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An Assessment of Illness in U.S. Government Employees and Their Families at Overseas Embassies (2020) / Chapter Skim
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Section 5: Acute Treatment and Rehabilitation
Pages 34-40

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From page 34...
... It was privy to anecdotal information about the treatment of some individuals, but this information was not standardized or systematic. The approach to initial treatment and rehabilitation was also complicated by a number of factors including remote locations and difficult access to specialized care, diverse clinical presentations by affected personnel, and a variety of reporting schemes at different times.
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From page 35...
... However, it is not unusual for patients to develop chronic nonspecific symptoms (e.g., fatigue, dizziness) following acute medical events such as mild traumatic brain injuries, acute peripheral vestibulopathies, cardiovascular or cerebrovascular events, cancer treatments, and complex surgical procedures, which may differ among individuals (Donnell et al., 2012; Gunstad and Suhr, 2001; Julien et al., 2017; Pavawalla et al., 2013; Polusny et al., 2011; Voormolen et al., 2019)
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From page 36...
... Negative prognostic features include stressful job and life situation, previous history of depression, and anxiety. Significant efforts are under way to identify genetic and other factors that may affect responsiveness to neurological rehabilitation.
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From page 37...
... SUMMARY The committee lacked information on patient-specific treatment approaches and responses, which would have helped in generating recommendations on potential alternatives. In reviewing best practices in neurological rehabilitation, the committee finds that early evaluation and treatment are essential for optimal outcomes, a supportive environment is important, and an interdisciplinary approach for rehabilitation of chronic neurological conditions is best, as are appropriate and early education and realistic expectation-setting.
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From page 38...
... 2019. Divergent six month functional recovery trajectories and predictors after traumatic brain injury: Novel insights from the citicoline brain injury treatment trial study.
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From page 39...
... 2011. Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in National Guard soldiers deployed to Iraq.
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From page 40...
... 2019. Risk of posttraumatic stress disorder and major depression in civilian patients after mild traumatic brain injury: A TRACK-TBI study.
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Key Terms

  • traumatic brain
  • mild traumatic
  • government employees
  • affected personnel
  • acute treatment

  • chronic neurological
  • affected dos
  • dos employees
  • neurological rehabilitation
  • affected individuals

  • citicoline brain
  • injury treatment
  • treatment trial
  • committee lacked
  • treatment approaches

  • clinical presentations
  • embassy employees
  • acute medical
  • neurological conditions
  • initial treatment

  • chronic symptoms
  • stress disorder
  • functional recovery
  • removing personnel
  • clinical characteristics

  • generating recommendations
  • direct testimony
  • medical events
  • supportive environment
  • potential alternatives


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