed since it began in 1919, despite The Legion’s declining membership numbers.

    While there are more active female Legion members today, there’s still no place for their spouses to gather in support of their service.

    “You know, my husband has said to me, ‘if there were other husbands here that I had a way to network with, we could go out and have a golf outing or we could do this or that,' so there is a need and an interest in networking,” Cooper said.

    Membership eligibility and the American Legion Auxiliary

    The complicated issue of changing policy to include male spouses of female Vets in the ALA is determined by different factors. These factors dictate how and if the constitution of the American Legion Auxiliary can be amended.

    ALA National Secretary and Executive Director Mary “Dubbie” Buckler released a statement in 2015 on the subject: “The American Legion Auxiliary is a separate corporation, incorporated as an all-female organization with our own Tax Identification and our own IRS Group Exemption independent from The American Legion. As such, we cannot amend our American Legion Auxiliary bylaws to change membership eligibility because our Articles of Incorporation filed with the government already prohibits it.”

    She went on to say: “The American Legion Auxiliary is both incorporated and constituted as an all-female organization and our national governing documents cannot conflict with The American Legion’s governing documents. The American Legion National Constitution Article 13, Section 2 specifically limits membership in the American Legion Auxiliary to females, as specified consistently in everything published stating membership eligibility criteria. Therefore, any changes to membership eligibility in The American Legion Auxiliary would first require a constitutional amendment to both the Legion and ALA constitutions and an amendment by the federal government to the IRS Code, which is considered very unlikely.”

    The Vets of Post 204 say the long explanation is an excuse by the American Legion and the Auxiliary so they won’t lose their standing as a federal charter.

    “They’re worried about losing their federal charter. If you leave [the tax code] the way it is, nobody can mess with it,” Stripling said. “Before we went to Panama and Grenada, the Legion went to the IRS and said, ‘You know, we are all dying, we will have no members … so let’s let some of those Cold War Veterans in’ and the IRS said, ‘Sure.’ … So you can see it’s a misnomer.”

    Another explanation came from the American Legion Frequently Asked Questions Guide in a 2013 document citing that the need for male spouses to have a separate auxiliary would be arbitrary.

    In direct response to the question of why female spouses don’t have a separate organization, the document read: “Over the last few years, Internal Affairs has had a few resolutions on male spouses of female Veterans (either to join SAL or to establish a separate male auxiliary) that were considered by various Convention Committees and all were rejected … it was unanimously decided that the American Legion is a wartime Veterans’ organization and not a social organization. Each of the three organizations has specific requirements for membership with specific purposes and to add spouses either male or as defined by specific states would not add value to our organizations.”

    American Legion Auxiliary headquarters did not respond to further questions on the subject of membership eligibility.

    What comes next?

    Master Sgt. Kacie Chiappini, a current Air Force reservist from the Youngstown Air Reserve Station in Vienna, Ohio, said she joined the American Legion because it was a way to bond with her WWII Veteran grandfather.

    “My grandfather was the last WWII [Veteran] still living that was a member at our post and we would meet him there a lot before he passed away. He loved it there … but it was mostly [him] that got me going there,” Chiappini said.

    Like the women of Post 204, Chiappini shares concerns over why her husband can’t join the club where she’s had so many fond experiences.

    “To me, it’s mostly principle,” Chiappini said. “It needs to change.”

    Chiappini brought the issue up to her commanding officer Lt. Col. John Boccieri. Boccieri is a also a member of the American Legion and a former U.S. congressman in Ohio’s 16th District.

    “I, too, was startled by the fact that the American Legion will not permit spouses of female service members to join the auxiliary organization. Permitting a family to honor all Veterans in such an esteemed organization as the American Legion can only strengthen the respect we pay to all Veterans, whether male or female,” Boccieri said.

    The movement for change is in early stages as more female Vets question the policies of The Legion.

    However, the women of Post 204 want Vets like Chiappini, and every other female service member, to have the opportunity for a male auxiliary in support of their service in the near future.

    Stripling, Cooper and Bissett shared their frustrations over previous efforts to file resolutions and how their voices, seemingly lost before having a chance to use them, may not be enough to spark the necessary measures of change.

    “These resolutions we filed, they go to committees, but sometimes they don’t even reach the committees because the staff pulls them,” Stripling said. “The committees are appointed, but you don’t know which committee sees the resolution.”

