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					Warfighter Brain Health: DOD Updates Senate Committee on Blast Exposure Research
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						Dr. Lester Martínez-López, assistant secretary of defense for health affairs, outlined the latest Department of Defense traumatic brain injury and blast exposure research to the Senate Armed Services Committee on Feb. 28, 2024.  (Courtesy photo)
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	<span class="topicTags"><span><a id="pagecolumns_0_newscontent_0_itemList_ctl00_articleLinks_topics_lvTopics_ctrl0_hlTopic" href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a></span> | <span><a id="pagecolumns_0_newscontent_0_itemList_ctl00_articleLinks_topics_lvTopics_ctrl2_hlTopic" href="/Military-Health-Topics/Centers-of-Excellence/NICOE">The National Intrepid Center of Excellence </a></span></span>

	
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				<p>Military health leaders updated the <a rel="noopener noreferrer" href="https://www.armed-services.senate.gov/" target="_blank" title="opens Senate.gov">Senate Armed Services Committee</a> on the Department of Defense’s traumatic brain injury and blast exposure state of research and practice during a hearing on Feb. 28.
</p><p>Dr. Lester Martínez-López, assistant secretary of defense for health affairs; Kathy Lee, director of the <a rel="noopener noreferrer" href="https://media.defense.gov/2022/Aug/24/2003063181/-1/-1/0/DOD-WARFIGHTER-BRAIN-HEALTH-INITIATIVE-STRATEGY-AND-ACTION-PLAN.PDF" target="_blank" title="open or view the PDF">Warfighter Brain Health Initiative, or WBHI</a>; and U.S. Navy Captain (Dr.) Carlos Williams, director of the Defense Health Agency’s <a href="/Military-Health-Topics/Centers-of-Excellence/NICOE" target="_self" title="opens NICoE on Health.mil">National Intrepid Center of Excellence</a>, outlined the latest updates to the SASC personnel subcommittee.</p><p>
The WBHI began executing in June 2022 to improve TBI research, speed the development of therapies to treat TBI, and enable the DOD to better track and prevent blast pressure exposure. Military Health System news about the WBHI is available on the <a href="/Military-Health-Topics/Warfighter-Brain-Health" target="_self" title="opens Health.mil">Warfighter Brain Health Hub</a>.</p><p>
DOD gives the highest priority to researching the impacts of TBI and blast overpressure exposure on service members and translating methods into practice through a joint effort between military operational and medical forces. Martínez described this process as iterative and agile.</p><p>
“We recognize, however, that more research and insight is needed in both the care and research dimensions to better understand the risk, how to protect warfighters, and how to treat brain injuries more effectively,” he said. “We look at how to refine for broader effectiveness when they do not work as expected, review why, and modify them to invest in research to advance alternative solutions.”</p><p>
“We communicate these insights not because we believe they are a full, foolproof solution, but rather enable collective action through shared knowledge,” Martínez said. “We seek to integrate solutions for the future as we provide recommendations to inform and affect change to safety, doctrine, and policy.”</p><p>
The DOD panel answered a number of questions about DOD policies on brain health protections and care as part of the WBHI, including:
</p><ul>
    <li>Starting baseline cognitive assessments once recruits are accepted into the military but haven’t yet begun training, which will expand this summer</li>
    <li>Standardized cognitive assessments at precise intervals over the course of one’s military career</li>
    <li>Guidelines to the number of weapons rounds to avoid unnecessary brain exposures to blast overpressure</li>
    <li>More emphasis on weapons manufacturers building in blast overpressure exposure thresholds</li>
    <li>Learning more about the length of time to rest post--mild TBI, or concussion) from weapons fired by service members</li>
    <li>Updates to the <a href="/News/Articles/2022/12/13/Blast-Overpressure-Research-Brings-NATO-Group-to-DHHQ" target="_self" title="opens Health.mil article">Nov. 4, 2022, interim guidance DOD memo</a> on a maximum allowable blast overpressure exposure limit of 4 pounds per square inch with more instructions to protect service members</li>
    <li>Business-case analysis of blast monitoring</li>
    <li>Off-the-shelf wearables pilot for <a href="/News/Articles/2022/11/17/DOD-Brain-Health-Initiative-is-at-Work-Across-the-Military" target="_self" title="opens Health.mil article">blast gauges</a></li>
    <li>Investigating symptom-based reporting of TBI</li>
