SUNDAY, SEPTEMBER 26, 2010
KLMNO
K EZ RE
Politics & The Nation A13
Prison officials being monitored for PTSD
Brownfield had dug out bodies
Stressful situations can trigger condition in returning veterans
BY CATHERINE TSAI
canon city, colo. — John Brownfield Jr. became a correc- tions officer after deployments to Afghanistan and Iraq. He was later charged with
accepting bribes from inmates seeking tobacco at the U.S. peni- tentiary in Florence, Colo. He told the judge thatwhen he came home, he suffered frominsomnia and nightmares, drank more heavily, was quick to anger and “reckless with everything” in his life. U.S. District Judge John Kane
suspected post-traumatic stress disorder. “Figuratively speaking, Brownfield returned from war but never really came home,” Kane wrote in a ruling sentenc- ing Brownfield to probation and treatment. Nationwide, law enforcement
groups are taking notice of veter- ans starting or returning to jail or prison jobs. Police and corrections officers
are loath to show weakness, and few seek help to deal with post- traumatic stress disorder, said Caterina Spinaris Tudor, founder of Desert Waters Correctional Outreach in Canon City. She said PTSD developed abroad can be re-triggered on the job by varying scenarios, including assaults and hostage situations, or suicides by inmates or fellow officers. The outreach center serves
corrections officers in Colorado’s Fremont County, home to 13 prisons. “We forget their heart is beating behind that hard shell,” Tudor said. “Let’s look at the problem instead of pretending it’s not there.” Brownfield was only 21 when
he was honorably discharged fromthe Air Force in 2005. As his former lawyer, Vaughn McClain, put it, his job was picking up body parts.
Repeated antibiotics use alters beneficial gut germs
Research continues to gauge effects on long-term health
BY LAURAN NEERGAARD Antibiotics can temporarily
upset your stomach, but now it turns out that repeatedly taking them can trigger long-lasting changes in all those good germs that live in your gut, raising questions about lingering ill ef- fects. Nobody knows whether that
leads to later health problems. But the finding is the latest in a flurry of research raising ques- tions about how the customized bacterial zoo that thrives in our intestines forms — and whether the wrong type or amount plays a role in ailments from obesity to inflammatory bowel disease to asthma. Don’t be grossed out: This is a
story in part about, well, poop. Three healthy adults collected weeks of stool samples so that scientists could measurehowtwo separate rounds of a fairly mild antibiotic caused a surprising population shift in their microbi- al netherworld — as some origi- nal families of germs plummeted and other types moved in to fill the gap. It’s also a story of how we
coexist with trillions of bacteria, fungi and other microbes in the skin, the nose and the digestive tract — what scientists call the human microbiome. Many are beneficial, even indispensable, especially the gut bacteria that play an underappreciated role in overall health. “Gut communities are funda- mentally important in the devel- opment of our immune system,” said David Relman of Stanford University, who led the antibiotic study published this month in Proceedings of the National Academy of Sciences. “Let’s not take them for granted.” Next, Relman plans to track
whether antibiotics taken during the first year or two of life, when youngsters form what will be- come their special set of gut bacteria, seem to predispose chil-
dren to later immune-related dis- eases.
Antibiotics should be used cau-
tiously because they can spur infection-causing bacteria to be- come drug-resistant. The new research raises different ques- tions about effects on beneficial bacteria — and, if abnormalities in the microbiome are linked to health problems, how those changes might begin. “We should start paying atten-
tion to this,” saysMartin Blaser, a microbiome specialist at New York University’s Langone Medi- cal Center. He wasn’t involved with Relman’s work but is plan- ning to study the issue in chil- dren. “The main point is that antibiotic use is not free in a biological sense.” Everyone is born with an es- sentially sterile digestive tract, but within days the gut is overrun with bacteria from Mom and Dad, the environment and first foods. Ultimately, a healthy per- son’s intestinal tract teems with hundreds of species of microbes, the body’s biggest concentration, with many involved in such things as digestion and immune reaction. In the not-so-healthy, scien-
tists have discovered that over- weight people harbor different typesandamountsof gut bacteria than lean people and that losing weight can change that bacterial makeup. They’ve also found links to other digestive diseases and precancerous colon polyps and
“The main point is that antibiotic use is not free in a biological sense.”