    In the coming months, Stripling will file a third resolution with the American Legion, hoping this time it will make a difference.

    “I just think that changing the culture of The Legion will help change the whole culture in the military. That’s what we’re here for,” Stripling said.

    The women say they won’t stop until The Legion recognizes the need for a male auxiliary in support of female Veterans, whose service is just as valuable as their male counterparts.

    “We’re gonna fight. And we’re eventually gonna get it,” Bissett said.

    Source

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  • Homeless Female

     

    MINNEAPOLIS (WCCO) — The number of female homeless Veterans is on the rise.

    A home was dedicated Thursday in Maplewood to honor their service by helping some women Veterans in their time of need.

    A five-bedroom, four-bath home is the result of a partnership between the Builders Association of the Twin Cities, Lennar homes and Minnesota Assistance Council for Veterans.

    MAC-V will take five homeless female Veterans and place them in this structured independent living home. There will also be services to help these Veterans get the resources they need.

    “We’re going to come around them with wraparound services, case manage all the way through and we stay with them for two years and beyond to make sure that they’re getting stabilized.”

    There are 30,000 female Veterans in Minnesota. Twenty women are currently on the registry for housing.

    Source

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  • Breast Cancer Trtmn 003

     

    Scientists say a new treatment is showing promise in the fight against aggressive breast cancer. Three years ago, at age 39, Maribel Ramos was diagnosed with advanced breast cancer. The type was triple negative.

    "I was angry and sad," Ramos said. "Because I know that the triple negative is a type of cancer that is really hard to treat."

    Ten to 20 percent of breast cancers are called triple negative because they don't have receptors – such as ones for estrogen – that can be targeted by certain medications. Treatment options are limited, and these cancers tend to be more aggressive, with worse outcomes.

    In 2016, Ramos entered a trial to test the immunotherapy drug Tecentriq on patients with advanced triple negative breast cancer.

    The drug works by targeting proteins found on immune cells and some cancer cells. It's approved for bladder and one type of lung cancer.

    Dr. Sylvia Adams of NYU-Langone Health was one of the trial investigators. She says the new drug helps the immune system recognize the cancer.

    "There are killer cells already in the cancer present and ready to fight, except that this cancer shields itself from the from the immune attack," Adams said. "So this drug is now able to take the shield down and basically paves the way for your own immune response to kill the tumor."

    The trial, at hundreds of sites in 41 countries, followed 902 patients and found the combination of immunotherapy and chemotherapy improved overall survival by nearly four months, (3.7 months) and nearly 10 months for those patients whose tumors tested positive for the targeted protein.

    "Hopefully this will actually improve the treatments for many other women with breast cancer as well," Adams said.

    "The tumor was getting smaller," Ramos said. "So every time, every four weeks it was getting smaller and smaller and I was so excited."

    "The last scan from just last week that shows that she's still completely without any evidence of disease," Adams said.

    Three years ago, Ramos worried she wouldn't see her oldest daughter graduate. In June, she did.

    Source

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  • Womens Mental Health

    Women currently comprise approximately 16 percent of the United States military. As of 2016, service women are permitted to serve in any military position for which they meet the gender-neutral performance standards and requirements. These expanded roles have increased the cadre of responsibilities that service women have, as well as increased their potential challenges. As such, it is more important than ever for military leadership, researchers, and health care providers to understand women’s health.

    The Departments of Veterans Affairs (VA) and Defense (DOD) collaborated to host the National VA/DOD Women's Mental Health Mini-Residency Aug. 28-30 in Arlington, Virginia. This mini-residency brought together more than 150 VA and DOD mental health providers so they could gain knowledge and skills in the provision of gender-sensitive care to women Veterans and service members. Specific topics included:

    • Complex trauma
    • Psychopharmacology
    • Safety planning
    • Suicide prevention
    • Compassion fatigue
    • Sexual functioning
    • Impact of health conditions
    • Ostracism, and many others

    During the mini-residency, attendees developed an action plan to disseminate these best practices and facilitate practice change at their local facilities -- to optimize women's mental health care in VA and DOD. Requests from DOD mental health providers to attend in person far exceeded the number of spots available, so we posted all DOD presentations and posters on the mini-residency website for you to read, download and share with colleagues.

    Today also marks the start of Women’s Health Month, a time to highlight women’s health, to include the mental health of service women. Throughout the month, we will showcase some of the exciting presentations from the mini-residency through our Clinician’s Corner blog series.