</ul><p>The WBHI and DOD “absolutely think it's imperative that we have an allowable number of rounds for all the weapons systems that are commonly used, so that we can avoid unnecessary blast exposure in our service members,” Lee said. In 2022, DOD directed developing rounds limits for each weapon system.</p><p>
“We believe that this also gives us an opportunity to be able to ensure the usage is correct with regard to proximity, stand-off distances, and all those safety pieces can come together. Our policies are moving in that direction to be able to protect the brain,” she stated. Lee noted round limitation measurement has been measured with hearing damage historically. “However, we are looking at what the brain effects are and will follow suit with our policies.”</p><p>
NICoE’s Williams said measuring and treating TBI requires “precision medicine” and “targeted therapy” individualized to each service member.</p><p>
“That's one of the things that we want to look at, is looking at what type of modalities are out there that can be developed to allow a patient to focus on their individual symptoms. But we have to know what that baseline is first for that individual ... each person is different.” As DOD and NICoE continue to do research, “I think we can get there soon,” Williams suggested.</p><p>
Personnel Subcommittee Chair Sen. Elizabeth Warren concluded the DOD panel, saying, “The Department of Defense needs to do better. We need to identify those who are most at risk for TBI because of the particular work they do. We need to collect better data. We need to do all of this on a much faster timetable. Congress also needs to do better. We need to make sure that you have the resources to do your work.”
</p><h2>
Partners Seeking Better Outcomes
</h2><p>Before the DOD panel, the subcommittee heard from a group representing nonprofit organizations, associations, and advocates committed to improving brain health in the military population. They testified on gaps in research, neurological and other physiological effects of TBI, ongoing research, and the significance of partnering with the DOD.</p><p>
Frank Larkin, a military veteran and chief operating officer of Troops First Foundation, a national advocacy group for military suicide prevention and brain trauma research, addressed the brain health and mental health aspects of TBI and blast exposure.</p><p>
“Blast exposure is a key threat to warrior brain health and potentially represents a significant national security threat to our force readiness and resiliency,” he said.</p><p>
Larkin is a former U.S. Navy SEAL. His son Ryan, also a U.S. Navy SEAL, died by suicide.</p><p>
During the hearing, Lee, the DOD’s WBHI’s director, praised Larkin as one of a concerned family of people working to protect and care for service members.</p><p>
“We're a family and we're going to take care of you, Mr. Larkin, as part of our team. We're all in this together with the same mission to take care of our people and take care of service members that make that sacrifice."
</p><h2>Prepared Testimony and Hearing Video</h2><ul>
    <li><a href="/Reference-Center/Congressional-Testimonies/2024/02/28/National-Intrepid-Center-of-Excellence-Regarding-Traumatic-Brain-Injury-and-Blast-Exposure-Care-testified-Before-the-Senate-Armed-Services-Committee" target="_blank" title="open or view the PDF">Joint opening statement from DOD</a></li>
    <li><a rel="noopener noreferrer" href="https://www.senate.gov/isvp/?auto_play=false&comm=armed&filename=armedB022824&poster=https://www.armed-services.senate.gov/assets/images/video-poster.png&stt=" target="_blank" title="watch the video">Subcommittee video of the hearing</a></li>
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            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Provider-Resources">Traumatic Brain Injury Resources for Medical Providers</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/TBI-Resources-for-Military-Leadership">TBI Resources for Military Leadership</a>
            <a  href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a>
            <a  href="/News/In-the-Spotlight/Be-a-Brain-Warrior">Be a Brain Warrior: Protect. Treat. Optimize.</a>
</fieldset>

</article>


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    <span class="dateStamp">Apr 10, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a></h3>            
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                <p>Warfighter brain health is the physical, psychological, and cognitive status that affects a warfighter's ability to adapt in any environment. Brain health affects readiness, operational capability, and mission effectiveness.</p>
            </div>
        </div>
    