Martin Blaser, microbiome specialist at New York University
are pursuing a theory that early use of antibiotics disrupts the developing microbiome in ways that spur autoimmune disorders such as asthma or allergies. Antibiotics aren’t choosey and
can kill off good germs as well as bad ones. But Relman and fellow research scientist Les Dethlesfs- en wondered how hardy gut bac- teria are, how well they bounce back. So they recruited healthy volunteers who hadn’t used anti- biotics in at least the past year to take two five-day courses of the antibiotic Cipro six months apart. The volunteers reported no diarrhea or upset stomach, yet their fecal samples showed a lot going on beneath the surface. Bacterial diversity plummeted as a third to half of the volunteers’ original germ species were nearly wiped out, although other species moved in. Yet about a week after stopping the drug, two of the three volunteers had their bacte- rial levels largely return to nor- mal. The third still had altered gut bacteria six months later. The surprise: Another die-off
and shift happened with the sec- ond round of Cipro, but this time no one’s gut bacteria had re- turned to the pre-antibiotic state by the time the study ended two months later. “History matters,” concludes Relman, whose next project is testing what jobs the most affect- ed bacteria performed — such as helping to maintain intestinal barriers against infection — and whether the new bugs fully re- placed them. “We may have to be more careful” about repetitive damage. Of course, antibiotics aren’t
the only means of disrupting our natural flora. Other research re- cently found that babies born by cesarean harbor quite different first bacteria than babies born vaginally, offering a possible ex- planation for why C-section ba- bies are at higher risk for some infections. Likewise, the gut bac- teria of premature infants con- tains more hospital-style germs than a full-term baby’s. The big issue is when such
differences will matter, some- thing that “we’re not really smart enough to know,” Relman says. —Associated Press
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of adults and children after an explosion. He removed dead sol- diers fromhelicopters, according to court documents. Working in prisons isn’t that
different from working in a war zone, Brent Parker, of the Colora- do Department of Corrections, told a conference here on prison workplace culture. “The only dif- ference is in the military, you cycle back to the real world eventually, hopefully,” said Park- er, a field training supervisor. Experts say it isn’t known how
many correctional officersmight have PTSD. Research suggests they have higher rates of divorce, substance abuse and suicide than the general population. “Work stress can cause prob-
lems at home. Work stress can lead to use of alcohol. They’re all things we’re trying to address,” said John Cunningham, director of the office of training for the New Jersey Department of Cor- rections. NewJersey formed a task force
after a string of suicides by corrections officers there. In a report last year, it estimated an annual suicide rate of 34.8 per 100,000 for correctional officers in the state, based on suicides from 2003 to 2007. The rate was 15.1 per 100,000 for New Jersey police officers and about 14 per 100,000 people for allNewJersey males between the ages of 25 and 64.
Therewas no data available on
military veterans. Tudor and oth- ers are particularly concerned about officerswithmilitary back-
“We forget their heart is beating behind that hard shell.”
Caterina Spinaris Tudor, founder of Desert Waters Correctional Outreach.
grounds who might have suf- fered PTSD during deployments to Iraq and Afghanistan butwere never treated for it before return- ing to prison jobs. “They are the walking wound-
ed who show up at work acting tough and invulnerable,” Tudor said. “I call it double-dose trauma,”
said John Violanti, a research associate professor with the Uni- versity atBuffalo School of Public Health and Health Professions, who studies suicides among po- lice officers. This summer, the Internation-
al Association of Chiefs of Police published guides for combat vet- erans returning to law enforce- ment jobs and for their supervi- sors to help themreintegrate into the workforce. Corrections departments com-
monly have employee-assistance programs. Butmany officers fear that seeking help can hurt their careers, said Cherie Castellano of the behavioral health-care divi- sion of the University of Medi- cine andDentistry ofNewJersey. She directs Cop 2 Cop, a pro-
gram created under New Jersey law to address suicide preven- tion and mental health support. Retired officers answer calls on Cop 2 Cop’s confidential hot line. “It comes down to two things:
Combating stigma and having officers feel like they can trust the resource they reached out for,” Castellano said. Brownfield, the Air Force vet-
eran, cannot return to a job in corrections because of his felony conviction. According to court docu-
ments, after leaving the Bureau of Prisons in October 2007, he worked as a youth counselor at a private school, a mobile phone salesman and a heavy-equip- ment driver for amining compa- ny.
During court proceedings, a
prosecutor asked Brownfield about his decision to break the law. “Ma’am, during that part of my life, I did a lot of things that I knew were wrong,” he said. “And I still have no clue why.” — Associated Press
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