    Dr. Nancy Skopp, PHCoE research psychologist, will describe the impact of gender stereotypes on diagnosis and treatment. Dr. Laura Miller of the Hines Jr. VA Hospital in Hines, Illinois, will highlight mental health across the female lifespan, and Dr. Margaret Altemus of the Yale School of Medicine in New Haven, Connecticut, will discuss perinatal and postpartum depression. Dr. Lauren Messina of the Consortium for Health and Military Performance will discuss a total force fitness approach to physical and mental health, which can help women and men improve their emotional health and manage symptoms of mental health disorders.

    For updated research and resources, be sure to check out our Women’s Mental Health webpage and follow us on Facebook for more women’s mental health-related posts and resources. Like, comment and share on your channels so we can promote women’s health awareness, and particularly the importance of women’s mental health, during October.

    Source

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  • Sexual assault 003

     

    The Defense Department in September released a first-of-its-kind study that estimates the risk of sexual assault service members face at different installations. The estimates were based on more than 170,000 survey responses service members completed in 2014 on whether they had personally experienced sexual assault. The data has limitations, but military officials will use it to help identify high-risk areas and see what additional steps can be taken to increase safety for men and women assigned there. The data is searchable by service, risk, location and estimated number of assaults.

    Service members can use the chart below, drawn from the detailed data tables published by RAND, to search for individual military installations and ships.

    The study conducted by the Rand Corporation includes two key measurements:

    Overall Sexual Assault Risk: This number indicates the average expected risk for the average men and women at the individual installations. For example, a 10 percent risk for sexual assault means it’s likely that one in 10 service members at that installation or ship will experience a sexual assault during the year. This number is affected by many factors, such as the age, rank or gender of the personnel assigned there. For example, installations with many younger, unmarried and junior ranking personnel (all risk factors) tend to have higher risk solely based on those demographic risk factors.

    Installation-specific risk: This number measures the risk for sexual assault that controls for all those personal factors and aims to more directly answer the question: Are individuals more at risk for a sexual assault here than elsewhere? This installation-specific risk may be associated with installation characteristics such as command climate, the community outside the gates of the installation, or other factors. A positive number indicates service members at that installation face an elevated risk for sexual assault, and a negative number indicates the risk there is lower than expected for a base of that size and demographic. For example, an installation with an installation-specific risk of 1 percent (or -1 percent) means that troops at that location are one percent more likely (or less likely) to experience a sexual assault compared to the average for a base of that size and demographic. To calculate installation-specific risk, RAND employed a number of analytical tools and computer models to create its best estimate on the probability a service member may face sexual assault at that location. The percentages reported are RAND’s best estimate based on its analysis of the 2014 survey data.

    Sexual assaults by service, gender and location

    (Click Source to view charts)

    Source

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  • Rehab Employment

     

    The U.S. Department of Veterans Affairs’ (VA) Vocational Rehabilitation and Employment Program (VR&E) recently began the process of reducing the average counselor-to-caseload ratio, to one to 125 or below, through the hiring of 172 vocational rehabilitation counselors (VRCs).

    The hiring effort, which began early this summer, will help improve service to Veterans with service-connected disabilities and employment barriers, as well as help provide them with expedited services to improve their ability to transition to the civilian workforce.

    “The VR&E program is much more than a benefits program,” said VA Secretary Robert Wilkie. “It’s a vital support network, where VA’s expert counselors work closely with Veterans on their personalized vocational rehabilitation goals. Congressional funding enables us to expand our team of counselors who are on the ground across the country working tirelessly for Veterans, and we appreciate their support.”

    VA is committed to ensuring its counselors have manageable caseloads and the resources needed to ensure Veterans are receiving thorough, quality services.

    Currently, 941 counselors are working across VA’s 56 regional offices, as well as in out-based and satellite locations.

    Once hiring is complete for the additional 172 counselors, a total of 1,113 VRCs will be deployed in the field to serve Veterans. This includes 905 VRCs at regional and out-based offices, 132 Integrated Disability Evaluation System counselors at 71 military installations and 76 Veteran Success on Campus counselors at 105 institutions of higher learning.

    Since 2014, over 56,000 Veterans have either completed a rehabilitation plan, are employed or have achieved a greater independence in living through VR&E assistance. The VR&E program currently has more than 123,000 participants. For more information about VR&E, visit www.benefits.va.gov/vocrehab/.