</article>


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    <div class="feedItemTag"><span>Article</span></div>
    <span class="dateStamp">Apr 4, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Dvids-Articles/2024/04/04/news467893">Medical Museum Hosts Annual Brain Awareness Day Program</a></h3>            
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                    <img src="/-/media/Images/MHS/DVIDS/Articles/news467893.ashx?la=en&hash=F0F4E69D6712A315EF4518373F383F616D849CAE" alt="Medical Museum Hosts Annual Brain Awareness Day Program" />
                </span>
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            <div class="feedText">
                <p>Traumatic brain injuries, one of the invisible wounds of war, affect many in the military and civilian populations. According to the Centers for Disease Control and Prevention, about 1.7 million people sustain TBIs annually, and since 2000, over 490,000 service members have sustained a TBI. </p>
            </div>
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            <a  href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a>
            <a  href="/About-MHS/Military-Medical-History/Museum">National Museum of Health and Medicine</a>
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</article>


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    <div class="feedItemTag"><span>Article Around MHS</span></div>
    <span class="dateStamp">Apr 3, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="https://www.dvidshub.net/news/467076/intrepid-warrior-garden-offers-innovative-nature-therapy-option-service-members">Intrepid Warrior Garden Offers Innovative, Nature Therapy Option for Service Members</a></h3>            
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                    <img src="/-/media/Images/MHS/Photos/IntrepidWarriorGarden725x410.ashx" alt="The Warrior Garden at Intrepid Spirit Center Camp Lejeune " />
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            <div class="feedText">
                <p>For military members seeking treatment for brain health, therapy options are growing – literally!</p>
            </div>
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            <a  href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a>
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</fieldset>

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    <span class="dateStamp">Apr 2, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/In-the-Spotlight/Be-a-Brain-Warrior">Be a Brain Warrior: Protect. Treat. Optimize.</a></h3>            
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                    <img src="/-/media/Images/MHS/Hero-Images/BIAM2023_Graphic-for-Web/BIAM2023_PostBIAM_SpotlightHeroGraphic_20230320.ashx" alt="Evergreen Brain Injury Awareness image " />
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                <p>The Department of Defense considers protecting, treating, and optimizing brain health a top priority.</p>
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            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/DOD-TBI-Worldwide-Numbers">DOD TBI Worldwide Numbers</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence">Traumatic Brain Injury Center of Excellence</a>
            <a  href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/NICOE">The National Intrepid Center of Excellence </a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/TBI-Resources-for-Military-Leadership">TBI Resources for Military Leadership</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/HCE">Hearing Center of Excellence</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence">Psychological Health Center of Excellence</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/VCE">Vision Center of Excellence</a>
            <a  href="/Military-Health-Topics/Access-Cost-Quality-and-Safety/Warrior-Care">Warrior Care</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/TBICoE-Podcasts">TBICoE Podcasts</a>
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    <span class="dateStamp">Mar 29, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Dvids-Articles/2024/03/29/news467375">Department of Defense Shares Lessons about Mild TBI with International Partners</a></h3>            
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                    <img src="/-/media/Images/MHS/DVIDS/Articles/news467375.ashx?la=en&hash=54AADDCDB024971084E8BFBA3CF01B25B35C5B53" alt="Department of Defense Shares Lessons about Mild TBI with International Partners" />
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                <p>Kathy Lee, director of the Department of Defense policy for the Warfighter Brain Health Initiative, speaks March 15, 2024, on traumatic brain injury at an international symposium overseas.</p>
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            <a  href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a>
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    <div class="feedItemTag"><span>Report</span></div>
    <span class="dateStamp">Mar 29, 2024</span>
    <h3 class="feedItemTitle"><a target="_blank" href="/Reference-Center/Reports/2024/03/29/2023-TBICoE-Annual-Report">2023 TBICoE Annual Report</a></h3>            
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                <p>The Traumatic Brain Injury Center of Excellence Annual Report provides an overview of accomplishments and activities in calendar year 2023.</p>
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            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/TBI-Resources-for-Military-Leadership">TBI Resources for Military Leadership</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Research">TBICoE Research</a>
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    <span class="dateStamp">Mar 28, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Gallery/Dvids-Videos/2024/03/28/video917372">Headaches and TBI: A Journey of Treatment Over Time</a></h3>            
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                    <img src="/-/media/Images/MHS/DVIDS/Video-Thumbnails/video917372.ashx?la=en&hash=9C21C33DDFDC6557782629F5E0FAB9422B88A721" alt="Headaches and TBI: A Journey of Treatment Over Time" />
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                <p>Dr. Joanne Gold, a pharmacist and neuroscience clinician with TBICoE, and experts from the National Museum of Health and Medicine discuss the treatment of headaches, past and present. Their conversation explores the museum's collections related to TBI and headache treatment, discusses ways to improve headache treatment, and highlights relevant TBICoE ...</p>
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            <a  href="/Military-Health-Topics/Warfighter-Brain-Health/Brain-Health-Topics/Traumatic-Brain-Injury">Traumatic Brain Injury</a>
</fieldset>

