September 15, 2015

Sgt. Shaft caricatureDear Sgt Shaft
My name is John; I am a patient in the Veterans health care system.  My clinic is in Evansville, Indiana our hospital which oversees our clinic is in Marion, I’ll. For over a year we have contact the administration concerning our clinics will not answer their phones. I have multiple physical disabilities and at times I need to contact my primary care clinic. I am not the only vet that is experiencing this. No one wants to listen, when they do listen it is all for show just to get us to shut up.  We send them messages to call us, they never do. I felt it was a privilege and my duty to serve my country. After giving them multiple chances to correct this problem, now it is time to contact news agencies. Commander Smith with Amvets said I should talk to you. I am better at talking than writing. You are my last hope. Please call me.

Evansville IN

Dear John
I will refer your missive to the powers that be at the Department of Veterans’ Affairs. I am sure that the Secretary will want his key people to resolve your problem.

Shaft Notes
U.S. Senator Tom Carper (D-Del.), a retired Navy captain and former naval flight officer, urged Secretary of Veterans Affairs Robert McDonald to investigate allegations that a number of questionable, unaccredited educational institutions have received G.I. Bill benefits, despite federal regulations to prevent it.

Following yet another shocking report by Reveal from the Center for Investigative Reporting, Senator Carper was joined by U.S. Senators Dick Durbin (D-Ill.), Richard Blumenthal (D-Conn.), Sherrod Brown (D-Ohio), Dianne Feinstein (D-Calif.), Chris Murphy (D-Conn.), Jack Reed (D-R.I.) and Patty Murray (D-Wash.) in sending a letter to Secretary McDonald asking him to address the issue.

“The report documents a number of educationally questionable, and in some instances morally repugnant, institutions that have inexplicably received VA education benefits.  These include an unlicensed massage therapy school, an institute whose parent organization is a listed hate group, and an institute on human sexuality claiming to be in possession of child pornography.  If true, this is a terrible failure of our promise to veterans and taxpayers,” the Senators wrote.

The Department of Veterans Affairs (VA) is announcing four new studies that will use genetic and other data from VA’s Million Veteran Program (MVP) to answer key questions on heart disease, kidney disease, and substance use—high-priority conditions affecting Veterans.

MVP, which has enrolled more than 390,000 Veterans so far, has already become the nation’s largest database linking genetic, clinical, lifestyle and military exposure information.  Part of a beta test for data access, the newly funded studies are among the first to use MVP data to delve into pressing questions on Veterans’ health. MVP-based studies on PTSD, schizophrenia and bipolar disorder are already underway.

“MVP is making important discoveries that will impact healthcare for Veterans and all Americans,” said VA Secretary Bob McDonald. “We’re grateful to our Veteran partners, whose altruism has made this possible.”

The new research, which will specifically include the understudied African American and Hispanic Veteran populations, ties into the broader national Precision Medicine Initiative announced by President Obama earlier this year.

“There’s already been an impressive amount of data collected through MVP, and we’re continuing to engage more Veterans in the program and building its research infrastructure through studies like these,” said Dr. Timothy O’ Leary, VA’s chief research and development officer.

The new studies, involving consortiums of VA researchers and university colleagues, will explore specific questions related to chronic illnesses common among Veterans. They will also help establish new methods for securely linking MVP data with other sources of health information, including non-VA sources such as the Centers for Medicaid and Medicare Services (CMS).

The new studies include the following:

Cardiovascular risk factors—Drs. Farooq Amin and Peter Wilson at the Atlanta VA Medical Center, and Dr. Kelly Cho at the Boston VA Health Care System, will lead an effort probing the genes that influence how obesity and lipid levels affect heart risk. Using MVP data, their team will also look at whether these genetic factors differ among African Americans and Hispanics. “These populations are extremely important in VA,” said Amin.

Multi-substance use—Drs. Daniel Federman and Amy Justice at the VA Connecticut Healthcare System, and Dr. Henry Kranzler at the Philadelphia VA Medical Center, will examine the genetic risk factors for chronic use of alcohol, tobacco, and opioids—and the dangerous use of all three together. “MVP offers an unprecedented opportunity to advance this field,” said Federman.

Pharmacogenomics of kidney disease—Dr. Adriana Hung at the VA Tennessee Valley Healthcare System will focus on how genes affect the risk and progression of kidney disease. One goal is to examine how patients with diabetes—who often develop kidney problems—respond differently to the drug metformin, the standard first-line treatment for diabetes, based on their genetic profile. The project will also look at the genetics of hypertension, a major risk factor for kidney disease.  “Kidney disease is a major cause of morbidity and mortality in Veterans and we’re hoping to gain insights that will drive personalized medicine for this population,” said Hung.

Metabolic conditions—Dr. Philip Tsao at the VA Palo Alto Health Care System and Dr. Kyong-Mi Chang at the Philadelphia VA Medical Center, leading a team of researchers from five VA regions and two universities, will explore the role of genetics in obesity, diabetes, and abnormal lipid levels (namely, cholesterol and triglycerides), as drivers of heart disease. “This project will help us more thoroughly understand the underlying causes of cardiometabolic disease and develop new therapies that are safe, effective, and personalized,” said Tsao. “This is also a great opportunity to partner with our colleagues at Stanford and the University of Pennsylvania,” added Chang.


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