    Source

    #Veterans #military #employment #Veteransaffairs

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  • Website Updates 002 

  • Walter Daniel

     

    Navy Lt. Rebekah Daniel bled to death after childbirth in a military hospital in 2014. But her husband, Walter, cannot sue because of a 1950 law.

    More than four years after Navy Lt. Rebekah Daniel bled to death within hours of childbirth at a Washington state military hospital, her husband still doesn’t know exactly how — or why — it happened.

    Walter Daniel, a former Coast Guard officer, demanded explanations from officials at the Naval Hospital Bremerton, where his wife, known as Moani, died on March 9, 2014.

    He says he got none. No results from a formal review of the incident, no details about how the low-risk pregnancy of a healthy 33-year-old woman — a labor and delivery nurse herself — ended in heartbreak, leaving their newborn daughter, Victoria, now 4, without a mom.

    “There was no timeline, no records of what steps were taken,” recalled Daniel, 39, sitting in his Seattle lawyer’s office last month. “I’ve had no answers.”

    Daniel, who now lives in Dublin, Calif., filed a wrongful-death lawsuit in 2015, but it was dismissed, as were subsequent appeals.

    The dismissals were based not on the facts of the case but on what’s known as the Feres doctrine, a 68-year-old federal ruling that bars active-duty military members from suing the federal government for injuries.

    This week, Daniel is taking his quest for answers to the U.S. Supreme Court.

    Through his lawyer, he petitioned the high court on Thursday to amend the 1950 ruling, creating an exception that would allow service members to sue for medical malpractice the same way civilians can.

    The military health system, with 54 hospitals and 377 medical clinics, serves about 9.4 million beneficiaries, including nearly 1.4 million active-duty members.

    “I don’t want this to happen to any other family,” Daniel said.

    The Supreme Court hasn’t considered the Feres doctrine in more than 30 years, since the 1987 case U.S. v. Johnson, where the justices ruled 5-4 to uphold the ruling. That decision drew a scathing dissent from Justice Antonin Scalia, who declared that the rule should be scrapped.

    “Feres was wrongly decided and heartily deserves the widespread, almost universal criticism it has received,” Scalia famously wrote.

    Since then, however, the court has refused to accept at least two petitions that would have allowed reconsideration of Feres. And chances are slim now. Of the 7,000 to 8,000 cases submitted to the Supreme Court each term, only about 80 are accepted.

    But Daniel and his lawyer, Andrew Hoyal of the Luvera law firm in Seattle, insist that the circumstances of Moani Daniel’s death warrant new scrutiny.

    “We thought if we’re ever going to take a shot at the Feres doctrine, this is the case to do it,” Hoyal said. “It was clear negligence. It was an awful situation. And every civilian in the country would be able to bring a lawsuit to get accountability, except for members of the service.

    “She was treated differently because she had lieutenant’s bars.”

    Daniel disputes the findings of a Navy autopsy concluding that Rebekah Daniel died of “natural” causes possibly linked to an amniotic fluid embolism, a rare, hard-to-prove complication of childbirth.

    Daniel claims that his wife — who worked in the maternity unit where she delivered her baby — died from botched medical care that failed to stop her from hemorrhaging nearly a third of the blood in her body.

    “It was utter chaos,” he recalled. “I remember multiple towels and sponges like they were trying to soak up the blood … but it kept coming.”

    Doctors failed to perform vital tests, to employ an obstetrical balloon — a standard device used to halt postpartum hemorrhage — and to start massive blood transfusions until too late, court documents claim.

    Just four hours after the birth of her 8-pound, 7-ounce daughter, Moani was dead.

    “I was in shock,” recalled Daniel.

    Capt. Jeffrey Bitterman, commanding officer of Naval Hospital Bremerton, said in an email that the circumstances of Moani’s death were “thoroughly examined in a quality review process.” The results of the review cannot be publicly released, he said, declining to comment further because of pending litigation.

    However, in a press release promoting the Aloha Moani 5K run organized in Daniel’s honor, Navy officials publicly said she died “due to a rare complication of childbirth.”

    Walter and Moani Daniel, who met in Hawaii, had been married nearly a decade when she became pregnant in 2013. Moani had a son, Damien, now 19, from a previous marriage.