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    <article class="feedItem download">
    <div class="feedItemTag"><span>Publication</span></div>
    <span class="dateStamp">Mar 28, 2024</span>
    <h3 class="feedItemTitle"><a target="_blank" href="/Reference-Center/Publications/2024/03/28/TBICoE-Research-Review-Multiple-TBI-Multiple-Concussion">TBICoE Research Review: Multiple TBI/Multiple Concussion</a></h3>            
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                <p>Prior history of TBI may predispose an individual to increased risk of subsequent TBI, which may result from less force, and lengthier recovery from post-injury symptoms. Activities such as contact sports and military service carry particular risk for multiple TBI.</p>
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    <article class="feedItem download">
    <div class="feedItemTag"><span>Publication</span></div>
    <span class="dateStamp">Mar 28, 2024</span>
    <h3 class="feedItemTitle"><a target="_blank" href="/Reference-Center/Publications/2024/03/28/Multiple-Concussion-Clinical-Pearls">Multiple Concussion Clinical Pearls</a></h3>            
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                <p>This new supplemental product to the detailed research review is designed to provide a brief summary of actionable clinical pearls for consideration during the evaluation and treatment of service members who have sustained multiple concussions.
</p>
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        </div>
    
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            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Provider-Resources">Traumatic Brain Injury Resources for Medical Providers</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/Research">TBICoE Research</a>
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    <span class="dateStamp">Mar 22, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="/News/Dvids-Articles/2024/03/22/news466774">How Hearing and Vision Problems Can be Related to Brain Injury</a></h3>            
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                    <img src="/-/media/Images/MHS/DVIDS/Articles/news466774.ashx?la=en&hash=A3D14DF2F34EBEA201855D6F8FB6224B3514D1EF" alt="How Hearing and Vision Problems Can be Related to Brain Injury" />
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                <p>Vision and hearing injuries can both be sustained due to traumatic brain injury, even mild TBI.</p>
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            <a  href="/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence">Traumatic Brain Injury Center of Excellence</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/VCE">Vision Center of Excellence</a>
            <a  href="/Military-Health-Topics/Centers-of-Excellence/HCE">Hearing Center of Excellence</a>
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    <article class="feedItem">
    <div class="feedItemTag"><span>Article Around MHS</span></div>
    <span class="dateStamp">Mar 18, 2024</span>
    <h3 class="feedItemTitle"><a target="_self" href="https://www.dvidshub.net/news/466210/tbi-awareness-month-observations-concussion-clinic-chief ">Brain Injury Awareness Month: Observations from a Concussion Clinic Chief</a></h3>            
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                    <img src="/-/media/Images/MHS/Photos/BrainImages725x410.ashx" alt="An MRI shows integrating multimodal imaging biomarkers of changes in brain structure and function. Mild traumatic brain injury, or concussion, is a major issue of concern in the military, as well as within the sports community. (Image courtesy of NIH.gov)" />
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            <div class="feedText">
                <p>The chief of the concussion clinic at Munson Army Health Center in Fort Leavenworth, Kansas, shares his experience diagnosing and treatment traumatic brain injuries in over 20 years of service. 
</p>
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    <article class="feedItem download">
    <div class="feedItemTag"><span>Publication</span></div>
    <span class="dateStamp">Mar 13, 2024</span>
    <h3 class="feedItemTitle"><a target="_blank" href="/Reference-Center/Publications/2024/03/13/The-Intrepid-Voices-Newsletter-March-2024">The Intrepid Voices Newsletter March 2024</a></h3>            
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                <p>Publication of the Defense Intrepid Network for TBI and Brain Health.</p>
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            <a  href="/Military-Health-Topics/Warfighter-Brain-Health">Warfighter Brain Health Hub</a>
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