    Moani loved her job, but she had submitted her resignation to the Navy months earlier and was set to leave the service in April 2014. Walter had accepted a job in Northern California, where he had moved with Damien to get him settled in school.

    The day after his wife’s death, Walter returned to her empty apartment.

    “She had all this stuff for the baby set up,” he recalled. “I’m like, ‘What the hell just happened?’ It was like a nightmare.’”

    The Feres doctrine holds that active-duty members of the military cannot sue under the Federal Tort Claims Act for harm “incident to service.” The justices wanted to ensure that Congress would not be “burdened with private bills on behalf of military and naval personnel.”

    They reasoned then that the military provides comprehensive relief for injuries or death of service members and their families — and that there’s no parallel with private liability because the relationship between the government and its armed forces is distinct. Later, the court insisted that a primary reason for barring such lawsuits is to maintain military discipline.

    But the decision, particularly the definition of “incident to service,” has been debated fiercely for years by scholars and, at least twice, in bills before Congress.

    The rule has been interpreted to include not just military duty, but virtually any activity of an active-duty service member, said Richard Custin, a clinical professor of business law and ethics at the University of San Diego.

    “It’s just grossly unfair,” he said. “Childbirth is not a military activity. It’s clearly not ‘incident to service.’ ”

    Custin and other critics claim that the Feres doctrine strips military members of a constitutional right to seek redress for grievances, while also allowing military hospitals and doctors to escape scrutiny for negligent care.

    Military hospitals reported 545 so-called sentinel events — medical omissions or errors — from 2014 to 2017, according to Defense Health Agency data. In 2014, Naval Hospital Bremerton reported at least one case of postpartum hemorrhage or hysterectomy.

    But such reports aren’t public, so Daniel doesn’t know whether his wife’s case was included in those records. A 2014 review of military health care found that the rate of postpartum hemorrhage was consistently higher in military hospitals than the national average, Hoyal noted.

    “What they do in the medical arena is no different than what civilian hospitals do, and they should be held to the same standards as civilian hospitals and civilian doctors,” Hoyal said.

    Officials with the Department of Defense declined interview requests regarding the Feres ruling.

    In an email, however, an agency spokeswoman said overturning the rule would “destroy the premise” of no-fault workers’ compensation available in the military and elsewhere. It would also “create an unsustainable inequity” between military members allowed to sue and others, such as those injured in combat, who couldn’t.

    And, rather than improving military health care, overturning Feres would “compromise its effectiveness,” the agency said, noting: “No medical system is perfect.”

    Custin, the law professor, said he sympathizes with Daniel, but isn’t optimistic that the court will view the case differently than other medical malpractice claims.

    “What this attorney needs to do is somehow distinguish Daniel from the long line of victims that have been maligned by Feres,” he said.

    Hoyal intends to argue that the Supreme Court’s rulings regarding Feres have been inconsistent and irreconcilable. In decisions that followed Feres, the court rejected its own “parallel liability” argument, said Hoyal. And it has never ruled that medical decisions like those at stake in Daniel’s case would undermine military discipline.

    “In short, the legal landscape has undergone a sea change since 1950,” Hoyal’s petition states. “Theories once central to Feres no longer matter. Rationales not considered in Feres are now central.”

    Such an argument may well sway an increasingly conservative Supreme Court that now includes justices loyal to Scalia’s views — as well as progressives inclined to support workers’ rights, said Dwight Stirling, chief executive of the Center for Law and Military Policy, a Southern California think tank.

    “The Feres doctrine does not divide the court members on your standard ideological grounds,” he said. “It tends to scramble the typical calculus.”

    Walter Daniel hopes so. After raising Victoria as a single dad for four years, he left the Coast Guard, recently remarried and returned to college to study to become a high school teacher. Even as his life moves on, he said, he hopes that Moani’s case will provide justice for others.

    “It’s not about the Daniel family, it’s about those thousands of service members throughout the world who are affected by this rule,” he said. “That’s what our fight is for.”

    Source

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  • Women and depression

     

    Imagine having feelings of worthlessness or helplessness. Imagine being unable to sleep, feeling restless and irritable much of the time, or even hiding under the covers afraid to face the day. Many who suffer from depression may not be able to concentrate at work or perhaps even get to work. Those experiencing high- and low-functioning depression know such feelings all too well.

    But for women, there are certain times in their lives when a depression diagnosis is more common. Research has shown that hormonal changes at three stages of life—puberty, post-pregnancy, and during perimenopause—may trigger clinical depression.

    Dr. Nancy Skopp, research psychologist at the Psychological Health Center of Excellence, described clinical depression, or major depressive disorder, as a depressed mood lasting at least two weeks and marked by a loss of interest in things that once were pleasurable. She noted that this period would contain a clear change from previous functioning. If someone isn’t completing work duties, shows up late for work, or experiences profound fatigue and avoids interaction with family and friends, depression could be the cause.

    “Depression symptoms in women often occur around a reproductive event,” said Skopp, adding that there is some evidence that suggests women may have a chronic and recurrent course with longer and more frequent episodes than men.

    Skopp cited statistics from the National Institute of Mental Health showing that 50-80 percent of new mothers may experience the “baby blues,” which usually appear about a week after giving birth and include feeling down, irritability, sleep problems, anxiety, and eating too much or too little. The difference is that the symptoms are mild and usually resolve in a week or two.

    Postpartum depression is much more serious, Skopp said. Between 10 and 20 percent of new mothers experience depression, according to NIMH statistics. Symptoms of extreme sadness, anxiety, and exhaustion may make it difficult to complete daily activities as a new mother.

    During perimenopause, usually between the ages of 40 and 50, when the ovaries gradually begin to make less estrogen, depressive symptoms combine with menopausal symptoms. Women may also experience other life challenges, such as the demands of caring for aging parents, a change in marital status, health problems, or negative attitudes about aging. Skopp said although men may experience similar stresses at midlife, the hormonal changes experienced by women may compound such stresses. “It’s a very challenging time,” she said.

    Approximately 12 million women in the United States experience clinical depression each year, with one in eight experiencing depression in her lifetime, according to NIMH research. This rate of depression corresponds to hormonal changes in women, particularly during these three life stages, suggesting that female hormonal fluctuations may be a trigger for depression. Another trigger may be gender differences between women and men, which may be genetic or involve life stressors and coping styles.

    Skopp says research shows women may have a greater tendency to internalize in the face of depressive symptoms. Men appear to be more likely than women to cope with such symptoms through behavioral distraction, such as doing something that takes the mind off depressive feelings. The result appears to be that more active distraction in men may shorten or prevent a depressive episode whereas internalization in women may prolong it. The Centers for Disease Control and Prevention reports that between 2013 and 2016, 10.4 percent of women experienced depression compared to 5.5 percent of men.

    “Being in the military can magnify the depression triggers one might experience in the general population,” said Navy Cmdr. Paulette Cazares, associate director for mental health at the Naval Medical Center San Diego.

    “The benefit of seeing depression as any other illness allows service members to realize the necessity of early treatment, and the ability to stay focused on career and personal goals,” Cazares said. “Psychotherapy or antidepressant medications are first-line options to treat depression and reduce chances of a relapse. Meditation and yoga as therapy have also been used successfully to alleviate depressive symptoms.”

    If you have symptoms of depression, talk to your health care provider. A loved one showing symptoms should be encouraged to speak to a health care provider as well. Military OneSource also has resources and information available for service members and their families.

    Source

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  • Women Vets Health 001

     

    Treating women Veterans

    Patty Axtell, RN, and Suzanne Rainforth, LPN, (pictured above) practice pelvic exam supply setup with instructor Jonna Brenton, RN, at Grand Island VAMC. The number of women Veterans is increasing rapidly. Consequently, the number of women Veterans receiving health care from VA tripled from between 2000 and 2016, growing from 160,000 in 2000 to 475,000 in 2016, driving an increase in need for high-quality, gender-specific health care.

    As of May 2017, 26 percent of enrolled women Veterans lived in rural and highly rural areas. These are areas in need of more trained primary care providers designated as Women’s Health Primary Care Providers (WH-PCPs) and nursing staff trained in women’s health.

    Since 2008, the Women’s Health Services (WHS) has developed and delivered a comprehensive education and training model for clinical staff, called the Women’s Health Mini-Residency, to address gaps in knowledge and skills in women’s health topics. This training is traditionally a three-day, face-to-face program offered 1-2 times per year in Orlando, Florida.

    Although more than 3,500 PCPs and 1,200 primary care nurses trained in this mini-residency model, additional training needs persist, including for staff in rural VA facilities.

    WHS understands that rural VA clinics, with fewer staff, may face challenges sending staff off-site for training without disrupting normal clinic operations. Travel from rural areas also means more time away from clinical care.

    Bringing the training to clinic sites

    To better support women Veterans’ long-term health and well-being, address staff training need and minimize the burden on the clinic and staff, WHS, funded by the Office of Rural Health (ORH), launched a blended learning approach to the Women’s Health Mini-Residency intended for providers and nurses at rural Community Based Outpatient Clinics (CBOC) and VA medical centers (VAMC) by bringing this training program directly to clinic sites. This modified mini-residency includes:

    • Core women’s health courses on topics such as abnormal uterine bleeding, contraception, breast issues and intimate partner violence offered via the Veteran Affairs’ Talent Management System (TMS) and done independently in advance of the one-day training delivered directly at clinic sites
    • Tailored one-day on-site training includes interactive portions of the program such as facilitated case discussions, simulation equipment for hands-on activities, videos of gynecologic procedures and exams, and live models for breast and pelvic exam instruction

    Patient-Aligned Care Team (PACT) providers and nurses train side-by-side in this inter-professional training program, which aligns with how care is provided. In all, each provider and nurse will receive more than 18 hours of accredited medical training. Launched June 2018, in partnership with ORH, WHS will provide this mini-residency for rural providers and nurses in up to 40 rural clinical sites per year to support the highest level of care for women Veterans in rural areas.

    If you have any questions about the Women’s Health Mini-Residency for Rural Providers and Nurses, please contact This email address is being protected from spambots. You need JavaScript enabled to view it..

    Source

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  • Natl Health Museum

     

    As docents at the National Museum of Health and Medicine (NMHM), Sara and David Handwerker will point out an adult female pelvis in the museum’s “Human Identification” exhibit to visitors. That kind of specimen shares a connection to their own professional histories as doctors: more than 30 years of experience in obstetrics/gynecology and maternal-fetal medicine. NMHM is especially grateful for their volunteerism in October, when women’s health gets special attention in the Military Health System (MHS). NMHM is a Department of Defense museum.

    October 2018 is also a service anniversary for the Handwerkers: four years of devoting their time to the medical museum’s visitors. The couple retired from New York City government hospitals several years ago and relocated to the Washington, D.C. metropolitan area to live near family. They joined the museum’s volunteer corps in October 2014, motivated by a love for history and medicine.

    The Handwerkers clearly enjoy volunteerism; this spring, Sara received a special pin from the museum and a Bronze Presidential Service Award from the Army Volunteer Corps (AVC) in appreciation for 163 hours of dedication and service at NMHM in 2017, the most time any docent devoted to the museum last year. David also received the AVC’s Bronze Presidential Service Award for providing 104 service hours to NMHM in 2017. They were recognized for guiding tours and assisting with educational programs.

    During Women’s Health Month in October, the MHS reminds women to be proactive in addressing their health issues and have regularly-scheduled visits to their health care provider. Both museum volunteers support the MHS message. They encourage women to engage in preventive care and talk with their health care providers; as doctors, they treated women with undiagnosed infections or breast cancer, and women who became ill while pregnant due to untreated conditions.

    Source

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  • PTSD Women

     

    There are far more men than women Veterans in the VA system. For this reason, many women Veterans are not aware of resources offered just for them. Many women Veterans prefer treatment with other women.

    Research shows that people often do better in treatment with others that are more like them. As a result, mental health services just for women are offered in many VA’s across the country.

    VA Women Veterans Program Managers

    Every VA Medical Center in the country has a Women Veterans Program Manager. This person is your advocate. She can help you get to VA services and programs, state and federal benefits, and resources in the area where you live.

    If you need help:

    If you have questions about your VA care, you should first go to your Women Veterans Program Manager. During normal business hours, you can also contact:

    • The Department of Veterans Affairs Center for Women Veterans at (202) 273-6193
    • The Veterans Health Administration Women Veterans Health Strategic Health Care Group at (202) 461-1070

    Types of VA programs for women

    The following list describes some of the mental health service programs offered by VA for women Veterans. To find out more, see VA PTSD Treatment Programs. The fact sheet links to a list of VA PTSD treatment programs. The list includes programs for women, with contact information. For other help locating a program or service, you should ask your Women Veterans Program Manager.

    • Women's Stress Disorder Treatment Teams (WSDTTs). WSDTTs are special outpatient (not live-in) mental health programs. They focus on treatment of PTSD and other problems related to trauma.
    • Specialized inpatient and residential programs for women. These are live-in programs for women Veterans who need more intense treatment and support. While in these programs, women live either in the hospital or in a residence with other women. For help locating a program, ask your Women Veterans Program Manager.
    • Cohort treatment or separate wings for women. These programs are like the live-in programs discussed above except these programs accept both men and women. Some programs accept women in groups that start treatment together on a certain date. Sometimes the program has a space set apart for women.
    • Women Veterans Comprehensive Health Centers. Complete health centers for women Veterans are located in many VA's around the country. Many of them provide outpatient mental health services to women Veterans. Check with your local Women Veterans Program Manager to see if there is a women's health center that provides mental health services near you.
    • Women Veterans Homelessness Programs. The Women Veterans Program can help you find shelter if you are homeless or at risk of being homeless. Certain VA locations have programs for homeless women Veterans and homeless women Veterans with children. Contact your Women Veterans Program Manager for resources near you. You can also contact the Social Work Services department at your local VAMC. For more information, go to Homeless Veterans.

    For more information

    To learn more about women and traumatic stress, please see this section of materials Specific to Women.

    Source

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  • Martha McSally AZ R

     

    WASHINGTON — More female Veterans are running for Congress this November than ever before. A total of 14 women are competing in congressional contests next month, and polling so far suggests several are likely to win new seats.

    If so, it could dramatically increase the number of female Veterans from the four currently in Congress today. Two of them — Republican Iowa Sen. Joni Ernst and Democratic Illinois Sen. Tammy Duckworth — are guaranteed to return, since they don’t face re-election this year.

    Here are five races with female Veterans to watch on election night:

    Martha McSally, Republican,Arizona Senate

    McSally, a former Air Force pilot who currently serves in the House, is in one of the most tightly contested Senate races in the country, one that could decide which party controls the upper chamber next year. Recent polls have given her a slight edge heading into the final days of campaigning.

    In her four years in office, McSally has already carved out a role as a vocal member of the House Armed Services Committee. If she wins a Senate seat, she would likely join Ernst as a senior female voice for Senate Republicans on a host of defense and Veterans issues.

    Mikie Sherrill, Democrat,New Jersey 11th

    Sherrill, a former Navy lieutenant commander, is vying to replace retiring Republican Rep. Rodney Frelinghuysen. Recent polls show her ahead, a result that could help her party gain a majority in the House.

    She has received significant support from Veterans groups, women’s advocates and other left-leaning resources. But she has also talked extensively on the campaign trail about her background as a helicopter pilot and federal prosecutor, and should could emerge as a key national security voice for Democrats in Congress next year.

    Chrissy Houlahan, Democrat,Pennsylvania 6th

    Like Sherrill, Houlahan — a former Air Force captain — is favored to win in a congressional seat currently held by a Republican (Rep. Ryan Costello). Pennsylvania is a key election battleground every two years, and following redistricting mandated by the Supreme Court earlier this year, Democrats are anticipating big gains in the state’s races.

    Given her advantage in recent polls and in fundraising over the last few months, Houlahan’s seat appears to be a must-win for Democrats if they hope to shift the balance of power in the House.

    Amy McGrath, Democrat,Kentucky 6th

    McGrath, a former Marine Corps pilot who flew combat missions in Afghanistan and Iraq, could serve as an early indicator on election night as to whether Democrats can take control of the House. Kentucky is among the first polls nationwide to close, and the race results could be made public early.

    She trails in most polls in the decidedly Republican district but has seen a significant influx of outside money in support of her. She’s also received direct criticism in recent weeks from President Donald Trump, who labeled her “an extreme liberal chosen by (House Minority Leader) Nancy Pelosi,” an attack that could help or hurt her depending on voters’ November mood.

    Gina Ortiz Jones, Democrat,Texas 23rd

    Jones, an Air Force Veteran who served in Iraq, is a long-shot to upset incumbent Republican Rep. Will Hurd. But her experience and campaign work has raised her profile significantly, and she could secure an upset victory if Democratic turnout in Texas outpaces expectations.

    If so, she would become the first out lesbian Veteran in Congress and the first Filipina-American to represent Texas there. She has spoken on the campaign trail about her experience serving under the military’s “Don’t Ask, Don’t Tell” law, and has argued that many of Trump’s military policies have weakened national security.

    Source

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